PATTS: Peaceful Alternatives to Tough Situations

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___________________________________________Reduction of Childhood Aggression
Running Head: REDUCTION OF CHILDHOOD AGGRESSION
Evaluation of a program for reduction of childhood
Ellen Williams
Center for Child & Family Services
2021 Cunningham Drive
Hampton, VA. 23666
(757)838-1960
[email protected]
Judith L. Johnson
Regent University
Address correspondence to:
Ellen Williams, LCSW
Center for Child & Family Services
2021 Cunningham Drive, Suite 400
Hampton, VA. 23666
1
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Abstract
This paper describes a program for reduction of childhood aggression. The Peaceful Alternatives
to Tough Situations (PATTS) is a nine-week modularized program. A quasi-experimental pretest post-test control group design was used to evaluate the efficacy of the program for students
in grades three through five and middle/high school. Analyses indicate significant positive
change occurred on posttest in the areas of decrease in physical assault (F (1, 99) = 11.43, p <
.001), psychological aggression (F (1, 99) = 12, p < .001), and vengefulness (F (1, 99) = 12.57, p
< .001). The two groups were not significantly different on the Conflict Tactics Scales of
Negotiation (F (1, 99) = .11, p < .74) and Physical Injury (F (1, 99) = 2.29, p < .134). Students
demonstrated a reduction of suspensions, principal referrals or new criminal offenses. Support
for the program’s efficacy is indicated, and implications are discussed.
___________________________________________Reduction of Childhood Aggression
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Research shows a significant correlation between early antisocial behavioral patterns and
long-term inability to function appropriately in life (Farrington, Gallagher, Morley, St. Ledger,
& West, 1988; Moffitt, 1994). The long term effects of childhood aggressive behavior have been
extensively studied and linked to a plethora of negative outcomes. These outcomes include drug
use, academic difficulties, reckless driving, delinquent activities, marital violence and
occupational difficulties (Brook,Whiteman & Finch, 1992; Elliott, 1994; Nagin & Farrington,
1992; Brook & Newcomb, 1995; Rose, Rose, & Feldman, 1989).
Youthful antisocial behavior has been separated into early versus later onset or lifecourse-persistent versus adolescent-limited antisocial behavior (Moffitt, 1994). Research
presents a grim prognosis for life-course antisocial behavior (Cummings, Ianotti & Zahn-Waxler,
1989; Rose, Rose, & Feldman, 1989). Life course antisocial behavior appears to be socialized to
this behavioral pattern through familial and primary caregivers, while adolescent limited
antisocial behavior is related to peer interaction (Moffitt, 1994). Educators are becoming more
alarmed by the increase of early signs of conduct disorder behaviors in elementary school age
children. We are seeing mature acts of deviance among younger and younger children (Bierman,
Cooic, Dodge, Greenberg, Lochman & McMahon, 1992).
For life course aggressive behavior, researchers seem to agree that early intervention is
essential to divert individuals from a path of life long violence (Cicchetti & Nurcombe, 1992;
Reid, 1993; Beauchaine, Strassberg, Kees, Drabick, (2002); Fraser, 1996a; Webster-Stratton &
Reid, 2003). Early detection of aggressive behavior frequently occurs in school-like settings
where children are interacting with peers and reacting to the structure of the classroom
environment. Early intervention and detection can stop the cycle in which a youth’s interactive
style leads him/her to select and create environments that reinforce their aggressive style (Caspi,
___________________________________________Reduction of Childhood Aggression
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Bem & Elder, 1989. This aggression can also lead to interactional continuity, which refers to the
reciprocal interaction with others, in which aggressive children will elicit aggressive responses
from others. These patterns develop into a spiraling decline of opportunities for positive social
skills acquisition and a lack of rewards for prosocial activities in the child’s social environment
(Tolan, Guerra, & Kendall, 1995). Despite the research that promotes early interventions,
adolescent- limited antisocial behavior also appears to be responsive to intervention efforts
(Ellickson & Mcguigan, 2000; Lochman, 1988; Feindler & Starr, 2003; Johnson, et al., 1997).
Interventions for young children and adolescents who are exhibiting aggressive behaviors
have a number of common recommendations. For example, cognitive problem solving in which
the youth learns to interpret social situations in a less defensive manner is highly recommended
for all ages of aggressive youth (Fraser, 1996; Lochma, 1992; Feindler & Starr, 2003;
Beauchaine, et al. 2002; Battistich, et al. 1989; Deffenbacher, et al, 1996). These researchers
have found that development of positive cognitive skills in aggressive youth results in
improvements in social competence, self-esteem and aggressive behavior.
Youth who are trained in ways to handle conflictual situations and mediate interpersonal
conflicts also appear to have a reduction in aggressive behavior (Johnson, et al. 1997; Prinz,
Blechman, & Duman, 1994; Johnson & Johnson, 1996). Increase of prosocial conflict resolution
skill training has been shown to reduce aggression in highly aggressive youth (Prinz,
Blechman,& Duman, 1994). Coupled with learning to walk away and mediation skills, it has
been shown that many youth need to learn to take time before they respond to conflict situations
(Beauchaine, et al. 2002). Research has shown that many aggressive children possess inadequate
cognitive repertoires for dealing with peer conflicts and by taking 15 seconds before they
respond to conflicts, they are better able to utilize positive conflict skills (Rabiner, Lenhart, &
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5
Lochman, 1990). Based on the link between adolescent limited antisocial behavior and peer
pressure it seems imperative that aggressive adolescents are empowered with the ability to turn
away from negative peer pressure (Brook & Newcomb, 1995; Moffitt, 1994).
Research also encourages the involvement of the parents and teachers of aggressive
children so they can learn better management of the youth’s aggressive behavior (Patterson,
DeBaryshe & Ramsey, 1989; Lochman & Salekin, 2003; Beauchaie, et al., 2002). Violent
behavior is not inevitable or uncontrollable; it is a learned response that begins in early
childhood as an acceptable way to solve problems (Vitale, 2001). Orpinas, Murray and Kelder
(1999) conducted a study that showed that children’s acceptance of violent resolution of conflicts
begins with the parent’s acceptance of such behavior, or lack of communicating that violence is
unacceptable. The best prevention program possible will involve families because many
children may resort to violence to solve problems simply because they have never been taught
nonviolent methods (Vitale, 2001).
Children spend a great deal of their day in the school environment, and this is a critical
factor that influences attitude about conflict resolution skills. For example, when the teacher
does not effectively address such things as name-calling, excluding, or teasing, the message is
sent that such behavior is acceptable or tolerated (Vitale, 2001). It is imperative that teachers
and school personnel understand the dynamics of the angry child, and positive ways to respond
the acting out behavior. Further, school policies that encourage pro-social behavior and quickly
address any aggressive conflict resolution should also be implemented. This will promote a safe
school atmosphere and provide the modeling of non-violent conflict resolution that can teach the
child appropriate social skills.
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Additionally, aggressive youth are frequently dealing with symptoms of post-traumatic
stress disorder which necessitates encouraging aggressive youth to appropriately deal with their
emotions (Jancin, 1997). Many of the youth are traumatized by the violence in their own lives
and therefore react in an aggressive manner instead of the traditional depression symptomalogy
(Pollack, 1999).
It has also been shown that many aggressive actions are retaliatory in nature due to prior
injustices. Worthington and Wade (1999) define unforgiveness as the delayed emotions of
resentment, hostility, hatred, bitterness, anger and fear that arise after ruminating about a
transgression. It appears key to aggression management that youth learn to reach a state of
forgiveness or at least reduce their level of unforgiveness or vengefulness (Wade & Worthington,
2003).
The PATTS (Peaceful Alternative to Tough Situations) program was developed by Ellen
Williams, LCSW (1993) with the goals of increasing youth positive conflict resolution skills, and
reducing vengeful and aggressive behavior. PATTS has three separate curricula, Kindergarten
through 2nd grade, 3-5th grade and middle/high school.
The program includes interventions
based on research literature regarding conflict management and reduction. Therefore, the
curriculum is focused on teaching cognitive skills, peer refusal, appropriate conflict resolution
skills, identification and verbalization of emotions, and forgiveness. All the programs are highly
interactive with role plays, games and skill review. Each curriculum consists of nine, one hour
weekly sessions. The Peaceful Alternatives to Tough Situations (PATTS) program is an
aggression management program for high risk children and adolescents
The Kindergarten through 2nd grade program focuses on pro-social behavior such as
cooperating with others, using caring words and responsible behavior. The program also
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incorporates anger management skills such as ways to calm down and learning to stop and think
before taking action. In the K-2nd grade program, as in all of the curriculums, there is an
emphasis on encouraging the children to verbalize their emotions in order that their concerns can
be expressed appropriately. . Due to difficulties in measuring outcomes for children in
kindergarten through the second grade, we were only able to obtain descriptive data (e.g.
suspensions, principal’s office visits) for this group.
The 3rd through 5th grade sessions focus on positive communication skills, calming
techniques, recognizing anger triggers, accepting responsibility for behavior and nonviolent
conflict resolution skills. The Middle and High school sessions focus on positive communication
skills, calming techniques, recognizing anger triggers, accepting responsibility for behavior and
nonviolent conflict resolution skills. There is an additional group session # 8 on peer-refusal
which is recommended for middle school students. The high school has an extra session on
consequences of violence for group session # 8. We have found that many high school students
are more willing to look at the long term consequences of violent conflict resolution upon their
life goals.
This program also emphasizes the necessity for integrating the child’s other support
people into the program. A parent night is offered to all PATTS participants as an opportunity to
inform the parents of the new conflict resolution skills that their children have learned. This will
encourage the parents or guardians to support their children in utilizing their newly acquired
skills.
The children who are participating in the PATTS program in the school system also need
the support of their teachers. Accordingly, this program provides a teacher training so that the
teachers can utilize the PATTS program in classroom conflicts. The program was administered
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to youth in traditional school settings, alternative school settings and juvenile court referrals.
This paper presents the one-year behavioral outcome measures on the participants in the
program.
Method
Purpose of study: The PATTS program was developed with the goals of increasing youth
positive conflict resolution skills and decreasing vengeful and aggressive behavior. The purpose
of this study is to test the efficacy of the PATTS program in achieving the program goals.
Participants: PATTS program participants were composed of youth from the ages of eight to
eighteen who were selected by School Counselors or juvenile court personnel based on their
previous aggressive behavior. The program was provided at seven local public schools from
urban and rural communities, one alternative school for academically delayed students due to
behavior problems and juveniles from the local court system.
Both PATTS and comparison
group participants had signed parental informed consent prior to their participation.
The comparison group participants for the school programs were selected in the same
manner as the experimental group, based on previous aggressive behavior exhibited in the
school. . The comparison group from the Juvenile Court system was selected from a waiting list
of youth court ordered to participate in the PATTS program due to aggressive behavior. The
comparison group participants were selected from the same schools or court system as the
experimental groups to maintain demographic similarity.
The number of participants included 71 PATTS and 35 comparison group students for a
total of 106. Approximately 69% of the students were African American, 31% Caucasian and 1%
other such as Hispanic or American Indian. Male students comprised approximately 74% of the
program participants and 26% were female.
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Materials: Conflict Tactics Scale-revised (CTS-R: Straus, M.A., Gelles, R.J., &
Steinmetz, S.K.,1980). This is a well established instrument with demonstrated reliability and
validity that has been extensively used. It assesses frequency and severity of partner abuse but is
readily adapted to measure interpersonal conflict and features of conflict management. It yields
information on the following four areas: psychological aggression, negotiation, physical assault
and physical injury.
For the present sample, Chronbach’s alpha was .81 for psychological aggression, .76 for
negotiation, .85 for physical assault, and .57 for physical injury.
Mauger Forgiveness Scale (Mauger, et al., 1991): This instrument was modified from a
dichotomous to a Likert-type scale ranging from Strongly agree to Strongly disagree. This scale
includes questions relating to forgiveness of self and forgiveness of others, and produces
composite scores representing each of these constructs. Higher scores on each scale are
associated with lower tendencies towards forgivingness. This scale has acceptable internal
consistency reliability. With respect to validity, Mauger (1991) reports findings from a factor
analytic study indicating different factor loadings for each of the scales. Forgiveness of Others
loaded on a factor named Alienation from Others which included scales named Cynicism,
Negative Attitude Toward Others, and Passive Aggressive Behavior. The Forgiveness of Self
scale loaded on Negative Self Image, Self Control Deficit and Motivation Deficit scales. These
two scales are modestly correlated (r = .37) suggesting separate but related processes (Mauger, et
al., 1992). The authors conclude that Forgiveness of Others and Forgiveness of Self measure
“distinct constructs”, and are predominately sampling different classes of behavior” (p. 174).
The present study only examined forgiveness of others since PATTS is particularly focused on
this aspect of forgiveness.
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To assess internal consistency reliability for forgiveness of others in the
present sample, Chronbach’s alpha was computed and yielded a coefficient of .75,
which is an acceptable level of reliability for nomothetic research.
Procedure
PATTS participants in the school system were referred by teachers, principals and school
counselors due to their prior aggression in the school setting.
PATTS participants from the
juvenile court system were referred by the judge, intake counselors or probation officers. Parents
of participants signed authorization for their child to participate in the PATTS groups and
completed a packet of questionnaires including a socio-demographic form. Parents and teachers
were given the opportunity to obtain feedback about their child/student’s results directly from the
group facilitators through direct or telephone contact.
The facilitators and co-facilitators for the groups were comprised of Master’s and
Bachelors level counselors from a local nonprofit counseling agency. The facilitators met weekly
to collaborate with the school counselor about participant’s progress, often times utilizing the
school counselor as a co-facilitator. The facilitators were all given eight hours of specific
training in administering the PATTS program.
At the time of a student referral, school personnel tabulated the number of principal
referrals, and suspensions according to severity of aggression and fights from the prior school
semester. This data was collected again three months later at the completion of the PATTS
program.
Each participant from 3rd grade through high school and the juvenile court
participants were administered the CTS and Mauger scales on the first day of group and during
the last group session.
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The control group participants from the school system were referred in the same fashion
as the test group. The control groups were called together and administered the pre-CTS and
Mauger scales. It was explained to the control group that “this questionnaire was a way for us to
understand how boys and girls handled conflicts”. The control group was not informed that they
would be participating in the PATTS group in the future. The control group were placed in a
PATTS group ten weeks later and administered the post-CTS and Mauger scales, on their first
day of beginning the PATTS program. The control group from the juvenile court was mailed out
the pre-CTS and Mauger scales with a stamped addressed envelope ten weeks prior to attending
their first group. Eight out of the ten questionnaires were returned. The court control group was
then administered the post-CTS and Mauger scales on their first day of PATTS group.
For children in kindergarten through the second grade, a valid, age-appropriate evaluative
tool regarding conflict resolution skills was not found. For this study, descriptive data was
gathered on behavioral referents typically associated with difficulties in anger and impulse
control. The data gathered from school administrators included prior principal referrals and
aggressive behavior. This data was gathered for the participants’ prior semester to participating
in PATTS and then tabulated again after they participated in the PATTS program.
. The criminal convictions of PATTS participants from the Juvenile Court system prior
to participation in the group were obtained by Court personnel. A six month follow-up to
determine recidivism rates for additional convictions since completing the PATTS program was
also reported.
Results
A quasi-experimental (non-randomized) pre-test post-test comparison group design was
used to evaluate the outcome measures from the CTS-R and Mauger Forgiveness Scale. Since
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the dependent variables were theoretically related, a multiple analysis of covariance
(MANCOVA) with pretest effects as a covariate indicated overall significant differences
between the PATTS (N = 71) and comparison group (N = 35), (Wilks’Lambda = .81, F (5, 95) =
4.41, p < .001). Subsequent univariate analyses indicated that the PATTS group scored
significantly lower on the Conflict Tactics Scales of Psychological Aggression (F (1, 99) = 12, p
< .001) and Physical Assault (F (1, 99) = 11.43, p < .001) than the comparison group. This
finding indicates that PATTS was effective in reducing instances of psychological aggression
and physical assault within the previous three months.
The two groups were not significantly different on the Conflict Tactics Scales of
Negotiation (F (1, 99) = .11, p < .74) and Physical Injury (F (1, 99) = 2.29, p < .134).
Although
this will be elaborated on in the Discussion section, PATTS does not teach negotiation skills per
se; in contrast PATTS emphasizes “walking away” from potentially volatile situations. Hence,
attainment of negotiation skills is not an objective of PATTS. In terms of the incidences of
physical injury, this scale measures more extreme events such as actual hospitalizations and
physical harm (e.g. broken bones); thus, this scale may hold less relevance for this sample and is
also range restricted.
Finally, the PATTS group was significantly higher on the forgiveness of others measure
than the comparison group (F (1, 99) = 12.57, p < .001), indicating lower levels of vengeful
behavior and thoughts. Posttest means (with pretests as covariates) for all dependent variables
for the PATTS and control groups may be found in Table One.
Descriptive data was gathered on behavioral indicators of difficulties in anger
management/aggression for students in kindergarten through the second grade who had attended
PATTS. This data was collected on all the 449 students participating in the PATTS program in
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the Hampton school system. These students showed a 24% decrease in suspensions, 45%
decrease in principal referrals and a 24% reduction in fighting behavior. Additional descriptive
date was gathered for the participants from the local Juvenile Justice Office by having the
Probation Supervisor reviewed the criminal records of all youth who participated in PATTS six
months after completing the program to determine recidivism rates for violent crimes. Youth
who participated in the PATTS program through the Juvenile Court System also demonstrated
only a 17% recidivism rate of crime, six months after completing the program.
Discussion
This study was designed to evaluate the efficacy of the PATTS program in reducing
physical and psychological aggression in youth ages eight through eighteen.
The findings
indicated that PATTS was effective in reducing instances of psychological aggression and
physical assault. Significant differences in the PATTS and comparison groups were evident with
the students participating in the 3rd-5th grade and middle/high school curriculums.
Not only did the students report less aggressive conflict tactics through The Conflict
Tactics Scale but the schools also reported that PATTS participants experienced fewer
suspensions, principal referrals and fighting behavior. The student’s from kindergarten through
middle school who participated in PATTS showed a 24% decrease in suspensions, 45% decrease
in principal referrals and a 24% reduction in fighting behavior in comparison to the prior
semester when they did not participate in PATTS.
The results for the kindergarten through second grade participants did not show a
significant difference in the measured areas of aggressive behaviors. This may be attributed to
the fact that a non-validated test was utilized. The Conflict Tactics Scale was not an appropriate
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measurement tool for this age group. This age group however did show a decrease in
suspensions, principal referrals and fighting behavior.
The PATTS program focuses on self control, personal responsibility and “walking away”
from a conflict. Although the curriculum teaches appropriate body language and the use of “I”
messages, the emphasis is not on negotiation a conflict situation. In many youthful conflict
situations it may be more appropriate to take a time out so that all parties can cool down or seek
adult assistance so that the situation does not escalate. After the parties are calm, than the use of
“I” messages to communicate and negotiate may be utilized.
Many of the physical injury items listed in the Conflict Tactics Scale were of an extreme
nature such as scalding, hospitalization due to a conflict or broken bones. The majority of the
subjects did not appear to experience such extreme level of physical injury during conflicts.
This, therefore, resulted in no significant difference in physical injury due to the PATTS
program.
The data also suggests that the PATTS program is effective in reducing vengeful
behavior. The program emphasizes the positive emotional benefits of forgiveness It also teaches
the cognitive skills to rationalize forgiveness despite a culture of “seeking retribution” is also
emphasized so that they can deal with peers who may pressure them to “get even” for a
perceived offense. The PATTS group was significantly higher in demonstrating forgiving
behavior a rated by the Mauger Forgiveness Scale.
The initial outcomes of the PATTS program in reducing aggressive behavior in school
age youth suggest the potential fruitfulness of youth participation in this program, along with the
involvement of teachers and parents. The multilevel efforts at promoting nonviolent conflict
resolution appear to significantly change the use of aggression by encouraging the youth in
___________________________________________Reduction of Childhood Aggression
supporting each other in making positive, nonviolent choices. It is imperative that the parents
and teachers also receive the education to support the youth in dealing with conflicts in a
nonviolent manner.
15
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Table One
PATTS and comparison group Post-test means with pre-tests as covariate
__________________________________________________________________
Group
Post-test Means (SD)
__________________________________________________________________
Forgiveness
Aggression
Negotiation
Assault
Injury
Group
42.15**
14.25**
15.04
19.26**
6.21
(N=71)
(9.30)
(12.15)
(10.42)
(17.51)
(8.15)
Group
48.48
21.31
12.85
27.45
8.25
(N=35)
(11.40)
(11.62)
(9.85)
(18.01)
(8.73)
PATTS
Comparison
**p < .001
20
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