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• Defining "life skills"
• Life skills and alcohol
• Impact of life skills education
• Implications for policy and prevention
• References

Over the past twenty years, “life skills” have become part of the vocabulary in alcohol education and the prevention of alcohol misuse. The term refers to programs targeted primarily at young people and based on the need to promote healthy lifestyles through health education. Life skills education emerged from a growing concern about certain health problems with particular impact on young people, including HIV/AIDS, sexual behavior, drugs, peer influence, and youth suicide. The emphasis of this approach is on basic personal and social skills, attitudes, and knowledge helpful in making positive decisions and lifestyle choices. 

Through the involvement of the World Health Organization (WHO), life skills programs have come to play an important role with regard to health—particularly mental health—in both the developing and developed countries. With regard to alcohol, the life skills approach relies on encouraging responsible alcohol consumption and preventing misuse. However, opinions are divided on the interpretation of the term life skills, the concepts underlying it, and the content and effectiveness of individual initiatives developed within this framework.

Defining "life skills"

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According to WHO, life skills may be defined as “abilities for adaptive and positive behaviour, that enable individuals to deal effectively with the demands and challenges of everyday life” (World Health Organization, 1997a, p. 1). “Every school should enable children and adolescents at all levels to learn critical health and life skills…. Such education includes….comprehensive, integrated life skills education that can enable young people to make healthy choices and adopt healthy behaviour throughout their lives” (World Health Organization, 1997b, p. 80).

The life skills approach lends itself well to implementation across cultures and has been integrated into curriculum in various countries (Bils, 1999; Godfrey, Toumbourou, Rowland, Hemphill, & Munro, 2002; International Center for Alcohol Policies, 2000; Lloyd, Joyce, Hurry, & Ashton, 2000). For example, South Africa’s Curriculum 2005 includes “life orientation” and skills for decision-making, critical and creative thinking, and effective communication. Also included are skills for developing healthy relationships and a positive self-concept (Department of Education, Republic of South Africa, 1997).

The themes addressed by this approach cover a broad range. They include core skills and additional areas that can be addressed in a culturally sensitive manner.

Core skills that are developed include (World Health Organization, Regional Office for the Western Pacific, 2003, p. 11):

• decision-making – ability to evaluate information and advice to make informed decisions, assess advantages and disadvantages of different options, change decisions to adapt to new situations, and plan for the future;
• problem solving;
• creative thinking;
• critical thinking – ability to analyze social and cultural influences on attitudes, values and behavior, question inequality, injustice, prejudice and stigma, explore and evaluate social roles, rights and responsibilities, and evaluate risks;
• effective communication;
• interpersonal relationship skills;
• self-awareness – ability to identify personal strengths, weaknesses and vulnerabilities, clarify personal values and beliefs, and recognize personal worth and personal happiness;
• empathy;
• coping with emotions;
• coping with stress.

The additional areas in which a culturally sensitive approach is needed include:

• goal setting;
• assertiveness;
• negotiation skills.

Life skills and alcohol

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In relation to alcohol, life skills programs attempt to teach individuals (young people, in particular) to make healthy, responsible, and appropriate choices about drinking in an effort to reduce alcohol misuse and problems related to excessive and abusive drinking patterns. This approach has been implemented in education and prevention through school-based programs and is also part of some initiatives that are not curriculum-based (Godfrey et al., 2002; International Center for Alcohol Policies, 2000; Marlatt et al., 2003; Spoth, Guyll, & Day, 2002). The life skills education has been used to help parents support their children and also to help them assess their own drinking (Ashery, Robertson, & Kumpfer, 1998; Foxcroft, Ireland, Lister-Sharp, Lowe, & Breen, 2003; Kumpfer, Alvarado, Tait, & Turner, 2002; Kumpfer, Alvarado, & Whiteside, 2003; Spoth, Redmond, & Lepper, 1999). It has also been applied within settings where a need for reducing or preventing harm had been identified, for example among prison inmates (Wald, Flaherty, & Pringle, 1999).

The life skills approach is a useful component of alcohol education but its successful implementation requires additional supporting elements (Perry et al., 1989). These include, for example, the provision of balanced and appropriate information about alcohol consumption, drinking patterns, and outcomes. Given the wide range of cultural views on alcohol, life skills programs need to be implemented in a culturally sensitive way and should address specific cultural issues.

Media and culture awareness have also been suggested as essential adjuncts to the life skills approach, beyond the critical thinking component that is already included. In addition, issues related to social environment, economics, and opportunity also need to be addressed, given their impact on the choices and decisions that people make about drinking and health in general.

Impact of life skills education

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The impact of life skills education has been debated (Foxcroft et al., 2003; Gorman, 2002; Palinkas, 1996; Plant & Plant, 1999). The basic questions to be addressed are how the impact of this (or any other) approach should be measured and what are its desired outcomes. For some, the acceptable outcome is measured in preventing people from drinking. For others, it is to enable the target audience to make informed choices and decisions about whether to drink and how to drink responsibly. How to measure an intangible result like this clearly presents a serious problem. It is difficult to quantify the development of skills such as coping with stress or the development of interpersonal skills. A qualitative assessment must often be sufficient.

In particular in developing countries where means and resources are often scarce, evaluation is difficult. For example, following up with a group of children in primary school to assess how they have developed can prove difficult due to high attrition rates. However, there is evidence that life skills education can have an impact (Botvin, Baker, Dusenbury, Botvin, & Diaz, 1995; Botvin, Griffin, Diaz, & Ifill-Williams, 2001; International Center for Alcohol Policies, 2000; Smith et al., 2004; Swisher, Smith, & Vicary, 2004).

Some general patterns, nevertheless, have emerged from the evaluations that have been undertaken in this field. Certain “factors of success” have been identified (World Health Organization, 1999, 2003). These include the need for:

• long-term programs;
• trained educators or providers;
• a focus on both generic and specific skills;
• developmentally appropriate inputs;
• active student involvement;
• links to other subjects;
• user-friendly materials; 
• peer leadership components.

Where these factors have been implemented, life skills programs contributed to a decrease in alcohol misuse, drug abuse, smoking, delinquency, violence, and suicide and to an improvement in pro-social behavior (e.g., Botvin & Kantor, 2001; "LifeSkills Training," n.d.; Perry, 1987). Other findings suggest a positive impact on mental health in relation to self-image, self-esteem, self-efficacy, and social and emotional adjustment and a decrease in social anxiety. School performance has been shown to improve with regard to behavior, academic achievement, and absenteeism (e.g., International Center for Alcohol Policies, 2000).

In general life skills development, there have been reported signs of improvement in problem solving, communication, and coping skills (Botvin & Kantor, 2001; Perry, 1987). It is these indicators and trends—often qualitative and anecdotal in nature—that indicate the potential of this approach and its particular contribution to the issue of alcohol use.

Implications for policy and prevention

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The life skills approach falls into the broader area of alcohol education (MODULE 1: Alcohol Education). It is one of many approaches aimed at reducing the potential for harm related to certain drinking patterns and at promoting responsible alcohol consumption. As with any policy approach, it is important to recognize that—on its own—life skills education cannot be expected to have a significant impact. The implementation of any alcohol education programs must be coupled with other measures and be part of a broader effort to effect change.

To this end, life skills programs also position alcohol consumption within the context of other lifestyle and health behaviors. Drinking, thus, is not viewed in isolation but as part of a range of life choices, all relying on the same decision-making skills. In many communities, especially in the developing countries, life skills education offers support to youths and other population groups that they are unable to receive elsewhere (e.g., International Center for Alcohol Policies, 2000).

The life skills approach has several useful advantages. It can be applied in a range of cultural settings and adapted to diverse views on alcohol consumption (International Center for Alcohol Policies, 2004). It lends itself to implementation in schools and other “formal” settings, but also to use in informal settings where skill development is the main goal ( Botvin & Kantor, 2001; Godfrey et al., 2002; International Center for Alcohol Policies, 2000; Marlatt et al., 2003).

Finally, life skills programs encourage a “bottom-up” approach that enables countries and communities to identify the way forward relevant to their particular needs and resources. This led to the development of materials that are tailored for specific target audiences and to the training of personnel who can apply these materials according to the needs of the community in which they work (e.g., training of pharmacists in Grant & Litvak, 1998, p. 284).

References

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Ashery, R. S., Robertson, E. B., & Kumpfer, K. L. (Eds.). (1998). Drug abuse prevention through family interventions. NIDA Research Monograph 177. Rockville, MD: National Institute of Drug Abuse.

Bils, L. (1999). Prevention primaire en Belgique francophone [Primary prevention in French-speaking Belgium]. Alcoologie, 21(HS), 187–192.

Botvin, G. J., Baker, E., Dusenbury, L., Botvin, E. M., & Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of the American Medical Association, 273, 1106–1112.

Botvin, G. J., Griffin, K. W., Diaz, T., & Ifill-Williams, M. (2001). Preventing binge drinking during early adolescence: One- and two-year follow-up of a school-based preventive intervention. Psychology of Addictive Behaviors, 15, 360–365.

Botvin, G. J., & Kantor, L. W. (2001). Preventing alcohol and tobacco use through life skills training. Alcohol Research and Health, 24, 250–257.

Department of Education, Republic of South Africa. (1997). Curriculum 2005: Grades 1–9. Pretoria, South Africa: Author.

Foxcroft, D. R., Ireland, D., Lister-Sharp, D. J., Lowe, G., & Breen, R. (2003). Longer-term primary prevention for alcohol misuse in young people: A systematic review. Addiction, 98, 397–411.

Godfrey, C., Toumbourou, J. W., Rowland, B., Hemphill, S., & Munro, G. (2002). Drug education approaches in primary schools. Melbourne, Australia: DrugInfo Clearinghouse.

Gorman, D. M. (2002). “Science” of drug and alcohol prevention: The case of the randomized trial of the Life Skills Training program. International Journal of Drug Policy, 13, 21–26.

Grant, M., & Litvak, J. (Eds.). (1998). Drinking patterns and their consequences. Washington, DC: Taylor & Francis.

International Center for Alcohol Policies (ICAP). (2000). Life skills education in South Africa and Botswana. Washington, DC: Author.

International Center for Alcohol Policies (ICAP). (2004). Alcohol education and its effectiveness. ICAP Report 16. Washington, DC: Author.

Kumpfer, K. L., Alvarado, R., Tait, C., & Turner, C. (2002). Effectiveness of school-based family and children's skills training for substance abuse prevention among 6–8-year-old rural children. Psychology of Addictive Behaviors, 16(Suppl. 4), S65–S71.

Kumpfer, K. L., Alvarado, R., & Whiteside, H. O. (2003). Family-based interventions for substance use and misuse prevention. Substance Use and Misuse, 38, 1759–1787.

LifeSkills Training. (n.d.). Retrieved March 16, 2005, from http://www.lifeskillstraining.com.

Lloyd, C., Joyce, R., Hurry, J., & Ashton, M. (2000). Effectiveness of primary school drug education. Drugs: Education, Prevention and Policy, 7, 109–126.

Marlatt, G. A., Larimer, M. E., Mail, P. D., Hawkins, E. H., Cummins, L. H., Blume, A. W., et al. (2003). Journeys of the Circle: A culturally congruent life skills intervention for adolescent Indian drinking. Alcoholism: Clinical and Experimental Research, 27, 1327–1329.

Palinkas, L. A., Atkins, C.J., Miller, C., Ferreira, D. (1996). Social skills training for drug prevention in high-risk female adolescents. Preventive Medicine, 25(6), 692-701.

Perry, C. L. (1987). Results of prevention programs with adolescents. Drug and Alcohol Dependence, 20, 13–19.

Perry, C. L., Grant, M., Ernberg, G., Florenzano, R.U., Langdon, M. C., Myeni, A. D., et al. (1989). WHO collaborative study on alcohol education and young people: Outcomes of a four-country pilot study. International Journal of the Addictions, 24, 1145–1171.

Plant, E., & Plant, M. (1999). Primary prevention for young children: A comment on the U.K. government's 10-year drug strategy. International Journal of Drug Policy, 10, 385–401.

Smith, E. A., Swisher, J. D., Vicary, J. R., Bechtel, L. J., Minner, D., Henry, K. L., et al. (2004). Evaluation of life skills training and infused-life skills training in a rural setting: Outcomes at two years. Journal of Alcohol and Drug Education, 48, 51–70.

Spoth, R., Redmond, C., & Lepper, H. (1999). Alcohol initiation outcomes of universal family-focused preventive interventions: One- and two-year follow-ups of a controlled study. Journal of Studies on Alcohol, (Suppl. 13), 103–111.

Spoth, R. L., Guyll, M., & Day, S. X. (2002). Universal family-focused interventions in alcohol-use disorder prevention: Cost-effectiveness and cost-benefit analyses of two interventions. Journal of Studies on Alcohol, 63(2), 219-228.

Swisher, J. D., Smith, E. A., & Vicary, J. R. (2004). A cost-effectiveness comparison of two approaches to Life Skills Training. Journal of Alcohol and Drug Education, 48, 71–87.

Wald, H. P., Flaherty, M. T., & Pringle, J. L. (1999). Prevention in prisons. In R. T. Ammerman, P. J. Ott, & R. E. Tarter (Eds.), Prevention and societal impact of drug and alcohol abuse (pp. 369–381). Mahwah, NJ: Lawrence Erlbaum Associates.

World Health Organization (WHO). (1997a). Life skills education for children and adolescents in schools: Introduction and guidelines to facilitate the development and implementation of life skills programmes. Geneva, Switzerland: WHO Programme on Mental Health.

World Health Organization (WHO). (1997b). Promoting health through schools. Report of a WHO Expert Committee on Comprehensive School Health Education and Promotion. WHO Technical Report No. 870. Geneva, Switzerland: Author.

World Health Organization (WHO). (1999). Partners in life skills education: Conclusions from United Nations Inter-Agency Meeting. Geneva, Switzerland: WHO Department of Mental Health.

World Health Organization, Regional Office for the Western Pacific (WHO/WPRO). (2003). Value adolescents, invest in future: Educational package. Facilitator's manual. Manila, Philippines: Author.