Much has changed in the world of prevention since the days of "Just Say No." Now the conversation is nuanced and fact-based, and the methodologies are backed up by data. Kids are given the information, and then they’re trusted to make the healthy decision. How else has prevention evolved? How do we empower kids to make the healthy choice? Tune in for this fascinating conversation between Deirdre Flynn, manager of Hazelden Betty Ford’s Prevention Solutions, and host William C. Moyers. Read the podcast transcript below or listen and subscribe on iTunes, Google Play, Spotify or watch on YouTube. 0:00:13 William Moyers Hello and welcome to Let's Talk, a podcast series produced by Hazelden Betty Ford. Today our topic is prevention—raising our children and students to be resilient in these difficult times. I'm your host, William C. Moyers, and my guest today is Deirdre Flynn, my colleague who was the Interim Manager of FCD Prevention Works. A key component on the front end of Hazelden Betty Ford's comprehensive mission. Welcome, Deirdre, thanks for being with us today. 0:00:42 Deirdre Flynn Thank you very much! Thank you for having me. 0:00:44 William Moyers Before we get into the specifics of the topic, tell me, where does your passion and your interest come from? 0:00:51 Deirdre Flynn Oh thank you for asking me that question, it's a great topic for me! I am—my name is Deirdre Flynn I'm the Manager of Field Operations for Prevention Solutions at this point. But 35 years ago, I was somebody who came into recovery from an active addiction. I was a young person who grew up in an environment where people wanted to help me, tried to help me. Really tried to step in along the way but really didn't know what to do. So, when I was 16 years old, I was able to go into treatment for addiction. And I've been able to stay in recovery since then. And then when I had my own children, I realized that we still—I still didn't know what to do to prevent the kind of issues that I had run into as a teenager. So I got involved in prevention, I found what was then FCD Prevention Works, and learned about what they were doing in terms of comprehensive prevention and tried to work it in my own family. 0:01:46 William Moyers Well there you go, you're a shining example of turning the adversity of your personal experience into the opportunity to help so many other people and we're glad that you're doing that today. 0:01:56 Deirdre Flynn Thank you. 0:01:57 William Moyers My question then around prevention is when we talk about prevention, what is it that we're trying to prevent? 0:02:04 Deirdre Flynn That is a really good question. And prevention solutions we see prevention as something that happens from before the time someone is born until up until the time that they die. So we are doing prevention throughout the lifespan. So we could be talking about prevention of substance use, substance misuse, substance abuse. And addiction later on. So we really focus on not just the addiction that could happen later in life, but we really focus on those negative consequences that begin to happen often when adolescents first start to use substances. So if we can focus on those early negative consequences, we really prevent the later negative consequences including addiction and sometimes up until including overdose or other untimely death. 0:02:53 William Moyers But it isn't just about prevention, which is certainly important. 'Cause when we talk about raising resilient children or resilient students, what is our goal? 0:03:02 Deirdre Flynn That exactly is our goal. To raise students who can recognize what risk factors are or protective factors are in their lives. Recognize when there are maybe social determinants of their health. Which are creating unhealthy situations for them. And teach them how to function and learn and grow despite those risk factors, those social risk factors, family risk factors, or individual risk factors. If we can give them the tools that they need to learn how to be resilient and to grow, even with those risk factors, we are helping to promote healthy protective factors. We know that they have a better likelihood of throughout their life of making healthier decisions. 0:03:48 William Moyers So you mean it's just not a question of encouraging them to just say no? 0:03:52 Deirdre Flynn It's not. [grins] I have to say that for a long time, that was a belief about what prevention was. We need to tell our children to just say no and if we punish them in just the right way, if they don't say no, then they will make healthier choices. And what we now know is that is just an ineffective way. It's not proven, it doesn't work in terms of helping to keep kids away from the kinds of behaviors that we are trying to prevent. So what we do is we provide them with nurturing protective factors. We help them identify their risk factors, help them identify what's healthy and unhealthy behavior, and if we give them the tools that they need to make healthy choices and to be resilient in those circumstances that they can't change, we actually do create healthier outcomes. 0:04:41 William Moyers But what a time! What a time to be doing this kind of work. I mean every generation of young people has its own challenges, and we are somewhat coming out of the pandemic. But there's all kinds of consequences and fallout as a result of the pandemic. Would you say, Deirdre, that this is probably or perhaps the toughest set of challenges that young people have faced in a long time? 0:05:15 Deirdre Flynn I have to say this is certainly one of the most significant community, global, worldwide challenges that certainly we've faced in recent history. And I think what we're seeing is that it is largely taking its toll on many people as individuals and many communities. And in our society and globally. We have seen a lot of changes. Unfortunately, the big data that we need to really approach this in an evidence-based or an evidence-driven way takes time. So we're working to try to make sure that we understand what those changes have been. And how to best provide support for our communities as well as our young people. With small bits of data and with data that may not be wholly accurate or may not be complete at this point in time. So it is a challenge for not just the individuals and not just our adolescents but for the people who are trying to keep them healthy. 0:06:15 William Moyers I wanna talk about some of those effective prevention strategies in just a minute, but before we get there, let's also talk about the role that social media plays— 0:06:24 Deirdre Flynn Hmm. [nods] 0:06:24 William Moyers —In exposing young people to risk. 0:06:28 Deirdre Flynn Yeah. We have known for a long time from research that adolescents who are exposed to more social media have unhealthier attitudes in many areas. More risky attitudes in many areas. And we see very clearly that adolescents who are exposed to more messaging on social media for instance about vaping are at significantly greater risk of trying and continuing to use vaping products. So electronic nicotine delivery systems. So we know that social media will affect them. And one of the strongest pieces of research that we've seen come out of this sort of COVID social distancing lockdown era is that not just adolescents, but adults who are exposed to continual social media messages about COVID tend to have more anxiety and depression. Those who are exposed to more sort of factual and news-based pieces of information about COVID tend to report less anxiety and symptoms of depression. So we know very clearly that social media can create fear and unhealthy attitudes that will lead to sort of those feelings of anxiety and depression. If we limit that, we can actually change how people are experiencing that. 0:07:47 William Moyers Let's move from the problem, from the challenges, to the “good news,” the hope, the effective strategies. What are some effective prevention steps that parents can take at home? 0:08:00 Deirdre Flynn Yeah. There are a lot of them. And that is the good news. Much of the conversation around prevention for many years has been very disempowering for parents. We've told parents for many years that you can't trust your children and you don't know your children well enough. And you need to be afraid. And they have felt very much like they don't know what to do. Just saying no isn't working, so what do we do?! So what we know is that there are a lot of effective strategies. And we have seen very clearly that the research even during COVID points to the idea that some students are having healthier outcomes during the social lockdown period and during the COVID period. And those are students who are reporting that they're spending more time with family. That they're sleeping longer hours. That they are not rushing from activity to activity. And they are engaging with their friends in a more controlled and limited way. And so we see that those protective factors that parents have been trying to put into place regularly over the years are still effective during COVID. Now not everybody has all of those protective factors. But we know very clearly that when parents are trying to nurture some of those protective factors like connection to trusted adults within and outside the family, when they're trying to nurture a feeling of connection to school and community. Not just a feeling of being there and being a part of, but being connected to school and community. And to having factual-based information about all kinds of health risks actually produces healthier outcomes over time. So parents have some control and some tools that they can use. 0:09:44 William Moyers What role do schools play in effective prevention and helping to raise resilient students? 0:09:52 Deirdre Flynn Schools play a really strong role. And one of the best, one of the most effective ways that they can work towards prevention is they can be focused on creating a comprehensive prevention plan for a community. School is one of the few places where a lot of things and a lot of people and a lot of ideas and a lot of cultures are all intersecting in one place. And you can create there a climate and a culture of health and prevention that it's hard to create outside of that. Not everybody in a community goes to the same church. Not everybody in a community is a part of the same groups. Not everybody in a family lives in the same house. But everybody in a community tends to be connected to the schools. So, one of the roles that schools can play is creating a comprehensive prevention plan. That includes parents and students. And other members of the community. And make that sort of a locust for starting to change that culture and that climate. And shift it a little closer towards prevention. And shift it a little closer towards a primary prevention. Where we're really talking to very young children, talking to healthy kids trying to keep healthy kids healthy. [smiles] 0:11:11 William Moyers We only have about five minutes left, I've got a couple other questions for you, but just to follow up on what you just offered—does that mean that the responsibility and the role of practicing or teaching prevention falls on the teachers? 0:11:29 Deirdre Flynn I would not say it's fair to say that it falls on the teachers. I think educators are educators. And if we give them the tools that they need to educate about substance use and misuse, they will be able to do so really effectively. I think the other thing schools can do is help educate parents so that they can play their role. But the truth is, parents aren't necessarily educators. So they can teach children about the substances that they may encounter. But even more effectively, they tell their children what their thoughts and their feelings are around those substances. So everybody's got a role in prevention and those roles are all key. And if educators can learn and have the tools that they need to effectively educate on alcohol and other drugs, let's give 'em those tools. 0:12:117 William Moyers Deirdre, when we talk about risk factors, specifically what are we looking at? 0:12:23 Deirdre Flynn Risk factors can be seen at a lot of different levels. So there can be individual risk factors, there can be risk factors in the family, and there can be communal risk factors. So individual risk factors might be something like for a middle school child, are they getting along with their peers? Do they struggle academically in school? Are they connected to activities outside of school? And are they—do they have trusted adults? So, at the family level, it's things like do their parents have extra harsh parenting techniques? Or is there substance use and abuse within the family that might be concerning? And then at the communal level, there's things at school. So is there effective classroom management in the school? Is there opportunities for a student to connect about their passions, whether or not it's sports of something else? Or it could be other social determinants of health. Like they do live in an area that experiences significant violence or has experienced significant violence? Do they live in an area where they have access to healthy food and healthcare? So there can be risk factors at every level there. And very often we focus on the individual risk factors. Do they have anxiety, do they have a genetic propensity for addiction? But there are a whole stream of risk factors which we can focus on. And if we can reduce or at least address those risk factors, we can create healthier children overall. 0:13:53 William Moyers So what are the healthy behaviors that counter that? 0:13:57 Deirdre Flynn So, there are lots of healthy behaviors or sort of protective factors that we see. And so, they very often are just the flip of what we see for risk factors. So for individuals, it's do they find some success at school? They don't have to be straight A students, but do they find some success at school? Do they feel connected? Do they feel valued as a person by the teachers at school? Or on the communal level, do they feel safe and secure? Do they feel like they can engage in a life with their community that's really nurturing for them? So, some of those behaviors that we see—those risk factors that we see—become the healthy behaviors on the other side. 0:14:43 William Moyers And those coping skills that we want our children or our students to have, can you detail those for us? 0:14:48 Deirdre Flynn Yeah. [nods] Sometimes I think we discount some of those coping mechanisms because they seem so simple or they're so ubiquitous. We talk about them all the time. But, some of the easy grabs that we see are teaching our children how to recognize symptoms of nervousness that later will become anxiety. Teaching them how to recognize their emotions and their feelings and name them early on. And then teaching them things like how to talk to one another when you're having an argument. Or how to breathe deeply in a way that will change the neurobiology and lower your anxiety levels. Or how to do some kind of exercise for fun. So it may not be engaging at a sport, a competitive sport, at school. It may be walking your dog on the weekends. So there are lots of healthy behaviors that we can encourage in our children. Often what we are encouraging becomes work for them. So we expect them to be involved in sports all year round. Because we know that connection to school and connection to exercise are good things. But we also have to engage their passions. So they might need to relax and just find something that they love to do that's also exercise. And we need to nurture and encourage and make space for that. And really supporting those coping skills that we hear about all the time but it's kinda hard to buy into because they're so common. Those, we know, work. [smiles] 0:16:24 William Moyers Hmm. We know that, well, FCD's been around a long time, long before it became part of Hazelden and Hazelden Betty Ford's mission. [Deirdre smiles, nods] I think that was back in about 2013. I remember when I traveled there to meet the team. I was bowled over by not just the knowledge but the passion— 0:16:42 Deirdre Flynn Yeah. [nods] 0:16:42 William Moyers —By which your team does its work and pursues its mission. And it's so nice to have FCD Prevention Works on the front end of our, you know, mission at Hazelden Betty Ford. So you've been around a long time doing this work. You're clearly passionate and knowledgeable about it. How do we measure effectiveness? How do we know that FCD Prevention Works? 0:17:05 Deirdre Flynn We have been around for a long time. FCD has been working in schools since 1976. We started in one school in Massachusetts and within one year, we were working internationally. And what we saw over the years was that we were following what other people in prevention were already doing. And that wasn't always the most effective strategy. And we had all this information from schools about what they needed. And from families and communities about what they needed. So what we did was we developed a Student Attitudes and Behaviors Survey and other assessment tools that we can use in a school to come in and really get a really good picture about what's actually going on in the environment. Target prevention efforts where they're going to be most effective and most efficient. And then we can measure over time to see if they work. And our Student Attitudes and Behaviors Survey has a database at this point of over 130,000 students worldwide. And we can see very clearly that there are effective strategies and we can see how change has happened in schools around the world. As a result of really the schools, the families, the communities partnering to engage in these effective prevention practices. 0:18:16 William Moyers FCD Prevention Works! [smiles] 0:18:19 Deirdre Flynn Prevention works. [chuckles, smiles] 0:18:20 William Moyers We're about out of time, Deirdre Flynn, but before we go I've just gotta ask you, what are some of your favorite moments working in this field? 0:18:28 Deirdre Flynn Oh. I could go on all day, but I won't. [Moyers laughs] I'll tell you that one of my favorite moments was at a school in Dubai. When I was in a classroom that had to have 60 different nationalities represented in that classroom. With ninth grade students who were really in a position of being curious about alcohol and other drugs, but knowing they were in an environment which was extremely risky for them to even engage in talking about alcohol and other drugs. And so I sat in a room of about 30 or 40 ninth graders and they just asked me questions. All of the questions that they were afraid to ask the adults in their lives for good reason. And at the end of the class, one of the girls looked at me and she said, 'You know, this has been the best thing that we've done all year because the truth is, nobody has ever talked to us about this topic like we were adults before. And given us the information we needed and trusted us to make the right decision.' And that has happened to me in Paris and it has happened to me in Texas. So knowing that we just give kids education and tools and talk to them as if they are agents of their own health, makes a difference. And that they appreciate it no matter where we are, that's my favorite piece of working in prevention. 0:19:44 William Moyers Well thank you so much for bringing clearly your passion and clearly your expertise. [Deirdre smiles, nods] To parents and schools and families across the country and around the world. And thanks for bringing it to us today. Deirdre Flynn, thank you. 0:19:57 Deirdre Flynn You're welcome. It's been my pleasure. 0:20:01 William Moyers [to camera] We're out of time but I wanna thank everybody for joining us again today. And also just to emphasize that if you are struggling with a substance use issue, if you have a young person who's struggling with it, or if you're in a community or a school that's struggling with you, don't put it off. It's okay to ask for help. We know that addiction to alcohol and other drugs does not discriminate. But, prevention and treatment do work. And resiliency and recovery are real. So, don't wait. Don't wait. If you or a loved one, a school or a community, needs help. Ask now. I'm your host, William C. Moyers, I hope you'll join us again for another edition of Let's Talk. See ya soon.