A primary preventive approach to children's drug refusal behavior: the impact of rehearsal-plus.

The effectiveness of a short-term prevention program to increase drug refusal behavior in a school-age population was assessed. Forty-two third-grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, or attention control. Children in the rehearsal-plus group were taught specific drug refusal techniques and appropriate social skills, and were provided a rationale for each response. This procedure included behavioral training and elaborative rehearsal. Training occurred in four socially validated situations corresponding to settings where children were likely to be offered drugs. The traditional procedure consisted of instructions derived from a "Just Say No" drug program. Assessment focused on specific refusal behaviors, procedural knowledge, and self-efficacy. Significant gains in desired functioning and appropriate behavioral and social skills were found. The effectiveness of the rehearsal-plus procedure as a method of increasing adaptive responding in dangerous and/or anxiety-arousing situations is discussed.