Middle School to High School Transition Project: Depression and Substance Abuse Prevention (CAST-T/HSTS)

University of Washington

Status and phase: Completed; Phase 1

Conditions: Substance-Related Disorders; Depression

Treatments: Behavioral: Brief Intervention; Behavioral: CAST-T/HSTS

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00071513

R01MH061984 (U.S. NIH Grant/Contract)

21484-EG

Details and patient eligibility

About

This study will implement a school-based program to prevent depression, academic failure, and substance use in at-risk adolescents transitioning from middle school to high school.

Full description

The transition from middle school to high school presents important challenges for adolescents. Programs that enhance personal efficacy and social support resources may prevent at-risk students from developing behaviors that can lead to substance use, academic failure, and depression. This study will implement a skills-based program called Coping and Support Training for the Transition (CAST-T) as a preventive intervention for at-risk students.

At-risk students in eighth grade will be randomly assigned to receive either CAST-T or school as usual. The CAST-T program will initially be delivered in twelve sessions over 6 weeks in the middle school setting. The program includes booster sessions, case management, structured home-based parent education, and support and skills training throughout the transition period. Participants will be assessed from the beginning of eighth grade to the end of ninth grade. Vulnerability to academic problems and depression will be assessed with school records and self-report scale scores.

Enrollment: 497 patients

Sex: All

Ages: 12 to 15 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• At-risk for substance abuse, academic failure, and depression
• Enrolled in eighth grade in Seattle Public Schools
• English-speaking

Exclusion criteria

• Score above the clinical cutoff on the Youth Self Report Aggressive subscale

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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497 participants in 2 patient groups

CAST-T/HSTS

Experimental group

Description:

The CAST-T/HSTS condition combined the Brief Intervention and 12 school based small group sessions which taught skills to enhance personal control (to manage depression, anger, stress), self-esteem, decision making and interpersonal communications. HSTS skills groups were held in the spring of 8th grade with 4 one-on-one booster sessions delivered to the students as 9th graders by HSTP leaders; parents also participated in 4 sessions. HSTS objectives are: 1) to increase the acquisition of coping skills competencies by teaching and practicing strategies taught; 2) to increase social support resources by building a supportive network; 3) to increase the youth's engagement in positive social activities; and 4) to motivate parents to increase their support via parent educational sessions.

Treatment:

Behavioral: CAST-T/HSTS

Brief Intervention

Active Comparator group

Description:

Brief Intervention: After each youth and parent completed baseline questionnaires the youth participated in a 1 on 1 standardized clinical follow-up with a trained clinician (blind to study condition) to review areas of concern, based on questionnaire responses including stressors at school, home, and with peers, level of support available and how to access support. The teen and clinician then planned a feedback call to parents, allowing teens to shape requests for support from parents as well as understand exactly what information would be shared with parents. Feedback call to parents reviewed concerns and made recommendations for services as needed. A similar procedure was followed after each assessment for all participants who indicated a risk of clinical depression or self-harm.

Treatment:

Behavioral: Brief Intervention