Program Profile: Coping Power Program-Child Component for Pakistani School Children

This is a school-based prevention program that targets fifth- and sixth-grade boys’ early aggressive behaviors to avoid later antisocial behavior in adolescence and adulthood. The program is rated Promising. The program was found to have a statistically significant effect in reducing both aggression in the boys and their tendency to interpret others’ actions as hostile. The program also improved the boys’ ability to respond in appropriate, non-aggressive ways to a variety of scenarios.

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals

Coping Power Program (CPP)—Child Component in Pakistan is a school-based, multicomponent prevention program that targets children’s early aggressive behaviors to avoid violent, delinquent, and antisocial behavior that can develop in adolescence and adulthood. Students learn organizational and study skills; social skills, such as resisting peer pressure; and emotional skills, such as how to handle anger and frustration. This version of the Coping Power Program was culturally adapted for Pakistani school children.

Target Population

The target population includes aggressive boys in late elementary or early middle school, generally in fifth and sixth grade, in Pakistan.

Program Components

CPP includes 25 child-focused group sessions and once-a-month individual sessions. The program is implemented over a 15- to 18-month period. The groups sessions are delivered to small groups of children in meetings that last approximately 50–60 minutes during recess/lunch. The sessions are divided into three parts. The first part focuses on a review of the weekly goal sheets, homework assignments, and content discussion. The second part  focuses on specific activities of the session, and the third part includes assigning points (for participation in activities and goal sheets), assigning homework, providing positive feedback, and a prize box. The first and third parts are repeated in every session, and the second part includes the new subjects and skills presented in each session.

Sessions emphasize group rules and contingent reinforcement, generating alternative solutions, modeling appropriate problem-solving skills, coping and social skills, coping with peer pressure to use substances, and study and organizational skills. Implementers use interactive and engaging methods such as puppets, videos, and demonstrations.

The individual sessions are held once a month for 20–30 minutes, to discuss problems and difficulties with each student.

Key Personnel

CPP can be administered by mental health workers, including school counselors, mental health practitioners, school social workers, or school psychologists who have expertise in implementing groups with children referred for disruptive behavior.

Program Theory

CPP is based on a social-cognitive model that focuses on parenting behaviors and children's social-cognitive risk factors for externalizing behavioral problems. It is specifically designed to help aggressive children who have difficulties processing incoming social information, the accurate interpretation of social events, and others’ intentions—which produces inaccurate thoughts. This contributes to cognitive deficits in problem-solving, which generates maladaptive solutions (Mushtaq et al. 2017).

Additional Information

This is a culturally adapted version of the Coping Power Program. The following changes were made to the original CPP program to make it suitable for Pakistani schoolchildren: 1) the manual was translated into Urdu, 2) religious and cultural beliefs and practices for anger management and control were added, and 3) feelings and emotions were labeled with culturally relevant language.

Study

Mushtaq and colleagues (2017) randomly assigned eligible study participants to either the Coping Power Program (CPP)—Child Component intervention group or to a wait-list control group. The study was implemented in Rawalpindi, a city in the Punjab province of Pakistan. Fourth-grade teachers from five public schools were asked to rate their male students using the Teacher Checklist of Social Behavior and three items that assessed verbal aggression, physical aggression, and disruptiveness. Students were identified as eligible to participate if they had aggression scores that were one standard deviation above the sample mean and were rated as 25 percent more aggressive than their classmates, based on the three aggression items. The study began when the students were in fifth grade. Participants in the intervention group received the abbreviated form of CPP. However, due to low parental response, the parent sessions were not implemented.

A total of 112 severely aggressive boys participated in the study. Of those, 51 were assigned to the intervention group, and 61 were assigned to the wait-list control group. The average age was 9 for both the intervention group and the control group. There were no statistically significant between-group differences on baseline characteristics or baseline levels of the outcome measures.

The outcomes of interest were aggressive behavior, social competence, and social cognition. Teacher-reported aggression was assessed using the Proactive–Reactive Aggressive Behavior Scale. Children’s perceptions of their competence and acceptance in their peer group were measured by self-reported scales of social competence and social support, used in the Center for Substance Abuse Prevention’s (CSAP’s) assessments of the original Coping Power program. Social cognition measures included hostile attribution biases and the generation of aggressive and competent responses to stimuli. Hostile attribution biases were measured using the Home Interview With Child (HIWC). The child was presented with eight stories and asked to judge the intention of the peer’s behavior in each of the stories. Responses were coded as having either benign or hostile intent. In the Social Problem Solving (SPS) measure, which consisted of eight cartoon stimuli with stories, children were asked to come up with up to eight alternative solutions to social problems. Only aggressive and competent responses were used in this study.

A multilevel modeling approach was used to control for the nested nature of children within schools. The intervention was conducted throughout the boys’ fifth-grade school year. Pretests were administered before the intervention was implemented, and posttests were conducted at the end of the intervention period, which ranged from 15–18 months. No subgroup analyses were conducted.

These sources were used in the development of the program profile: