The Coping Power Program- Capitolo Introduttivo

8/10/2019 The Coping Power Program- Capitolo Introduttivo

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The Coping Power Program: Preventive Intervention at the Middle School Transition

John E. Lochman

The University of Alabama

Karen C. Wells and Maureen Murray

Duke University Medical Center

The development and evaluation of this program has been supported by grants from the Center

for Substance Abuse Prevention, the National Institute for Drug Abuse, the Department ofJustice, the Centers for Disease Control and Prevention, and the US Department of Justice. The

initial program development and program implementation have been assisted by our dedicated

and creative intervention staff including Vicki Brown, Craig Colder, Becky Frank, MaryGifford-Smith, Laura Gilliom, Lisa Lenhart, Terri McCandies, Desiree Murray, Lisa Reiter-

Lavery, and Sue Smith-Scott. We express appreciation to the staff and administrators of the

Durham NC School System who collaborated in the orginal planning and implementation of theCoping Power program. Further information about the Coping Power program, and about

training for the program, can be obtained by contacting John E. Lochman, PhD, Department of

Psychology, Box 870348, The University of Alabama, Tuscaloosa, AL 35487.

Citation:Lochman, J.E., Wells, K.C., & Murray, M. (2007). The Coping Power program:

Preventive intervention at the middle school transition. In P. Tolan, J. Szapocznik, & S.

Sambrano (Eds.), Preventing youth substance abuse: Science-based programs for children and

adolescents (pp. 185-210).American Psychological Association: Washington, DC.

Running Head: Coping Power

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Larry is a 14 year old African-American male from Durham, North Carolina

(Durham is an urban area of approximately 250,000 and is a minority-majority city). He

entered the Coping Power program at the age of 11 and was repeating the 4th

grade at the

time intervention began. He was residing with his mother and his two younger siblings

and had minimal contact with his father. The family lived in a neighborhood in which

frequent crimes occurred, including both drug sales and shootings related to the drug

trade. During the course of intervention Larry and his family moved five times, though

all of these moves were within the same dangerous neighborhood. During this time

Larry was doing poorly academically; his school attendance was poor, he was not

completing his homework, and his mother had no involvement with Larrys school.

Larry had frequent disciplinary referrals to the school office. Most of these involved

either conflicts with peers or explosive outbursts with teachers. He was suspended from

school on several occasions, for fighting with other students, destroying school property,

and making threatening remarks to his teachers. When approached, both Larry and his

mother agreed to participate in the Coping Power program.

The Coping Power Program

The Coping Power program is based on a contextual social-cognitive model of childhood

aggression (Lochman & Wells, 2002a), which is a risk marker for later adolescent substance use.

This program is provided to preadolescent aggressive children and their parents. In this

intervention, aggressive children are identified as being in the top 30 percent of children based

on teachers ratings of aggressive behavior. Coping Power includes a child component, which

consists of a 34 session group intervention, and a coordinated 16-session parent component, both

of which are designed to be delivered over a 16 to 18 month period of time. The child and parent


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components target four central predictor variables which have been associated with adolescent

substance use: childrens social competence, childrens self regulation and self control,

childrens social bond with school, and caregivers positive involvement and consistent

discipline.

The Coping Power Model

Substance abuse can be conceptualized in a developmental framework to be the result of

a set of familial and personal factors, with childrens aggressive behavior often being part of that

developmental course (Lochman & Wells, 1996). This developmental course is set within the

childs social ecology, and an ecological framework is needed to guide preventive efforts

(Conduct Problems Prevention Research Group, 1992). Research has suggested that childrens

aggressive behavior serves as an important risk factor for later substance use. Loeber (1990)

theorizes that as these aggressive behavior patterns become entrenched, later sequelae on the

trajectory to substance abuse and conduct disorder occur. In early to middle childhood, the

increasingly oppositional children can experience highly negative reactions from teachers and

rejection from peers. Childrens academic progress and their social bond to school weakens and

by early adolescence they become more susceptible to deviant peer group influences. By

adolescence, this trajectory results in a heightened risk of substance use, delinquent acts and

school failure. Thus, as prior research (e.g., Hawkins, Catalano & Miller, 1992) indicates, four

relevant predictors of adolescent and adult substance abuse include (1) childrens lack of social

competence and inability to get along with other children, (2) poor self regulation, self control

and impulse control, (3) weak social bond with the school, and resulting academic failure, and

(4) poor care giver investment in the child, (involving a lack of a warm and protective and

protective environment, and consistent discipline) and in parenting interventions. These

predictor variables, which mediate childrens behavioral difficulties and later drug abuse, have


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also been identified in extensive reviews of the risk factors for drug problems, (Hawkins,

Catalano & Miller, 1992), and will be briefly reviewed here.

Social Competence

Children who experience peer rejection and social isolation in the elementary school

grades are at risk for early-onset drug use, and other negative adolescent outcomes such as

school failure and criminality (Coie, 1990; Hawkins, Catalano & Miller, 1992; Kellam et al.,

1980). Children who are rejected by peers are often highly aggressive (Coie, 1990), and

characteristic social competence and social information processing difficulties are apparent for

these children (Crick & Dodge, 1994; Lochman & Dodge, 1994; Lochman, Wayland & White,

1993). The characteristic social information processing deficits for aggressive children include

(a) hypervigilance to hostile cues, (b) a hostile attributional bias as children have distorted

interpretations about the hostility of others intentions, (c) a dominance-oriented pattern of social

goals, (d) social problem-solving deficits involving recall of strategies that are primarily action-

oriented and do not involve verbal assertion or negotiation, and (e) beliefs that aggressive

behavior will produce rewards for them. Because of the lack of acceptance by most of their peer

group, socially incompetent children become susceptible to the influence of deviant peer groups

in adolescence

Self Regulation and Self Control

Unregulated, emotional distress, especially impulsive anger, has been associated with

aggressive behavior problems and with adolescent drug use. When emotionally-activated,

aggressive children problem solve in an automatic, preemptive manner, they generate less

competent, more action-oriented solutions than when they think of solutions in a deliberate,

slower manner (Rabiner, Lenhart & Lochman, 1990). Childrens inability to regulate their

emotional responses contributes to their poor social competence (Eisenberg & Fabes, 1992).


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Notably, reactive aggressive behavior has been related to unregulated, intense emotional arousal

in general, and to high levels of anger in particular (Dodge, Lochman, Harnish, Bates & Pettit,

1998; Lochman, Dunn & Wagner, 1997). Aggressive behavior has emerged, in turn, as a

predictor of adolescent substance use. For example, Lochman and Wayland (1994) found that

eleven-year-old boys who were nominated by their classmates as being highly aggressive, using

sociometric procedures, were using substances at a significantly higher rate than were

nonaggressive peers when all of the boys were followed up four years later, at age 15.

Social Bond With School

Children who have low commitment to school and who have high rates of school failure

are at risk for drug use (Hawkins, Catalano & Miller, 1992). Adolescent who dislike school and

who spend little time on homework and perceive school work to be irrelevant experience earlier

onset of drug use. The ability of children to develop an adequate protective bond with school, is

the result of multiple factors, including capacities of the children themselves (e.g. study skills,

organization skills; positive relationships with teachers) and of parents active involvement with

the schools, and parents encouragement and structuring of childrens study behavior.

Caregiver Involvement

In an extensive review of the risk factors for drug problems, Hawkins, Catalano and

Miller (1992) identified several caregiving risk factors which are also directly linked to

childhood aggression, including: (1) deficient family management practices involving lack of

maternal involvement, inconsistent parenting, unusually severe or permissive parenting, and poor

monitoring and unclear expectations of behavior; and (2) low levels of warmth and involvement

in parent-child relations. Taken together the available evidence suggests that family and parent

factors exert a direct effect on adolescent substance abuse and in addition, these family factors

exert an indirect effect via their association with child aggression and antisocial behaviors, poor


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social competence and academic failure (Santisteban, Szapocznik, & Kurtines, 1994), which, as

noted earlier, are themselves associated with later adolescent substance abuse. As children

emerge into early adolescence, appropriate parental monitoring assumes increasing importance

in preventing the adolescents gravitation to deviant peer groups, and to substance using and

delinquent behavior (Fletcher, Darling & Steinberg, 1995).

Staff, Training and Supervision

Intervention Staff

Intervention staff for the Coping Power Program typically consists of social workers and

school counselors at the Masters Degree level of professional training and psychologists at the

PhD level. These individuals are responsible for conducting child groups in the schools and

parent groups with parents of these same children.

Training

All intervention staff began their training by reading two intervention manuals containing

session by session outlines of the content and process of each of the major components of

Coping Power (Child Component and Parent Component) (Lochman, Lenhart, and Wells, 1996;

Wells, Lenhart & Lochman, 1996). Then, two-to-four all day training workshops are conducted

by the primary developers of the model in which the treatment model is presented including

background and rationale, and review of session material. Some role-playing of specific

techniques occurs. Many therapy process issues also were discussed during training such as,

how to manage a large group of disruptive children; how to provide clear group structure; how to

present parent training in a non-blaming manner; and how to discuss the problems with the use

of physical punishment without appearing judgmental toward parents who may use it.

Supervision


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Intervention staff receive ongoing supervision during the entire course of the 18-month

intervention. Supervision occurs in both group and individual formats. On a regular basis

(weekly for intervention research studies; monthly for dissemination efforts) staff meet with

experienced Coping Power trainers to discuss ongoing groups and to plan for upcoming parent

and child group meetings. Staff shared their experiences with staff who had upcoming meetings

on the same topic. Group supervision also allowed for peer support among staff when the

inevitable frustrations of doing clinical work with disruptive child populations came up.

The Coping Power Program at the Middle School Transition

The Coping Power Program delivered at the time of childrens transition to middle school

includes both indicated preventive intervention components and universal intervention

components. Intervention begins in the year prior to the middle school transition (typically 5 th

grade) and continues into the first year in middle school (typically 6th

grade), although the

program is generally developmentally appropriate for children from the middle elementary

school grades through the middle years of middle school, and can be adapted to cover grades 3 to

7. The Coping Power indicated intervention is delivered to target children who have been

identified by teacher and parent ratings of childrens aggressive behavior as being relatively high

in aggressive behavior problems, and has both a child component and a parent component. The

child and parent components are developed to be delivered in tandem, and certain topics are

designed to come up at common times in the parent and child groups. The Coping Power

targeted intervention components address these high risk childrens deficits in social

competence, self regulation, school bonding, and positive parental involvement. The universal

prevention program is directed at all parents and at teachers, and is designed to have ecological

influence on the social bonds between home and school, child and school, and parent and child.

An intervention combining both of these universal and indicated prevention components, through


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its greater intensity in addressing the social competence and self control of the peer ecology

around the indicated target children, was expected to produce greater change in the mediating

predictor variables than was either part of the intervention program separately.

Coping Power Child Component: Group Sessions

The Coping Power child component is a 16-to-18 month program, with 22 group sessions

scheduled for the fifth grade year, and 12 group sessions for the sixth grade year, as implemented

in our CSAP-funded project. Child Component group sessions typically take place at childrens

schools (after school, before school, or during nonacademic homeroom periods), but were also

scheduled at community centers or at our research offices. Group sessions lasted for 45-60

minutes. The group sessions usually included 4-6 children. In addition to group sessions, each

child was planned to receive a total of 6 individual hour sessions at their school, on the

average of once every 6 to 8 weeks. The individual sessions were provided by the staff school-

family program specialist, and encouraged generalization of intervention effects.

The Coping Power Child Component program addressed the social-cognitive deficits

identified in prior studies; these skills were also the focus of our previously-evaluated 18 session

Anger Coping program. The Coping Power Child Component (Lochman, Lenhart, and Wells,

1996) was derived from an earlier Anger Coping Program (Lochman et al, 1987).

Group purpose and group rules. In the first group session, the purpose of the group is

articulated, and the group rules are generated by group members. Childrens adherence to these

rules (e.g. keeping your hands and feet to yourselves, no name-calling) leads to weekly points

that children can earn. Children can also earn points for positive participation during sessions,

and for accomplishing personal behavioral goals (explained in sessions 2 and 3). A poster board

is used to keep track of childrens accumulating points across sessions, and children are able to

spend their points for items on a menu of reinforcers. The total number of points accumulated by


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participants in each group is also summed so that the group as a whole can attempt to earn group-

level reinforcers (e.g. pizza parties).

Long-term and short-term goals. In the second and third sessions, children are asked to

identify long-term and short-term goals for themselves, and these goals lead to specific

behavioral goals that children commit themselves to achieve during the subsequent week, using

goal sheets. Teachers (or parents) are canvassed prior to these sessions to identify an array of

behavioral goals appropriate for each child, and goals are elicited from each child until they

suggest goals that have been suggested by the teachers or parents. It is critical that these

behavioral goals be clearly observable, and that the initial goals be of moderate difficulty, to

assist children in having successful experiences in the early stages of goal attainment. Each

childs goals are monitored on a daily basis by the teacher or parent, and the child earns points

based on their success. The goal-setting procedure continues throughout the course of the group,

and was found in earlier research to be an important method for enhancing childrens

improvement in the classroom and other settings outside of the meeting room.

Larry readily identified goals for himself, though initially he had much difficulty with

follow through. He often would forget his goal sheet or not work towards achieving his pre-

selected goal. One of the interventions particularly effective with Larry was the opportunity to

earn tangible reinforcers. This point system was very motivating for Larry and he looked

forward to earning points that could later be traded in for small items which were typically

valued by young boys (baseball cards, special school supplies, small toys, etc.). He began to

remember to have his goal sheet signed by his teachers, and brought his goal sheet to group

regularly.

Organizational and study skills. Because of our explicit focus on assisting children to

adjust to the academic as well as the social demand of school, some specific methods for


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adapting to school tasks are addressed. Relatively early in the intervention each year (Session 9,

and the Supplementary Meeting between sessions 23 and 24 in the second year of intervention)

there are sessions on adjusting to the organizational and study skills required for adequate school

progress. These sessions particularly address how these organizational and study skills will

become even more important in middle school. This particular session can be actually

implemented at any time in the curriculum to coincide with key academic times (e.g., report card

dates), but it is most useful to provide this session at the same time that related issues are

covering in the parent groups. During one of the individual sessions Larry reported that he was

having a lot of difficulty in math. When asked if he was receiving any additional help, he replied

no. After Larrys mother was prompted to consult the school counselor, Larry began individual

tutoring services at his school.

Awareness of arousal and anger. Sessions four and five focus on childrens emotional

reactions in various problematic situations, especially focusing on their experience of anger in

response to provocation or frustration. Using an anger thermometer, children are assisted to

identify different levels of anger they may experience (e.g., rage, irritation, annoyance), and in

identifying the different types of problems which trigger these different levels of anger.

Larry learned how to use the anger thermometer to visualize the continuum of angry

states (from mildly upset, to angry, to very enraged). He also identified triggers that frequently

set him off, for example becoming mildly upset if someone touched his property, angry if a peer

tried to boost a fight, or very enraged if someone dissed or messed with his family. Larry

was able to recognize different physical cues (racing heartbeat, clenched fists, sweaty palms,

rapid breathing, etc.) as warning signals to let him know how intensely he was reacting to a

given situation. This early recognition of physical cues led Larry to be able to make a choice to

exit a situation before he reached the point of no return. Larry knew that if he became


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intensely angry in a situation he would not be able to exit, and would consequently make bad

choices with negative consequences. By recognizing these early cues Larry was often able to

either walk away from problem situations or, later in the program, seek adult assistance.

Anger management self regulation. This focus on self-awareness of the physiological

and behavioral signs of anger then leads to a major unit in the intervention on methods for anger

management (sessions 6-8, 10-11). Children are introduced to the use of coping self statements,

distraction techniques, and brief relaxation methods as means to handle the arousal associated

with anger without resorting to aggression. A series of activities designed to be progressively

more realistic are used to assist children in trying out these methods in vivo in the sessions.

Children first try to screen out distractions from peers during simple memory and building tasks,

then use the anger management skills during puppet role-plays, and finally use the skills during

taunting tasks with peers. It is important for leaders to model these skills at each stage of these

tasks, and to proactively coach children in their use of these skills during the taunting tasks. The

intervention is based on the assumption that children must learn how to handle the surge in

arousal and anger in response to a perceived provocation before they can successfully begin to

use problem-solving strategies.

When Larry was first introduced to this section of the curriculum he appeared somewhat

skeptical about whether or not he could learn better ways of handling his anger when provoked.

He initially reported that aggressive solutions were often effective when dealing with problem

situations. Rather than try to convince him otherwise, the staff focused instead on situations

when things didnt turn out the way he wanted and/or times that the negative consequences he

earned for his actions outweighed the benefits. An example of this was when Larry got into a

fight at school. Although he blamed the other student, stating he started it, both he and the other

student were both suspended for 10 days. He didnt feel as though he deserved the punishment


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yet he also didnt like being suspended from school. In one of our subsequent sessions the staff

used this problem situation to talk about things Larry could do in the future if confronted with a

similar situation. As long as I keep my cool, Im in control, He would like me to get angry.

Well Im going to disappoint him and I dont have to prove myself to anyone were some of

the suggestions given to Larry for things he might say or think to himself when trying to deal

with a difficult situation. Whenever possible, using real life problems that group members

brought into the sessions helped to effectively demonstrate the various coping skills being taught

in the program.

Problem identification and attribution re-training. Session 12 introduces the first part of

the problem solving model, known as Problem Identification, Choices, Consequences (PICC),

which children learn to use. This focus on accurate identification of the social problems that face

the children leads into several sessions (Sessions 13-15) on perspective taking. Role-playing and

discussion activities are used to illustrate how hard it often is to accurately understand another

persons intentions in a problem situation, resulting in retraining of the hostile attributional bias

which many aggressive children have. Although the primary focus of these activities is on peer

situations, aggressive children also often misperceive teachers intentions. Thus, a teacher

interview has been designed to address the perceived unfairness and harshness of teachers.

Most of Larrys interactions with his teacher thus far had been prompted by problem

behaviors that Larry was exhibiting in the classroom. His negative attributional bias extended to

adults, and thus he projected blame on his teacher for his classroom difficulties. In essence,

Larry felt the teacher was out to get him. Larry completed the teacher interview activity in a

one-to-one meeting with his teacher, permitting his teacher to share her experiences when she

was in school herself, and her goals and intentions when she is leading academic tasks in the

classroom and when she has to enforce rules in the classroom to permit learning to occur. This


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positive interchange began a gradual change in Larrys perception of his teacher, and in his

assumption of greater responsibility for his own behavior. In addition, his teacher was able to

gain a greater understanding of how hard Larry was working to change his behavior, and her

improved attitude toward him acted as further motivation.

Social problem-solving skills. The unit of the intervention with the largest number of

sessions involves the steps and the use of the PICC problem solving model (Sessions 16-22, 24-

27). Brainstorming discussions, as well as hands-on activities and use of PICC forms are used to

introduce the range of choices, or possible solutions, that children have in most social problem

situations, and then to introduce the range of consequences which result from these various

choices. The exercises also address how childrens social goals and their use of impulsive,

automatic processing can impair their problem-solving skills. The PICC model is then used on

childrens own problems. One time Larry came to group very upset about an incident that took

place between he and a non-group peer on his way to group. The group leader noticed that Larry

was upset and suggested that the group pick apart the problem using the PICC model. Larrys

newfound ability to utilize the group to assist him in coping with a difficult situation

demonstrated the effectiveness of this intervention strategy.

A particularly useful way to generate childrens active involvement in learning problem-

solving is to have them as a group create a videotape of a problem situation with several possible

winning solutions (Sessions 20-22). Because they typically look forward to this task, the

video-taping activity tends to maintain childrens motivation in the program, even among these

high risk children. During the second year of the program, a series of sessions (Sessions 24-27)

address how the PICC model could be used in common problem situations with teachers,

siblings, and peers. The peer sessions focus on the difficulties many of these children experience


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with successfully joining ongoing activities of peers, and in negotiating with peers during

disagreements.

Peer pressure and involvement with nondeviant peers. The latter group sessions (28-32)

primarily address issues related to peer pressure, and childrens involvement in deviant peer

groups. These sessions focus on childrens awareness of peer pressure to participate in drug use,

and in various peer pressure coping strategies, using videotapes and role-plays. The dangers that

can be evident in childrens neighborhoods are addressed by having children complete

neighborhood surveys, emphasizing dangers that can lead to peer pressure to engage in deviant

behavior or that can lead to violence. These sessions also assist children in thinking about where

they stand in existing peer groups at their schools and in their neighborhoods, and how they can

become progressively more involved with non-deviant groups of peers.

As Larry was preparing to enter middle school, his behavior and attitude changed

significantly. He began hanging out with a group of neighborhood kids that were getting into

trouble. During these latter group sessions at school Larry was able to talk about issues

involving negative peer influences. He also shared that one of the benefits associated with this

type of affiliation was safety. Larry viewed this deviant peer group in his unsafe community as a

means of protection, rather than a potential hazard. Until Larry and his family moved away from

this environment, the negative peer culture remained a potential significant influence in his life.

Coping Power Child Component: Individual Sessions

The planned individual sessions between Coping Power staff and the children were used

primarily for monitoring and reinforcing childrens attainment of classroom and social behavior

goals (e.g., avoiding fights with peers; resisting peer pressure). The one-to-one sessions also

provided for individual discussion about the general information provided during group sessions

and about coping with specific attributional biases and social problem-solving deficiencies


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children have had in recent social conflicts with peers, teachers or parents. In addition, it is

anticipated that the individual sessions could help to increase the positive relationships between

the children and their group leaders, thus defusing childrens conflicts and oppositional

behaviors in groups, and increasing the group leaders social reinforcement value to the children.

During one of these individual meetings Larry talked about feeling unsafe in his

neighborhood. He mentioned having heard gunshots the previous evening, which made him feel

more fearful about going outside to play with friends. This information helped his

interventionist to better understand the environment in which Larry was residing, and provided

more awareness and insight into his world. The staff interventionist was also able to follow up

with his mother, Belinda about the situation.

Coping Power Parent Component: Group Sessions

The Coping Power parent component is a 16 session parent group program with sessions

distributed over the same 18 month period in which the child component also occurred (5th

and

6th

grade years). Parents met in groups of up to 12 parents or parent dyads with two co-leaders.

Assertive attempts were made to include mothers and fathers in parent groups, although in most

cases only one parent (usually the mother) attended.

The content of the Coping Power parent component is derived from social learning

theory-based parent training programs developed and evaluated by prominent clinician-

researchers in the field of child aggression (McMahon & Forehand, in press; Patterson, Reid,

Jones and Conger, 1975). However, in addition to these standard parent training skills, parents

in Coping Power also learned additional skills that support the social-cognitive and problem-

solving skills that their children learned in the child component. These parent skills are

introduced at the same time that the respective child skills are introduced so that parent s and

children can work together at home on what they are learning. For example, parents learn to set


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up homework support structures and to reinforce organizational skills around homework

completion at the same time that children are learning organization skills in the Coping Power

child component. Parents learn to apply the problem-solving (PICC) model to family problem

solving so that child skills learned in the group will be prompted and reinforced in the family

context. A final section of the Coping Power parent component includes two sessions on stress

management for parents. Part of the rationale for this is to help parents learn to remain calm and

in control during stressful or irritating disciplinary interactions with their children. The sessions

also emphasize the importance of parents taking care of themselves for their own sake.

Attaining parents active involvement in the intervention is one of the harder tasks in

implementing the program. Initially it was very difficult to engage Larrys mother, Belinda.

Numerous home visit attempts were made to encourage participation in the parent component of

the program. She appeared interested and often stated that she planned to attend sessions, yet

during the first semester of the intervention she attended no meetings. In response to outreach

efforts Belinda gradually began to engage in the program. After attending a first session,

regularly scheduled phone calls and home visits were arranged to review material from previous

sessions that she had missed. Now feeling more comfortable, she attended each successive

session. She was also given individual attention to review ongoing homework suggestions from

recent parent meetings. She readily joined in and became an active participant in the group. She

expressed regret at not having attended during the first year and often said how helpful the parent

meetings were. She was sorry to see the program come to an end.

Orientation to parent training. In the first parent group session, an orientation to parent

training is provided. This includes a non-blame-oriented framework for why learning parenting

skills is important in assisting high-risk children through the transition to middle school and a


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presentation of the structure of the group. Parents also complete a checklist of positive and

negative child behaviors with reference to their particular child.

Subsequently, the leaders present the more formal content of the meeting which includes

an explanation, in lay language, of social learning principles including the concepts of positive

and negative consequences for child behavior. An A-B-C (Antecedents-Behavior-

Consequences) chart is introduced in the session and used in all subsequent sessions. As new

parenting skills are introduced, they are entered onto the chart in the appropriate column (e.g.,

"parent praise is written in the column under C). Leaders discuss the specific skills of labeled

and unlabelled praise in this session, and the group ends with a homework assignment to practice

using praise for prosocial child behaviors at home.

Academic support at home. Because session two occurs early in the school year it is

designed to coordinate with child component meeting that are focusing on skills for academic

success and what parents can do to support their children in these area. The primary emphasis is

on how parents can support the completing of homework by the child, and Homework Contracts

are introduced. There is discussion of setting up homework rules, structures, and routines;

providing an appropriate place and materials for homework; and praising and rewarding children

for completing homework. For children with organizational difficulties, parents learn how to

assist the child in organizing completed homework papers and returning them to schools. For

example, parents discuss the importance of checking the childs homework after it has been

completed and prompting the child to place his completed homework in his bookbag.

Belinda initially reported that Larry did not have a regular homework routine.

Homework was done late at night when Larry was too tired to be effective, or in a rushed fashion

in the early morning as he was trying to prepare for school. Belinda was skeptical at first

regarding the likelihood of success of a structured homework routine. However, at the urging of


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other parents in the group, who had used this strategy successfully, she agreed to try setting up a

homework routine. She was given specific instruction about homework routines (consistency of

time, place, etc.), but also allowed some flexibility to tailor this to her own home and family

routines. At the next parent meeting she reported success for Larry in completing homework

(three out of five nights).

Praise and ignoring. In session 3, parents learn how to catch children in prosocial

behavior with further emphasis on rewarding and praising their children when they catch them

being good. Parents refer back to the checklist of positive and negative behaviors that they

completed in the first session and select two positive behaviors from the list to work on. Specific

skills for verbal praise and nonverbal rewards are discussed. Conversely, parents also learn in

this session to ignore minor negative behaviors when they occur. There is a great deal of

discussion of minor behaviors that can be ignored versus more serious misbehaviors that should

not be ignored. Leaders may model ignoring as a skill and/or may ask parents to role play with

them how to ignore a child who is engaging in minor disruptive behavior.

In response to the session material on positive reinforcement, Belinda voiced concern

about praising her son for doing things he is supposed to do. One of the behaviors that she had

checked on the behavior checklist was argues a lot. In group we discussed the concept of

catching your child being good and providing positive consequences. Though Belinda

remained skeptical, she was willing to contract to try praising good behavior for two weeks to

see what happens. At the next meeting Belinda reported that she was successful in carrying out

the homework assignment and noticed that it was useful.

Instructions, rules and expectations. Sessions 4 and 5 focus on the antecedents to child

compliance, giving good instructions and setting up age appropriate rules and expectations.

Leaders present examples of good instructions (i.e., those that elicit compliance) and bad


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instructions (i.e., those that elicit noncompliance from children). Humorous examples are given

and parents are invited to identify which types of instructions they typically use. Examples of

bad instructions are repeating instructions over and over again, and giving instructions in the

form of a question rather than in the form of a declaration. Examples of good instructions are

giving no more than one or two instructions at a time and following instructions with a period of

silence so that the child has a chance to comply. The importance of establishing clear, age

appropriate rules and expectations is also discussed and parents are invited to share examples of

rules and how to communicate them effectively to children. Many parents selected No hitting

or No namecalling as rule for the house. Some parents posted these rules on the refrigerator

door or on a family communication poster board. Use of these structures in the home assisted

with transfer of skills from the group setting to the home environment.

Discipline and punishment. Sessions 6 and 7 are devoted to the topic of discipline and

punishment. Because this is a delicate topic for some parents, parents are first asked about their

ideas about appropriate punishment procedures for children this age. Alternatives to physical

punishment are then presented including time-out, response-cost procedures (e.g., privilege

removal) and the use of contingent work chores as punishment. At the end of the session,

parents are asked to select one punishment procedure that they will try on a consistent basis for

one to two weeks and then report back to the group. Role-play techniques are used in some

groups (where parents are comfortable doing so) to illustrate the appropriate use of punishment

procedures such as time-out and to facilitate transfer of skills to home.

Belinda talked openly about her frustration in parenting Larry. He refused to comply

with her directions and often talked back to her. She wanted some suggestions on how to handle

this problem. During our sessions on discipline and punishment she began to see how ineffective

some of her past strategies had been, and in particular saw how damaging it was to her as a


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disciplinarian when she did not follow through on announced consequences. After practicing in

group with some new techniques, using role play to help her feel comfortable with them, she

chose to implement the work-chore punishment procedure (assignment of extra chores as a

consequence for misbehavior) as outlined in the manual. She began seeing improvement upon

the consistent use of this intervention.

Stress management. Sessions 8 and 9 depart from traditional parent skills training and

focus instead on stress management skills for parents. While a general definition of stress is

given, there is particular focus on the stress involved in parenting. The importance of parents

setting aside time to take care of themselves is introduced and parents are asked about their

own ideas about how to operationalize that concept. Then, active relaxation training is

introduced and the group leaders lead the parents through an exercise of autogenic relaxation

(using guided imagery). In addition, the idea that cognitions about ones child can contribute to

parenting stress and irritable overreactions is introduced and parents give examples of

dysfunctional cognitions associated with parenting. Homework focuses around practicing

relaxation; implementing procedures for taking care of oneself and catching and modifying

dysfunctional cognitions when they occur.

The sessions on stress management were particularly important for Belinda. As an

introduction to this session, parents were asked to do an activity involving a pie chart. They

were asked to draw a circle or pie and to label slices of the pie to correspond to the different

roles they play in life (e.g., being a parent; being a worker, being a friend, being a partner).

Parents were instructed to identify the many things that they do and to make the size of each slice

correspond to the amount of time spent in each area. When asked to share her pie chart with the

group, Belinda was surprised at how small the slice devoted to taking care of myself was in

comparison to the other slices. Likewise, most of the parents either did not have any space


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devoted to taking care of themselves, or if they did, it was by far the smallest slice. The

importance of taking care of oneself was then discussed in the contexts of personal stress

management as well as maintaining the energy to care for others.

Planning for summer and for the transition to middle school. In these sessions, specific

community resources for summer are described and, consistent with the emphasis on the

transition to middle school, school counselors from the middle schools are invited to come and

talk to parents about the middle schools. They discuss how their childs school experience will

change; some of the stresses children face in this transition; how parents can access and work

with middle schools and what parents can do assist their child with coping with this transition.

Family cohesion building. In the fall of the second school year (most children are now in

the 6thgrade) parent groups begin again. The first session of this year (Session 12 overall) opens

with a welcome and reorientation to parent group and a review of parents and childrens

activities over the summer. The importance of setting up academic support structures at home

(e.g., homework rules) early in the school year is emphasized and parents are encouraged to

involve themselves in their childs new middle school. The importance of family cohesion is

discussed even though children are now in middle school, and parents share ideas about how to

conduct family pleasant activities with their children.

During the session on family cohesion building Belinda talked about the lack of fun

times for the family. Their busy schedule, combined with very limited financial resources

presented real barriers to needed relaxation for the family. During our brain storming session

Belinda was able to generate a couple of ideas to try to implement between that session and the

next. She decided to have a family fun night at home on Fridays, during which time the family

could play board games and have popcorn. While these sound like simple solutions (or regular

routines) for many families, for Belinda it was a first step in structuring some planned special


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time with her children. That she was able to do so within the real and severe financial limitations

on her was empowering to her as well.

Family problem-solving and family communication. The next set of parent group

sessions (Sessions 13 and 14) focus on family problem solving and family communication.

Parents are taught the same problem solving model (the PICC model) that children have learned

in their child groups, and parents are encouraged to use the PICC model at home with their child

in addressing parent-child as well as sibling-sibling conflict. A child who is particularly skillful

in using the PICC model is often asked to come to this session and role-play with his/her parent

the use of the PICC model for the group. Parents and children who role-played in group

experienced directly how these skills could be used at home. Other parent group members who

observed the role-play often reported that watching a parent and child actually using the PIC

procedures successfully, made them want to go home and try the procedures with their own

child. In this session, strategies are discussed for managing child disruptive behavior outside of

home, including point systems and privilege removal techniques. Discussion focuses on how

such strategies could be used at the grocery store, at church, at a neighbor or family members

home and in other relevant settings outside of home.

Long-term planning. Session 15 involved a focus on long-term planning. The

importance of parents continuing to be behavior managers and school and community advocates

for their child after the end of the parent training program was emphasized. Leaders discussed

strategies for long term maintenance and also presented material on school and community

resources that parents could use in subsequent years.

Termination session. In a final, termination session (Session 16), leaders presented an

overview of the parent training program and elicited parents feelings and reactions to the

program and about the ending of the program. Often a celebratory event was planned (picnic or


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light supper) and leaders and parents shared their final observations about the group. Where

needed and ethically indicated, specific referral recommendations for treatment were made for

some children and families.

Coping Power Parent Component: Home Visits

Home visits were conducted with the majority of families participating in the parent

component. The primary objectives of home visits were to help promote and sustain engagement

of the families, assist them in problem solving situations, and assess home environmental

issues/needs. In addition, families are supported and assisted as they began implementing skills

covered in parenting group sessions. Assessing families and linking them with available

resources as well as assisting them in the process of obtaining these services was yet another

goal. Telephone calls to the families were used at times to accomplish these goals, in place of

actual visits to the homes.

In addition to these regularly planned home visits, periodic home visits were also

conducted with many of the families in the study during the period of active group intervention.

Home visits were generally scheduled for specific reasons, were problem focused in nature, and

did not follow a set curriculum. For those families without a phone or otherwise hard to reach,

outreach efforts were necessary in order to establish a relationship with them and encourage their

involvement in the program. As was true in the case of Belinda, were multiple attempts not

made to reach her at home, she never would have followed through and participated in the

program. Meeting parents on their own turf often seemed to help bridge the gap that

sometimes interfered with the process of establishing a relationship with them. Once the bond

was made, assisting hard to reach and/or engage families to actively participate in the parent

component of the project became a far less challenging task. Home visits were sometimes


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conducted when a parenting session was missed in order to help parents catch up on what was

covered during the time they were out. Due to the sequencing of the curriculum, giving parents

the opportunity to obtain and review missed session content was viewed as an integral

component of the intervention protocol. This enabled parents to effectively implement the newly

learned parenting skills and techniques that were covered in the program.

Home visits were also scheduled when problems emerged that either did not seem to be

appropriate for bringing up in the group session or had to do with a parent that was not attending

group. An example of this type of home visit took place when Larry stopped attending school.

After the holiday break he did not return to school. The interventionist eventually was able to

locate Belinda, and discovered they had moved to another home that was in a different school

district. The focus of the session dealt with helping Belinda to come up with a plan for getting

her kids back in school.

Coping Power Universal Intervention Components

Universal teacher component. The universal intervention known as Coping with the

Middle School Transitions (CMST) had two components, parent meetings and teacher inservice

meetings, designed to promote home-school involvement, and to address parents upcoming

concerns about transition to middle school. The teacher intervention component consisted of

five 2-hour meetings during the fifth-grade year, with six teachers meeting together with a

Coping staff. Participants earned CEU hours for credit towards license renewal. Teachers were

also paid a stipend for their attendance. Meetings took place after school and the location varied

depending on the needs of individual groups. The first meeting included a focus group approach

in which teachers identified critical middle school transition problems and coping strategies, and

they identified how parents can become involved with school and with their children to facilitate

this coping. Teachers assisted in planning for the first and subsequent parent meetings, and


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teachers are encouraged to attend these parent meetings. In this meeting, and in the subsequent

four teacher meetings, there were a combination of didactic presentation of information on the

topic of that day, and time for teacher problem-solving around the topic, following the format

used in prior research on teacher consulting to facilitate childrens social competence and self-

control (Lochman, Lampron, Gemmer, Harris & Wyckoff, 1989).

The topics for the subsequent teacher meetings were: (2) Methods for promoting positive

parent involvement in the school setting and in their childs education; (3) Enhancing childrens

study skills, abilities to organize work, and completion of homework, including a focus on

childrens self control, the parent-teacher communications around homework, and childrens

social bond to school; (4) Enhancing childrens social competence, by emphasizing teacher

facilitation of childrens emerging social problem-solving strategies; and (5) Enhancing

childrens self control and self regulation, through conflict management strategies involving peer

negotiation and teacher use of proactive classroom management.

Teachers that actively participated in this component of our project expressed a high level

of satisfaction with the collaborative model of the in-service program. Teachers are well trained

in working collaboratively with their peers on academic issues yet rarely have the opportunity to

do so in areas related to social development and behavior management. Identifying the teachers

as the expert, and encouraging them to share with us and one another their suggestions, strategies

and experiences in the classroom aided us in the process of obtaining this valuable information.

Universal parent component. The SMST Parent Meetings consisted of four sessions

scheduled during the fifth grade year, and the sixth grade year. The parent/caretakers of all

children in universal intervention classrooms were invited to attend each of these meetings. The

first Parent Meeting session addressed issues related to childrens success in school and

promoted positive parent involvement with school and their child. The session promoted home-


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school connections, especially around management of homework, and focused on optimal

methods for remaining in communication with teachers. Reinforcement of organized study

behavior was emphasized. Session (2) addressed promoting childrens successful relations with

peers, and what parents can do to promote childrens problem-solving skills in developing new

friends and handling difficult peer situations. Session (3) was in the spring of the fifth grade year,

and addressed parents concerns about the middle school transition, and the academic, social and

behavioral tasks that children have to master during this transition. During the sixth grade year,

groups met with the same composition of parents as in the prior year. Session (4) addressed how

children are coping with middle school, and the obstacles to adequate adjustment there. This

session prepared parents for upcoming adolescent issues, relating to peer pressure, deviant peer

groups, need for parental monitoring, and emergence of adolescent risk-taking behaviors. To

promote parents attendance at their Parent Meetings, a variety of presentation modes were used

at each session (e.g. videos, outside speakers, discussion), and offered light snacks.

Description of Coping Power Participants

High-risk Children Who Received Indicated Prevention Intervention

Coping Power was designed to serve children at the developmental period of transition

from elementary school to middle school, who are deemed to be at risk for later substance use

and abuse. Because it is a prevention intervention program, intervention in the late elementary

school years when substance abuse rates are still relatively low, is designed to prevent or retard

the rapid acceleration in substance use that occurs over the middle school and high school years.

Children were selected for the program on the basis of key risk factors for later substance

use. These risk factors involved moderate to high levels of aggressive and disruptive behavior.

During the first year of the CSAP-funded project 245 preadolescent boys and girls in the

Durham, NC public school system, were selected from 17 fourth grade classrooms. Schools


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were selected primarily from the poorer sections of the city (based on percentage of children

receiving free/reduced lunch). Fourth grade teachers rated all children in their classes on three

items, using 5 point scales, about how verbally aggressive, physically aggressive and disruptive

the children were. The parents of the 31% most aggressive children were then contacted

regarding their consent for participation in the project and 52% gave their consent, resulting in a

total of 245 high-risk children. Of these, the ratio of boys to girls was about 2 to 1.

Approximately 78% of the participants were African American and approximately 22% were

Caucasian. There were 2 Hispanic families in the sample.

Non-risk Children Who Received Universal Intervention

To address the social ecology around the targeted, high-risk children, and thus to have a

greater impact, Coping Power also included a Universal Intervention component. This

component was offered to all children in the same classrooms in which there was at least one

target high-risk child, resulting in 672 children offered this component. The teachers and parents

of these children were also invited to participate in the Universal Intervention component as

described in a later section.

Program Effectiveness

As indicated in a previous section, the Coping Power program was designed to effect

change in four classes of predictor variables for child and adolescent substance abuse:

Childrens social competence, childrens self regulation and self control; childrens school

bonding; and parenting investment and skills. The ultimate goal, of course, is to prevent or

retard the development of substance use and abuse. Follow-up studies show that the Coping

Power program has produced significant preventive effects in childrens substance use and a

number of improvements in the predictor variables presumed to mediate substance use.


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By the end of intervention, even though relatively few sixth graders are using substances

overall, the Coping Power program has led children to have significantly lower levels of

substance use (an overall score of tobacco, alcohol and marijuana use) than did control children

(Lochman & Wells, 2002b). Teachers rated the Coping Power intervention children as having

improvements in social skills, intervention children perceived that their social competence had

improved, and intervention children tended to have less aggressive beliefs and were less angered

by social problems. Teachers also rated the intervention children as having improved behavior,

and both teachers and parents rated the intervention children as having lower levels of proactive

aggression by post-intervention. Intervention effects on school bonding were more limited,

although intervention children tended to perceive they were more academically competent.

Intervention parents had become more supportively involved with their children. On several of

these outcomes, the children who had received both the indicated Coping Power program

targeted at high risk children and the universal intervention had the best post-intervention results,

indicating the importance of nesting targeted interventions for high risk children within universal

interventions. At a one-year follow-up, the Coping Power children had significantly lower rates

of self-reported substance use, and of self-reported delinquency, and higher levels of behavioral

improvement in school (Lochman & Wells, 2003). These preventive outcomes were the same for

boys and girls, and for children of different racial groups.

Perhaps most notably, these findings replicate the follow-up results of another sample,

this one consisting only of aggressive boys (Lochman & Wells, 2004). In this second study, the

boys who received Coping Power had lower rates of substance use, delinquency, and physically

aggressive behaviors at school one year following the interventions end, in comparison to

control children (Lochman & Wells, 2004). Mediation analyses have found that these latter

preventive effects were mediated by the programs effects on the mutable child and parent


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processes that were the focus of the intervention, including childrens hostile attributions,

childrens expectations that aggression has positive outcomes, an internal locus of control over

events in the childrens lives, and parents consistency in their parenting practices (Lochman &

Wells, 2002a).

Conclusion

The available evidence of the effects of the Coping Power program are encouraging, and

indicate that the program has an effect on aspects of childrens problem behaviors, and on their

substance use at the end of intervention, and at a one-year follow-up. This intervention was

carefully designed to impact factors that have been found to influence adolescent substance use,

and thus addresses childrens social competence, self-regulation, school bonding, and parental

involvement. Delivery of this form of intervention at the point of childrens transition from

elementary school into middle school appears to be useful and timely. The success of the

program depends in part on the effective management of various common implementation

issues, including adequate participation by teachers and especially parents in the program

(Lochman & Wells, 1996). In this regard, a problem-solving, collaborative relationship with

parents and teachers is as critical as it is with the children involved in the program. Careful

attention to training and consultation are also critical for successful implementation of the

Coping Power program.


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The Coping Power Program- Capitolo Introduttivo

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