Bright Spot: Seven Challenges

Photo by Priscilla Du Preez on Unsplash

This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.


Detailed Description

The Seven Challenges is designed to treat adolescents with drug and other behavioral problems. Rather than using pre-structured sessions, counselors and clients identify the most important issues at the moment and discuss these issues while the counselor seamlessly integrates a set of concepts called the seven challenges into the conversation.

The challenges include:

  1. Talking honestly about themselves and about alcohol and other drugs
  2. Looking at what they like about alcohol and other drugs and why they are using them
  3. Looking at the impact of drugs and alcohol on their lives
  4. Looking at their responsibility and the responsibility of others for their problems
  5. Thinking about where they are headed, where they want to go, and what they want to accomplish
  6. Making thoughtful decisions about their lives and their use of alcohol and other drugs
  7. Following through on those decisions

These concepts are woven into counseling to help youth make decisions and follow through on them. Skills training, problem solving, and sometimes family participation are integrated into sessions that address drug problems, co-occurring problems, and life skills deficits.

The Seven Challenges reader, a book of experiences told from the perspective of adolescents who have been successful in overcoming problems, is used by clients to generate ideas and inspiration related to their own lives. In addition to participating in counseling sessions, youth write in a set of nine Seven Challenges Journals, and counselors and youth engage in a written process called cooperative journaling. The program is flexible and can be implemented in an array of settings, including inpatient, outpatient, home-based, juvenile justice, day treatment, and school. The number, length, and frequency of sessions depend on the setting. Counselors with various levels of experience in working with mental health and substance abuse problems are trained in program implementation.

Expected Outcomes

The expected outcomes are:

  • Increased abstinence
  • Decreased substance use severity and related problems
  • Improvements in mental health symptoms

Cost Details

Cost of the training is $8,700 per agency and includes an agency license. Designated program leaders must go to an additional 3-day training. Off-site training costs $700 per person, and on-site training costs $6, 400 per agency. Cost of materials range from $10 to $70. The first year support/fidelity site visit is $2,000. The Annual Fidelity Fee is $5,000 per year.

Key Steps for Implementation

Providers interested in offering The Seven Challenges program need to assess the potential match between The Seven Challenges and community needs, program needs, and community resources. Providers also need to assess whether the The Seven Challenges philosophy fits their agency's philosophy. The Seven Challenges works closely with organizations, providing the training, tools, and support necessary to successfully use the program with young people. They have developed implementation strategies to help organizations attain program sustainability and systems for monitoring their fidelity to the model. The Seven Challenges has been implemented in a wide variety of counseling settings, including residential, outpatient, juvenile justice, schools, and home-based, and will work cooperatively with organizations to adapt the program to their various service delivery needs.

Required Staffing (FTEs)

Existing counselors and clinical supervisors can implement this program.

Books and journals used in The Seven Challenges Program are published by Viva Press. Use of these materials requires training, so Viva Press will only sell these publications to organizations that are authorized to provide the Program. The Seven Challenges provides many additional documents free of charge to authorized organizations during their Initial Training, Leader Training, and ongoing support sessions. Some of these include program supervision aids, quality assurance forms, scripted sessions for helping counselors as they get started using the program, training materials, mini-posters for youth, and diplomas for youth for completion of each of the Journals.


Below is a brief summary of the training and support services provided by The Seven Challenges:

  • We provide an on-site, 3-day Initial Training for the counselors who will be using the program, as well as the clinical supervisors. The organization is also encouraged to have employees such as youth care workers, assistant group facilitators, or caseworkers who will be working with youth, attend the Initial Training. This training prepares counselors to immediately begin providing The Seven Challenges Program.
  • The organization will have an opportunity to select their Seven Challenges Leaders. Leaders attend an additional three day Leader Training which teaches advanced Program skills and how to supervise counselors delivering the service. Leaders help their organization maintain Program fidelity, participate in quarterly Support Calls with The Seven Challenges, and are also taught how to facilitate the Initial Training for new staff joining the organization. The Leaders are key to creating Program sustainability.
  • Implementation assistance begins soon after the Initial Training with the first Support Call between The Seven Challenges and the Leaders. This quarterly conference call is designed to provide assistance with clinical and implementation questions. The Seven Challenges also provides assistance through the Leader Forum on this website, which is monitored by Dr. Schwebel. The Leader Forum presents an opportunity for Leaders around the country to share ideas with one another and receive feedback from Dr. Schwebel and The Seven Challenges Program Specialists. We also provide an array of helpful training, supervision, and implementation documents for organizations.
  • An on-site Support/Fidelity Visit takes place about nine months after the Initial Training, and annually thereafter. During this visit, counselors and leaders receive more help with their clinical and implementation questions. Extra time is spent helping the leaders with supervision issues and counselor and staff training efforts. A Seven Challenges session is observed with feedback provided to the facilitating counselor and leaders. The leaders and program specialist work together during this visit to develop plans for strengthening the program within the organization.

Types of Staff

Existing counselors and clinical supervisors can implement this program.

Outcome Measures

This intervention does not include evaluation measures, but when an organization is planning an outcome study, The Seven Challenges is willing to provide support to their process.

Process Measures

This intervention does not include evaluation measures, but when an organization is planning an outcome study, The Seven Challenges is willing to provide support to their process.

 Related Topics

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Young and Emerging Adults

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Substance Use

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Children and Youth