Program

Oct 28, 2010

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.

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.