Apr 28, 2009


CAST is a suicide risk prevention program. CAST incorporates life skills training and social support in 12 small-group sessions. In the evaluation described below, the CAST intervention is compared with another treatment group that uses the Counselors Care (C-CARE) curriculum and a control group. The evaluation involved a brief assessment interview as a well as an intervention intended to simulate a school’s typical protocol. This evaluation found significant treatment effects on participants’ suicide risk behaviors at post-test and at the nine-month follow up. Furthermore, at the nine-month follow up, participants had significantly less suicidal ideation, depression, hopelessness, anxiety and anger. CAST also led to improved problem-solving coping and personal control, but did not impact family support levels. Of those participants in CAST, females had greater declines in anxiety and anger than males. There were no significant impacts on attitude toward suicide and direct suicide threats.


Target population: Adolescents identified as being at risk for suicide.

CAST includes 12 small group sessions that take place over the course of six weeks. Sessions are administered by trained master’s-level high school teachers, counselors or nurses. Throughout the sessions students work on problem solving, anger management, drug use, recognizing their progress, and building their self-esteem. The CAST curriculum costs $699 and CAST student notebooks are $26.50 each. Training workshops are available; cost varies by the length of the training.


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: 460 students who were determined to be at risk for suicide from seven high schools in two urban school districts comprised the study sample. Participants were between the ages of 14 and 19. The sample was 49% white, 4% Native American, 18% Asian American/Pacific Islander, 19% African American and 10% Latino or Hispanic. Fifty-two percent were female and 48% were male.

Approach: Each school was randomly assigned to one of the three study conditions (CAST, C-CARE, and a usual care control group). Within each school, the three study conditions were rotated through during four semesters with a “pause” semester being added. Possible participants were identified by examining data on academic performance, attendance, prior dropout status and referrals. Participants were then randomly sampled at-risk from this sub-population and invited to participate. Participants then responded to initial measures intended to assess risk of suicide. Only those determined to be at risk for suicide remained in the study.

Data were collected at pre-test, post-test, and at a 9-month follow-up. The post-test for C-CARE occurred four weeks after pre-test; whereas the post-test for CAST occurred ten weeks after pre-test. Measures assessed suicide risk behaviors, related risk factors (depression, hopelessness, anxiety, and anger), and protective factors (personal control, problem-solving, coping, and family support).

Results: The treatment groups (CAST and C-CARE) and the control group showed reduction in suicide risk behaviors and emotional distress at both immediate nine-month follow ups. However, at the nine-month follow up, participants in the two treatment groups had significantly less suicidal ideation, depression and hopelessness, indicating sustained reductions of these feelings. There were also significant treatment differences found between CAST and the control conditions for anxiety and anger-control problems, with females experiencing decreased emotional distress and males remaining at similar levels. The CAST intervention had significant influences on the rate of change in personal control and problem-solving coping at post-test and at follow-up. CAST did not impact levels of family support.


Link to Program Curriculum:


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, 15,48-64.

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.

Adolescence (12-17), Young Adulthood (17-24), Youth (16+), School-Based, High-Risk, Counseling/Therapy, Life Skills, Mental Health, Social Emotional Health, Depression, Anxiety, High School, Urban, White or Caucasian, Cost, Manual.

Program information last updated 4/28/2009.