Home  «  Program  «  Coping Cat  « 

Coping Cat

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Coping Cat program has been rated by the CEBC in the area of: Anxiety Treatment (Child & Adolescent).

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Children experiencing problematic levels of anxiety

Coping Cat has been rated by the CEBC in the area of Anxiety Treatment (Child & Adolescent). Coping Cat is a cognitive-behavioral treatment for children with anxiety. The program incorporates 4 components:

  1. Recognizing and understanding emotional and physical reactions to anxiety,
  2. Clarifying thoughts and feelings in anxious situations,
  3. Developing plans for effective coping, and
  4. Evaluating performance and giving self-reinforcement

Coping Cat also has a version for adolescents, ages 14-17, known as the C.A.T. Project. The C.A.T. Project has not been tested separately, but has the same elements as Coping Cat except that it contains materials more developmentally appropriate for older adolescents.

Essential Components

Components of the Coping Cat Program include:

  • Psychoeducation, involving information for children and families about how anxiety can develop and be maintained, and how it can be treated.
  • Exposure tasks, which give the child the chance to be in the feared situation and have a mastery experience.
  • Somatic management, which teaches relaxation techniques.
  • Cognitive restructuring which addresses FEAR: Feeling frightened, expecting bad things, attitudes and actions that will help, and results and rewards.
  • Problem solving to generate and evaluate specific actions for dealing with problems.

Child Component

Coping Cat was designed with a child component that addresses the following presenting problems and symptoms:

  • Anxiety

Age range: 7 – 13

Developmental Delays:

This program was not developed for children with developmental delays; but has been tested for children with developmental delays.

Relevant research studies:

Suveg, C., Comer, J., Furr, J., & Kendall, P. C. (2006). Adapting manualized CBT for a cognitively-delayed child with multiple anxiety disorders. Clinical Case Studies, 5, 488-510.

Parent / Caregiver Component

Coping Cat was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Parents are involved in the child-focused (individual treatment) program, and meet in sessions 4 and 9, as well as in other sessions as needed for the exposure tasks. There is also a family (parents included) treatment section.

Group Format

Coping Cat was designed to be conducted in a group setting, and has been tested for use in a group setting.

Recommended group size:

4 to 5 participants

Testing References:

Flannery-Schroeder, E., & Kendall, P. C. (2000).  Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial.  Cognitive Therapy and Research, 24, 251-278.

Flannery-Schroeder, E., Choudhury, M., & Kendall, P. C. (2005). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: One-year follow-up. Cognitive Therapy and Research, 29, 253-259.

Kendall, P. C., & Martinsen, K. D. (in press). Using the Coping Cat program with groups of children and adolescents: Supplementing the individual program. Oslo: Universitetsforlaget.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Group Home
  • Hospital
  • Residential Care Facility
  • School

Homework

Coping Cat includes a homework component:

STIC tasks (where STIC stands for "Show That I Can"). One per week.

Languages

Coping Cat has materials available in languages other than English:

Chinese, Hungarian, Japanese, Norwegian, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Child workbook
  • Therapist manual
  • Office space
  • Access to an internet-connected computer if using the computer-assisted program

Minimum Provider Qualifications

None have been set at this time.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

There are several training DVDs, including a computer-based training program (CBT4CBT) available at www.WorkbookPublishing.com

Number of days/hours:

The DVDs range in time from 40-90 minutes.

Implementation Information

Since Coping Cat is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Assessments

There are no pre-implementation assessments to measure organizational or individual provider readiness.

Implementation Tools — for the program (e.g., implementation guides or manuals)

There are therapist manuals (treatment manuals) for each of the several treatment programs (the individual Coping Cat program, group Coping Cat program, and for the C.A.T. Project). These manuals are all available from Workbook Publishing.

There are other training materials that have been recently developed and released, One is a training DVD, CBT4CBT, this is also available from Workbook Publishing.

Fidelity Measures

All of the following fidelity assessment processes require either contracting with the developer of the Coping Cat program (Philip C. Kendall, PhD) to have one of their treatment experts perform the task or having them train a designated person to be a treatment expert at the implementing site to perform the task.

A rigorous assessment would require taping all of the treatment sessions and having a treatment expert listen and rate all of the session tapes.

A less demanding approach, but an acceptable alternative, would be to tape all of the treatment sessions and then randomly select 20% of the tapes to be reviewed and checked by a treatment expert.

Assessing fidelity can also be accomplished by printing the session goals from the training manuals and having a treatment expert do an integrity check that focuses on whether each of the listed/printed goals was addressed.

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Kendall, P. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62(1), 100-110.

Type of Study: Long-term follow-up
Number of Participants: 47

Population:

  • Age range — 9-13 years
  • Race/Ethnicity — Treatment: 78% White, 22% African American; Control: 76% White.
  • Gender — Not Specified
  • Status — Children with anxiety disorders who were referred by community sources.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Children were randomly assigned to receive active treatment or to a wait-list control group. Children were given self report measures which included the Revised Children's Manifest Anxiety Scale (RCMAS), State-Trait Anxiety Inventory for Children (STAIC), the Fear Survey Schedule for Children, the Children’s Depression Inventory (CDI), and the Coping Questionnaire. Parents completed the Child Behavior Checklist (CBCL) and the State-Trait Anxiety Inventory for Adults (STAI) for parents. Interviews of children were also conducted using the Anxiety Disorders Interview Schedule for Children (ADIS-C). Analyses showed that over 60% of treated children had returned to within normal anxiety levels by the end of treatment and that this percentage was significantly greater than the control group. Treatment gains were maintained at one year. Limitations include a small sample size and an inability to rule out the children’s relationship with the therapist as a factor, since the waitlist participants received no treatment at the time of the study.

Length of post-intervention follow-up: 1 year.

Kendall, P. C., & Southam-Gerow, M. A. (1996). Long-term follow-up of a cognitive-behavioral therapy for anxiety-disordered youth. Journal of Consulting and Clinical Psychology, 64(4), 724-730.

Type of Study: Long-term follow-up
Number of Participants: 36

Population:

  • Age range — 11 to 18 years at follow-up
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Youth who had completed treatment for an anxiety disorder.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were clients who had completed cognitive behavioral therapy for an anxiety disorder at least 2 years prior to this follow-up. Self-report assessments were mailed to participants and phone interviews were conducted with parents. Self-report measures included the Revised Children’s Manifest Anxiety Scale (RCMAS), the Coping Questionnaire, the Children’s Negative Affectivity Self-Statement Questionnaire, and the Children’s Depression Inventory (CDI). The parent interviews included the Child Behavior Checklist (CBCL), the State-Trait Anxiety Inventory (STAI) and parent versions of the Coping Questionnaire and the Anxiety Disorders Interview Schedule for Children (ADIS-C). Therapeutic gains were maintained according to measures of anxiety, self-reported anxious self-talk, and self-reported depression. The authors note that there was no control group for this analysis because the entire original wait-list group had received treatment.

Length of post-intervention follow-up: 2 to 5 years.

Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindell, S. M., Southam-Gerow, M., Henin, A., & Warman, M. (1997). Therapy for youths with anxiety disorders: A second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65(3), 366-380.

Type of Study: Randomized controlled trial
Number of Participants: 94 children

Population:

  • Age range — 9-13 years
  • Race/Ethnicity — 85% Caucasian, 5% African American, 2% Hispanic, 2% Asian, 5% other.
  • Gender — Not Specified
  • Status — Children referred from community sources with a diagnosis of primary anxiety disorder.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Children were randomly assigned to receive a 16-week cognitive-behavioral treatment or to an 8-week wait-list group. Anxiety was assessed with the Anxiety Disorders Interview Schedule for Children (ADIS-C). Child self-report measures included the Revised Children’s Manifest Anxiety Scales (RCMAS), the State Trait Anxiety Inventory for Children (STAIC), and the Coping Questionnaire. Parents completed the Child Behavior Checklist (CBCL) and the Coping Questionnaire for parents. Children were reassessed at post-treatment and at 1-year post-treatment. Results showed significant reductions in severity of anxiety at post-treatment, with over 50% of children scoring as free from their primary disorder. Gains were maintained at the 1-year follow-up.

Length of post-intervention follow-up: 1 year.

Flannery-Schroeder, E. C., & Kendall, P. C. (2000). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial. Cognitive Therapy and Research, 24(3), 251-278.

Type of Study: Randomized controlled trial
Number of Participants: 37

Population:

  • Age range — 8-14 years
  • Race/Ethnicity — Individual therapy: 8% minority, Group therapy: 17% minority, Wait-list: 8% minority
  • Gender — Not Specified
  • Status — Referred from community resources for anxiety disorders.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Children were randomly assigned to receive Group Cognitive-Behavioral Therapy (CBT), Individual CBT, or to a wait-list control group. Child self-report measures of anxiety included the Revised Children’s Manifest Anxiety Scale (RCMAS), the State-Trait Anxiety Inventory for Children (STAIC), the Coping Questionnaire-child, and the Social Anxiety Scale for Children-Revised. Parent measures included the Child Behavior Checklist (CBCL), the State-Trait Anxiety Inventory (STAI) for parents and the Coping Questionnaire for parents. The study also included the Anxiety Disorders Interview Schedule for Children (ADIS-C), which was administered to parents and children by clinicians. Results showed that 73% of the children receiving Individual CBT and 50% of those receiving Group CBT no longer met the diagnosis criteria for anxiety disorders at post-treatment, compared with 8% of the wait-list group, and the improvements were maintained at three months. No differences were noted between the individual and group therapy conditions, which may have due to small sample sizes.

Length of post-intervention follow-up: 3 months.

Kendall, P. C., Safford, S., Flannery-Schroeder, E., & Webb, A. (2004). Child anxiety treatment: Outcomes in adolescence and impact on substance abuse and depression at 7.4 year follow-up. Journal of Consulting and Clinical Psychology, 72(2), 276-287.

Type of Study: Long term follow-up
Number of Participants: 86

Population:

  • Age range — 15 to 22 years at the time of this study
  • Race/Ethnicity — 86% Caucasian, 6% African American, 2% Latino, 2% Asian, 4% Biracial
  • Gender — Not Specified
  • Status — Youth referred from community sources and diagnosed with a primary anxiety disorder.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study is a long-term follow-up of the sample use in Kendall, et al. 1997. This report includes those participants originally randomly assigned to the Cognitive-Behavioral Therapy (CBT) condition and also wait-listed children who received CBT after the conclusion of the initial study period. Anxiety measures for the long-term follow-up included the child and parent versions of the Anxiety Disorders Interview Schedule (ADIS), or the Lifetime version of the ADIS for those participants over 17. Youths’ self-report measures also included the Revised Children’s Manifest Anxiety Scale (RCMAS), the Children’s Depression Inventory (CDI), the Coping Questionnaire, and the Adolescent Perceived Events Scale, which assesses stressful events. Parents completed the Child Behavior Checklist (CBCL), the parent version of the Coping Questionnaire, and the State-Train Anxiety Inventory for Children (STAIC). Alcohol and drug use was assessed with the appropriate module of the Comprehensive Adolescent Severity Inventory (CASI). Results showed that the majority of participants maintained treatment gains with regard to anxiety. Those who had been successfully treated in the initial study also reported fewer problems with substance abuse in the long-term follow-up. The major limitation to this study was the lack of a comparison group, so that maturation and other effects could not be ruled out.

Length of post-intervention follow-up: 5.5 to 9.3 years post-treatment.

Flannery-Schroeder, E., Choudhury, M. Y., & Kendall, P. C. (2005). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: 1-year follow-up. Cognitive Therapy and Research, 29(2), 253-259.

Type of Study: Randomized controlled trial
Number of Participants: 37

Population:

  • Age range — 8-14 at treatment
  • Race/Ethnicity — 11% minority
  • Gender — Not Specified
  • Status — Referred to a clinic for an anxiety disorder.

Location / Institution: Philadelphia, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study uses the same sample as Flannery-Schroeder & Kendall, 2000.) Participants who had been randomly assigned to receive Individual Cognitive-Behavioral Therapy (ICBT), Group Cognitive-Behavioral Therapy (GCBT), or to a waitlist control group (WL) were re-assessed at one year post-treatment using the Anxiety Disorders Interview Schedule for Children (ADIS-C). The children completed the Revised Children’s Manifest Anxiety Scale (RCMAS) and the children completed the State-Trait Anxiety Inventory for Children (STAIC) and their parents completed the State-Trait Anxiety Inventory (STAI). In addition, parents completed the Child Behavior Checklist (CBCL) and the Coping Questionnaire and teachers completed the Teacher Report Form (TRF). Results showed that 81% of ICBT and 77% of GCBT children had maintained treatment gains.

Length of post-intervention follow-up: 1 year.

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.

Type of Study: Randomized controlled trial
Number of Participants: 161

Population:

  • Age range — 7-14 years
  • Race/Ethnicity — 85% Caucasian, 9% African American, 3% Hispanic, 3% Other/Mixed
  • Gender — Not Specified
  • Status — Youth referred by community sources with a diagnosis of a principal anxiety disorder.

Location / Institution: Unknown

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were randomly assigned to Individual Cognitive-Behavioral Therapy (ICBT), Family Cognitive-Behavioral Therapy (FCBT), or to a family-based education, support, and attention (FESA) comparison group. Children’s anxiety was measured using a semi-structured interview (the Anxiety Disorders Interview Schedule for Children (ADIS-C/P)) and two self-report measures, the Multidimensional Anxiety Scale for Children (MASC) and the Coping Questionnaire-Child (CQ-C). Parent and teacher reports of child functioning were also collected using the Child Behavior Checklist (CBCL), the Teacher Report Form (TRF), and the Coping Questionnaire-Parent (CQ-P). Results showed that children in the ICBT and FCBT conditions improved significantly more than those in the FESA condition, although all groups improved over baseline. Improvements were maintained at one year. Children whose parents also had an anxiety disorder showed greater improvement in the FESA condition. The authors suggest that future research should expand outcome assessment beyond symptom reduction.

Length of post-intervention follow-up: 1 year.

Walkup, J., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753-2766.

Type of Study: Randomized controlled trial
Number of Participants: 488 children

Population:

  • Age range — 7-17 years.
  • Race/Ethnicity — 78.9% White, 9.0% Black, 2.5% Asian, 1.2% American Indian, 0.4% Pacific Islander, 8.0% Other, 12.1% Hispanic.
  • Gender — Not Specified
  • Status — Children with a primary diagnosis of separation or generalized anxiety disorder or social phobia.

Location / Institution: United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Children were randomly assigned to receive Cognitive-Behavioral Therapy (CBT) alone, sertraline (Zoloft) alone, a combination of CBT and Zoloft, or a placebo. Outcomes were assessed at baseline, 4, 8, and 12 weeks using the Clinical Global Impression Improvement Scale (CGII) and the Pediatric Anxiety Rating Scale. All therapies were better than the placebo, with the percentages of children rated as very much or much improved 80.7% for the combined therapy, 59.7% for CBT, and 54.9% for Zoloft alone, compared with 23.7% for the placebo group. Limitations included a lack of children in the lowest socioeconomic groups and exclusion of children with other diagnoses such as depression.

Length of post-intervention follow-up: None.

References

Show references...

Kendall, P. C., Choudhury, M., Hudson, J., & Webb, A. (2002). The C.A.T. project therapist manual. Ardmore, PA: Workbook Publishing.

Kendall, P. C., Choudhury, M., Hudson, J., & Webb, A. (2002). The C.A.T. project workbook for the cognitive-behavioral treatment of anxious adolescents. Ardmore, PA: Workbook Publishing.

Kendall, P. C., & Hedtke, K. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.

Kendall, P. C., & Hedtke, K. (2006). Coping Cat workbook. (2nd ed). Ardmore, PA: Workbook Publishing.

Khanna, M., & Kendall, P. C. (2008).  Computer assisted CBT for child anxiety: The Coping Cat CD-ROM.  Cognitive and Behavioral Practice, 15, 159-165.

Contact Information

Name: Philip C. Kendall, PhD, ABPP
Agency/Affiliation: Temple University
Website: www.workbookpublishing.com
Email:
Phone: (215) 204-7165
Fax: (215) 204-0565

Date Reviewed: May 2009