Duke Center for Adolescent Substance Use Treatment (CAST)

Welcome to Duke’s Center for Adolescent Substance Use Treatment (CAST) program for adolescents and their families. CAST has over 20-years established history of providing evidence based addiction services for adolescents aged 13-24 and their families.

We provide a broad range of services for adolescents and their families suffering from the effects of substance use and addiction. We start with a comprehensive evaluation, clinical interview with the adolescent and family including urine drug screening. We do an interpretive to recommend specific levels of care. Our clinicians know the resources available for outpatient, intensive outpatient, crisis stabilization, residential and long term residential treatment. We know that most adolescents come to evaluations resistant and our clinicians are trained about rolling with that resistance.

Teenagers are in their prime developmental years. Substance use interrupts and delays this important process. Helping a teen return to normal developmental functioning is the primary goal of the treatment process.

We are not a crisis stabilization clinic. Some teens use substances as a result of suffering from other psychiatric problems and need additional care and sometimes stabilization before outpatient treatment can be helpful. We make appropriate referrals for assessments and treatment of other psychiatric problems that may be possible contributions to or results of substance use.

Addiction is treated as a medical issue with biological, emotional, social, family, and spiritual aspects/vulnerabilities. We know it is treatable and the most effective program involves treating the whole person and family. The CAST Program is family centered. We know it is difficult to maintain recovery without the active support of those around you, including family, extended family, and social/peer supports.

Clinical Services

  • Triage, comprehensive evaluation, interpretive, treatment and referral
  • Individual, family, group and intensive outpatient therapy
  • Therapy for individuals provided opiate replacement treatment
  • On-going residency, fellow and medical student training for psychiatry and pediatrics at Duke Medical as well as developmental pediatrician rotations from UNC Hospital

Therapeutic modalities utilized:

Family systems, motivational enhancement, cognitive behavioral, psycho-educational, introduction to social support networks. Manualized Intensive Outpatient Treatment (IOP), approximate 8 week cycle, and Drug Education and Counseling (DEAC), 8 1.5 hour cycle.

Program Staff:

Gary Sauls, LCAS - Program Coordinator

David Goldston, PhD - Consultant Adolescent and Child Psychologist

John Looney, MD - Consultant Adolescent and Child Psychiatrist

Paul Nagy, LPC, LCAS, CCS - Program Clinical Supervisor

Shane Phillips, LCAS, LCSWA - Program Counselor

Latoya Dunston, LPC-A, LCAS-A - Program Counselor

Angela M. Tunno, PhD, MS - Coping Skills Group Leader

Anna Van Dis, LCSW, RYT - Teen Yoga Instructor

Matthew Brown, BA - Peer Support Specialist

CAST Program descriptions

Adolescent Intensive Outpatient Substance Use Treatment Program (AIOP)

We provide the industry standard of nine hours per week of group therapy for the AIOP with an additional hour of weekly family therapy.  Patient and families may utilize our Twenty-four Hour (24) Pager / On-call System that greatly decreases family conflict, improves crisis stabilization and works to eliminate visits to emergency facilities.   A family systems model is used for family work in both individualized family sessions and multi- family psychotherapy groups.  Patients participate in weekly yoga and meditation, dialectical behavioral therapy skills groups, cognitive behavioral skills groups and intensive multi-family groups as a part of their healing process.  Psychiatric and or psychological evaluations are available upon entrance into the program and when necessary thereafter.  Outpatient, individual, family and group counseling are available as a step down to the AIOP. Abstinence is an expectation of this level of care and is strictly enforced.

Outpatient Substance Use Evaluations (OPE)

Outpatient evaluations include comprehensive adolescent and family interviews, urine drug screening, and an interpretive with the adolescent and family members to discuss recommendations for treatment or referral. The evaluation covers all areas of functioning. Clinicians have expert knowledge of local or national services for referral or placement. Outpatient psychiatric evaluations can be arranged when indicated.

Outpatient Individual and Family Substance Use Treatment Program (OPT)

Outpatient treatment typically occurs once a week. Urine drug testing is a part of this model. Psychiatric evaluation and medication management when required are available through the substance use team. Clinicians take a family systems approach in most cases. Psycho-education, CBT and supportive counseling are also utilized. A level of care system is utilized to motivate change in both the patient and in his or her family. Abstinence is a goal in this level of care.

12 Hour School Substance Use Treatment Program (12OP)

This program is for adolescents who have violated school system policies regarding possession of alcohol or drugs or who have been caught using or have become intoxicated at school. Twelve (12) hours of family centered substance use education and counseling are provided. This is an alternative to long term suspension. Abstinence is required prior to completion of the 12 hour program. This program serves students in both the Durham and Wake county public school systems.

For ALL referrals, contact our CAST Team at 919-681-2091.