By Keelyn Ingmire & Austin Matthews, 9/2022
What is Coping Cat?
Coping Cat is an intervention for children and adolescents ages 7-13 experiencing elevated levels of anxiety. The intervention can be used in individual or group settings. Coping Cat is based in cognitive-behavioral theory with the goal of reducing anxiety and learning adaptive coping skills. The intervention can be used in a variety of settings, including hospitals, community-based agencies, group or residential care, and school settings. Parents are also involved in the intervention and participate in sessions 4, 9, and as needed during exposure sessions. The materials are available in English, Chinese, Hungarian, Japanese, Norwegian, and Spanish. Parents (California Evidence-Based Clearinghouse (CEBC), 2018).
Components of Coping Cat
The intervention is given in weekly 50-minute sessions over 16 weeks.
Group sessions typically consist of 4-5 participants (Manhattan Psychology Group, PC, 2021).
The materials needed for this intervention include a therapist manual, which guides the practitioner through the intervention, and a child workbook including worksheets for in-session work and the STIC (Show That I Can) tasks (CEBC, 2018).
In the first 8 sessions, children and adolescents are taught about recognizing and managing anxious feelings and physical reactions to anxiety, clarifying anxious thoughts and feelings, and practicing coping skills.
The last 8 weeks consist of practicing the new skills while being exposed to imaginary and real life situations going from low stress/anxiety to high stress/anxiety (Manhattan Psychology Group, PC, 2021).
The primary components of Coping Cat include psycho-education, somatic management, cognitive restructuring, problem solving, and exposure tasks. The practitioner provides psycho-education regarding information about how anxiety is developed, maintained, and treated. Participants are taught somatic management through relaxation techniques.
Cognitive restructuring is taught through the acronym FEAR: feeling frightened, expecting bad things, attitudes and actions that will help, and results and rewards through self-evaluation of performance of using coping skills at home and in exposure tasks and contingent reinforcement.
Problem solving is practiced through generating and evaluating specific steps for dealing with problems. In the exposure tasks, the child is placed in an anxiety-inducing situation and is able to use the skills taught to have a mastery experience. Homework is also assigned through the Coping Cat intervention.
One STIC (Show That I Can) task is assigned each week, and these assignments help participants practice skills learned in session in the real world (CEBC, 2018).
Evidence of Coping Cat Effectiveness
A meta-analysis of Coping Cat’s effectiveness found a large effect size in Coping Cat’s reduction of anxiety when compared to no-treatment or waitlist groups, and participants in the experimental group were significantly better at managing their anxiety. When compared to alternative treatments, Coping Cat had a small effect size, and participants who participated in the Coping Cat intervention had a slight advantage in managing anxiety (Lenz, 2015). Further research has indicated that children with anxiety were more likely to fully recover, reported less negative emotions associated with recent negative events, and were more likely to remain in recovery after a year when in the Coping Cat intervention than in child-centered therapy (Silk et al., 2016).
California Evidence-Based Clearinghouse (CEBC). (2018). Coping Cat. Retrieved from https://www.cebc4cw.org/program/coping-cat/detailed
Lenz, A. S. (2015). Meta-analysis of the coping cat program for decreasing severity of anxiety symptoms among children and adolescents. Journal of Child and Adolescent Counseling, 1(2), 51-65. doi:10.1080/23727810.2015.1079116
Manhattan Psychology Group, PC. (2021). Treating anxiety in children with the "Coping Cat" program. Retrieved from https://manhattanpsychologygroup.com/treating-anxiety-children/
Silk, J. S., Tan, P. Z., Ladouceur, C. D., Meller, S., Siegle, G. J., Mcmakin, D. L., Forbes, E. E., Dahl, R, E., Kendall, P, C., Mannarino, A., & Ryan, N. D. (2016). A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 47(4), 542-554. doi:10.1080/15374416.2016.1138408