This paper has two primary objectives. The first is to assess the current status of efforts to prevent mental health problems in children of divorce by highlighting the importance of using theory in the design and evaluation of prevention programs and by reviewing the empirical research on the efficacy of programs to improve outcomes for children of divorce. The second objective is to propose two future directions for advancing theory-based preventive interventions for children of divorce: (a) improving our understanding of the theoretical mechanisms underlying prevention program effects, and (b) bridging the gap between the current evidence of program efficacy and the development of a public health strategy to reduce the negative outcomes experienced by children of divorce.
Key Words: children, divorce, intervention, prevention, resilience, public health.
Parental divorce is experienced by 1.5 million children each year in the United States, and 40% of American children are predicted to reside with a divorced parent prior to age 16 (National Center for Health Statistics, 1995). Although the popular public press has described a controversy regarding the risks associated with divorce (e.g., Corliss, 2002), the empirical evidence is not equivocal. Approximately 20-25% of children of divorce exhibit serious mental health or life adjustment problems (e.g., Amato & Keith, 1991; Hetherington, Bridges, & Insabella, 1998). Serious problems can persist into adulthood, as indicated by the 39% increase in the risk of clinical levels of mental health problems in children of divorce relative to their peers from two-parent families at age 23 (Chase-Lansdale, Cherlin, & Kiernan, 1995) and the 85% increase at age 33 (Rodgers, Power, & Hope, 1997). In addition, 41% of children of divorce report receiving mental health services between ages 18 and 22 compared with 22% of their peers from two-parent families (Zill, Morrison, & Coiro, 1993), and children of divorce have a shorter life span relative to their peers by over 4 years (Schwartz et al., 1995). Also important is that children of divorce are at increased risk for additional stressful family transitions such as remarriage. Thus, divorce can be seen as having an important impact on public health, and interventions that prevent the negative effects of divorce on children have major public health significance.
Our first objective here is to assess the current status of prevention efforts to change the legacy of divorce for children, both by highlighting the importance of using theory in the design and evaluation of prevention programs and by reviewing the empirical research on the efficacy of programs to improve child outcomes. Our second objective is to propose two primary future directions to advance prevention programs for children of divorce. One direction involves expanding tests of the theoretical mechanisms underlying program effects. We illustrate this direction by presenting secondary data analyses on a previously evaluated intervention to test a theoretical pathway through which the intervention reduced children's mental health problems. A second direction involves devoting research attention to bridging the gap between evidence of program efficacy and the development of a public health strategy to change the legacy of divorce for children.
Prevention Programs to Change the Legacy of Divorce
In this section we first discuss the benefits of using theory in the design and evaluation of prevention programs and present our approach to constructing an underlying theory of a prevention program for children of divorce. We then review the experimental and quasi-experimental trials of prevention programs for children of divorce, noting both the program effects and the underlying theory of the program, if specified.
Using Theory in Designing Prevention Programs for Children of Divorce
The use of theory in intervention design and evaluation offers three critical advantages (e. …