Camp Cope-A-Lot  (CCAL )

Children ages 7–13 experiencing stress and anxiety, to be used with the support of a coach (e.g., parent, counselor, or therapist)

For children/adolescents ages: 7 - 13

Camp Cope-A-Lot (CCAL) is a 12-module online educational program based on cognitive-behavioral strategies for anxious youth. Children progress independently through the first six modules and complete the final six with a coach, who helps review skills and plan practice. The modules teach core cognitive-behavioral therapy (CBT) skills—recognizing body signs of anxiety, identifying anxious thoughts, problem-solving, and practicing gradual, real-life exposures—through animated camp scenarios and interactive activities. CCAL includes printable Go-To-Gadget pages to record hierarchies, homework, and reviews between sessions. It is designed for use in varied settings (e.g., schools, community agencies, private practices, hospitals/training clinics). No formal CBT training is required for coaches and the program reduces therapist hours (approximately six hours per child across 12 sessions). CCAL is intended as an educational tool and does not replace clinical assessment or treatment. 

Muniya Khanna, PhD

• Agency/Affiliation: OCD & Anxiety Institute
• Website: https://copingcatparents.com/Camp_Cope_A_Lot
• Email: muniya.khanna@gmail.com
• Phone: 610-202-9274

The goals of Camp Cope-A-Lot (CCAL) are:

• Learn to notice body signs of anxiety and name feelings
• Identify and challenge worried thoughts
• Practice coping skills (e.g., calm breathing, problem-solving) in real situations
• Learn how to face fears gradually using step-by-step, in-vivo exposure tasks
• Increase confidence and reduce avoidance in school, social, and daily activities
• Use skills at home/school with support from a coach and the Go-To-Gadget workbook

The essential components of Camp Cope-A-Lot (CCAL) include:

• Cloud-based e-learning program for children 7-13
• 12 modules:
  • Modules 1–6 child-directed
  • Modules 7–12 coach-guided
• The essential components include:
  • Psychoeducation about anxiety
  • Identifying physical symptoms
  • Cognitive coping
  • Problem-solving
  • Exposure planning and practice using:
    • Animated camp vignettes
    • Video examples
  • Printable Go-To-Gadget workbook pages for:
    • Hierarchy building
    • Homework
    • Review activities
  • Videos of children using coping strategies and exposures
• In Modules 7-12, a parent/counselor/therapist is required to support:
  • Skills review
  • In-session/real-life exposure planning

Child/Adolescent Services

Camp Cope-A-Lot  (CCAL ) directly provides services to children and addresses the following:

• Anxiety symptoms (e.g., worry, fear, avoidance), stress management difficulties 

Recommended Intensity

Recommended one 35-minute module per week for the child self-guided modules (1–6) plus coach-guided modules (7–12); total coach/therapist time ≈ 6 hours per child across program 

Recommended Duration

12 weeks

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Community-based Agency / Organization / Provider
• Hospital
• Outpatient Clinic
• School Setting (Including: Day Care, Day Treatment Programs, etc.)
• Virtual (Online, Smartphone, Zoom, Telephone, Video, etc.)

Homework

This program does include a homework component.

Children use the Go-To-Gadget to record their exposure hierarchy, homework, and review activities between modules 

Resources Needed to Run Program

The typical resources for implementing the program are:

• Therapist/parent/school based behavioral health staff ”Coach”
• Computer or tablet with reliable internet access and audio
• Ability to print Go-To-Gadget pages (printer) or share fillable pdf
• Private space for child
• Optional headphones/microphone for virtual coaching sessions

Prerequisite/Minimum Provider Qualifications

A coach (e.g., parent, counselor, or therapist) and no formal CBT training is required  

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

A coach (e.g., parent, counselor, or therapist) and no formal CBT training is required 

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Training can occur onsite or virtually. CBT4CBT for Child Anxiety is an online training program that trains providers in implementation of Coping Cat and Camp Cope-A-Lot that can be accessed at the link in the Training Contact section above. 

Number of days/hours:

Training workshops can be ½ day or full day. CBT4CBT for Child Anxiety is an online training program that trains providers in implementation of Coping Cat and Camp Cope-A-Lot that can be accessed at the link in the Training Contact section above.

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Camp Cope-A-Lot .

Formal Support for Implementation

There is formal support available for implementation of Camp Cope-A-Lot  as listed below:

Formal support/ongoing consultation is offered but not required. Time and delivery specifics can be tailored for the organization. Please contact the Training Contact above. 

Fidelity Measures

There are fidelity measures for Camp Cope-A-Lot  as listed below:

Fidelity measures were used to evaluate the fidelity of implementation in the randomized controlled trial. Please contact the Training Contact above for fidelity training and measures

Implementation Guides or Manuals

There are implementation guides or manuals for Camp Cope-A-Lot  as listed below:

There is a Coach’s Manual available for download from within the program that describes implementation procedures.

Implementation Cost

There are no studies of the costs of Camp Cope-A-Lot .

Research on How to Implement the Program

Research has been conducted on how to implement Camp Cope-A-Lot  as listed below:

Child Welfare Outcome: Child/Family Well-Being

What is included in the Relevant Published, Peer-Reviewed Research section?

• Khanna, M. S., & Kendall, P. C. (2010). Computer-assisted cognitive behavioral therapy for child anxiety: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(5), 737–745. https://doi.org/10.1037/a0019739 

  Type of Study: Randomized controlled trial

  Sample:

  Age — 7–13 years (Mean=10.1 years)

  Participants: 49

  Race/Ethnicity — 84% Caucasian, 14% African American, and 2% Hispanic

  Gender — 33 Male

  Status — Participants were youth with anxiety disorder.

  Location/Institution: Not specified

  Summary:

  The purpose of the study was to examine the feasibility, acceptability, and effects of Camp Cope-A-Lot (CCAL), a computer-assisted cognitive behavioral therapy (CBT) for anxiety in youth. Participants were randomly assigned to (a) CCAL, (b) individual CBT (ICBT), or (c) a computer-assisted education, support, and attention (CESA) condition. Measures utilized include the Anxiety Disorders Interview Schedule for Children–Parent Version (ADIS-P), Children’s Global Assessment Scale (CGAS), Multidimensional Anxiety Scale for Children (MASC), Children’s Depression Inventory (CDI), Computer Experience Questionnaire (CEQ), Therapeutic Alliance, Adherence, and Flexibility scale, and the Client Evaluation of Services (CSQ-8). Results indicate that at posttreatment, CCAL or ICBT children showed significantly better gains than CESA children; 70%, 81%, and 19%, respectively, no longer met criteria for their principal anxiety diagnosis. Gains were maintained at follow-up, with no significant differences between CCAL and ICBT. Parents and children rated all treatments acceptable, with CCAL and ICBT children rating higher satisfaction than CESA children. Limitations include the length of follow-up, reliance on self-report measures, small sample size, and concerns for generalizability given study demographics.

  Length of controlled postintervention follow-up: 3 months.

• Storch, E. A., Salloum, A., King, M. A., Crawford, E. A., Andel, R., McBride, N. M., & Lewin, A. B. (2015). A randomized controlled trial in community mental health centers of computer‐assisted cognitive behavioral therapy versus treatment as usual for children with anxiety. Depression and Anxiety, 32(11), 843–852. https://doi.org/10.1002/da.22399 

  Type of Study: Randomized controlled trial

  Sample:

  Age — 7–13 years

  Participants: 100

  Race/Ethnicity — 72 Caucasian, 12 Hispanic, 11 Black, 3 Asian/Pacific Islander, and 2 Other

  Gender — 56 Male

  Status — Participants were youth with clinically significant anxiety.   

  Location/Institution: Florida outpatient community mental health centers, distributed at minimum 200 miles apart (Panhandle, Central Coast, and Southeastern Florida)

  Summary:

  The purpose of the study was to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol, Camp Cope-A-Lot, relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. Participants were randomly assigned to Camp Cope-A-Lot or to TAU. Measures utilized include ADIS-IV-C/P,PARS, Clinical Global Impressions-Severity, Clinical Global Impressions-Improvement,Service Assessment for Children and Adolescents-Service Use Scale (SACA), Child Behavior Checklist (CBCL), Columbia Impairment Scale-Parent Version (CIS-P), Childhood Anxiety Impact Scale-Child/Parent (CAIS-C/P), Multidimensional Anxiety Scale-Child (MASC), Children’s Depression Inventory (CDI), Therapeutic Alliance Scale-Child/Parent (TAS-C/P),and Client Satisfaction Questionnaire-8 (CSQ-8). Results indicate that relative to TAU, Camp Cope-A-Lot was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving the intervention were high. Treatment gains in the intervention were maintained at 1-month follow-up. Limitations include a lack of follow-up for the TAU condition, a predominantly Caucasian sample; unmeasured environmental stressors; inability to assess efficacy relative to standard CBT; clinic-based initial sessions limiting evaluation of time savings; and a short 1-month follow-up.

  Length of controlled postintervention follow-up: None.

• Cruz Pryor, F., Lincoln, A., Igelman, R., Toma, V., & Iravani, R. (2021). Efficacy of a computer-assisted cognitive-behavior therapy program for treating youth with anxiety and co-occurring autism spectrum disorder: Camp Cope-A-Lot. Research in Autism Spectrum Disorders, 83, Article 101748. https://doi.org/10.1016/j.rasd.2021.101748 

  Type of Study: Randomized controlled trial

  Sample:

  Age — 8–15 years

  Participants: 24

  Race/Ethnicity — 19 Caucasian, 3 Other/Mixed, and 2 Hispanic/Latino

  Gender — 22 Male and 2 Female

  Status —  Participants were youth with at least one diagnosed anxiety disorder.   

  Location/Institution: San Diego, California

  Summary:

  The purpose of the study was to describe the efficacy of a computer-assisted intervention program, Camp Cop-A-Lot (CCAL) for youth with autism spectrum disorder (ASD) who also experience co-occurring anxiety. Participants were randomly allocated to either Group 1 or Group 2. Participants in Group 1 received CCAL, and participants in Group 2 received The Social Express (TSE), that does not employ CBT nor is it targeted for the treatment of anxiety. After completing their respective interventions, outcomes were measured. Group 1 then crossed over to TSE, and Group 2 then crossed over to CCAL, and outcomes were measured again after intervention completion. Measures utilized include Anxiety Disorders Interview Schedule- Child (ADIS-C), Parent Interview Schedule (ADIS-P), Social Skills Improvement System – Parent form (SSIS-P), The Social Communication Questionnaire (SCQ), Multidimensional Anxiety Scale for Children – Child and Parent forms (MASC-C and MASC-P), Spence Children’s Anxiety Scale – Parent and Child forms (SCAS-P and SCAS-C), Social Responsiveness Scale (SRS), and Friendship Qualities Scale (FQS). Results indicate that CCAL was efficacious for treating anxiety. Participants who completed CCAL demonstrated significant clinical reductions in anxiety when compared to participants who completed TSE. Both interventions, CCAL and TSE, resulted in some limited improvement in social skills. Limitations include a small sample size, lack of controlled postintervention follow-up, the sample of primarily Caucasian male youth, and the entire sample drawing from Southern California. 

  Length of controlled postintervention follow-up: None.

• Child Mind Institute. (2018). Understanding anxiety in children and teens: 2018 children’s mental health report. https://childmind.org/about-us/reports/2018-report/

• Khanna, M. S., & Kendall, P. C. (2008). Computer Assisted CBT for Child Anxiety: The Coping Cat CD Rom. Cognitive and Behavioral Practice, 15, 159–165. https://doi.org/10.1016/j.cbpra.2008.02.002