Probably most mental health professionals are, or should be, critics of society for we see how certain social conditions inflict damage and emotional pain on our clients. James Garbarino, Ph.D., author of the book "Lost Boys: Why Our Sons Turn Violent and What We Can Do to Save Them" (The Free Press, 1999), is no exception to my prediction.

Preventing lethal youth violence will be no easy task, argues Dr. Garbarino. It will involve changes and increased efforts on three levels: individual, social and therapeutic.

On the individual level, we must do everything we can to provide all boys-indeed all children-with caring family relationships. The more family members who can be there for children in loving, supportive ways, the better for their mental health.

Boys who may become violent need to be taught to actively cope with stress. Paradoxically, most violent boys are passive and see themselves as victims, except when they act out violently. They must be taught to take personal responsibility for their behavior rather than blame others or blame the system.

Boys who may become violent must also be given what Garbarino calls authentic self esteem. They must also have positive social support outside of the family, roles that can be played by teachers, coaches and/or clergy persons.

Garbarino also focuses on social changes to prevent lethal youth violence. He presents a study conducted at Fordum University on the health of our society. Sixteen factors were used to rate the state of our nation and it was found that there has been an overall decline in the health of our society from 74 points in 1970 to 41 points in 1992, quite a precipitous drop.

Children need to feel safe in their environment. One study found that one third of children between the ages of six and twelve were afraid they would be shot.

Another societal problem is the economical inequality that has been growing in the United States and which contributes to resentments, frustrations and instability in any society.

Obviously, all children should have access to health care. It is also important that through education and the support of parents, we encourage healthy parent/child relationships.

Early education programs for children, such as pre-schools, Headstart and well-run day care centers, should also be utilized. One study found that for every dollar spent on early education programs saved seven to eight to dollars later by keeping youth out of the criminal justice system.

Child Protective Services should be strengthened to prevent and treat child abuse, since it is one of the major causes of lethal violence. Also, there should be programs in schools to teach conflict resolution skills to youth. We should also be doing whatever we can to reduce media and video game violence.

Although this may be controversial to some, Garbarino also argues we should control and restrict children's access to guns.

On the therapeutic level, early diagnosis and treatment is essential. The earlier we can detect problems of aggression in children, the better prognosis.

Garbarino argues for what he calls a multisystemic therapy. This includes both family and individual therapy, since research has found that individual therapy alone for violent youth is not sufficient to bring about changes in them.

Also, residential programs are an important component in preventing and treating violent youth. However, Dr. Garbarino argues that the "bootcamp" approach which has become popular recently has not been successful with these youths.

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