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A workbook aimed at reducing anxiety in children

Implementing

Coping Cat

Kendall and Hedtke (2006) emphasize the importance of inviting group members to make personal connections with the group facilitator in the first session in order to establish an effective partnership

According to Corey and Corey (2013), it is important for the group facilitator to establish a trusting relationship by showing respect and an understanding of the group’s culture

The first step of the FEAR plan prompts clients to recognize symptoms of anxiety through analyzing facial expressions, gestures, body posture, and the body’s physical cues to alert themselves to their feelings of anxiety (Kendall et al., 2005).

The second step of the FEAR plan prompts clients to analyze any thoughts and beliefs that contribute to their symptoms of anxiety (Kendall et al., 2005).

The third step of the FEAR plan calls on the client to begin replacing maladaptive thoughts, beliefs, and reactions with more positive ones (Kendall et al., 2005).

The final step of the FEAR plan emphasizes the role of both the facilitator and the client in recognizing the benefits of appropriately managing symptoms of anxiety by celebrating achievements and identifying outcomes (Kendall et al., 2005).

References

Beidas, R. S., Benjamin, C. L., Puleo, C. M., Edmunds, J. M., & Kendall, P. C. (2010). Flexible Applications of the Coping Cat Program for

Anxious Youth. Cognitive and Behavioral Practice, 17(2), 142–153. doi:10.1016/j.cbpra.2009.11.002

Collins, S., Woolfson, L. M., & Durkin, K. (2014). Effects on coping skills and anxiety of a universal school-based mental health

intervention delivered in Scottish primary schools. School Psychology International, 35(1), 85-100. doi:10.1177/0143034312469157

Corey, M., & Corey, G. (2013). Groups: Process and practice (9th ed.). Pacific Grove, Calif.: Brooks/Cole Pub.

Faust, C. (2014). STAP curriculum plans. Unpublished manuscript.

Kendall, P., & Hedtke, K. (2006). The coping cat workbook (2nd ed.). Ardmore, Pa.: Workbook Pub.

Kendall, P. C., Robin, J. A., Hedtke, K. A., & Suveg, C. (2005). Considering CBT with anxious youth? Think exposures. Cognitive and

Behavioral Practice, 12, 136-148. The National Registry of Evidence-based

Moonshine, C. (2008). Acquiring competency and achieving proficiency with dialectical behavior therapy, the clinician's guidebook. Eau

Claire, Wis.: PESI.

National Alliance of Mental Illness (NAMI). (2012). Cognitive behavioral therapy (CBT). Retrieved May 3, 2015, from http://

www2.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Treatments_and_Supports/Cognitive_Behavioral_Therapy1.htm

Programs and Practices (NREPP). (2014). Intervention Summary - Coping Cat. Retrieved May 3, 2015, from http://

www.nrepp.samhsa.gov/ViewIntervention.aspx?id=91

Signs And Symptoms Of Anxiety In Children. (2015). Retrieved May 4, 2015, from

Stallard, P. (2002). Think good- Feel good: A cognitive behavioral therapy workbook for children and young people. Hoboken, NJ: John

Wiley & Sons.

Summer Therapeutic Activities Program (STAP) For Children & Adolescents Programs and Services

Philhaven. (n.d.). Retrieved May 7, 2015, fromhttp://www.philhaven.org/ProgramsandServices/ForChildrenAdolescents/SummerTherapeuticActivitiesProgram(STAP).aspx

Using the Coping Cat Curriculum

in Group Therapy

Christina Faust

Millersville University

SCCN 622

Coping Cat Curriculum

Coping Cat is based on the principles of

cognitive behavioral therapy

(CBT) encourages the client to explore the

connections between their thoughts, beliefs,

emotions, and behavior. The goal is to

recognize and modify beliefs and thoughts

that lead to destructive behaviors.

(NAMI, 2012).

Goals of Coping Cat

Using Coping Cat as a School Counselor

Identify triggers for anxiety

Recognize somatic symptoms and behavioral reactions of anxiety

Identify thoughts and beliefs that arise in fearful situations

Identify actions that can be taken to

manage anxiety

(Kendall & Hedtke, 2006)

Supplementing the Curriculum

Since the curriculum is intended to be used in hour long sessions, it can be used with groups in the school

setting with students struggling

with anxiety.

Coping Cat is designed to be used

in a group setting in 16

weekly sessions

(Kendall et al., 2005).

  • Beidas et al. (2010) suggests using games, role playing activities, and crafts to provide extra practice, reinforce new and developing skills, and to make the process of Coping Cat more engaging and appealing.

  • The curriculum includes various opportunities for the facilitator to utilize alternative activities based on the needs and interests of the clients (Beidas et al., 2010; Kendall & Hedtke, 2006).

Coping Cat's FEAR Plan

Kendall et al. (2005) emphasizes the importance of reinforcing each component of the FEAR Plan as a cohesive plan to manage symptoms of anxiety

I supplemented the curriculum with various games, crafts, and activities to apply Coping Cat to STAP's programming schedule

The FEAR Plan is introduced over several

sessions and focuses on 4 components

of managing anxiety

  • Feeling frightened?
  • Identify somatic reactions and feelings triggered by anxiety
  • Expecting the worse?
  • Recognize thoughts and beliefs related to the fearful stimuli
  • Attitudes and Actions
  • Develop a plan to cope with anxiety by modifying thoughts and beliefs
  • Rewards and Results
  • Evaluate performance & positively reinforce progress(Kendall et al., 2005)

Supplemental Activity Example

Have group members make a

FEAR Plan Brochure

(Faust, 2014)

My Application of Coping Cat

Skills Practice

Skills Training

The children begin applying the learned concepts in vivo

  • Through the exposure tasks, children experience build confidence in coping with situations that provoke anxiety by practicing the skills they’ve learned (Kendall et al., 2005, pg. 18).

Group sessions are focused on learning skills by building on CBT principles

I used the Coping Cat curriculum as a thematic and theoretical foundation in STAP for children with an anxiety diagnoses

Coping Cat

Outcomes

Summer Therapeutic Activities

Program (STAP)

  • Psychoeducational groups “focus on developing members’ cognitive, affective, and behavioral skills through a structured set of procedures within and across group meetings” (Corey & Corey, 2013, pg. 8).

  • Instead of didactic methods of teaching clients to recognize components of their anxiety, the Coping Cat curriculum utilizes play to allow clients to notice their feelings and thoughts in a natural way (Beidas et al., 2010).

The program typically runs for 6 hours a day,

5 days a week, for 5 weeks

Funding requires that 5 hours of therapeutic programming occurs each day.

(Kendall & Hedtke, 2006)

“The Summer Therapeutic Activities

Program offers structured and therapeutic programming that targets skill development and emotional support for children and adolescents

with social, emotional and behavioral issues” (Philhaven, 2015)

3 separate experimental studies measured the effects of the curriculum using the Anxiety Disorder Interview Schedule (ADIS)

  • The scales were administered to children and their primary caretaker
  • All studies reflected favorable outcomes in reducing symptoms of anxiety
  • Study 1: Participants diagnosed with overanxious disorder or separation anxiety disorder saw a reduction in symptoms of anxiety 1 year and 3 ½ years after treatment.
  • Study 2: 92% of participants no longer had an anxiety disorder as their primary diagnosis when interviewed more than 7 years after treatment
  • Study : In a 1 year follow-up, 81% of participants engaged in either individual or group format applications of Coping Cat

no longer met criteria for an anxiety diagnosis

(NREPP, 2014)

Skills Training

FEAR Plan:

Feeling Scared?

Skills Training

FEAR Plan:

Expecting the Worst?

Skills Training

FEAR Plan: Rewards & Results

Skills Training

FEAR Plan:

Attitudes and Actions

Building Rapport

The workbook includes worksheets that the facilitator can use to facilitate the client’s development of these skills

Using the Coping Cat

Workbook

It is also helpful to prompt clients to recognize how negative thinking can multiply and cloud your judgement (Stallard, 2002)

Sample Lesson Plan

The workbook opens with sample questions for clients to ask their group facilitator (e.g. what is your favorite T.V. show?), as well as a space for children to write their own questions (Kendall & Hedtke, 2006).

Sample Lesson Plan

The process of cognitive restructuring activities include reducing negative self-talk by replacing it with:

  • positive self-talk, thought redirection,
  • challenging negative thoughts,
  • and having a premade plan

(Beidas et al., 2010; Stallard, 2002).

Beidas et al. (2010) suggests that the group facilitator allows the child to name these cognitions as they see fit (e.g., “my scared voice”) in order to increase self-awareness and ownership of feelings and thoughts.

It is important that the child is guided to identify both intrinsic and extrinsic rewards for managing their anxiety (Kendall & Hedtke, 2006).

(Stallard, 2002)

(Kendall & Hedtke, 2006)

The workbook includes worksheets that the facilitator can use to facilitate the client’s focus on what they are thinking about when they encounter an anxiety provoking situation (Kendall & Hedtke, 2006).

Coping Skills as Actions

"Coping skills are viewed as likely protective factors in reducing the risk of excessive

anxiety by facilitating management of stressful situations" (Collins, Woolfson, & Durkin, 2013, pg. 86)

In order to cultivate an understanding of possible somatic reactions to anxiety and

normalize the experience, clients can survey each other, the group facilitator, or parents to gain additional insight (Beidas et al., 2010; Kendall & Hedtke, 2006).

(Kendall & Hedtke, 2006)

(Moonshine, 2008)

(Kendall & Hedtke, 2006)

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