Coping Cat/C.A.T. Project

Coping Cat/C.A.T. Project is an intervention designed for students with generalized anxiety disorder, social phobia, and/or separation anxiety disorder. It is a manual-based Cognitive-Behavioral Therapy (CBT) treatment, and includes a workbook with client tasks. Coping Cat is aimed at students aged 6-12, while C.A.T. Project is aimed at students aged 13-17. The intervention includes parent companion materials and digital materials as well.

Included are 16 sessions for youth:

• 8 skill training sessions on:

  • Physiological components of anxiety

  • Recognition of anxious self-talk

  • Modifying problematic self-talk

  • Developing stress management, distraction, and coping strategies

  • Self-evaluation, success attribution

  • Self-reward for successful management

• 8 skills practice sessions on:

  • Rehearsal, multiple attempts

  • Social support group for members

  • Generalization to other contexts

Coping Cat uses the FEAR acronym:

1. Feeling Frightened = recognize physiological signs of anxiety

2. Expecting Bad Things to Happen = identifying anxious cognition(s)

3. Attitudes and Actions That Can Help = coping strategies

4. Results and Rewards = contingency management

The intervention also uses Show That I Can (STIC) tasks as weekly homework to demonstrate mastery over new skills learned in session.

According to the SAMHSA Review of the Coping Cat intervention:

• 16+ outcome study journal articles have been published, with several replications

• 3 experimental randomized controlled trial (RCT) studies

• 3 outcome studies:

  • Youth aged 6-17

  • Male and female

  • Multiple race/ethnicities for most studies; mostly white

• Measures:

  • Anxiety Disorder Interview Schedule (ADIS)

  • 6 instruments used to measure child self-report of symptoms

  • Child Behavior Checklist (CBCL) used for parent-report

  • CBC-Teacher Report Form used for teacher reports

• Statistically significant findings:

  • Decrease in anxiety symptoms 1, 3.5, and 7.4 years after treatment

    • 81% of participants in the 2005 study no longer met criteria for anxiety diagnosis 1 year after intervention - significantly less than the waitlist control group

  • Increase in coping ability in youth

  • Decrease in parent-reported and teacher-reported symptoms

    • 60% of children who participated in Coping Cat, compared to 0% of the controls, had normal range for internalizing behaviors

  • Decrease in observed behavioral signs of anxiety