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Dr. Carl Bell's Keys to Reducing Violence and Re-Engaging Youth to Society

Dr. Carl C. Bell, M.D., F.A.P.A., FA.C.P. President & CEO Community Mental Health Center of Chicago

For over 30 years, Dr. Bell has practiced psychiatry. As an internationally recognized lecturer and author, he has given numerous presentations on mental wellness, violence prevention, and traumatic stress caused by violence. Most recently, he has participated as the Principle Investigator with CHAMP, an HIV/AIDS youth prevention research project in South Africa. He is the author of The Sanity of Survival: Reflections on Community Mental Health and Wellness and co-author of Suicide and Homicide Among Adolescents. Dr. Bell is also a clinical professor of psychiatry and public health at the University of Illinois School of Medicine. In recognition of his efforts to reduce violence, he became the first recipient of the American Psychiatric Foundation's Minority Service Award in 2004. He is also the recipient of the American Psychiatric Association's Presidential Award.

Dr. Carl C. Bell's Seven Principles for Changing At-Risk Behavior and Cultivating Resiliency Among Youth


1. Rebuilding the Village/Reweaving the social fabric/Recreating a sense of community
Reestablishing a sense of community by bringing together churches, schools, and families to create networks, organize resources and establish programs that provide support, safety and security for our youth. A sense of community also reinforces cultural identity.

2. Providing access to ancient and modern technology to provide practical systems for the application of knowledge
Providing models, tools, skills and techniques to facilitate implementation of the concept or program (for example, mentoring, multi-family groups, how to cultivate resiliency and wellness, and manualized family interventions).

3. Providing a sense of connectedness
Creating situations, programs and relationships that foster a sense of connection, attachment, and belonging to a larger group or a common goal. This counters feelings of alienation, helps provide feelings of security, and increases self-esteem. Again, reestablishing the village reinforces cultural identity and can be a platform for the delivery of cultural education. Well thought out rites of passage (e.g. the belt system of progression in Japanese martial arts) programs have been very effective in actualizing this principle.

4. Providing opportunity to learn social & emotional skills
Providing social and emotional skills that people need to interact and communicate with each other. This not only increases self-esteem but effectiveness in relationships as well. These include parenting skills, refusal skills, negotiating skills, the capacity to remain calm in a crisis, and more.

5. Providing opportunities to increasing self-esteem
A. Giving our children a sense of power (self-efficacy) by showing them they can do things for themselves and positively influence their own lives. For example, adopting healthy behaviors creates both a sense of wellness and an outcome of wellness.
B. Providing a sense of models to help our young make sense of the world and teaching them how things work. Mentoring is a very powerful model that can be used to achieve this. A strong cultural value system is another.
C. Creating a sense of specialness and uniqueness as an individual or group. Clearly, knowing and respecting your culture gives you a sense of power by virtue of being connected to something valuable and strong.
D. Creating a sense of connectedness - encouraging bonding and connection to a culture, group or an idea. Teaching them their history and cultural significance creates a sense of power from being associated with a rich and powerful legacy. Spirituality is another powerful influence in encouraging connectedness.

6. Providing an adult protective shield
Providing an adult protective shield and monitoring speaks to providing supervision, discipline, and a caring adult presence. These foster a sense of safety and security. The concept of the village with multiple adult figures taking responsibility for the nurture and well-being of the village children is a concept that connects us to our culture and our spirituality. Wellness is also important in this respect. A child can be severely stressed by the illness of a caretaking adult, so it is in the best interest of the adult to adopt behaviors that promote wellness, both personally, and as a model for children to emulate.

7. Minimizing trauma
Minimizing trauma - Developing an individual's spirituality, a person's sense of self-efficacy, helping create a sense of safety, and providing stress management skills as well as psychological first aid (see attached) to encourage a sense of self-mastery and turn helplessness into helpfulness are all examples of putting this principle into action.

You may contact Dr. Bell at:

Carl C. Bell, M.D.
President/C.E.O. Community Mental Health Council
8704 S. Constance
Chicago, IL 60617
(773) 734 - 4033 x 204 (office)

www.thecouncil-online.org
carlcbell@pol.net

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West
Comment by Rev.Dr.Niinana Kweku on March 15, 2013 at 3:57pm

First I would like to commend all that takes part in this conversation, also thank you Dr Bell for outlining your program.  Also I just want to remind everyone that dr bell's  program strongly ressembles the ancient cardinal virtues virtues of MAAT. I think we too often are saying  the right thing or trying to recreate the process' for me the map for us to be successful as a people we need to take total control of all the things that affect positive outcomes.  That means economics, politics'education and security. To continue to allow the european culture to educate our children is at the center of our problems. We must take control of what goes into our children's minds if we hope to change things.We must become a global people community we can't continue to spend the few dollars they allow to trickle down to us and then we turn around and spend it supporting the system that is destroying the fabric our of communities. Are we afraid of garvism ? or are we so blinded by the idea of the american dream? that we can't see that we control nothing that has to do being a community. We need to give the ruling culture thier god' back and reclaim the creator of our forefathers then and only then will we regain our spiritual connection to the one real creator' when we do that all the things dr bell talked about will become a reality.


Chicago-Midwest
Comment by Carl C Bell on June 21, 2012 at 3:20pm

To answer Asinia Lukata Chikuyu:  You are 100% correct implementation is always the challenge.  Having implemented the model in Chicago Public schools in the 1990s we were able to show a decrease in violence, drug use, and teen age sexual debut in an experimental design.

1992 – 1999:

Aban Aya Youth Program - UIC School of Public Health    (Brian Flay, et. al.)

Research on the Triadic Theory of Influence demonstrated this approach could reduce violence, drug use, and sexual debut in African-Americans in Chicago Public Schools.

Results:  Performed in 12 Metropolitan Chicago schools from 1994 – 1998, Aban Aya was responsible for the following significant results:

 i. Reduced rate of increase in violence behavior (by 35% and 47% in the two experimental conditions compared to the controls)

 ii. Reduced provoking behavior (41% and 59% in the two experimental conditions compared to controls)

 iii. Reduced school delinquency (31% and 66% in the two experimental conditions compared to the controls)

 iv. Reduced drug use (32% and 34% in the two experimental conditions compared to the controls)

 v. Reduced recent sexual intercourse (44% and 65% in the two experimental conditions compared to the controls). 

 vi. Improved rate of increase in condom use (95% and 165% in the two experimental conditions compared to the controls) in boys. 

 vii. There were no significant effects for girls for any measures. 

Examples:  Although this research was based on the Triadic Theory of Influence (TTI), the 7 Field Principles which tie directly back to TTI can be illustrated in this work:

 i. Rebuilding the village:  In the School/Community condition we developed Local School Task Forces for each school so students would have social fabric around them thus there were school-wide community fairs; annual trips for program parents and children so the children became everyone’s children as in a village; funds were solicited from local businesses so the businesses would have a stake in the children at the school.

 ii. Access to modern technology:  In the School/Community condition we actualized this principle by having teacher and staff in-service training regarding proactive classroom management skills, and the use of the curriculum to prevent drug use, violence, and sexual debut.

 iii. Improving bonding, attachment, & connectedness dynamics:  In both the School and School/Community conditions we had lessons on empathy, communalism, cultural pride, and mentoring in the curriculum to increase bonding, attachment & connectedness.  In the School/Community condition we sought to teach parents how to improve parent-child communication.

 iv. Improving self-esteem: (as defined by Bean, 1972)

  • A sense of power:  We emphasized youths’ personal strengths and taught a sense of cultural pride.
  • A sense of models:  We taught skills for anger management; communication; decision making, problem solving; and goal setting.
  • A sense of uniqueness:  The curriculum was African centered with maxims at the start of each lesson, e.g., for violence prevention we started with “The elephant does not swat the mosquito.”
  • A sense of connectedness:  see Improving bonding, attachment, & connectedness.

 v. Increasing social skills of target recipients:  In both the School and School/Community conditions, we taught lessons on communication (specifically “I messages”); refusal skills to the youth.  In the School/Community condition we taught parents how to reinforce the social skills their children were learning in the curriculum and we taught anger and stress management skills to the parents.

 vi. Reestablishing the adult protective shield and monitoring:  In the School/Community condition we taught parents how to improve child supervision and methods of discipline, and sought to improve parent-teacher communication.

 vii. Minimizing the residual effects of trauma:  We taught skills regarding stress management.

Appendix 1 - Flay BR, Graumlich S, Segawa E, Burns J, Amuwo S, Bell CC, Campbell R, Cowell J, Cooksey J, Dancy B, Hedeker D, Jagers R, Levy SR, Paikoff R, Punwani I, & Weisberg R.  The ABAN AYA Youth Project: effects of comprehensive prevention programs on high-risk behaviors among inner city African American youth: A randomized trial. Archives of Pediatrics and Adolescent Medicine, Vol. 158, No. 4: pp. 377 – 384, April 2004.).

1997 – 2000:

Chicago Public School Violence Prevention Work with CPS C.E.O.   (Paul Vallas, et al.)

The first iteration of the Dr. Bell’s Seven Field Principles of Health Behavior Change and Cultivation of Resiliency that showed a reduction in violence, decrease in teen pregnancy, etc. in Chicago Public Schools.

Results:  The Cradles To Classroom Program outcomes noted of the 2000 teens in 54 Chicago Public Schools had babies in 2002 (500 freshmen, 200 sophomores, 500 juniors, and 500 seniors) with 495 of the seniors graduating with 78% enrolled in a 2- or 4- year college and only 5 had repeat pregnancy while still in school.  Another major outcome was suspensions in the prior year 1998-1999 went from 31,665 down to 15,986 in 1999-2000 and expulsions in the prior year 1998-1999 went down from 638 to 454 in 1999-2000.  Another major outcome was that weapons and contraband in Chicago Public Schools were reduced during the intervention as indicated in the below table.

 

1997-1998

1998-1999

1999-2000

Firearms                    

0

1

1

Knives, box cutters, razors

107

96

54

Narcotics

75

63

51

Pagers

816

649

534

Other weapons

158

200

29

 i. For the three school years for which data is shown, the number of random metal detector operations by safety and security and Chicago Police Department personnel increased (number of random sweeps per year: 59 in 1997-1998, 65 in 1998-1999 and 89 in 1999-2000).

Examples: 

 i. Rebuilding the village: An example of this principle being actualized was the Chicago Public School’s Interfaith Partnership - After a windshield survey was done to determine the strengths of the communities in which schools were located we learned that many schools who wanted to start mentoring programs had 2-3 large black churches within ½ mile of the school.  Accordingly, the C.E.O. of CPS went to each church highlighting the need the neighborhood school had for mentors - thus rebuilding the village as the churches were more than happy to supple the school with mentors.  Another example were the school-community programs and activities that were developed, e.g., CPS Logan Square Neighborhood Association designed to create five community learning centers to improve adult education, children and youth education and recreational programming, in addition to providing home work assistance, child care and other family-focused activities - this initiative trained more than 400 parents for placement in classrooms where they tutored children and helped teachers.  There were many, many more examples as the basic principle allowed each community to actualize the basic principle differently.

 ii. Access to modern technology: We put in metal detectors in the schools and did random metal detector checks.  As with Aban Aya, we also taught classroom management techniques to Chicago Public School teachers.  Security cameras were also installed in the schools.

 iii. Improving bonding, attachment, & connectedness dynamics:  This principle was actualized by having school uniforms so all students felt a part of the same team.  We also actualized this principle by opening the schools after the school day so kids could get attached to the schools by virtue of the enriching after-school activities - chess clubs, swimming pools, team sports, etc.  CPS also started school-based summer programs so youth could experience schools as a fun place to be where they could be safe, have fun, and learn.  We also developed Cradles to Classroom to ensure that pregnant teens could bond to the schools and their infants.  A program called “Parents as Teachers First” was started to help parents understand the importance of reading to young children.  Truancy efforts were re-started to reconnect youth to schools - parents were enlisted for these efforts.

 iv. Improving self esteem:

  • A sense of power: This principle was actualized by having service-learning requirements to graduate from high school, e.g., if you wanted to graduate you would need to volunteer in a senior citizen home thus creating a sense of power.
  • A sense of models:  Character development initiatives were started at CPS to give youth a model of how to be.
  • A sense of uniqueness:  Efforts were emphasized to try to discover ever child’s talent and a range of diverse activities were supported for student involvement.
  • A sense of connectedness: See above.

 v. Increasing social skills of target recipients: Student were given opportunities to develop conflict resolution skills, there were CPS Peer Leadership Programs, Young Negotiators Programs, Peer Mediation Programs, etc. 

 vi. Reestablishing the adult protective shield and monitoring:  This principle was actualized by having a security presence in the school, having metal detectors, having security cameras in schools, etc.  Another strategy was making sure that when students changed from classroom to classroom there were teachers in the halls to provide an adult protective shield to minimize the conflicts in the hallways.  Parents were required to pick up their child’s report cards so that teachers could be assured that parents were monitoring their child’s academic performance and behavior in school.

 vii. Minimizing the residual effects of trauma:  This was handled by social services, but retrospectively we should have used Psychological First Aid strategies.

I do not like to use manuals because this work to be implemented correctly needs to be done up close and personal and manuals only mislead people.  However, that said, my experience is that in working with several communities, many of them are already doing something that is in concert with my seven field principles that are derived from the Triadic Theory of Influence but many of them do not have a clear concept or model but are doing things that make sense from a mother wit perspective instead of a scientific perspective (acutally if my science, personal experience and ancient literature align, I know I am on the right path).  My experience is by showing the community group the seven field principle model, they quickly get it even more better and do better work.

 

Next to brother Mickel Hendrix aka Nat Turner, I am afraid you missed something when you read my 7 principles.  Your admonishment to teach young Black people about racism is contained under my principle of "self-esteem - a sense of models."  Understanding how racism works and teaching it to our youth is a model they need to understand in order to survive in a hostile environment.  The more we understand how things work, the better we are in a position to change things. 

Regarding the rest of your comments - being a black male I am completely clear about how the police hunt black children - boys especially.  Regarding "black leadership' and black athletes - you are entitled to your perceptions and models, but remember models are like toothbrushes - everyone has one and wants to use their own.

 

Appendix 4 - Bell CC, Gamm S, Vallas P, Jackson P.  Strategies for the Prevention of Youth Violence in Chicago Public Schools.  In M. Shafii & S. Shafii (Eds). School Violence: Contributing Factors, Management, and Prevention.  Washington, D.C., American Psychiatric Press, 2001, p.  251 - 272 and Lamberg, L.  (2003). Programs Target Youth Violence Prevention.  Journal of the American Medical Association, Vol. 290 (5): 585 - 586.


South
Comment by Mickel Hendrix aka Nat Turner on January 27, 2009 at 7:51pm
hetep,

i see everything except discussing among our youth the very reason why they have turned inward on each other, which creates the illusion of black on black crime. all too often, we can come up with every solution known to our black selves, but those of us, who profess to be experts on black youth psycho-dysfunctionalism, do not put the issue of white supremacy on the table, as a way to explain why our youth are so-called at risk. at risk from what? how often are they taught about the various mechanisms of white supremacy? there should be a political education class for them as well.

whenever i'm in the field engaging the black youth of new orleans, the first thing i get them to understand is that they are a hunted lot, that they have no material value or worth other than being a young nation of consumers, and future army recruits for the imperialistic wanton wars orchestrated by the powers-that-be. and since war has been declared on them, the p.i.g.s. are the first line of defense, which is why there has been a historical pattern of youth being executed and deemed justifiable by the propagators of the enemy state. they must be made to understand that the powers-that-be operate along the lines of a divide and conquer strategy, which fosters secularism in terms of area of location, which has been made to serve tribal factionalism, which achieves deadly results. hence, the concept of internalized black on black crime and a get rich quick scheme at the same time. therefore, black death equals money.

they must also be made to understand that so-called black leadership has been in cahoots with their natural enemies, which should be viewed by them as an act of treason. therefore, i charge the likes of jesse jackson, al sharpton, cornel west, tavis smiley, eric michael dyson etc. etc. of being guilty of sacrificing our youth, in particular, in exchange for access to material luxury, the lifestyles of the black rich and famous.

lastly, since it is the black youth, who are heavily responsible for allowing all the black athletes, entertainers and big screen actors to live the very fabulous lifestyles that they are known to live and floss, they have to be made to understand that they have the right to turn to those figureheads for any type of financial assistance that is necessary, in order to make life a little better than their present downtrodden situation indicates. therefore, the black youth should rise up against any of the famous blacks, who would refuse to assist them in their endeavors, such as putting some of the c.r.e.a.m. back into the hood for a collectivist agenda, as opposed to predatory capitalism.

uhuru!

South
Comment by Asinia Lukata Chikuyu on January 27, 2009 at 2:34pm
This well articulated formula for improving the quality of life in the village. the trick is implementation of the principles. where is the manual?

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