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

This study has been completed.
National Institute of Mental Health (NIMH)
Information provided by (Responsible Party):
Elizabeth McCauley, University of Washington Identifier:
First received: October 24, 2003
Last updated: July 7, 2016
Last verified: July 2016
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.

Condition Intervention Phase
Substance-Related Disorders
Behavioral: CAST-T/HSTS
Behavioral: Brief Intervention
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Middle School to High School Transition Project

Further study details as provided by University of Washington:

Primary Outcome Measures:
  • Change in Short Moods and Feelings Questionnaire (SMFQ) [ Time Frame: Baseline to 18 months ] [ Designated as safety issue: Yes ]
    The Short Moods and Feelings Questionnaire is a 13 item measure of level of self reported depressive symptoms. Each item in scored on a 3-point Likert scale as follows: "True" (0), "Sometimes" (1), and "Not True" (2) rated within the timeframe of the previous two weeks. A total score is obtained; scores can range from 0 to 26. Total scores of 12 or higher may signify that a child/adolescent is suffering from depression. Higher scores on this scale suggest a worse outcome or greater endorsement of depressive symptoms. Change is measured based on two time points baseline to the 18 months follow-up assessment.

Secondary Outcome Measures:
  • School Attachment [ Time Frame: 18 months ] [ Designated as safety issue: No ]

    School attachment measure consisted of 4 items. Item responses range from 0 (unsatisfied, rarely attended, not involved, etc.) to 6 (highly satisfied, regularly attended, very involved, etc). Scores could range from 0 to 36 with higher scores indicating more positive school attachment. Item were:

    My overall satisfaction with classes was… Overall, how safe did school feel last semester… Overall, how friendly did school feel… How involved were you in school activities…

Enrollment: 497
Study Start Date: March 2003
Study Completion Date: June 2007
Primary Completion Date: June 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CAST-T/HSTS
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.
Behavioral: CAST-T/HSTS
Skills training small group.
Active Comparator: Brief Intervention
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.
Behavioral: Brief Intervention
Assessment of needs and referral to services as needed.

Detailed 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.


Ages Eligible for Study:   12 Years to 15 Years   (Child)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00071513

United States, Washington
University of Washington
Seattle, Washington, United States, 98195
Sponsors and Collaborators
University of Washington
National Institute of Mental Health (NIMH)
Principal Investigator: Elizabeth McCauley, PhD University of Washington
Principal Investigator: Ann Vander Stoep, PhD University of Washington
  More Information

Additional Information:
Responsible Party: Elizabeth McCauley, Professor, Psychiatry and Behavioral Sciences, University of Washington Identifier: NCT00071513     History of Changes
Other Study ID Numbers: 21484-EG  R01MH061984 
Study First Received: October 24, 2003
Results First Received: December 6, 2015
Last Updated: July 7, 2016
Health Authority: United States: Institutional Review Board
Individual Participant Data  
Plan to Share IPD: No
Plan Description: Add data has been de-identified. De-identified data is available to share.

Keywords provided by University of Washington:
Substance Abuse

Additional relevant MeSH terms:
Depressive Disorder
Substance-Related Disorders
Behavioral Symptoms
Mood Disorders
Mental Disorders
Chemically-Induced Disorders processed this record on October 21, 2016