1

Nyanungo (2005) defines Community Psychology as a field in psychology that focuses on prevention rather than cure. It emphasizes the creation of alternatives through identifying and developing the resources and strengths of the community focusing on actions directed toward the competencies of the people; Neitzel, Bernstein and Milich (1991:18). Community psychologys goal is to minimize or prevent psychological disorders, not just treat them; Wood and deGlanville (1997). These efforts began with community health programs designed to make traditional treatment methods more accessible to the poor and others who are unseen or undeserved by mental health professionals; Neitzel, Bernstein and Milich (1991:18). Later, community psychology broadened its perspective to include efforts at preventing psychological disorders by altering the conditions that cause or aggravate them. There are many alternative approaches to community psychology, for example the ones by Bloom-Heller, Bronfenbrenner and the Public Health one. This essay is going to examine the three categories of prevention activities as proposed by Caplan (1964) and explain their significance to community psychology. The three categories of prevention according to Caplan (1964) are primary prevention, secondary prevention and tertiary prevention. According to Orford (1993:155), Primary prevention seeks to reduce incidence by preventing new cases of the disorder from developing. Focus in primary prevention is on people who are completely free of the disorder at the time, those at mild risk and those at particularly high risk. Partly due to definitional problems, Forgays suggested a triadic breakdown of primary prevention as a way of addressing the definitional problems; Lahey (1995:55). Primary prevention was then divided into Primary prevention 1 (for those completely free from the disorder), primary prevention 2 (for the part of the population that is at mild risk) and primary prevention 3 (for those at high risk). Secondary prevention aims at detecting the disorder early and to provide effective treatment at an early stage of the disorder. It

Community Psychology PSY304

has to do with the reduction of prevalence of a disorder. Orford (1993:155) further goes on to say that it cannot reduce incidence, but if it successfully nips the progressive conditions in the bud, then its effect will be to shorten the duration of the disorder and hence the overall prevalence within the community. Tertiary prevention is premised on the idea that a disorder need not necessarily produce disability and that a disability need not necessarily result in handicap; Yule as cited by Orford (1993:155). In other words, tertiary prevention has to do with the prevention of disabilities and handicaps which may be associated with a disorder. As mentioned earlier, primary prevention as a whole has to do with the correcting of negative conditions before significant problems emerge as a consequence of these conditions. The application of this model necessitates a degree of social change. In February 2002, BIIC AIDS project, conducted trainers of trainers workshops for youths and enlisted the services of an NGO called Deseret International which is a firm believer of behavior change as the solution to HIV/AIDS; Mpofu, Chiremba and Kent (2003:83). Part of their statement of beliefs reads as follows: The pandemic affects everyone. Our experience as affected and infected individuals proves that the behavior change is possible. We believe that behavior change is the most essential strategy in overcoming the HIV pandemic. Mpofu, Chiremba and Kent (2003:83). Some of their strategies they used in their prevention programmes were AIDS awareness campaigns, youth festivals and poetry formation of Anti-AIDS clubs in schools, just to name a few. In Primary prevention 1, intervention programmes are provided without necessarily identifying the group to be at risk. The provision of bins by the City of Harare to almost every household is a good example and it assumes a form of social orientation. Genetic counselling of young couples considering to have children can help them at reducing genetic linked disorders

Community Psychology PSY304

such as Anemia and Fragile X; Mpofu, Chiremba and Kent (2003:8). The issue of Rhesus negative blood mixing with Rhesus positive blood in pregnant mothers can also be averted by being tested though it is regarded as a very rare occurrence yet deadly when it does happen. Problems can occur if the foetus positive blood manages to find way into the mothers negative blood either during pregnancy or during labour, the mothers blood may create antibodies to attack the rhesus negative blood in the foreign body that is the baby; Lahey (1995:232). Primary prevention 2 targets groups in the populace that are considered to be at mild risk. The dental fluoridation of children in rural primary schools, an exercise that the author witnessed in 1994 was targeted at children of low socio-economic status, who were mostly not adequately educated on how to care for their teeth and most likely did not brush their teeth every day. When authorities realize that a place, for example a squatter camp like Porta farm, is overpopulated and there arent enough toilets, they can help them build toilets through the participation for material incentives typology. In this case, people participate by providing labour in exchange of building materials. The participation of the community and its involvement in problem solving cannot be over emphasized in community psychology. Prevention interventions must be collaborative & delivered in a way that avoids paternalistic style that characterizes some traditional therapistclient interventions; Rappaport and Seidman (2000). According to Elias et al as cited by Orford the school transition program is a milestone intervention program aimed at helping pupils adjust from elementary or primary school to secondary school. Retirement training for the elderly who are about to retire from their jobs is another example of a milestone transition intervention program. The Tonggat Sugar Company in Hippo Valley gives all its workers anti-malarial tablets prophylactically every Wednesday because the place is a malaria prone area. However, in taking

Community Psychology PSY304

anti-malarial tablets in this way, there is no suggestion that those who do not take them will necessarily suffer from malaria. Some groups in our societies are identified as at great risk of developing serious mental disorders based on factors unique to those groups; Mpofu, Chiremba and Kent (2003:9). Women who have been raped, victims of war and witnesses of genocides are all groups in society that are likely to develop serious mental health illnesses in their lives such as Post Traumatic Stress Disorder. Primary prevention 3 deals with such groups. Secondary prevention has to do with the detection and correcting of problems early. This involves screening large numbers of people, including people who are not seeking help and those that do not appear to be at risk. Mpofu, Chiremba and Kent (2003) further state that it is targeted at people already showing signs of the disorder and the two conditions necessary for successful secondary prevention programmes are early, accurate diagnosis plus effective treatment. In the case of abuse, Pasquali et al (1989) says there is need for early identification of cases of abuse in the community and the prompt and effective treatment of the abusers and their victims. The Prevention of Parent to Child Transmission programme is an example of secondary prevention. Mother or parent to child transmission of HIV/AIDS can virtually be eliminated by effective voluntary testing and counseling, access to antiretroviral therapy, safe delivery practices and the widespread availability and safe use of breast milk substitutes; Ford (2009). If these interventions were used worldwide, they could save the lives of thousands of children each year. The distribution of clean water storage containers, water purification tablets and teaching people about the etiology and symptoms of cholera in Cholera awareness programs is an example of secondary prevention that took place here in Zimbabwe. Thus secondary prevention aims at preventing the continuation and worsening of the problem.

Community Psychology PSY304

Tertiary prevention seeks at reducing the duration and negative effects of the problems after they have occurred; Kaplinski (2011). After the Cholera epidemic and the death of many people, UNICEF recruited counsellors mostly from the Zimbabwe Open University to go door to door, counselling those who had been bereaved in areas where the outbreak took place. This prevention model often involves rehabilitation for example in prisoners. While in the past, rehabilitation may have been directed at 'reforming the character' of prisoners, its focus is now on preventing reoffending; Owen (2010). Most of the convicts carry complex psychosocial problems and need instruction for the outside world. In 2006 the Mexican Government came up with the Maria Marias Program which was created by SEJUS, in partnership with the Ministry of Justice. It was aimed at female prisoners, with the purpose of reintegrating them into society through socio-educational, vocational and cultural actions enabling them to rescue their citizenship and their productive value; Judith (2011). The relapse prevention plan then takes each step of an offender's cycle and generates options, diversions and alternate behaviours that interrupt his offense path. In the case of sexual offenders, the offender is required to acknowledge all his sexual offenses during therapy, whether they are known or unknown to people outside himself. The goals of therapy include identification of his chain and cycle of offending, reduce denial, working toward taking full responsibility, recognizing impact on victims and victim empathy, recognizing impact of victimization on family members and friends, plan for regaining trust from family members, self management of deviant sexual arousal, and working toward implementing an effective relapse prevention plan; Owen (2010). Other issues, such as healthy attitudes toward sexuality, substance abuse and anger management are also addressed. The offender is expected to increase available coping skills for all activities, especially when stress or gratification needs are present. Usually, the offender is expected to

Community Psychology PSY304

remain in treatment for 12 to 18 months to successfully develop an effective, individualized relapse prevention plan. Community psychology plays a very important role in today's world. The development of community psychology has helped to combine individualistic cultures with collectivistic cultures. The mix of these two helps to fill the desire and need to belong; Kaplinski (2011). Since Maslow's hierarchy of needs ranks needing to belong high, it is great that community psychology has been adapted. With community psychology we can establish leadership using organization, joint efforts, recognizing individual talents, and empowering the community. For this sense of community it is important to have membership, influence, integration and fulfillment of needs, and a shaped emotional connection. Kaplinski further asserts that with community psychology we have been able to open up resources and lines of communication, which helps to show our pure altruism.

Community Psychology PSY304

Bibliography Lahey B. B. (1995) Psychology: An Introduction. 5th Edition. London. McGraw-Hill Company Mpofu W.; Chiremba W and Kent D. (2003) Community Psychology. Harare. Zimbabwe Open University Neitzel M. T.; Bernstein. R.M. and Milich R (1991) Introduction to clinical Psychology. New Jersey. Prentice Hall Nyanungo K. L. R. (2005) Psychology the public and other professions. Harare. Zimbabwe Open University Orford J. (1993) Community Psychology Theory and practice. New York. John Wiley and sons. Pasquali E. A.; Arnold H. M. and De BaSio N. (1989) Mental health nursing: A holistic approach. Michigan. The CV Mosby Company publishers Rappaport, J. and Seidman E. (2000) Handbook of community psychology. New York. Prentice Hall Wood C. H; deGlanville H., Vaughan J. P. (1997) Community Health.2nd Edition. Nairobi. African medical and research foundation. Ford J. D. (2009) Posttraumatic Stress Disorder: Scientific and professional Dimensions (Online) http://books.google.com/ date accessed: 01/05/2012 Judith C.G.C ( 2011) Rehabilitation of prisoners. http://www.interdisciplinary.net/probingtheboundaries/wpcontent/uploads/2012/04/cabraleppape r.pdf. Date accessed: 03/05/2012 Kaplinski E. (2011) Careers in psychology. (Online) www.apa.org. Date accessed: 01/05/2012 Owen R. (2010) Prison Rehabilitation. (Online) http://www.politics.co.uk/reference/prisonrehabilitation. Date accessed: 03/05/2012

Community Psychology PSY304