On the way to work each morning as I turn onto Halsted at Division, I find myself right in the middle of the Chicago Housing Department’s Cabrini Greene Complex — infamous for every thing home shouldn’t be — kids walking the streets who should be in school, dirt and rubbish where gardens should bloom, dinner tables lacking meat at the end of the month and invisible fathers at the head of the table more often than not.

However, middle class and affluent suburban adolescents have their own set of risk factors, too. We’ll explore the differences.

Sub-cultures of urban youth

The music-centered, male-dominated, rebellious, assertive presence of the urban youth that inhabit these communities shape the language, culture, fashion and world view, not only from mainstream Eurocentric traditions, but to a surprising degree, from its own African-American heritage. The culture is flooded with messages condoning drug use and abuse.

The hip-hop generation continues to be difficult to categorize, exhibiting several distinct and differing subcultures. The appreciation of rap music and a need to strike a stance separate from mainstream society still serves as a common bond among urban youth. Beyond that, however, there is not a single unifying force that allows the use of any one strategy for influencing behaviors. No “magic bullet” easily addresses all segments of this population. Subgroups remain differentiated by characteristics such as age, belief systems and motivations. While urban hip-hoppers are primarily disadvantaged urban youth, a significant number of affluent suburban youth embraces the culture and icons and imitates its lifestyles.

Within the group, however, there are various contexts of drug use and abuse. Each requires specific strategies/interventions to moderate, and ultimately end, the resultant anti-social and self-destructive behaviors. One important subgroup that needs to be urgently addressed includes young people who regularly consume drugs and alcohol for recreational and other purposes. Chief among recent trends is an increased incidence of marijuana use.

Interestingly, many youth view marijuana as “not a real drug.” Its use is an accepted part of their social scene. Substance use and abuse seem to be on the increase among urban teens and those who embrace the hip-hop lifestyle. Today, marijuana is the illegal substance of choice while beer/malt liquor is the legal substance of choice for the hip-hop generation. Marijuana use gives “insider” status to urban youth who want to demonstrate their belonging to the street culture (oppositional culture) by taking risks.

Violence as ‘normal’

Unfortunately, violence, in its myriad forms, remains a reality in the daily lives of America’s urban teens. Violence has always been a part of American society. In the ’90s, due to the increased availability of guns and the overwhelming exposure to violence in the media, violence has become more intense, and its consequences more deadly. The fatalistic, “nothing-to-lose” attitude of today’s urban youth means that disagreements, which may have been settled in the past with a verbal put-down or even a fist fight, are now being resolved with more violent, frightening and often fatal consequences. It seems that each generation’s lack of conflict-resolution tactics has escalated the level of violence, at the same time, producing younger and younger perpetrators and victims of violence. The pervasive drug culture exacerbates and escalates the perception of violence as “normal.”

Sex and sexuality continue to be defining issues for urban teens. Sex is perceived as many things: a road to popularity, a means of power and control, and a viable form of entertainment. Many decisions made by teens regarding sexual activity are heavily influenced by peer pressure: the idea that “everyone else is doing it.” Although urban teens show awareness of sexual health issues such as HIV and sexually transmitted diseases, many do not exhibit corresponding behavior changes, such as using a condom or abstaining from sexual behavior. Far too many still believe “It’s [AIDS] not going to happen to me.”

Misunderstood, misdiagnosed, misplaced, ‘missed’!

Youth involvement in drug use and drug trafficking is a serious problem, not only in disadvantaged urban areas, but throughout the nation. In Illinois, for example, between 1993 and 1995, the number of juveniles taken into police custody for drug offenses statewide increased by 40 percent from 7,341 to 10,221. In 1995, that number increased by another 30 percent, 81 percent of these juveniles was from Cook County. Nearly 20 percent of the 55,000 arrests made in 1997 from drug charges were for individuals under age 18.

This problem is prominent in low-income areas such as Chicago’s mid-south side where alternatives to the “drugs and crime” lifestyle are particularly limited. A typical juvenile justice profile for youth involved in drug trafficking indicates that youth are arrested for possession or delivery of a controlled substance, but on further investigation — including drug testing — are found to not be using drugs significantly. These youth often admit to involvement in drug testing during assessment. TASC finds that nearly 40 percent of Chicago youth charged with drug possession referred to the agency for assessment each year fit this profile.

Most likely, these youth have used some marijuana and/or alcohol and may have experimented with other drugs. Young, and in the early stages of drug use, they are convinced they will not become addicted. They are involved in the “off the books” drug economy and culture, and believe the myths of earning lots of money. These are not first-time offenders. Without intervention, they are likely to continue along the continuum to more serious crimes.

Few appropriate diversion options exist for these at-risk youth. Substance- abuse treatment, for example, is designed to break the hold of drug addiction, and these youth are not yet addicted to drugs. They are involved in drug trafficking to earn money, or because it is part of their environment, and they are experimenting with their own product. Treatment is not designed to address these issues. In fact, youth that are inappropriately placed in treatment may sabotage the program for other participants who need it. At the other end of the spectrum, community youth service programs are not sufficiently structured nor targeted to provide effective intervention for these high-risk youth. Yet, without intervention, these youth are likely to become addicted or fall victim to the violence which permeates the world of drug trafficking.

What’s up, Counselor?

Over the course of the last five years or so the treatment community has embraced the Logic Model in designing substance-abuse treatment programs.

The Logic Model requires that there be a logical connection between risk factors for substance abuse, logical assumptions about the consequences of these risk factors, intervention strategies and client-expected outcomes. In fact, the perceived risk factors or causes or circumstances that facilitate substance abuse are to determine the parameters of the intervention. For our programs to be effective we must keep in mind that there are usually very different factors driving substance-abuse behavior for urban and suburban youth.

Middle class and affluent suburban adolescent substance abuse is often driven by the need to assert one’s identity, escape boredom, experience excitement, enhance self-esteem or fill personal voids. Traditional treatment programs can be quite effective in addressing these issues.

In the urban hip-hop environment, substance abuse is often the result of involvement with the drug culture that permeates their environment and often provides what is perceived as their only chance for success or even survival. This is a population where the devastation caused by drug use is known and understood. As the opportunities are presented, the urban youth counter culture is highly tolerant of individual behavior even to the point of declaring that the self-destructive behaviors of others “ain’t none of my business.”

There may appear to be many similarities in the types of obstacles that may prevent both urban and suburban youth from the benefits of substance-abuse treatment, but they must be examined closely for certain nuances. For instance:

• Peer pressures
• Family influence
• Denial
• Limited continuum of services
• Distorted view of addictions
• Sex/dating/violence

Other obstacles appear more likely in urban areas, such as:

• Physical danger due to crossing gang areas to get to treatment
• Selling drugs as a career option among few other options
• Facilities with limited resources, impacting both treatment and outreach services
• Less chance for early identification (intervention may come more likely from the juvenile justice system than from the school system)
• Political disenfranchisement
• Multi-generational poverty
• Low safety educational systems
• Lack of emotional stability within families and communities

There seems to me to be a difference in the treatment approach. With the origin of the 12 Steps being rooted in the population of middle-class, middle-aged white males, something is lost as these characteristics no longer fit the client. The spirit rich, but urban poor, young Latina would have a very different reaction to the 12-step model. This challenges treatment providers to establish culturally relevant models that speak to rituals, traditions, customs, music and learning styles (flavors) that reconnect the youth to the strengths within his/her community. Programs incorporate mentoring services as one way to promote this.

In suburban treatment facilities, there is less concern about this connection and greater focus on the individual and protecting his/her confidentiality. The general focus seems to help youngsters feel comfortable enough in AA or NA to continue their recovery there.

Many segments of society — government agencies, corporate America, non-profit organizations, churches and concerned parents and teachers — have made efforts to communicate informative and pro-social messages to at-risk teens in the African-American community. While these efforts are worthwhile, their effectiveness, especially concerning the impact of media public service campaigns, is open to question.

Our research finds that message strategies and delivery systems that prove effective for mainstream audiences are less successful with urban youth. Authenticity is the key to reaching this audience. But it is a moving, mutating target population whose most powerful evolutionary engine is the hip-hop culture. The challenge for us then, is to find more effective methods for communicating with this audience. We must deal with the perception of many urban youth that “no one is really talking to me.” Often the messages we send them don’t get through. They may hear the messages, and even be able to recite them, but they do not believe nor internalize the messages.

We are all the same; we’re all different — Word Up!

In 1993, I developed the Center For Violence Interruption at Treatment Alternatives for Safer Communities (TASC, Inc.) We recognized that urban and suburban youth can be separated and connected in alliance building through support for recovery; a process that repairs the harm effected by the drug culture. Harm is also effected by counselors and systems that fail to recognize that life styles, learning styles and communication styles can look alike when they are very different. To this end we adopted and reconfigured a strategy, originally devised by Carol Ann Tomlinson of “differentiated” learning styles. This is called a Differentiated Clinical Approach (DCA). The DCA’s working assumptions drive the energies of this urban intervention.

Assessment and instruction are inseparable in differentiated clinical approaches, assessment is ongoing and diagnostic. The goal of assessment is to provide the counselor with current information on clients’ ideas and skills, interests and learning profiles. Assessment is today’s means of understanding how to modify tomorrow’s instruction. Such formative assessment may come from small-group discussions with the counselor, whole-class discussion, journal entries, portfolio entries, skill inventories, pretests, homework assignments, client opinion or interest surveys. Concurrent assessment yields an emerging picture of a client’s understanding of important ideas and ability to perform targeted skills, at what level of proficiency and with what degree of interest. The counselor then shapes or customizes tomorrow’s and even today’s lesson to help individual clients progress from their current level of competency.

In differentiated therapy approaches, all clients are able to participate in respectful work. Certain essential understandings and skills are goals for all clients, however, some client’s needs are very different based upon their attitudes, actions and values. Effectiveness is enhanced when the counselor has a deep respect for the identity of the urban/suburban individual. The counselor in a differentiated clinical approach under-
stands that he/she does not show respect for clients by ignoring their inherent differences. Respect for clients is shown by respecting and addressing both their commonalities and their differences.

In differentiated therapy approaches, the counselor and client collaborate in learning. Counselors are the chief architects of change, but clients should assist with the design and building. It is the counselor’s job to know what constitutes essential learning, to diagnose, to prescribe, to vary the instructional approach based on a variety of purposes, to ensure smooth functioning of the clinical approaches and to assure that time is used wisely.

Clients can provide diagnostic information, develop clinical approach rules, participate in the governing process grounded in those rules and learn to use time as a valuable resource.

The counselor must also balance group and individual norms. Counselors in differentiated clinical approaches understand group norms; but, they must also understand individual norms. A great coach never achieves greatness for himself or for his team by working to make all his players alike. To be great, and to make his players great, he must make each player the best that he or she possibly can be. No weakness in understanding or skill is overlooked. Every player plays from his or her competencies, not from his/her deficiencies. There is no such thing as “good enough” for any team member. In an effectively differentiated clinical approach, assessment, instruction, responses and grading consider both group and individual goals and norms.

With DCA, counselors must attend to client differences through differentiated clinical approaches. The counselor must understand that human beings share the same basic needs for nourishment, shelter, safety, belonging, achievement, contribution and fulfillment. However, they find those things in different fields of endeavor, according to different timetables and along different paths.

By recognizing and respecting the human differences, the counselor can best help clients address their common needs. Our experiences, culture, gender, genetic codes and neurological wiring all affect how we look, see, hear and act. In a differentiated clinical approach, the counselor unconditionally accepts clients as they are, and expects them to become all they can be.

Every young person is entitled to a promise of a counselor’s enthusiasm, time and energy. All young people, be they urban, suburban, hip hop, new jack, generation X or your child are entitled to counselors who will do everything in their power to help them realize their potential every day. It is unacceptable for any teacher to respond to any group of children (or any individual child) as though the children were inappropriate, inconvenient, beyond hope or not in need of focused attention. Word!

Leo Hayden is director of Treatment Alternatives for Safer Communities (TASC, Inc.) at the Center for Violence Interruption, Chicago, where he founded and developed TASC’s Violence Interruption Process.

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