•Alex Smith
•Kyle Lawrence
•Kyle Shireman
Introduction
 CBT tool for youth anxiety (7 – 13 years old) who meet
criteria for Generalized Anxiety Disorder, Social
Phobia, and/or Separation Anxiety Disorder.
 Consists of 16 sessions, follows a therapist manual,
uses a client workbook.
 Manual guides treatment, workbook contains client
tasks.
Intro (con’t)
 Sessions 1-8: Dedicated to psychoeducation. The
client learns to identify cues for anxiety and skills to
help him/her cope with anxiety.
 Sessions 9-16: Behavior focused. The client faces
his/her fears in a graded hierarchy.
FEAR Plan
 “F” : Feeling Frightened? Focuses on somatic reactions to
anxiety
 “E” : Expecting Bad Things to happen? Helps youth
identify anxious cognitions
 “A” : Attitudes and Actions that Can Help. Provides coping
skills for the youth implement (coping thoughts, problemsolving, relaxation, belly breathing)
 “R” : Results and Rewards. Allows youth to rate their
performance and effort and be rewarded for facing their
fears.
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Beidas, Rinad S., Benjamin, Courtney L., Puleo, Connor M., Edmunds, Julie M., Kendall, Philip C. (2010). Flexible applications of the
Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153.
Evidence-base of Coping Cat
 47 children were referred (ages 9-13) due to principal diagnosis of anxiety.
Compared to control, participants demonstrated a significant positive change
from pre- to posttreatment on self-report, parent report, and behavioral
observations (Kendall, 1994).
 36 of the previous 47 children were reassessed and treatment strategies/gains
were maintained at a 3.35 year follow-up (Kendall & Southam-Gerow, 1996).
 Coping Cat has been effectively modified in other countries and results
indicate that 50% to 72% of participants no longer meet criteria for their preexisting anxiety disorder (Barret, Dadds, & Rappee 1996).
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Sources:
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Barrett, P.M., Dadds, M.M., & Rappee, R.M. (1996). Family treatment of childhood anxiety: a controlled trial. Journal
of Consulting and Clinical Psychology, 64, 333-342.
Kendall, P.C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal
of Consulting and Clinical Psychology, 62, 100-110.
Kendall, P.C. & Southam-Gerow, M. (1996). Long-term follow-up of a cognitive behavioral therapy for anxietydisordered youths . Journal of Consulting and Clinical Psychology, 64, 724.730.
When would you use Coping Cat?
 Help youth cope with anxiety
 Age Range for Coping Cat Program is 7-13 yrs old for
children who meet criteria for Generalized Anxiety
Disorder, Social Phobia, and/or Separation Anxiety
Disorder.
 Program for Adolescents- Cognitive Analytic Therapy (C.A.T)
project-ages 13-17.
 Appropriate Populations:
 No differences in outcomes based on ethnicity or gender
 Understanding a child’s developmental level (child should
have an IQ of over 80 to understand)
Beidas, Rinad S., Benjamin, Courtney L., Puleo, Connor M., Edmunds, Julie M., Kendall, Philip C. (2010). Flexible applications of the
Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153.
Potential Barriers/Strategies to
Overcome Barriers
 Barrier: Younger children (7-8 yrs old) – They may not
understand the feelings that you are trying to explain so using
play to help discover feelings, thoughts, and behaviors.
 Strategy to Overcome: Games: Charades- Act out the feelings.
Feelings Dictionary. Spy Detective: Go around looking for different
feelings. Drawing the feelings
 Barrier: Kids with Social Skills Deficit
 Strategy to Overcome: Discuss basic emotions, (Sad, afraid, happy).
Challenge children to work on the “E step” thoughts and the “A
step” actions. These children worry about fitting in which can be
legitimate. Counselor should work on separating their realistic and
unrealistic thoughts and then work on their actions (Exposure
Task).
Beidas, Rinad S., Benjamin, Courtney L., Puleo, Connor M., Edmunds, Julie M., Kendall, Philip C. (2010). Flexible applications of the
Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153.
Potential Barriers/Strategies to
Overcome Barriers
 Barrier: Inattentive/Hyperactive Kids
 Strategy to Overcome: High Structure with shorter
intervals interspersed with short breaks. (breaks can
include jumping jacks or a short game). Use a picture
schedule with the breaks built in so that the child can
see when they will get breaks. Increase interactions and
engagements (use charades for the feelings part instead
of collage or having a catch with a nerf ball while
discussing feelings). Alter the setting so that there are
minimal visual distractions. Work in a reward system.
 32% comorbidity with Anxiety.
Beidas, Rinad S., Benjamin, Courtney L., Puleo, Connor M., Edmunds, Julie M., Kendall, Philip C. (2010). Flexible applications of the
Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153.
Potential Barriers/Strategies to
Overcome Barriers
 Barrier: Depressive Symptoms
 Strategies to Overcome: A child who is comorbid with
anxiety and depression may not improve with just
anxiety interventions. Increase the rapport building
time to longer than just one session. Possibly spend the
first 10 minutes of each session building rapport.
Cognitive restructuring : When going over the
automatic thoughts be on the lookout for negative
cognitions and spend time on those thoughts. Attempt
to increase their activity levels (Exposure therapy).
Beidas, Rinad S., Benjamin, Courtney L., Puleo, Connor M., Edmunds, Julie M., Kendall, Philip C. (2010). Flexible applications of the
Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153.
Process of Using Intervention
 Session 1: Build Rapport, provide
overview of program. Encourage child’s
participation. Play personal facts
game…promote fun activities
 Session 5: Introduce relaxation training.
(e.g. deep breathing and progressive
relaxation). Review recognition of
somatic cues.
 Session 2: Talk about treatment goals.
Identify different feelings and somatic
responses to anxiety. Normalize
fear/anxiety. Develop a hierarchy of
anxiety-provoking situations. Introduce
“F” step of the FEAR plan…remember???
 Sessions 6: Review relaxation training.
Introduce “E” step of FEAR plan. Help
child recognize anxious thoughts.
Promote positive self-talk via modeling
and cartoons.
 Session 7: Review anxious self-talk and
reinforce changing anxious self talk into
coping self talk. Introduce problem
solving and the “A” step of the FEAR
plan- Actions and attitudes that can
help.
 Session 3: Review distinguishing anxious
feelings from other feelings. Identify
individual somatic responses to anxiety.
 Session 4: Parent Session. Provide info
on treatment and give opportunities to
discuss concerns. Encourage ways for
parent involvement.
 Session 8: Introduce self-evaluation and
reward… “R” step of FEAR plan- Results
and rewards
Podell, J.L., Mychailysyn, M., Edmunds, J., Peulo C., & Kendall, P.C. (2010). The Coping Cat program
for anxious youth: the FEAR plan comes to life. Cognitive and Behavioral Practice, 17, 132-141.
Process of Using Intervention
 Session 9: Parent session. Explain
second half of treatment. This portion
may promote greater anxiety.
 Session 13 : Continue to practice skills
for coping in scenarios that promote
moderate anxiety.
 Session 10: Practice 4-step coping
(FEAR) plan under low-anxiety
situations.
 Session 14: Practice skills for coping with
anxiety in live situations that produce
moderate levels of anxiety. Begin
planning “commercial” that summarizes
experiences to help inform other
children
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Session 11: Continue practicing skills for
coping with anxiety in low-level
imaginable situations.
 Session 12: Practice skills for coping in
scenarios that promote moderate
anxiety.
Podell, J.L., Mychailysyn, M., Edmunds, J., Peulo C., & Kendall,
P.C. (2010). The Coping Cat program for anxious youth: the
FEAR plan comes to life. Cognitive and Behavioral Practice, 17,
132-141.
 Session 15: Practice skills for coping with
anxiety in real situations that produce a
high level of anxiety.
 Session 16: Continue to Practice skills
for coping with anxiety in real situations
that produce a high level of anxiety.
Review and summarize program. Tape
“commercial,” award certificate.
Demonstration:
 Session 7: Review anxious self-talk
and reinforce changing anxious self
talk into coping self talk. Introduce
problem solving and the “A” step of
the FEAR plan- Actions and
attitudes that can help.
Conclusion
 Overall, Coping Cat is a program that utilizes CBT
tools to help youths cope with anxiety.
 The general structure of the program is manualized,
but can be adapted to fit individual and group needs.
It is flexible! (Beidas et al. 2010; Podell et al. 2010)
 Therapists can set an agenda, progress monitor,
conduct a mood check-in, undergo specific session
tasks, provide opportunity for feedback, and conduct
mood check-out for each meeting.
 Children are given any opportunity to practice skills
learned through “STIC” tasks between sessions.