The Children's Aid Society Carrera Adolescent Pregnancy Prevention Program uses a holistic approach that aims to empower youth. The program helps young people to develop personal goals and the desire for a productive future. In addition to developing sexual literacy and educating teens about the consequences of sexual activity, the program also emphasizes the importance of education and employment. Dr. Michael A. Carrera sees the sum of all these activities as having a "contraceptive effect," providing that extra infusion of caring, support and structure.

The beginning of realistically dealing with the national concern about adolescent pregnancy is to accept that there are no quick-fix solutions, no single-intervention programs, no slick political slogans which will, by themselves, impact upon the problems that haunt us and take such a huge toll on the lives of so many young people. It is time to face facts: we simply cannot "teach" our way out of this problem by sending young people home with dolls for the weekend and hoping they will learn the responsibilities of being a parent. Cognitive approaches alone are insufficient to meet this challenge.

In fact, educating young people about abstinence, avoiding unintended pregnancy, HIV infection, and sexually responsible behavior requires that we first reduce hopelessness and fatalism and begin to produce life changes that generate a genuine desire in adolescents not to become pregnant. The desire to live a long, successful, and productive life and to achieve mastery over life's many challenges are what produce a genuine delay in the onset of intercourse or in the conscientious and consistent use of contraceptives during intercourse. However, we have not yet been able to properly motivate some young people to understand that teen pregnancy and teen parenthood is undesirable and increases the odds that their lives will be difficult, complicated, and painful for years to come.

We do know that the desire to avoid such a situation is more likely to exist if a young person has a stable and nurturing family life, characterized by an adult who: (1) believes that the teen is precious and capable of "going places"; (2) supports the teen in setting a realistic life agenda; (3) encourages the development of a hopeful sense of the future; and (4) regularly reinforces the notion that foregoing early pregnancy and child bearing will enhance life opportunities to communicate their thoughts and feelings about sexuality and sexual expression with a concerned adult during their development.

Unfortunately, many teen males and females do not have the good fortune of living in such situations and do not see much of a future for themselves. Most young people see little employment opportunity around them and will probably face a life of low economic status, ever-present racism, and inadequate opportunities for quality education. Even at a young age, the specter of hopelessness surrounding their possibilities for success in life becomes vivid and daunting. These are the forces that spur the splintering of the American family and lead to that cul-de-sac of desperation, fatalism, and hopelessness. Growing numbers of adolescent voices are now saying, "There is no hope. There is no one who values me. There is no one who cares." Under such conditions, it is no wonder that some young people, instead of becoming industrious and hopeful, become sexually intimate for a short-term sense of comfort, and ultimately become profoundly fatalistic. In such cases, intercourse is used as a coping mechanism. Youth workers, teachers, and counselors must replace the use of that coping mechanism with concrete and hopeful (not rhetorical) alternatives such as decent employment, a bank account, improvement in school, a place in college, or a meaningful career or vocational track. These are the elements that produce desirable outcomes in young people and reduce teen pregnancy, teen violence, and teen substance abuse.