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Coping and Support Training (CAST)

Public Health & Prevention: School-based
Benefit-cost estimates updated May 2017.  Literature review updated August 2017.
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Coping and Support Training is a school-based program for reducing the risk of adolescent suicide. The program consists of 12 group sessions delivered over 6 weeks. The curriculum addresses mood management, school performance and drug involvement. In the single study included here, the participants also received a 1-1/2 hour assessment followed by 1 hour of counseling prior to beginning the group sessions.


BENEFIT-COST
META-ANALYSIS
CITATIONS
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2016). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $2,720 Benefits minus costs $7,963
Participants $5,512 Benefit to cost ratio $18.43
Others $294 Chance the program will produce
Indirect ($106) benefits greater than the costs 91 %
Total benefits $8,420
Net program cost ($457)
Benefits minus cost $7,963
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
K-12 grade repetition $15 $0 $0 $7 $22
Labor market earnings associated with anxiety disorder $2,477 $5,454 $0 $0 $7,931
Health care associated with anxiety disorder $243 $79 $301 $122 $745
Costs of higher education ($14) ($21) ($6) ($7) ($49)
Adjustment for deadweight cost of program $0 $0 $0 ($228) ($228)
Totals $2,720 $5,512 $294 ($106) $8,420
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $457 2016 Present value of net program costs (in 2016 dollars) ($457)
Comparison costs $0 2016 Cost range (+ or -) 10 %
The per participant cost is estimated using the average annual salary of a school counselor in WA, assuming counselors work 6 hours per day for 180 days in a year and that benefits are 44% of salary. The cost per participant then is 3-1/2 hours of individual counseling plus 12 hours of group therapy, assuming 7 students per group plus the cost of the student workbook. Cost also includes required training of $1,100 per facilitator and $455 for curriculum, assuming that one facilitator continues in the job for 3 years and conducts 3 groups per year. Salaries for school counselors obtained from Bureau of Labor Statistics. (https://www.bls.gov/oes/current/oes_wa.htm) Cost of training and CAST materials obtained from the Reconnecting Youth website. (http://www.reconnectingyouth.com/programs/cast/)
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

^WSIPP’s benefit-cost model does not monetize this outcome.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
Anxiety disorder 2 300 -0.241 0.148 17 -0.111 0.074 18 -0.377 0.011
Major depressive disorder 1 150 -0.143 0.209 17 0.000 0.021 18 -0.223 0.286
Suicide attempts^ 1 150 -0.049 0.209 17 n/a n/a n/a -0.077 0.714

Citations Used in the Meta-Analysis

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(5), 742-752.

For more information on the methods
used please see our Technical Documentation.
360.664.9800
institute@wsipp.wa.gov