The Mentor Foundation recently honored the Good Behavior Game, a prevention program for young children that was developed with NIDA support. The game utilizes children’s desire for rewards to engender positive peer pressure to reduce aggressive and disruptive behaviors in the classroom. Student teams win stickers or other small rewards for complying with rules for good behavior, such as sitting quietly and not talking out of turn. The game has been shown to prevent drug abuse and other problems in adolescence and young adulthood.
Her Majesty Queen Silvia of Sweden established the Mentor Foundation in 1994 in conjunction with the World Health Organization to promote drug abuse prevention. Queen Silvia presented the International Best Practice Award to the American Institutes for Research (AIR). Dr. Sheppard Kellam, professor emeritus at Johns Hopkins University, and AIR’s Dr. Jeanne Poduska accepted the award on AIR’s behalf at a Mentor USA ceremony on September 20, 2012, in Washington, D.C.
Dr. Kellam, Dr. Poduska, and colleagues have worked together on the Good Behavior Game for more than 20 years. Dr. Kellam has led three generations of large-scale, randomized trials of the Good Behavior Game in Baltimore City Public Schools. Dr. Poduska now leads the Good Behavior Game implementation program at AIR and conducts research into the most effective ways to train and support teachers using the Good Behavior Game.
Mentor Executive Director Jeff Lee says the Foundation honored the Good Behavior Game because the program has “a sound evidence base for effectiveness, an international track record, and the potential for adaptation and piloting in new countries.” Mr. Lee says Mentor sought recommendations from a broad range of drug prevention organizations, institutions, and individual experts around the world, and “the Good Behavior Game was on the lists of most who responded, and at the top of many lists.”
Aggressive Boys Show Most Improvement
Beginning in 1985, Dr. Kellam and colleagues conducted a randomized trial of the Good Behavior Game with 41 first- and second-grade classes in 19 Baltimore City Public Schools. He followed the students until they reached the ages of 19 to 21 and reported that students who played the game, compared with those who did not, had lower rates of:
- Drug and alcohol use disorders
- Antisocial personality disorder
- Delinquency and incarceration for violent crimes
- Suicidal thoughts
- Use of school-based services such as behavioral counseling, remedial or special education, and therapy
The improvement was most striking for boys who had higher levels of aggressive and disruptive behaviors in first grade. Twenty-nine percent of aggressive boys who played the Good Behavior Game reported drug use and dependence disorders as young adults, compared with 83 percent of aggressive boys who did not play the game. Similar improvements were reported in every category.
Many researchers using the Good Behavior Game have reported similar dramatic reductions in preventing drug abuse and other adverse outcomes. Researchers in Belgium, The Netherlands, and the United States have tested the Good Behavior Game independently; AIR pilot-tested the Good Behavior Game in Oxfordshire, United Kingdom. Positive findings were consistent across all four countries, from childhood through adolescence and into young adulthood.
University of Kansas researchers Harriet Barrish, Muriel Saunders, and Montrose Wolf designed the Good Behavior Game in the 1960s. NIDA and the National Institute of Mental Health have supported Good Behavior Game research. The NIDA International Program has supported the International Good Behavior Game Network.
|Outcomes||Groups||Good Behavior Game Classroom||Standard Classroom|
|Drug abuse and dependence disorders||All males||19%||38%|
|Highly aggressive males||29%||83%|
|Regular smoking||All males||6%||19%|
|Highly aggressive males||0%||40%|
|Alcohol abuse and dependence disorders||All males and females||13%||20%|
|Antisocial personality disorder (ASPD)||Highly aggressive males||40%||100%|
|Violent and criminal behavior (and ASPD)||Highly aggressive males||34%||50%|
|Service use for problems with behavior, emotions, drugs, or alcohol||All males||25%||42%|
|Suicidal thoughts||All females||9%||19%|
Table Source: Kellam, SG, et al., The Good Behavior Game and the Future of Prevention and Treatment. Addiction Science & Clinical Practice, 6(1), 73-84, 2011. Full Text Available