only with respect to psychological outcomes but also with respect to their cost, would provide unique and valuable information about ways to cultivate positive youth development most efficiently.

Along with assessment of symptoms and diagnoses, the measurement of positive characteristics should be thorough. Existing measures of positive emotions, flow, subjective well-being, character strengths, and competencies should be included, not just pre-and postintervention but also in the course of the program, to allow the hypothesized mediating roles of these positive constructs to be tested explicitly through causal modeling. We also call for long-term follow-up with the full battery of positive and negative measures. Long-term means years following the end of the program. In particular, it would be important to see how cultivated positive characteristics help a young person make transitions out of high school and into college, into the work force, and into lasting relationships—the important societal institutions that help young people become fulfilled adults.

The questions of immediate interest are which individuals develop a disorder and which do not, and whether some disorders are more easily prevented than others. We are also interested in determining what happens to those youth who do develop a disorder despite these interventions. Some will show recurrent problems, and some will not. What factors predict differing courses following initial episodes? The positive psychology prediction is that even if cultivated positive characteristics do not prevent a disorder, they might well limit recurrence and allow the eventual achievement of a good life.

The second sort of intervention study we propose again uses existing best-practice youth development programs, not with youth in general or with at-risk youth, but instead with troubled teens mid-or postepisode. In other words, we call for positive rehabilitation and hypothesize that positive interventions like those developed by positive psychologists and positive youth development practitioners may maximize the likelihood that the individual will grow up to lead a full and productive life.

Adults in therapy can usually expect some relief (Nathan & Gorman, 1998, 2002), but most can also expect to be in and out of treatment for the rest of their lives. At its worst, this phenomenon is dubbed “revolving-door psychiatry.” Even at its best, this phenomenon leads to perpetual aftercare in the form of support groups, booster psychotherapy sessions, and/or prophylactic medication (Weissman, 1994). Self-identification as being always “in recovery” may be inevitable, and ongoing stigma is likely (Penn, 2003).

Matters may be different for young people. Among adults, it seems clear that prognosis worsens with age for almost all psychological disorders (e.g., Seivewright, Tyrer, & Johnson, 1998). Although the apparent magnitude of this effect may be an artifact of studying patient samples rather than community samples, past psychological problems remain the best predictor of future psychological problems. A depressed middle-aged adult will likely become depressed again, no matter how effective treatment may be in the short term, but young people who become depressed may not become depressed again if early intervention takes place (e.g., Birmaher, Arbelaez, & Brent, 2002; Clarke et al., 2001; Lewinsohn, Pettit, Joiner, & Seeley, 2003; but cf. Weissman et al., 1999).

The same is true for many other problems, such as anxiety disorders (Dadds et al., 1999). Indeed, among adolescents showing early (prodromal) symptoms of schizophrenia, early intervention may help stave off the full-blown disorder (Cannon et al., 2002; Harrigan, McGorry, & Krstev, 2003; McGorry et al., 2002; Phillips, Yung, Yuen, Pantelis, & McGorry, 2002; Schaeffer & Ross, 2002). And it is clear that many teenagers experiment with drugs or alcohol without dooming themselves to a life in recovery (Spooner, Mattick, & Noffs, 2001). At least for some young people and for some disorders, it becomes meaningful to speak of curing mental illness, which provides a powerful rationale for the focus on youth taken by this volume.

Why are young people different? We speculate that it is not age per se that is the crucial factor but rather the number of untreated episodes someone experiences and the psychosocial consequences of these episodes that determine long-term prognosis—the doors closed by lost time, missed opportunities, and pervasive stigma. In

deed, the more episodes of a disorder, the greater the likelihood of still more episodes and the worse the prognosis for an individual. If this downward spiral can be interrupted at a sufficiently early point, perhaps the business of life can take over as a curative agent.

Consistent with this analysis, Joiner (2000) grappled with the self-propagating nature of depression and argued that interpersonal processes such as excessive reassurance seeking and conflict avoidance are largely responsible for its persistence and/or recurrence. Other interpersonal processes by implication set the person on a different course that entails true recovery. Perhaps youth development programs can preclude recurrence of depression, and other psychological problems, by imparting appropriate strengths and competencies on which the person can rely when troubled.

Along these lines, recent longitudinal studies of life satisfaction imply that job loss (especially for males) and divorce (especially for females) can leave lasting “scars” in the sense that individuals never return to their initial levels of well-being, even with new jobs and new marriages (Clark, Georgellis, Lucas, & Diener, 2004; Lucas, Clark, Georgellis, & Diener, 2003). The mechanisms responsible for these effects, which are not inevitable, have yet to be identified, but if they are interpersonal, the implication again is that youth development programs may work against them.

Supporting this possibility is the consistent finding that assets such as intelligence and an intact family predict better long-term prognosis for youth posttreatment (e.g., Otto & Otto, 1978). The constructs of concern to positive youth development and positive psychology provide a more articulate starting point for understanding how life can cure. Relationships with other people are established, positive emotions are experienced, talents and strengths are identified and used, and meaningful careers are chosen and pursued (Richter, Brown, & Mott, 1991; Shoemaker & Sherry, 1991; Todis, Bullis, Waintrup, Schultz, & D'Ambrosio, 2001). If life becomes satisfying, one can navigate it well. The overall likelihood of psychological disorder is decreased, and the likelihood of successfully dealing with disorder is increased.

It is difficult to mount such an argument with existing data. For example, among children and youth, early onset of a disorder is usually associated with worse prognosis, which seems to contradict our hypothesis (e.g., Jarbin & von Knorring, 2003). However, early onset may reflect a greater biological contribution to disorder and certainly greater severity. Early onset may reflect a more chaotic social context to which successfully treated youth return. Consider as well the ongoing challenge in reliably diagnosing disorders among the very young and the associated reluctance by professionals to label youth unless the problem is unambiguous.

We nonetheless know that some youth who enter the mental health system are successfully treated and are never seen again, just as we know that the majority of young peole who enter the juvenile justice system never return again (Snyder & Sickmund, 1999). The skeptic might argue that these cases are not really cures; maybe the initial diagnoses were simply wrong, maybe the problems recurred but further treatment was not sought, and so on. The positive perspective suggests that we take this phenomenon at face value and fill in its details with the facts. The natural history studies we have proposed would begin to yield critical information about single-episode individuals. How many are literally cured?

But the studies of positive rehabilitation that we propose would go further in trying to influence prognosis by deliberately cultivating the ingredients of a healthy life. Our proposal is supported by studies of psychosocial rehabilitation for troubled adolescents. Psychosocial rehabilitation embraces an educational model, in contrast to a disease model, and tries to teach psychological and social skills that facilitate productive community reintegration of youth following treatment (Byalin, Smith, Chatkin, & Wilmot, 1987; Fruedenberger & Carbone, 1984). Such programs are effective in reducing recurrence of a variety of problems and seem to be cost-effective (e.g., Barasch, 1994; Mishna, Michalski, & Cummings, 2001; Rund et al., 1994). The positive psychology perspective goes beyond typical psychosocial rehabilitation to specify the active ingredients that allow imparted skills to be deployed to best effect.

Studies of positive rehabilitation would use

the same general research design already sketched for studies of positive prevention: randomly assign research participants, in this case adolescents with disorders, to intervention and comparison groups and do thorough assessment of both positive and negative characteristics before, during, and after the intervention. Measures of perceived stigma would be an informative addition to the assessment battery. Those in comparison groups would, of course, receive conventional (business-as-usual) aftercare. Both specific and general programs should be included. It might also be of interest to see if the timing of positive rehabilitation matters: Should it begin during treatment of a disorder (mid-episode) or following symptom relief (postepisode)?

Studies of positive prevention and especially positive rehabilitation for youth would represent a strong test of the perspective put forward here. When positive psychology was first formulated, its goal was phrased as moving people not from −3 to zero but from +2 to +5 (Seligman, 2002). But if the positive perspective on youth development has legs, it should also be able to move young people from −3 to +5 and keep them there.