Compare
Click the checkbox below to add an intervention for comparison
Clicking this button will open the self-assessment tool in a new window.
Key overview details
- Targeted
- Promoting Emotional Wellbeing
- Anxiety / Worry / Stress
- Emotion Regulation / Emotional literacy
- Primary school: 6 to 12 years
- Adolescents: 13 to 18 years
Coping Cat
Summary
Coping Cat is a targeted intervention designed to treat anxiety and anxiety disorders in children aged 7-13 years. The individualised programme applies cognitive behavioural approaches to teach skills for managing general anxiety disorder, social phobia, and/or separation anxiety. It also teaches skills to enhance emotional management, and boost understanding of social influences.
Coping Cat is delivered in two sections that consist of sixteen sessions in total. These sessions are delivered over 16-20 weeks, in one-hour weekly sessions. The first section is delivered in eight sessions and focuses on psychoeducation as well as skills needed to identify and manage anxiety (including body arousal, identifying anxious thought and feelings, building coping skills, relaxation, and problem solving). The second section also consists of eight sessions. It involves exposing participants to anxiety provoking scenarios and encouraging them to draw on the skills taught in the first section to manage these situations. Programme activities include role-play, exposure tasks, and homework assignments.
Coping Cat has not been delivered in Scotland, but has been delivered in England.
Website:http://childanxiety.org/wps/treatment/,https://www.workbookpublishing.com/
Core Components
Coping Cat is a targeted intervention designed to treat anxiety and anxiety disorders in children aged 7-13 years. The manualised programme applies cognitive behavioural approaches to teach skills for managing general anxiety disorder, social phobia, and/or separation anxiety. The programmes’ overall goal is to help children recognise signs of anxiety, and to apply the strategies taught in this programme to manage anxiety. It also teaches skills to enhance emotional management, and boost understanding of social influences.
Coping Cat comprises of two sections, which contain sixteen sessions in total. These sessions are delivered over 16 weeks, in one hour weekly sessions. The first section is delivered in eight sessions (sessions 1-8), and focuses on psychoeducation as well as skills needed to identify and manage anxiety. Within this section, participants are exposed to four key concepts delivered in a “FEAR” plan:
- “F” (Feeling frightened?)- Recognition of body response to anxiety
- “E” (Expecting bad things to happen) - Identification of anxious thoughts
- “A” (Attitudes and Actions) - Strategies to manage anxiety (e.g. problem solving, coping skills, relaxation)
- “R” (Results and Rewards) - Self-rating of anxiety management, and self-rewards for efforts made
The FEAR acronym helps participants learn and remember the strategies to apply when facing anxiety. After learning the concepts within the first section, programme participants proceed to the second section. This latter section also consists of eight sessions (9-16), and involves exposing participants to anxiety provoking scenarios, while encouraging them to draw on skills taught in the first section. The exposure tasks that participants embark on depend on the specific anxieties they present with. Two of the sixteen sessions (i.e. sessions four and nine) are delivered to parents. These parents-only sessions aim to enhance parental knowledge of the programme, promote parental co-operation, and gather parental input.
Coping Cat is delivered in outpatient clinics, inpatient settings, schools, and community centers, typically as an individualised intervention. In outpatient clinics and community centers, the weekly individualised sessions last about one hour, but are usually shorter (lasting about 30 minutes) when delivered in the school setting. Coping Cat can also be delivered in group format, with one practitioner delivering the programme to groups of about six participants. Group sessions are only delivered after three to four initial individualised sessions have been completed. These initial individualised sessions prepare participants for group sessions. Group sessions are delivered over 50-90 minutes, depending on the setting of delivery, number of children in the group, participants’ progress and practical constraints. Activities conducted during programme sessions include coping modelling, role-plays, exposure tasks, and weekly homework assignments (to reinforce taught skills). Participant recruitment can be via advertisements, or referrals from paediatricians, school counsellors, and mental health professionals.
Fidelity
Programme fidelity is ensured by implementation of the following measures:
- Use of therapist manual that contains detailed session-by-session programme content and specific goals
- Ensuring completion of session goals using monitoring checklist. This can be assessed by practitioners within the implementing organisation
- Programme developer review of video-recorded sessions, and provision of feedback on these sessions
Modifiable Components
The Coping Cat manualised programme can be adapted to meet the individual needs of participants. This includes, delivering the intervention remotely online, and among other features, selection of exposure tasks that are specifically individualised based on participants’ anxieties. Coping Cat has been modified for delivery to children with autism spectrum disorder. Coping Cat is also available as Camp Cope-A-Lot, an online programme for children aged 7-13 years; as C.A.T project for adolescents aged 13-18 years; and Brief Coping Cat, a shorter 8-session version of the programme. A family therapy manual is available for use if parents are included as co-clients, and a group treatment manual is available for programme delivery to children in group format. Coping Cat is available in Spanish, Norwegian, Portuguese, Polish, Hebrew and Urdu.
Support for Organisation / Practice
Implementation support is provided by Professor Philip C. Kendall and the Child and Adolescent Anxiety Disorders Clinic (CAADC) team at Temple University, USA.
Implementation Support
Supports provided include practitioner training, supervision, and data analysis on collated data. Programme resources (including treatment manual, practitioner training resources, and participant workbooks) can be accessed online via the Workbook Publishing, Inc. webpage.
Licence Requirements
There are no licence requirements for programme delivery
Start-up Costs
Start-up costs required for programme delivery include costs of therapist manual at $24.00, and participant workbook at $26.95 (per participant). Highly recommended costs include one-day (virtual or face-to-face) practitioner training at $4500 (for 40-80 practitioners), or a more intense two-day (virtual or face-to-face) training at $9000 (also for 40-80 practitioners). The two-day training provides opportunities for practitioners to try several treatment strategies and get feedback from programme trainers. The training costs do not include travel. Other highly recommended costs include training DVD at $55.95; session-by-session DVD guide at $85.95; and parent companion at $19.00. Optional programme implementation costs include cost of practitioner supervision charged at $240 per hour; as well as cost of review of video-recorded sessions and feedback on the sessions charged at $240 per hour. Trainer training is available on request.
Building Staff Competency
Qualifications Required
Coping Cat can be delivered by social workers, teachers, psychologists, counsellors, graduate students, and doctoral students. Other professionals can also deliver this programme, and an educational degree is not a requirement. Experience working with children is preferable.
Training Requirements
Practitioners are required to read the Coping Cat therapist manual before delivering the programme. In addition, it is very highly recommended that practitioners receive training prior to programme delivery. Training is delivered over six hours (one day) either remotely (via live Zoom training) or face-to-face. A less preferred training option is available on a 42-minute Coping Cat DVD, and on an 82-minute session-by-session DVD guide. Practitioners who receive Coping Cat training can also deliver the C.A.T project, brief Coping Cat, and Camp Cope-A-Lot. Training facilitates practitioners’ application of programme strategies for managing youth anxiety. A two-day trainer training is available on request.
Supervision Requirements
Supervision is available to practitioners after they complete practitioner training, and are in the process of delivering the programme. Supervisory sessions are one-hour long, delivered remotely, and can be requested multiple times.
Theory of Change
The Coping Cat programme is centered on cognitive behavioural approaches, as it combines cognitive strategies (e.g. recognition of perceived threat, self-appraisal, problem solving, changing self-talk) to behavioural strategies (e.g. relaxation, exposure tasks, homework, rewards) for the purpose of addressing anxiety. This helps young people recognise signs of anxiety, and apply the taught strategies to manage anxiety.
Primary school: 6 to 12 years - Rating: 4
Research Design & Number of Studies
The best evidence for Coping Cat in children aged 6-12 years comes from four Randomised Controlled Trials (RCT) conducted in collaboration with programme developers. One RCT was conducted in Norway, and included 165 majority Caucasian youth (98.8%), aged 7-13 years (Villabo et al, 2018); another RCT was conducted in USA, and included 133 youth from different ethnic groups (majority Caucasian, 89%), aged 9-14 years (Silk et al, 2016); a similar RCT was conducted in USA, and included 161 youth from different ethnic groups (majority Caucasian 85%), aged 7-14 (Kendall et al, 2008); the largest RCT was conducted across 6 sites in the USA, and included 488 youth from different ethnic groups (majority Caucasian 78.9%), aged 7-17 years (Walkup et al, 2008). Participants included in all RCTs met diagnostic criteria for separation anxiety disorder (SAD), social anxiety disorder (SOC), and/or generalized anxiety disorder. Separate data for children aged 7-12 years was not reported.
Outcomes Achieved
Compared to comparison conditions the following outcomes were observed:
Child Outcomes
- Significantly reduced principal/ primary anxiety diagnosis at post-test (Villabo et al, 2018; Kendall et al, 2008), and significantly reduced all anxiety diagnosis at post-test (Villabo et al, 2018)
- Significantly reduced anxiety severity at post-test (Walkup et al, 2008; Kendall et al, 2008), and at 1-year follow-up (Silk et al, 2016)
- Significantly higher recovery from anxiety at 1-year follow-up (Silk et al, 2016)
- Significantly reduced internalising symptoms and anxiety symptoms at 1-year follow-up (Kendall et al, 2008)
Parent Outcomes
None
Key References
Villabø, M., Narayanan, M., Compton, S., Kendall, P. C., & Neumer, S. (2018). Cognitive-behavioral therapy for youth anxiety: An effectiveness evaluation in community practice. Journal of Consulting and Clinical Psychology, 86(9), 751-764.
Silk, J. S., Tan, P. Z., Ladouceur, C. D., Meller, S., Siegle, G. J., McMakin, D. L., ... Ryan, N. D. (2016). A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology. Advance online publication. doi:10.1080/15374416.2016.1138408
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., ... & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753-2766.
Kendall, P. C., Hudson, J. L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76(2), 282-297
Adolescents: 13 to 18 years - Rating: 4
Research Design & Number of Studies
The best evidence for Coping Cat in children aged 13-18 years comes from four Randomised Controlled Trials (RCT) conducted in collaboration with programme developers. Participants in these studies were between 7 years old and 17 years old. Separate data was not available for children 13 year olds. Evidence outcomes for the age range 13-18 years are the same as for the 6-12 years evidence above.
Key References
Villabø, M., Narayanan, M., Compton, S., Kendall, P. C., & Neumer, S. (2018). Cognitive-behavioral therapy for youth anxiety: An effectiveness evaluation in community practice. Journal of Consulting and Clinical Psychology, 86(9), 751-764.
Silk, J. S., Tan, P. Z., Ladouceur, C. D., Meller, S., Siegle, G. J., McMakin, D. L., ... Ryan, N. D. (2016). A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology. Advance online publication. doi:10.1080/15374416.2016.1138408
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., ... & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753-2766.
Kendall, P. C., Hudson, J. L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76(2), 282-297
Values
Coping Cat is a targeted intervention designed to treat anxiety and anxiety disorders in children aged 7-13 years. The programme is typically delivered as an individualised programme, and it applies cognitive behavioural approaches to teach skills for managing general anxiety disorder, social phobia, and/or separation anxiety.
- Does this approach align with the key values of your organisation?
Priorities
Coping Cat programmes’ overall goal is to help children with anxiety and anxiety disorders (aged 7-13 years) to recognise signs of anxiety, and apply the strategies taught in this programme to manage their anxiety (including general anxiety disorder, social phobia, and/or separation anxiety).
- Is your service looking to deliver a targeted programme to treat general anxiety disorder, social phobia, and/or separation anxiety in children aged 7-13 years?
- Is a programme that is designed to teach skills to recognise anxiety and manage anxiety a priority for your service?
- Would an intervention that also focuses on other mental health conditions be a better fit?
Existing Initiatives
- Does your organisation have existing programmes that aim to treat anxiety and anxiety disorders in children?
- Are there components addressed by Coping Cat that are not met by existing programmes?
- Are the existing initiatives effective?
- Do existing initiatives fit your current and anticipated future requirements?
Workforce
Coping Cat can be delivered by social workers, teachers, psychologists, counsellors, graduate students, and doctoral students. Other professionals can also deliver this programme, experience working with children is preferable. Practitioner training is delivered over six hours either remotely (via live Zoom training) or face-to-face. Practitioner DVD training is also available. Coping Cat programme sessions are delivered to targeted children over 16 weeks, in one hour weekly sessions.
- Does your organisation have practitioners who are available and interested in learning and delivering this programme?
- Can your organisation support the time commitment required for practitioner training, programme delivery, and trainer training?
Technology Support
Practitioner training is delivered remotely (via live Zoom training), face-to-face, or via DVD. As part of fidelity monitoring, the programme developer can review video-recorded sessions, and provide feedback on these sessions.
- Does your organisation have technology to support practitioner training (if training is to be delivered via Zoom or DVD)?
- Is there available technology to record and send video recordings for fidelity monitoring?
Administrative Support
Coping Cat is delivered in several settings including outpatient clinics, schools, and community centers. Participants can be recruited via advertisements, or referrals from paediatricians, school counsellors, and mental health professionals.
- In what setting will the programme be delivered? Does your organisation have a venue (within this setting) to run programme sessions?
- How will programme participants be recruited?
- Does your organisation have administrative capacity and systems to access available training, support participant recruitment, and deliver the programme in the chosen setting?
Financial Support
Start-up costs required for programme delivery include costs of therapist manual at $24.00, and participant workbook at $26.95. Highly recommended costs include one-day (virtual or face-to-face) practitioner training at $4500 (for 40-80 practitioners), or a more intense two-day (virtual or face-to-face) training at $9000 (also for 40-80 practitioners). Other highly recommended costs include training DVD at $55.95; session-by-session DVD guide at $85.95; and Coping Cat parent companion at $19.00. Optional programme implementation costs include cost of practitioner supervision charged at $240 per hour; as well as cost of review of video-recorded sessions and feedback on the sessions charged at $240 per hour
- Will your service train practitioners to deliver Coping Cat?
- Will your service train trainers?
- Can training costs be financially supported?
- What type of training will your practitioners receive (Zoom, face-to-face, DVD)? Can this be financially supported?
- Can other implementation costs (including programme materials and fidelity monitoring) be financially supported?
Comparable Population
Coping Cat is a targeted intervention designed to treat general anxiety disorder, social phobia, and/or separation anxiety in children aged 7-13 years. Evidence of effectiveness in comes from the RCTs conducted in Norway and across the USA. These studies included young people from different ethnic groups (majority Caucasian), aged 7-17 years. All included participants met diagnostic criteria for general anxiety disorder, social phobia, and/or separation anxiety.
- Is this comparable to the population your organisation would like to serve?
Desired Outcome
Coping Cat is designed to treat anxiety and anxiety disorders by helping children to recognise signs of anxiety, and teaching them to apply taught strategies in managing their anxiety. Programme delivery is associated with significant reductions in anxiety disorders, anxiety severity and internalising symptoms.
- Is delivering a programme designed to treat anxiety and anxiety disorders in children aged 7-13 years a priority for your organisation?
- Does your organisation have other initiatives in place that effectively and efficiency address the above outcomes?
Dr. Philip C. Kendall
pkendall@temple.edu
+01 215 204-7165