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Program Findings Sheet

The Residential Student Assistance Program (RSAP)

Student Assistance Services

Percent Use in Past 30 Days

Location
Westchester County, New York

Program sites
Six residential child care facilities: a locked county correctional facility, a residential treatment center, a nonsecure residential facility, and three foster care facilities.

Target group
Institutionalized adolescent children of substance abusers who have committed violent or delinquent acts; have been physically, sexually, or psychologically abused; have experienced chronic failure in school; and/or have experienced mental health problems, including attempted suicide.

Program objectives

  • Delay the start of and decrease alcohol and drug use.

  • Develop peer resistance skills.

  • Improve self-image and sense of self-worth.

  • Improve communication skills and interpersonal relationships.
Findings
  • Adolescents in the treatment group showed dramatic reductions in the use of alcohol, marijuana, and tobacco from pre- to posttest measures, while in-house comparison youth showed relatively unchanged rates of use.

  • At the two most successful sites, counselors reported that they received enthusiastic administrative support, as evidenced by attractive offices where private individual sessions could be held, provision of a meeting place for groups, consistent scheduling of group meetings at times that did not interfere with other residential facility activities, and access to dependable transportation for additional off-campus support group meetings, such as Alateen and Alcoholics Anonymous.

  • Change in use of alcohol within last 30 days: 81.8% of those who did not report use at pretest remained nonusers. Of the users at pretest, 72.2% no longer reported use at posttest.

  • Change in marijuana use within last 30 days: 83.3% of those who did not report use at pretest remained nonusers. Of the users at pretest, 58.8% no longer reported use at the posttest.

  • Change in tobacco use within last 30 days: 78.4% of those who did not report use at pretest remained nonusers. Of the users at pretest, 26.9% no longer reported use at posttest.
Evaluation design
  • Pretest and posttest nonequivalent comparison group design.

  • Nonrandom treatment and comparison groups: self-selected treatment group and cross-sectional comparison group.

  • For youth, a shortened version of the Johnston Questionnaire, a student self-report for drug use, was used to measure drug use; the Rosenberg Self-Esteem Test and the Global Assessment of Functioning were also used to assess psychological measures.

  • The Community Oriented Program Environment Scales were used to measure the residents’ and staff’s perception of the site environment.
Program interventions
  • Provide individual and group prevention and intervention services within the residential facilities for the adolescents.

  • Train residential facility staff and provide employee assistance programs for staff in need of them.

  • Coordinate substance use prevention programs, services, and policies of the facilities.

  • Conduct drug assessment for all new residents entering the facility.

  • Refer and follow up with residents needing substance abuse treatment out of the residential facility.

  • Provide outreach services to encourage self and peer referrals and to provide primary prevention services for nonusers.

The Residential Student Assistance Program (RSAP)

Program Description

The Residential Student Assistance Program in Westchester County, New York (Grant #618) was a 5-year demonstration program begun in 1988. The program model was based on successful Employee Assistance Programs (EAPs) used by industry to identify and aid employees whose performance and lives had been adversely affected by substance use. Also feeding into the design of this effort were the successful experiences the county had in 1979 when it initially implemented Student Assistance Programs with the county’s high school population. A large part of this effort was designed to determine if the program could be adapted and remain effective with very high risk, institutionalized adolescent youth. As such, the residential facilities included in this project included a locked county correctional facility, a residential treatment center for adolescents with severe psychiatric problems, a nonsecure residential facility for juvenile offenders sentenced by the court, and three foster care facilities for abused, neglected, orphaned, or troubled adolescents placed by social service agencies. Participants were primarily 14- to 17-year-olds of African-American or Hispanic origin.

The RSAPs employ highly trained, professional Student Assistant Counselors (SACs), placed full- or part-time in the residential facilities to provide culturally sensitive substance use prevention and intervention services, including:

  • Establishing a supervisory partnership between an alcohol, tobacco, and drug prevention agency and the residential child care facility. In this vein, a Residential Facility Staff Task Force composed of clinical, administrative, and line staff meets with the SAC weekly for about an hour to discuss relevant problems and develop plans aimed at remediation.

  • Providing training and consultation with the child care, clinical, and teaching staff to increase their awareness and ownership of and skill in implementing alcohol, tobacco, and drug prevention strategies.

  • Implementing an EAP for residential child care staff experiencing personal problems.

  • Assessing all new residents’ substance use upon entry into the facility.

  • Assisting residents through developing and leading an Adolescent Resident Task Force. The task force meets for 30–45 minutes weekly and is designed to change the culture and norms of the facility, to decrease the stigma of interacting with SACs, and to increase self-referral for prevention/treatment activities.

  • Implementing small educational discussion groups in which 8–10 residents discuss and role-play for about 45 minutes in 6–8 sessions issues related to adolescence, consequences of substance use, family problems, and stress. These sessions are to familiarize residents with the counselor and to begin to change attitudes, behaviors, and feelings regarding alcohol/drug use of the residents.

  • Providing individual educational and motivational counseling for residents who have chemically dependent parents (COAs/COSAs) and/or are using alcohol and drugs. These sessions of 45-minute duration are directed at increasing residents’ awareness of the effects of parents’ behavior, motivating adolescents to join counseling groups and/or seek treatment, or providing extra time for adolescents who need to discuss issues that may not be appropriate for a group.

  • Implementing group counseling for COAs, COSAs, and substance users. These groups help residents identify and resist social and situational pressures to use substances, correct misperceptions about normative substance use, and better understand the effects of their parents’ alcohol and drug use. Each of these groups lasts 8–12 sessions and requires 45 minutes each.

  • Making substance use treatment referrals outside the residential facility.

  • Hosting 12-Step meetings at the facility.
The focus of the evaluation reported is the 125 new entrants who participated in the final year of the RSAP with both pretest and posttest data. A quasi-experimental design included an internal comparison group (youth at the residential site who chose not to participate in the RSAP) and an external comparison group (youth in a residential facility without an RSAP). In total, 201 youth participated in comparison groups. The fall pretest and spring posttest were given at the respective school located at each of the six sites. The entire staff and all adolescents completed written assessments of the milieu at the site. Also, the RSAP counselors were interviewed.

Numerous analyses demonstrated that the services offered by the RSAP were a key ingredient in a marked decrease in substance use among participants. For alcohol, 81.8% of nonusers remained nonusers, while 72.2% of the users became nonusers; for marijuana, 83.3% of the nonusers remained nonusers, while 58.8% of the users became nonusers; and 78.4% of tobacco nonusers remained nonusers, while 26.9% of the users became nonusers. Several constructed indexes were used and all showed results of similar magnitude and direction. Highly significant decreases in use for the 132 new program youth were found on the paired t-test for the Quantity-Frequency Index (t131=4.25, p=.000), while a two-group independent t-test for the cross-sectional comparison group showed virtually no change between pretest and posttest (t453=0.43, p=.67). The authors translated decreased drug use for the 132 new program youth into an effect size of ES=0.46. While the cross-sectional comparison group showed some decreased drug use, it was minimal (ES=0.05). An independent t-test between cross-sectional program and cross-section comparison youth was nonsignificant at pretest but highly significant at posttest (p=.000). Extensive dosage analyses (number of hours in the program) explained program effectiveness. A regression analysis for the Quantity-Frequency Index showed the variance accounted for was significant for pretest use (R2=61.2%), for number of hours (R2=8.7%), and for site variations (R2=3.7%). Logistic regressions for success (nonuser remains nonuser, etc.) resulted in an odds ratio of 1.8 for youth receiving 5–11 hours of RSAP. These data indicated that the observed differences over time between program and comparison groups are quite reliable and indicate high levels of program impact.

For the 52 youth who participated in the RSAP who reported no use of any specified substance (alcohol, marijuana, or 11 other substances) at pretest (tobacco excluded), 71% continued to report no use of any substance at posttest. For the 80 youth who reported using alcohol, marijuana, or 11 other substances at pretest, 68% reported decreased use at posttest. Therefore, if effectiveness is measured by nonusers remaining nonusers and users decreasing use, the program has an overall effectiveness of 69% for users and nonusers.


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Last Updated: March 4, 2002