making a difference

One day after group a student stayed to discuss some of the battles she had overcome since [CAST] started. This student had very poor attendance and poor grades due to her lack of school attendance, was depressed and disconnected from school, friends, and family. Her mid-term report showed she was now a B student that had only missed 2 days in the last 3 months of school! She had also made a few new friends in CAST which she credited for the positive lift in her day-to-day mood.


CAST Facilitator, West Salem, WI

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CAST Studies

The documents listed below were reviewed for Quality of Research by SAMHSA’S National Registry of Evidence-Based Programs and Practices (NREPP).

Eggert, L. L., Thompson, E. A., Randell, B. P., & Pike, K. C. (2002). Preliminary effects of brief school-based prevention approaches for reducing youth suicide: Risk behaviors, depression, and drug involvement. Journal of Child and Adolescent Psychiatric Nursing, 15(2), 48-64. [View/Close Abstract]

PROBLEM: Few empirically tested, school-based, suicide-prevention programs exist. The purpose of this study was to evaluate the post-intervention efficacy of Counselors-CARE (C-CAST) and Coping and Support Training (CAST) vs. “usual care” controls for reducing suicide risk.
METHODS: A randomized prevention trial; 341 potential dropouts, 14 to 19 years old, from seven high schools (52% female, 56% minorities) participated. Trend analyses using data from three time points assessed over time changes.
FINDINGS: Significant decreases occurred for all youth in suicide-risk behaviors, depression, and drug involvement. Intervention-specific effects occurred for decreases in depression.
CONCLUSIONS: School-based prevention approaches are feasible and show promise for reducing suicidal behaviors and related depression.

For more information, visit the webpage discussing this study.

Randell, B. P., Eggert, L. L., & Pike, K. C. (2001). Immediate post intervention effects of two brief youth school-based prevention program. Suicide and Life-Threatening Behavior, 31(1), 41-61. [View/Close Abstract]

This study evaluated the immediate post-intervention effects of two brief suicide prevention protocols: a brief interview–Counselors CARE (C-CARE)–and C-CARE plus a 12-session Coping and Support Training (CAST) peer-group intervention. Subjects were students “at risk” of high school dropout and suicide potential in Grades 9-12 from seven high schools (N = 341). Students were assigned randomly to C-CARE plus CAST, C-CARE only, or “intervention as usual.” The predicted patterns of change were assessed using trend analyses on data available from three repeated measures. C-CARE and CAST led to increases in personal control, problem-solving coping, and perceived family support. Both C-CARE plus CAST and C-CARE only led to decreases in depression, and to enhanced self-esteem and family goals met. All three groups showed equivalent decreases in suicide risk behaviors, anger control problems, and family distress.

Thompson, E. A., Eggert, L. L., Randell, B. P., & Pike, K. C. (2001). Evaluation of indicated suicide risk prevention approaches for potential high school dropouts. American Journal of Public Health, 91(5), 742-752. [View/Close Abstract]

OBJECTIVES: This study evaluated the efficacy of 2 indicated preventive interventions, post-intervention and at 9-month follow-up.
METHODS: Drawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up.
RESULTS: Growth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females.
CONCLUSIONS: School-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors.

For more information, visit the webpage discussing this study.

Eggert, L. L. (1996). Psychosocial approaches in prevention science: Facing the challenge with high risk youth. Communicating Nursing Research, 29, 73-85.

Eggert, L. L. (2000). Science-based prevention approaches to promoting healthy adolescent behaviors. Communicating Nursing Research, 33, 1-13.

Eggert, L. L., Herting, J. R., & Thompson, E. A. (1996). The Drug Involvement Scale for Adolescents (DISA). Journal of Drug Education, 26(2), 101-130. [View/Close Abstract]

This article specifically addressed the need for a multidimensional approach to measuring adolescents’ drug involvement. The Drug Involvement Scale for Adolescents (DISA) was theoretically specified and its measurement properties were tested using Confirmatory Factor Analyses and traditional procedures with 705 high-risk and typical high school students. Five first-order dimensions, Drug Access, Alcohol Use, Other Drug Use, Drug Use Control Problems and Adverse Drug Use Consequences, and a hierarchical model of Drug Involvement demonstrated a good fit between model and data. Further, the DISA demonstrated good internal consistency (alpha = .91); correlated as expected with known correlates of adolescent drug use; discriminated drug involvement between high-risk and typical high school students; and predicted later drug involvement and known drug-related consequences among adolescents. The results suggest the DISA should be useful for capturing a multidimensional view of adolescent drug involvement in both etiologic and prevention studies. A major advantage of the DISA is its brevity: twenty-two indicators constructed from twenty-nine items.

For more information, visit the webpage discussing this study.

Herting, J. R., Eggert, L. L., & Thompson, E. A. (1996). A multidimensional model of adolescent drug involvement. Journal of Research on Adolescence, 6(3), 325-361. [View/Close Abstract]

A multidimensional view of adolescent drug involvement has been called for in literature to help understand the general etiology of drug progression and to provide a better evaluative tool for prevention and intervention efforts. Hence, in this study, we posited and tested a multidimensional model of adolescent drug involvement with test and verification samples of high school students (N = 705 and 489, respectively). Five first-order dimensions–drug access, alcohol use, other drug use, drug control problems, and adverse drug use consequences–were tested as a higher-order confirmatory factor analysis model of drug involvement, demonstrating a good fit of the data and the expected associations with known correlates of adolescent drug use frequency. Models of change for high-risk versus low-risk youths highlighted the importance of a multidimensional perspective by revealing both differential levels and rates of change across the first-order dimensions of drug involvement. Implications for future studies of the etiology and prevention of adolescent drug involvement are suggested.

Powell-Cope, G. M., & Eggert, L. L. (1994). Psychosocial risk and protective factors: Potential high school dropouts versus typical youth. In R.C. Morris (Ed.), Using what we know about at-risk youth: Lessons from the field (pp. 23-51). Lancaster, PA: Technomic Publishing.

Thompson, E. A., Mazza, J. J., Herting, J. R., Randell, B. P., & Eggert, L. L. (2005). The mediating roles of anxiety, depression, and hopelessness on adolescent suicidal behaviors. Suicide and Life-Threatening Behavior, 35(1), 14-34. [View/Close Abstract]

The purpose of this study was to explore the roles of anxiety, depression, and hopelessness as mediators between known risk factors and suicidal behaviors among 1,287 potential high school dropouts. As a step toward theory development, a model was tested that posited the relationships among these variables and their effects on suicidal behaviors. Structural equation models, estimated separately by gender, revealed support for the model, and substantial similarities between males and females. The results showed direct effects of depression and hopelessness on suicidal behaviors for males, and direct effects of hopelessness, but not depression, for females. For both males and females, anxiety was directly linked to depression and hopelessness; drug involvement had both direct and indirect effects on suicidal behavior. As hypothesized, lack of family support showed indirect influences on suicidal behaviors through anxiety for both males and females. The results have important implications for future model development regarding adolescent suicidal behaviors.

For more information, visit the webpage discussing this study.

Thompson, E. A., Moody, K. A., & Eggert, L. L. (1994). Discriminating suicide ideation among high-risk youth. Journal of School Health, 64(9), 361-367. [View/Close Abstract]

This study examined the hypothesis that among one group of high-risk youth–potential high school dropouts–key psychosocial factors would distinguish adolescents endorsing high suicide ideation from those who do not. Survey data compared high-risk youth with high suicide ideation (n = 43) with randomly selected samples of high-risk (n = 43) and “typical” youth (n = 42) without high suicide ideation. Repeat sampling of comparison groups verified results. Compared to high-risk and typical youth without suicide ideation, high-risk youth with high suicide ideation reported more psychosocial distress, problems with drug involvement, and disrupted family relations. They also described more unmet school goals and perceived a greater likelihood of dropping out of school. Discriminant analysis revealed that depression and low self-esteem were most effective in distinguishing between high-risk youth with and without high suicide ideation; family strain, anger, stress, and drug involvement also were differentiating factors. Implications for school-based screening and prevention programs are discussed within the context of the findings.

For more information, visit the webpage discussing this study.

Walsh, E., Randell, B. P., & Eggert, L. L. (1997). The Measure of Adolescent Potential for Suicide (MAPS): A tool for assessment and crisis intervention. Reaching Today’s Youth, 2(1), 22-29.