Preventive Interventions 4411995). Paul Lemkau (1955), a public health psychiatrist,
taught mental health professionals public health approaches
to prevention at the Johns Hopkins University School of
Public Health. A pioneer community psychologist at the Uni-
versity of Rochester, Emory Cowen, began school-based
prevention work in the 1950s with elementary school
children who were showing signs of academic difficulties
(Cicchetti, Rappaport, Sandler, & Weissberg, 2000; Cowen,
1997, 2000a, 2000b; Cowen, Hightower, Pedro-Caroll,
Work, & Wyman, 1996). Each of these early efforts, in com-
bination, helped to create the supportive background and
commitment for the passage of the Community Mental
Health Services Act of 1963. This act included prevention as
one of the 10 essential services.
Prevention as a Defining Focus
for Community Psychology
As stated earlier in the chapter, the Swampscott report em-
phasized prevention as a defining element of the field. Since
the Swampscott Conference, the prevention perspective has
become institutionalized and formalized within the field of
community psychology. This institutionalization of preven-
tion has occurred through the establishment of prevention-
focused conferences, participation of psychologists in federal
commissions, and the development of professional organiza-
tions and interest groups dedicated to prevention activities.
At one such conference, the 1975 Austin Conference, par-
ticipants repeatedly expressed the need to identify and mobi-
lize the existing strengths and resources in a community as a
primary intervention approach (Iscoe, 1975). One working
group focused on intervention and preventive models and
discussed “competency-based programs” that aimed at in-
creasing the capacity of community members. Participants
also emphasized the role of the community psychologist as
“increasing clients’ access to resources, and promoting equal
distributions of resources” (Iscoe, 1975, p. 5). This encour-
aged the growth of “an awareness of professional responsi-
bility to the client and community” (Iscoe, 1975, p. 8).
Conference participants continued the discussions of moving
away from the disease–treatment model to a new service de-
livery system that would focus on promoting wellness and
disease prevention, and adapted an educational (training)
model rather than a treatment orientation.
Also in 1975, George Albee, an author of one of the
influential Joint Commission publications (Albee, 1959)
convened the First Annual Vermont Conference on Primary
Prevention. These conferences, initially funded by the Waters
Foundation and later the NIMH, created opportunities for
researchers and practitioners to focus on the details of
prevention research and preventive interventions for a span
of over 15 years (Kessler & Goldston, 1986; Kessler,
Goldston, & Joffe, 1992). The Vermont Conferences were
also important because they brought together persons of dif-
ferent disciplines, including those from local and state pre-
vention programs, who had roles in policy development for
mental health services. The ability of preventionists, includ-
ing community psychologists, to influence policy at local and
national levels was essential for the widespread application
of a prevention orientation to mental health services. For
example, psychologists’ contribution on The Prevention Task
Force Report of the Carter Commission on Mental Health
Servicesin 1978 was influential in emphasizing the signifi-
cance of prevention, as the report recommended the creation
of field stations to do prevention research (Levine & Perkins,
1997).
Prevention was further legitimized with the creation of the
Center for Prevention Research at NIMH in 1982. Under the
leadership of Mort Silverman, research grants became avail-
able to fund Prevention Research Centers. These centers gen-
erated prevention research sites, including those at Arizona
State University, the University of Michigan, Johns Hopkins
University, Albert Einstein College of Medicine, and the
Oregon Social Learning Center. Consistent with the mission of
NIMH, much of the emphasis of these centers was to prevent
mental disorders, such as conduct problems, substance abuse,
and depression. Much of this research has been published in
scientific journals (e.g., Koretz, 1991) and has informed the
field on state-of-the-art advances in the field of prevention.
While theoretical discussions surrounding prevention
focused on communities and community members, empiri-
cally driven prevention research continued to focus primarily
on building the personal competencies of individuals. For ex-
ample, Spivack and Shure’s (1974, 1985) groundbreaking
competence-building intervention, Interpersonal Cognitive
Problem Solving (ICPS), sought to build a set of skills in
young children in order to maximize their adjustment and in-
terpersonal effectiveness. This intervention was based on a
number of problem-solving skills identified in adjusted chil-
dren and attempted to further promote these natural strategies.
After finding ICPS to be relevant to a variety of populations,
Shure spoke of the “central role that interpersonal compe-
tence plays in human adjustment, and the place of ICPS in that
competence” (Spivack & Shure, 1985, pp. 230–231). Build-
ing specifically on the work of Spivack and Shure, Weissberg
et al. (1981) developed a skills-building intervention called
the Social Problem-Solving Skills (SPS). SPS sought to teach
a group of second-, third-, and fourth-grade students a number
of skills designed to build their social problem-solving skills
and eventually improve their adjustment. Central to their