November/December 2016 Issue

Children and Families Forum: Addressing High School Bullying — Online
By Jane Timmons-Mitchell, PhD, and Deborah A. Levesque, PhD
Social Work Today
Vol. 16 No. 6 P. 32

Behaviors that enable bullying—inflicting harm intentionally and repeatedly on a person or group with lesser power, according to Nansel et al. (2001)—were reduced among students who completed an online prevention program, according to new research from Case Western Reserve University and Pro-Change Behavior Systems, Inc.

As a rising and significant public health problem, bullying affects millions of adolescents. About 1 in 5 students report being physically bullied, and more than one-half have experienced verbal bullying. Around the same percentage of students says they have been bullied on school property.

Currently, most antibullying programs are taught in person as a curriculum and have proven to be a hard sell to schools pressed to complete compulsory coursework and testing. They have also yielded mixed results, with some studies showing them especially ineffective for nonwhite students and students in eighth grade and higher.

As an alternative, an online-based program, known as StandUp: A Program to Prevent Bullying—which uses the Transtheoretical Model of Change (TTM)—has been developed to guide students through exercises designed to help them prepare to implement changes in behavior and then put the changes into action.

Bullying's Negative Effects
StandUp is designed for both bullies and those who are bullied. That's because being either a victim or a bully can increase the likelihood of depression, thoughts of hurting oneself, and self-harm behavior.

Students who engage in bullying may be even more likely to have negative effects. Young bullies become disproportionately involved in criminal activity. Girls who are bullies are more likely to attempt suicide. Even observing bullying can increase the risk of alcohol use, depression, anxiety, and self-harm behavior. Victims of bullying display decreased concentration on schoolwork and receive lower grades.
Perhaps of most concern is the finding that youth who are bullied have persistent effects: depression and thoughts of self-harm continue into adulthood.

Prevention Programs Show Varying Results
StandUp differs significantly from the most widespread antibullying program in educational institutions—the Olweus Bullying Prevention Program, which targets the school, the classroom, and the individual. The school level involves assessment, staff engagement, and increased supervision of school areas such as the playground, cafeteria, and restrooms.

The classroom level establishes clear and consistent rules against bullying. Discussions and activities present the harm caused by bullying and strategies to prevent it. The individual level includes interventions with bullies, victims, and their parents to promote cessation of bullying behavior and to support victims.
Data show that when the Olweus program is undertaken with students different from those in Norway where it was developed, results are not as robust. In Seattle, for example, white students but not black students showed benefit.

The Transtheoretical Model
The TTM can help us understand how behavior changes. StandUp—based on the TTM—seeks behavior changes using the following five stages:
• precontemplation (not ready);
• contemplation (getting ready);
• preparation (ready);
• action (making behavioral changes); and
• maintenance (maintaining behavior changes).

Over the past 35 years, the TTM has been shown to address a variety of health issues effectively, including smoking cessation, domestic violence cessation among adults, exercise and healthy eating among high school students, and bullying prevention among middle and high school students.

StandUp users are given individualized guidance matched to their bullying experiences, including an emphasis on the following six healthy relationship skills:
• using calm, nonviolent ways to deal with disagreements (eg, leaving the room to cool down);
• respecting the boundaries of others;
• communicating feelings and needs clearly and respectfully;
• making decisions in social situations that are right for each person;
• respecting the feelings and needs of other people; and
• how to appropriately take a stand to stop bullying.

Adapted from the online program Teen Choices: A Program for Healthy, Nonviolent Relationships, StandUp is a three-session program that provides feedback tailored to the individual's bullying experiences, stage of change, and use of stage-matched principles and processes of change. Each session lasts about 25 to 30 minutes.
Personal testimonials and curriculum content are presented, matched to the person's stage in the TTM. At the beginning of each of the later sessions, the program assesses and provides feedback on bullying since the last intervention session.

StandUp also addresses cyberbullying—unlike Olweus, which, as mentioned earlier, focuses upon the school, the classroom, and the individual.

Measures
A pilot test involving 113 high school students was conducted to assess the StandUp program's impact on students' healthy relationship skills and bullying-related behavior. Measures were administered by computer at the beginning of each StandUp session.

Use of healthy relationship skills. Participants were presented with each of the six healthy relationship skills and asked to indicate how often they used each skill during the past month. Response options ranged from 1 = never to 4 = always. A scale score was computed by taking the sum of scores on all six items.

Bullying perpetration, victimization, and bystander passivity. Questions in the program included: "Do you treat others unfairly or in mean ways?"; "Do you hurt people by pushing, hitting, or kicking them?"; "Do people treat you unfairly or in mean ways?"; "Do people hurt you by pushing, hitting, or kicking you?"; "Do you let people treat others unfairly or in mean ways?"; and "Do you let people hurt others by pushing, hitting, or kicking?".

Response options were "no," "sometimes," and "yes." Students reported experiencing between 12% (engaging in physical bullying) and 66% (being the victim of physical bullying) on these questions.

Results
Of the participants who completed a baseline assessment, 84% completed two sessions, and 78% completed all three.

Use of healthy relationship skills increased significantly from the first to last sessions—a very large effect. All forms of bullying examined decreased somewhat from session one to session three. Those who completed the program were much less likely to stand by while someone was emotionally or physically bullied.

Implications for School-Based Practice
StandUp could be delivered as a universal prevention program for teenagers, perhaps during health class or English class, as is often done. A school social worker could introduce the broad construct of bullying and discuss how school social workers can support students who struggle with bullying issues. If a school social worker becomes aware of a situation in which bullying has taken place, it might be helpful to offer StandUp to the students who witnessed it, as well as to those who participated in it, and then follow up to see whether further action is needed.

Additional materials are proposed that could be distributed to parents, both about bullying in general and about StandUp. School social workers would also want to be available to field questions from parents and to be available to students whom parents refer after reading the materials.

Showing encouraging results for change in high school students, StandUp could provide programming that takes little instructional time—making it an attractive option for bullying prevention in schools.

— Jane Timmons-Mitchell, PhD, is senior research associate with the Begun Center for Violence Prevention Research and Education at Case Western Reserve University's social work school, the Jack, Joseph and Morton Mandel School of Applied Social Sciences.

— Deborah A. Levesque, PhD, is chief science officer at Pro-Change Behavior Systems, Inc.

Resources
Levesque, D. A., Johnson, J. L., & Prochaska, J. M. (2016). Teen Choices, an online stage-based program for healthy, nonviolent relationships: Development and feasibility trial. Journal of School Violence. Retrieved from http://www.tandfonline.com/doi/abs/10.1080/15388220.2016.1147964?journalCode=wjsv20.

Levesque, D. A., Johnson, J. L., Welch, C. A., Prochaska, J. M., & Paiva, A. L. (2016). Teen Choices: A Program for Healthy, Nonviolent Relationships: Effects on peer violence. Manuscript under review.

Levesque, D. A., Johnson, J. L., Welch, C. A., Prochaska, J. M., & Paiva, A. L. (2016b). Teen dating violence prevention: Cluster-randomized trial of Teen Choices, an online, stage-based program for healthy, nonviolent relationships. Psychology of Violence, 6(3), 421-432.

Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: prevalence and association with psychosocial adjustment. JAMA, 285(16), 2094-2100.

Timmons-Mitchell, J., Levesque, D.A., Harris, L. A., Flannery, D. J., & Falcone, T. (2016). Pilot Test of StandUp, an online school-based bullying prevention program. Children & Schools, 38(2), 71-79.