Philip C. Kendall, Ph.D., ABPP, & Kristina A. Hedtke, Ph.D.,Temple University, Child and Adolescent Anxiety Disorders Clinic Empirically-supported CBT to reduce anxious distress in youth. This newest edition is a revision of the original Coping Cat Workbook by Philip Kendall that has been in use since 1992. Sixteen therapy sessions promote coping skills for dealing with anxiety. The program can be adapted for use with individual youth or with groups. Appendices include "situation cards" with three levels of difficulty, a "feelings barometer", as well as other cut-outs and a certificate of achievement. (81 pages)
Empirically-supported CBT to reduce anxious distress in youth. This newest edition is a revision of the original Coping Cat Workbook by Philip Kendall that has been in use since 1992. Sixteen therapy sessions promote coping skills for dealing with anxiety. The program can be adapted for use with individual youth or with groups. Appendices include "situation cards" with three levels of difficulty, a "feelings barometer", as well as other cut-outs and a certificate of achievement. (81 pages)
kendall 1990 coping cat cbt
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Kujawa, A., Swain, J. E., Hanna, G. L., Koschmann, E., Simpson, D., Connolly, S., Fitzgerald, K. D., Monk, C. S., & Phan, K. L. (2016). Prefrontal reactivity to social signals of threat as a predictor of treatment response in anxious youth. Neuropsychopharmacology, 41(8), 1983-1990.
Coping Cat. For the treatment of anxiety, the seminar reviewed the Coping Cat manual. Coping Cat is a 16 session CBT intervention for children that addresses anxiety and has been validated in a number of clinical trials (Kendall, 1994; Kendall et al., 1997). Coping Cat includes three phases of treatment: psychoeducation regarding anxiety, skills training to manage anxiety, and then gradual exposure to anxiety provoking situations (Kendall, Kane, Howards, & Siqueland, 1990). Coping Cat works with patients to: identify anxious feelings and thoughts, apply behavioral techniques such as relaxation, and apply cognitive techniques by trying to think more positively. Coping Cat was covered over four seminar sessions.
Treatment adapted from the Coping Cat program for Australian youth. Twelve sessions focused on recognition of anxious feelings, bodily reactions to anxiety, cognitive restructuring, coping self-talk and exposure,
Parent + Child conditions are ten weekly sessions focusing on psychoeducation, relaxation skills, exposure, and social skills training. Parents received information on child anxiety, management techniques, positive parental coping skills, and communication and problem-solving skills. Parent Only condition covered same material without the child involved.
Cognitive behaviour therapy (CBT) is a well-established, highly researched, evidence-based intervention for the treatment and prevention of anxiety (Silverman, Pina & Viswesvaran 2008; Walkup et al. 2008). However, despite CBT's encouraging outcomes, less than one quarter of children who experience anxiety difficulties receive treatment (Korkodilos 2016; Lawrence et al. 2015; Merikangas et al. 2010), and of those who do, many will terminate treatment prematurely (Pina et al. 2003; Wergeland et al. 2015), fail to respond (Rey, Marin & Silverman 2011) or continue to experience recurrent difficulties despite treatment (Last et al. 1996). A potential strategy to overcome these limitations, and manage the high prevalence of anxiety and its negative consequences, is to place greater focus on anxiety prevention (Johnston, Kemps & Chen 2018). Prevention programmes aim to reduce the incidence or onset of mental health disorders by reducing risk factors and developing protective factors to prevent the development of these disorders (World Health Organization 2004). Prevention programmes are usually conceptualised by their intended focus, either indicated (targeted to participants displaying sub-clinical or mild symptoms of disorder), selective (targeted to participants identified as being at risk of developing a particular disorder) or universal (targeted towards whole populations regardless of risk status) (Liddle & Macmillan 2010; Mrazek & Haggerty 1994; World Health Organization 2004). Universally delivered CBT-based anxiety prevention programmes have shown very positive results; however, they have focused primarily on children without disabilities (see Johnston et al. 2018 for an overview). The most well-known CBT group-based anxiety prevention programmes are Kendall's (1990) Coping Cat programme and Barrett's (2005) FRIENDS programme. Although CBT-based anxiety intervention programmes have reported promising outcomes, these programmes are not suitable for children with visual impairments, as much of their content relies on visual presentation or representations (i.e. printed worksheets, cartoons, pictures and video-material). To the researchers' knowledge, there is currently no anxiety intervention programme tailored to meet the specific needs of children with visual impairments. Considering the given factors and the notion that children with visual impairments are possibly more prone to the development of anxiety (Visagie et al. 2013), the researchers and colleagues (Visagie 2016; Visagie, Loxton & Silverman 2015; Visagie et al. 2017) developed and implemented a specifically tailored CBT-based anxiety intervention programme (Positive and Motivating programme - PAM) for South African visually impaired children.
The PAM programme (Visagie 2016) is a brief CBT-based early intervention and prevention programme for anxiety, specifically tailored to meet the needs of visually impaired children between the ages of 9 and 14 years. Participants received 10 PAM group sessions over the course of 5 weeks. Sessions were delivered twice weekly and lasted approximately 45 min. Sessions were delivered in either English or Afrikaans depending on the children's language of schooling (English at school 1 and Afrikaans at school 2). During the programme, children participate in activities, which teach coping skills and problem-solving techniques, thereby helping them to deal more effectively with anxiety. Activities teach skills to identify feelings; to learn to relax, to identify unhelpful thoughts and replace them with more helpful thoughts (cognitive restructuring), how to face and overcome daily problems and challenges and how to illicit family and peer support (Barrett, Lowry-Webster & Turner 1999; Stallard et al. 2007; Visagie 2016). The programme uses a tangible soft toy dog (named PAM) with a collar and eight symbolic charms to represent key anxiety management skills. Charms include the following: (1) a heart, a reminder that feelings come from your heart; (2) a hat, a reminder that thoughts come from your head; (3) a butterfly, a reminder of how the body reacts to anxiety (i.e. the butterflies in your tummy); (4) a noodle, a reminder to use relaxation strategies to help the body relax (like a cooked noodle); (5) a musical note, a reminder to do things, which help you to relax and make you feel good (e.g. listen to music, sing a song, play a game, etc.); (6) a shoe, a reminder of the steps to take to face and solve your problems; (7) a star, a reminder to reward yourself for trying your best; and (8) a hand, a reminder to reach out for others when you need help. The format of the programme included large and small group work sessions, role plays, games, stories, activities and quizzes (more information pertaining to the programme's content can be attained on request).
Johnston, K.M., Kemps, E. & Chen, J., 2018, 'A meta-analysis of universal school-based prevention programs for anxiety and depression in children', Clinical Child and Family Psychology Review 21(4), 466-481. -018-0266-5 [ Links ]Kendall, P.C., 1990, The coping cat workbook, Temple University, Merion Station, PA.
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