Promoting Anger Management Skills with the
Coping Power Program:
Adaptation and Dissemination
John E. Lochman, PhD, ABPP
The University of Alabama
Penn State TIES Summer Institute ---- 5/19/11
Topics

Coping Power program
 Intervention research
– Efficacy and effectiveness studies
– Adaptations of program:
 With diagnosed DBD children
 Shorter version and boosters
 individual vs group format
– Dissemination issues:
 parent engagement
 training intensity
 Counselor and school characteristics
Contextual Social Cognitive Model
Background
Community Context
Neighborhood Problem
Family Context
Maternal Depression
Low Social Support
Marital Conflict
Low SES
Mediating
Outcomes
Proximal
Aggressive
Behavior
Parenting
Practices
Context
Child Social
Cognition
and Self
Regulation
Substance
Abuse
Delinquency
Child's
Perception
of Peer
Context
Academic
Failure
Coping Power
Child and Parent Components
Coping Power Child Component:
Derived from the Anger Coping Program
Group format, 5 to 6 children per group
 34 sessions
 Implemented with children ages 8-14
 Also includes periodic 1-to-1 sessions (reinforce
generalization, extend problem-solving, enhance
relationship to adult co-leaders)
 Case-centered teacher consultation

Foci for Coping Power Child
Component

Behavioral and personal
goal setting
 Organizational and study
skills
 Accurate awareness of
feelings related to anger
and vulnerability
 Anger management
training, including methods
for self-instruction,
distraction, and relaxation

Perspective-taking and
attribution retraining
 Social problem-solving in a
variety of situations (peer,
teacher, family)
 Resistance to peer
pressure and focus on
involvement with nondeviant peer groups
Coping Power Parent Component
 Group
format with two co-leaders.
 6 to 12 sets of parents in each
parent group.
 16 sessions.
 Periodic home visits and phone
check-ins.
Foci for Coping Power Parent
Component





Positive attention and rewards
for appropriate child behavior.
Ignoring minor disruptive
behavior.
Provision of clear commands,
rules, and expectations.
Use of consistent
consequences for negative
child behavior (response cost,
time-out, withdrawal of
privileges).
Monitoring of children’s
behavior in the community.




Improvement of family
communication and increasing
family activities.
Improvement of parents’ own
stress management.
Informing parents of children’s
current work on socialcognitive skills (e.g., problemsolving skills) in their group, so
parents can reinforce
children’s use of these new
skills.
Academic support at home.
Coping Power
Intervention: Efficacy and
Effectiveness
NIDA-funded study of
Child Component only
vs.
Child and Parent Components
Lochman & Wells (2004), Journal of Consulting and Clinical Psychology, 72, 571-578
Sample

183 high risk boys, in the top 22% of teacher-rated
aggression on a screening measure administered in the 4th
and 5th grades of 11 schools, randomly assigned to 3
conditions: Child Component Only, Child + Parent
Component, Control [73% assessed at the follow-up]
 61% African American, mean income of $25,000
 No baseline differences across conditions in ethnic status,
cognitive ability, or aggression screen score
 Normative Comparison: 63 non-risk boys: 47% AfricanAmerican, mean income of $35,000 [87% assessed at
follow-up]
Effect Sizes of Contrasts with Control Cell:
Outcomes at 1 Year Follow-up
Child Component Only
Child + Parent
Component
Delinquency
-
.37*
Substance Use (Parentrated)
-
.66*
.42*
.34*
School Behavioral
Improvement
Contextual Social-Cognitive
Mediators and Child Outcome at a
One Year Follow-up: Mediation of
Coping Power Effects
Lochman & Wells (2002), Development and Psychopathology, 14, 945-967
Intervention
.19**
Ethnic Status
.12
Grade
.04
.10
Screening Status
Delinquency
.07
Attributions
Outcome Expectations
Internal Control
Person Perception
Parental Inconsistency
.21*
.26
**
-.11
.14
+
.13
Attributions
-.22*
Outcome Expectations
-.22*
Internal Control
-.14+
Person Perception
.19*
Parental Inconsistency
Intervention
.11
Ethnic Status
.07
Grade
.02
.10
Screening Status
Delinquency
.07
Attributions
Outcome Expectations
-. Internal Control
Person Perception
Parental Inconsistency
.21*
26
**
-.11
+
.14
.13
Attributions
-.22*
Outcome Expectations
-.22*
Internal Control
.14+
-.08
-.07
-.14+
Person Perception
.02
.19*
Parental Inconsistency
.21*
CSAP-funded Effectiveness
Study
Lochman & Wells (2002) Psychology of Addictive Behaviors, 16, S40-S54
Lochman, J.E. & Wells, K.C. (2003), Behavior Therapy, 34, 493-515
Sample
245 moderate to high risk children , in the top
30% of teacher-rated aggression on a screening
measure administered in the 4th grades of 17
schools
 66% male
 78% African American
 No baseline differences across conditions in
sex, ethnic status, cognitive ability, or
aggression screen score
 84% assessed at one-year follow-up, 83%
assessed at two-year follow-up

Post-Test: Parent-Rated Proactive
Aggressive Behavior
Time X Indicated: F(2,416)=2.68
1.45
1.4
Proactive 1.35
Aggression
1.3
Baseline
Mid-Int
Post
1.25
1.2
Indicate
Control
Condition
Post-Test: Teacher-Rated Proactive
Aggressive Behavior
Time X Indicated: F(1,183)=3.02
6.2
6
5.8
5.6
Mid-Int
Post
5.4
5.2
5
4.8
Indicated
Control
Substance Use (youth self report of use of
Tobacco, Alcohol, and Marijuana in the past month)
Coping Power vs Control: F(1,120)=10.8, p=.001
3.7
3.6
3.5
3.4
3.3
Coping P
Control
3.2
3.1
3
2.9
2.8
Baseline
1 yr FU
Delinquent Behavior
(Youth self report of theft, assault, property destruction, fraud,
and drug selling in the past month)
Coping Power vs Control: F(1,129)=4.30, p=.04
7.2
7
6.8
Coping P
Control
6.6
6.4
6.2
6
1 yr FU
Teacher-rated Peer Aggressive
Behavior
(fighting and harming others from the TOCA-R)
Coping Power vs Control: F(1,80)=4.18, p=.04
6
5
4
Coping P
Control
3
2
1
0
Baseline
1 yr FU
Longer – Term 3 Year Follow-up:
TOCA Aggression: Coping Power vs Control
CP vs C: AGGCONC*YEAR*CP
1.3
CPOWER = 0.000000
CPOWER = 1.000000
1.2
1.1
A
G
G
C
O
N
_
C
1.1
1.0
1.0
0.9
0.8
0.8
0.7
0.7
0.00
1.17
2.34
3.51
CP_YEAR
4.68
5.86
Coping Power
Intervention: Adaptations
Coping Power Study
with ODD/CD Dutch Children
van de Wiel, N.M.H., Matthys, W., Cohen-Kettenis, P.T., Maassen, G.H.,
Lochman, J.E., & van Engeland, H. (2007). The effectiveness of an
experimental treatment when compared with care as usual depends on
the type of care as usual. Behavior Modification.
Zonnevylle-Bender, M.J.S., Matthys, W., van de Wiel, N.M.H., &
Lochman, J. (2007). Preventive effects of treatment of DBD in middle
childhood on substance use and delinquent behavior. Journal of the
American Academy of Child and Adolescent Psychiatry, 46, 33-39.
van de Wiel, NMH, Matthys, W, Cohen-Kettenis, P, & van Engeland, H
(2003), Behavior Therapy, 34, 421-436.
Sample and Program

77 children with ODD or CD were randomly assigned to Utrecht
Coping Power (UCPP; N=38) or to Care-As-Usual (N=39) in child
psychiatry clinics
 8-13 years of age
 UCPP was 23 session child program and 15 session parent
program adapted from full Coping Power program
 UCPP implemented with new trainees (0.5 years experience); CAU
given by experienced clinicians (10.0 years experience)
 Primary therapy types in CAU were CBT and Family Therapy
 CAU continued to receive services in the period between Post and
Follow-Up (26/39 cases; vs 4/38 for UCPP)
Results at 4 Year Follow-Up:
Substance Use
Tobacco (last month)
CAU
(N=31)
42%
UCPP
p
(N=30)
17%
0.02
Alcohol (last month)
65%
67%
ns
Marijuana (ever)
31%
13%
0.04
Booster Intervention with Briefer
Version of Coping Power

A remarkably understudied assumption, with few
randomized tests of whether boosters promote long-term
maintenance or produce long-term preventive effects, as
assumed
– Have been positive effects of a brief booster to the Anger Coping
program in maintaining observed classroom disruptive off-task
behaviors at a 3 year follow-up (Lochman, 1992), and of a booster for a
family-focused prevention program on child aggression at a 1 year
follow-up (Tolan et al, 2009)
– However, boosters have not produced additional effects in a
treatment for adults with impulse-control problems (Hodgins et al, 2009)
nor for a classroom social problem solving program to reduce
aggression (Daunic et al, 2006)
Sample and Design (Lochman, Boxmeyer,
Powell, Roth & Windle, 2006, New Directions for Evaluation)

240 children in 7 schools screened for
aggressive behavior by teacher ratings (top 30%),
randomly assigned to CP versus control
– 64% boys; 69% African-American
CP intervention delivered during 5th grade
 CP children randomly assigned to Booster in 6th
grade
 5 assessment points: T1 (pre), T2 (postintervention), T3 (post-Booster), T4 FU1, T5 FU2

HLM Growth Curve Analyses Time 1-5
Level 1 – time
 Level 2 – individuals and intervention
condition
 Level 3 – nested within schools


Quadratic effects not significant
Brief Coping Power – Growth Curve Analyses
Time 1-5 – on Teachers’ APSD ImpulsiveConduct Problems
COEFFICIENT
(SE)
p VALUE
CP-Only vs
Control
-.27 (13)
.032
CP-Booster vs
Control
-.59 (.20)
.004



Coping Power delivered during 5th grade (24 child sessions, 10 parent sessions)
CP Booster – monthly individual sessions in grade 6
CP-Only:60: CP-Booster:60; Control:120
Impulsive-Conduct
Teacher APSD Impulsive-Conduct
Problem Ratings by Condition
Teacher Rated APSD Impulsive-Conduct Problem
5.83
Control
CP Only
Booster CP
5.37
4.92
4.47
4.02
0
0.97
1.93
Year
2.90
3.87
Brief Coping Power – Growth Curve Analyses
Time 1-5 – on Teachers’ APSD Ratings of CU
Traits
COEFFICIENT
(SE)
p VALUE
CP-Only vs
Control
-.40 (.20)
.045
CP-Booster vs
Control
.10 (.15)
ns



Coping Power delivered during 5th grade (24 child sessions, 10 parent sessions)
CP Booster – monthly individual sessions in grade 6
CP-Only:60: CP-Booster:60; Control:120
Teacher APSD CallousUnemotional Ratings by Condition
CU Trail
Teacher Rated APSD Callous-Unemotional Trail
6.00
Control
CP Only
Booster CP
5.72
5.44
5.16
4.87
0
0.97
1.93
Year
2.90
3.87
Teacher APSD CU: CP-Only X Sex
CU Trail
Teacher Rated APSD Callous-Unemotional Trail
6.39
Girl, Control
Girl, CP Only
Boy, Control
Boy, CP Only
5.88
5.37
4.86
4.35
0
0.97
1.93
Year
2.90
3.87
Individual vs Group Formats

Although overall Coping Power program effects have
significantly reduced children’s problem behavior, it is
plausible that the degree of positive effects may be reduced
or truncated to some degree by deviant peer effects and
other behavioral management problems with groups of
children.
– The steepest growth of substance use occurs among adolescents
with drug-using peers (Chassin et al., 1996; Curran et al., 1997).
– Similarly, aggressive children within classrooms with high rates of
other aggressive children are more likely to increase their aggression
during that academic year (Barth et al., 2004).
Intervention Research on
Deviant Group Effects

By a 1-year follow-up, Dishion and Andrews (1995) found that
youth who had received youth ATP sessions had higher rates
of tobacco use and of teacher-rated delinquent behaviors
than did the control children, and these iatrogenic effects
were evident even if the parents had also received
intervention in the combined condition.
– At a 3-year follow-up, the teen intervention conditions continued to
have more tobacco use and delinquency (Poulin et al., 2001).
– Analyses of the iatrogenic group conditions revealed that subtle
dynamics of deviancy training during unstructured transitions in the
groups predicted growth in self reported smoking and teacher ratings
of delinquency (Dishion et al., 2001).
Pilot Study of Individual vs Group
format for Coping Power

11 schools randomly assigned to either the ICP (individually
delivered Coping Power) or GCP (group delivered Coping
Power) condition (ICP: 30; GCP: 30)
 abbreviated CP intervention: 24 child sessions and 10
parent sessions during the 4th grade year
 Assessments: T1, T2 (after 5 sessions), T3 (post; 98%
retention)
Baseline-Post (T1-T3)
parent-rated BASC Conduct Problems – ICP vs GCP contrast
Repeated Measures Anova: Time X Cond: p=.008*
OJ J DP
S a ml p e
I CP
vs
GCP
L S me a n _ CP p a r e n t
7. 0000
6. 0000
5. 0000
4. 0000
1
2
T i me
Co n d i t i o n
Gr o u p - CP
3
Po i n t
I n d i v i d u a l - CP
Baseline-Post (T1-T3)
Dominance/Revenge Social Goals – ICP vs GCP contrast
Repeated Measures Anova: Time X Cond: p= 01**
OJ J DP
S a ml p e
I CP
vs
GCP
L S me a n _ S GCc o mp
0. 2000
0. 1000
0
- 0. 1000
- 0. 2000
- 0. 3000
- 0. 4000
- 0. 5000
- 0. 6000
- 0. 7000
- 0. 8000
- 0. 9000
- 1. 0000
- 1. 1000
- 1. 2000
1
2
T i me
Co n d i t i o n
Gr o u p - CP
3
Po i n t
I n d i v i d u a l - CP
Baseline-Post (T1-T3)
Self-Dysregulation – ICP vs GCP contrast
Repeated Measures Anova: Time X Cond: p=.03*
OJ J DP
S a ml p e
I CP
vs
GCP
L S me a n _ T o t A DI
1. 3900
1. 3800
1. 3700
1. 3600
1. 3500
1. 3400
1. 3300
1. 3200
1. 3100
1. 3000
1. 2900
1. 2800
1. 2700
1. 2600
1. 2500
1. 2400
1. 2300
1. 2200
1. 2100
1. 2000
1. 1900
1. 1800
1. 1700
1
2
T i me
Co n d i t i o n
Gr o u p - CP
3
Po i n t
I n d i v i d u a l - CP
Pilot: Individual vs Group Effects

Individual format (ICP) is more effective than Group
Format (GCP) in reducing parent-rated children’s
conduct problems; no difference for teacher-rated
externalizing at post
 GCP was more effective than ICP in reducing
children’s dominance/revenge-oriented social goals
and in improving their self-regulation
 Thus, group and individual delivery of programs
may affect different types of outcomes; unclear how
format will affect longer term followups
Other adaptations in progress
Other adaptations/moderator
studies in progress…..
Use of “Adventures of Captain Judgment” to
augment intervention and to make a briefer, more
efficient intervention
 Coping Power for early adolescents (repair of

damaged relationships, etc) – w/ Bradshaw & Ialongo - Hopkins
Coping Power with Family Check-Up – adaptive
parent intervention – w/ Bradshaw & Ialongo - Hopkins
 Cultural adaptations in Ireland, Italy and Pakistan
 Neurodevelopmental predictors (Prefrontal cortex;
limbic system) of CP response – w/ Drabick, Steinberg

Dissemination Issues

Parent engagement in preventive intervention
is only a function of parent characteristics ?
Parenting Practices Mediate Effect of Family Context
on Parent Attendance at CP Parent Sessions
Ryan, Boxmeyer & Lochman, Behavioral Disorders, 2009
Parental
Monitoring
Positive
Parenting
Parent
Involvement
Dominant
Social Goals
Maternal
Depression
Child Social
Goals
Community
Support
Revenge
Social
Goals
Contextual
Factors
Parenting
Community
Problems
Attendance
SES/Parent
Education
Parent
Attendance
Feedback
Form: Tool
to
communicate
and connect
family
strength and
areas of
concerns.
Enhancing parent engagement:
through children

Lag effects of child engagement and parent
engagement during Coping Power sessions
Parent and Child Engagement Across early, Middle
and Late Intervention
Ellis, Lindsey, Barker, Boxmeyer & Lochman, under review
Parent T1
Parent T2
0.59
0.81
Parent T3


0.34
0.11
0.19
Child T1
0.62
Child T2
0.47
Child T3
Parent
engagement:
attendance
Child
engagement:
attendance,
goal points
earned, group
points earned

Parent engagement is affected by parent
characteristics, such as their parenting patterns
 However, parenting characteristics such as
motivation can be changed (e.g. with the Family
Check-up), and child characteristics, such as
children’s initial engagement in their own sessions,
can directly affect parent engagement
Dissemination within real-world
settings: training issues
and organizational factors
Field Trial: Effects of the Intensity of
Training Provided to Counselors
Lochman, Boxmeyer, Powell, Qu, Wells, & Windle (2009). Journal
of Consulting and Clinical Psychology
.
Training Study: Field Trial
School selection:

57 schools from 5 public school systems
 Range of urban and suburban schools in Alabama
 Random assignment by counselor to:
– Basic Training (CP-BT; 19 schools)
– Intensive Training (CP-IT; 19 schools)
– Care-as-usual comparison (C; 19 schools)
Field Trial Methods
Participant selection:

Teacher screening for “at-risk” youth
– Rated proactive and reactive aggressive behavior of all 3rd
grade students
(Hill et al., 2004; Lochman & CPPRG, 1995)
– 3,774 3rd graders screened
– 30% most aggressive eligible for participation
– 531 participating students (79% of 670 contacted):



183 CP-BT schools; 168 in CP-IT; 180 in C
84% Af Am; 14% Cauc; 2% Other
95% retention at post-intervention (2 yrs after baseline)
Field Trial Methods
Counselor characteristics:

49 counselors
– 17 in CP-BT, 15 in CP-IT, 17 in C
– 8 counselors served 2 of the participating schools
96% Female, 4% Male
 51% Af Am, 49% Caucasian
 18% Doctoral level, 80% Master level, 2% BA
 Years experience:

– 9.9 in CP-BT, 11.9 in CP-IT, 8.8 in C
Field Trial Methods
Training process:
(1) 3 days of workshop training
(2) Monthly meetings (2 hours) while
intervention underway
For CP-IT counselors only:
(3) Individualized feedback on
audiotaped sessions
(4) Technical assistance from trainers
via telephone and email contacts
Results: Program Implementation
Implementation Quality
– Counselor engagement (audio coder ratings,
with children and with parents; 5-point ratings on 14
items on warm tone, tone not irritable, makes teaching
moments, provides consequences for group rules,
stops to clarify material; elaborates beyond manualized
material, stimulates discussion, etc) – alpha: .86 (w/
children), .82 (w/ parents)
Results: Implementation Quality
5
CP-Basic
Training
CP-Intensive
Training
4
p<.02
3
2
1
Positive Child
Group Leadership
Positive Parent
Group Leadership
Results: Training Outcomes
Outcomes:
HLM used to evaluate if intervention
condition/training intensity influenced:
-Children’s externalizing behavior problems
-Child and parent mediating processes
Two-level model with:
-Level 1 Students (within-unit model)
-Level 2 Counselors (between-unit model)
CP-Intensive
vs Control
**p<.01, *p<.05,
Estimate (SE)
Behavior Problems
BASC Externalizing
(teacher-report)
-.41* (.11)
BASC Externalizing
(parent-report)
-.23*(.12)
NYS Minor Assault
(child-report)
-.25** (.12)
Targeted Processes
BASC Social/Academic
(teacher)
.35* (.13)
BASC Social (parent)
Outcome Expectations
(child)
APQ Inconsistent Discipline
(parent)
-.24* (.08)
**p<.01, *p<.05, +p=.06
CP-Intensive vs
Control
CP-Basic
vs Control:
Estimate (SE)
Estimate (SE)
Behavior Problems
BASC Externalizing
(teacher-report)
-.41* (.11)
BASC Externalizing
(parent-report)
-.23*(.12)
NYS Minor Assault (childreport)
-.25** (.12)
Targeted Processes
BASC Social/Academic
(teacher)
.35* (.13)
BASC Social (parent)
Outcome Expectations
(child)
APQ Inconsistent
Discipline (parent)
-.24* (.08)
.24+ (.13)
Conclusions/Implications for Training

Evidence-based prevention programs such as Coping
Power can be disseminated effectively to counselors
in real-world settings, although:
 The intensity of training makes a difference in whether
improvements in children’s outcomes and mediating
processes occur
 Ongoing supervisory feedback about program
implementation (particularly to foster client
engagement) may be critical to promoting positive
outcomes
 The intensity of training required will likely vary according to
the experience and prior training of the providers, to the
type of psychopathology being addressed, and to the
complexity of the program being used
The Effect of School and Counselor
Characteristics on Implementation of a
Preventive Intervention
Lochman, Powell, Boxmeyer, Qu, Wells, & Windle. (2009).
Professional Psychology: Research and Practice
Field Trial: Sample and Design

The two training conditions, with 32 counselors,
were pooled for these analyses
Field Trial: Implementation Analyses

1.
The predictors of implementation:
school environment (Moos’ Work Environment Scale;
Moos, 1981) – completed by all 4th and 5th grade teachers
- staff relationships (staff cohesion and
support)
- staff autonomy
- degree of managerial control
Field Trial: Implementation Analyses
2.
counselor characteristics
- neuroticism (NEO Five Factor Inventory; Costa &
McCrae, 1992)
- extraversion (NEO)
- openness (NEO)
- agreeableness (NEO)
- conscientiousness (NEO)
- cynicism (Cynicism about Organizational Change;
Reichers et al,
1997)
Field Trial: Post Analyses

Implementation dependent variables are:
1. Program Delivery
–
Objectives completed
– Sessions scheduled
2. Implementation Quality
– Counselor engagement (audio coder ratings, with children
and with parents)
Hierarchical Regression Analyses Beta
Coefficients (Standard Errors):
Program Delivery
*p<.05, +p<.10
Agreeableness
Objectives
Sessions
Completed Scheduled
.086* (.042)
.185+ (.103)
Managerial Control
-.286+ (.149)
Hierarchical Regression Analyses Beta
Coefficients (Standard Errors):
Counselor Engagement
**p<.01, *p<.05
Conscientiousness
With
Children
.068* (.032)
Agreeableness
.112** (.039)
-.734** (.200)
Managerial Control X Cynicism
Autonomy X Cynicism
With
Parents
.674** (.173)
Autonomy X Cynicism
Engagement with Children
2
1.5
1
Cynicism No
Cynicism Yes
0.5
0
-0.5
-1
Low Autonomy
High Autonomy
Conclusions About Counselor and
School Characteristics
The GOOD NEWS: It is ok to be neurotic, not
particularly open-minded, not particularly
extraverted, and cynical if you are in the right work
environment
 Degree and quality of implementation can be
influenced by agreeableness and conscientiousness
of counselors and by characteristics of the school
setting which interact with counselor characteristics
(counselor cynicism in interaction with school
autonomy and rigid managerial control)
