CARE, ASSESS, RESPOND, EMPOWER (CARE)

 

OVERVIEW

 

The Care, Assess, Respond, Empower (CARE) program (formerly C-CARE) is a high school-based suicide prevention program that targets high-risk adolescents and youth.  In Findings from a random assignment study of at-risk adolescents and youth from seven high schools indicated that the CARE intervention was associated with faster rates of decline in suicide risk behaviors and suicide related risk factors compared to the usual-care control group.  However these effects tapered more quickly than the effects associated with the usual-care control group.

 

DESCRIPTION OF PROGRAM

 

Target population:  High-risk high school students and young adults

 

The Care, Assess, Respond, Empower (CARE) program is a high school-based suicide prevention program that targets high-risk adolescents and youth.  There is also a version of the program adapted for young adults.  The CARE program was designed to decrease suicide behaviors and suicide-related risk factors and to increase personal and social assets by assessing an individual’s needs and providing him or her with counseling and social support resources. 

 

The CARE program consists of a two-hour one-on-one computer-assisted suicide assessment interview.  Following the assessment, participants take part in a two-hour counseling and social support intervention designed to deliver empathy and support, to provide a safe context for sharing personal information, and to reinforce positive coping skills and help-seeking behaviors.  The CARE program then assists the individual in connecting to a school-based caseworker or teacher.  A program official also establishes contact with a parent or guardian of the adolescent or youth’s choosing to enhance support, access to help, and communication.  Nine weeks after the initial counseling session, a follow-up assessment of suicide risk and protective factors, as well as an additional counseling session are conducted.

 

The CARE program is typically delivered by school or advanced-practice nurses, counselors, psychologists, or social workers who have completed the program’s implementation training and certification process.  Online implementation training currently is being developed for those wishing to deliver the program.

 

Though the online implementation training resource is not yet completed, costs include the following:  The training and registration fee; the purchase of a license for the use of the computer-assisted program; and follow-up training and certification process fees.  Additionally, the cost of implementation tools are as follows:  $6.50 for each High School Questionnaire: Profile of Experiences, long version (for pre and post-test measures); $5.00 for each High School Questionnaire: Profile of Experiences, short version (for midpoint intervention measures); and $5.00 per participant for the CARE Process Evaluation package.  

 

EVALUATION(S) OF PROGRAM

 

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, 742-752.

 

Evaluated population:  Youth who were at risk for suicide from seven different high schools served as the sample for this investigation.  A total of 460 youth took part in the evaluation.  The sample was 52% female.  It was an ethnically diverse sample comprised of 49% whites, 19% African Americans, 18% Asian Americans or Pacific Islanders, 10% Hispanics or Latinos, and 4% Native Americans.

 

Approach:  At-risk youth were identified using a two-step process.  First, researchers identified individuals who were willing to participate in the study and who exhibited risk factors for dropping out of high school.  Researchers then used this group of individuals to select a random sample who were given a suicide risk assessment.  Individuals who were identified as at risk for suicide took part in the evaluation.

 

Schools were randomly assigned to one of the following three study conditions:  1) The C-CARE intervention group (the program has since been renamed as CARE), 2) the CAST intervention group, or 3) the usual-care control group.  Within schools, the three conditions were rotated such that each school received each condition: C-Care, CAST, and the usual-care control, in addition to a “pause” semester during which no interventions were implemented.

 

For more information about CAST, click here.  The usual-care control group simulated procedures typically used by school personnel in response to adolescents and youth exhibiting behaviors indicative of suicide risk.  First, independent interviewers conducted a suicide assessment.  Following the assessment, the interviewers implemented established school policies and social-network connection strategies.

 

Youth were assessed o suicide risk behaviors, depression, hopelessness, anxiety, anger, personal control, problem-solving coping, and family support.

 

Results:  Compared to usual care, youth in the CARE intervention were associated with significantly faster rates of decline in favorable attitudes toward suicide, suicidal ideation, depression, hopelessness, anxiety, and anger.  However, the effects also tapered significantly faster than the effects on the same outcomes for the usual care control group.  Changes in mean levels of suicide risk behaviors, namely direct suicide threats and suicide attempts in the past month, declined at equal rates in all three of the groups.  There was no impact on rates of increase in personal control and problem-solving coping Changes in mean levels of family support increased at the same rate across all of the groups. 

 

SOURCES FOR MORE INFORMATION

 

Intervention materials may be obtained from:

 

Beth McNamara, M.S.W.

Director of Programs and Trainers

Reconnecting Youth, Inc.

P.O. Box 20343

Seattle, WA 98102

Phone:  (425) 861-1177; Fax:  (206) 726-6049

E-mail:  beth@reconnectingyouth.com

Web site:  http://www.reconnectingyouth.com

 

References:

 

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, 742-752.

 

Program categorized in this guide according to the following:

 

Evaluated participant ages:  14 to 19 years

Evaluated participant grades: High school

Program age ranges in the guide: Adolescence, Youth, Young Adults

Program components: Mentoring/Tutoring, Counseling/Therapy, School-Based

Measured outcomes: Social and Emotional Health, Physical Health, Mental Health

 

Keywords: Adolescents, Young adults, High school, Males and Females, High-risk, Urban, Clinic/provider based, Counseling/therapy, Depression/mood disorders, Anxiety disorders/symptoms, Aggression/bullying, Other mental health, Life skills.

 

Program information last updated on 10/28/10.

 

 

 

		© Child Trends 2004