Program

Sep 29, 2017

OVERVIEW

Promoting Alternative Thinking Strategies (PATHS) is a school-based program designed to improve children’s ability to discuss and understand emotions.  According to several evaluations of children in special needs and regular classrooms, PATHS appears to make children more comfortable with discussing feelings, increases their perceived ability to manage their emotions, and results in lower externalizing (acting out) and internalizing (depression) problems and improved social problem solving, with some of these results continuing two years after the program.  However, there were mixed results on impacts on emotional understanding, and the program was not found to have an impact on social competence.

DESCRIPTION OF PROGRAM

Target population: Elementary school aged-children

PATHS is a school-based curriculum that provides children with instruction regarding the expression, understanding, and regulation of emotions.  The program assumes that a child’s ability to understand emotions is an important component of effective problem solving.  Teachers who attend a three-day training workshop and receive weekly consultation and observation from project staff as they deliver the PATHS curriculum to their students.  The lessons, lasting twenty to thirty minutes each, are taught about three times per week throughout most of the school year.  The program assists teachers in applying the skills taught in the program to other aspects of the school day and it focuses on the relationship between cognitive understanding and real-life situations.  Program activities teach children that all feelings are okay to have, but that not every behavior is okay as a response to one’s feelings.  During the program, students make their own Feeling Boxes where they store representations of each emotion, “Feeling Faces,” they learn about throughout the program.   These self-made representations of emotions allow them to communicate their feelings easily throughout the day by attaching them to a small plaque on the front of their desks.  Similarly, students in the program also construct a “Control Signals” poster which resembles a traffic signal with red, yellow, and green lights.  These lights represent each step a child should go through when problem solving; red is “Stop-Calm Down”, yellow is “Go Slow-Think”, and green is “Go-Try My Plan”.  After navigating the different steps of the poster, children are instructed to evaluate how their solution worked.

The curriculum is available from Channing Bete and ranges in price from $399 to $799 per classroom module, depending on the grade level.

EVALUATION(S) OF PROGRAM

Greenberg, M. T., Kusche, C. A., Cook, E. T., & Quamma, J. P. (1995).  Promoting emotional competence in school-aged children: The effects of the PATHS curriculum.  Development and Psychopathology, 7, 117-136.

Evaluated population: The study sample included 286 children (167 males, 119 females).  At the time of the pretest, the students were in the first and second grades with ages ranging from 6 years, 5 months to 10 years, 6 months at pretest (Mean age = 8 years, 0 months).  The sample included 165 Caucasians, 91 African Americans, 11 Asian Americans, 7 Filipino Americans, 7 Native Americans, and 1 Hispanic.  Four children were of unknown ethnic origin.  67 percent were in regular education and 33 percent were in self-contained special education classrooms.

Approach: Regular education classes were drawn from four schools in a Seattle school district while special education classes were drawn from 3 different school districts; Seattle, Highline, and Shoreline.  Randomization occurred at the school level with two schools being assigned to the treatment condition (N = 83 students) and two to the control condition (N = 109).  For special education classes, randomization was done on a classroom basis resulting in 47 special education students being assigned to the treatment condition and 47 to the control condition. Data were obtained in the spring before the intervention for most students and then the following spring, about a month after the intervention ended. Intervention teachers received three days of training, plus weekly consultation and guidance.

Results: Children who received PATHS learned significantly more words for naming feelings than the control group children in regular education and special education.  The regular education students in the intervention group gained 1.2 positive emotion words (F(1, 282)=21.5) and 2.6 negative emotion words (F(1, 282)=49.9), while the control group regular education students gained only 0.1 positive words and 0.4 negative words.  The special education students in the intervention group gained 1.2 positive words and 2.6 negative words, while the special education students in the control group gained 0 positive words and only 0.4 negative words.  Intervention group children in regular education also showed a significant increase in knowledge of five complex feelings relative to regular education children in the control group (F(1, 281)=7.2).  The intervention group regular education students gained 1.7 total definitions while the control group only gained 0.5.  This same impact did not occur in special education students.  Children in the intervention group could provide more appropriate personal examples to feelings than the students in the control group (F(1, 282)=10.4).  Intervention group children also improved their level of reasoning (M=2.77) about how others feel and they were more likely than control group children (M=2.03) to think that they and other people could hide their feelings.  However, no impacts were found for children’s level of reasoning about hiding their own feelings.  Intervention group children were significantly more likely to respond positively to questions about changes in feelings than were control group children. This was driven by findings for the special education students.  Based on these results, the researchers suggest that PATHS at this time seemed to influence children’s fluency and comfort in discussing basic feelings and children’s beliefs about their ability to manage their feelings, but the program had a smaller effect on the children’s knowledge about how emotions work.

Greenberg, M. T., & Kusche, C. A. (1996).  The PATHS project: Preventative intervention for children.  Final Report to the National Institute of Mental Health, Grant No. R01MH42131.

Greenberg, M. T., & Kusche, C. A. (1997).  Improving children’s emotion regulation and social competence: The effects of the PATHS curriculum.  Paper presented at meeting of the Society for Research in Child Development, Washington D. C.

Greenberg, M. T., & Kusche, C. A. (2002).  The PATHS curriculum: Follow up effects and mediational processes.  Development and Psychopathology, in press.

Evaluated Population: 200 regular education 2nd and 3rd graders.  The sample was 65% Caucasian, 21% African-American, and 14% designated as “other” ethnicity.

Approach: Randomization occurred at the school level with 2 schools assigned to the PATHS treatment condition (N=87 students) and 2 schools assigned to the control condition (N=113).  There were no differences between groups at the pretest data collection point.  Measures were taken of students’ social problem solving, non-verbal cognitive abilities, achievement, and teacher/parent/child ratings of behavioral difficulties.  Students were tested at one month, one year, and two years after the end of the intervention.

Results: At posttest, children in the intervention group showed greater improvements over the control group in social problem solving and emotional understanding.  The intervention group was also more likely to give prosocial solutions to interpersonal conflicts and less likely to offer aggressive solutions than the control group.  Significant improvements in cognitive ability were shown in the intervention group.  At the one year follow-up, these differences between intervention and control groups were found again.  Along with the differences found at the initial post-test, the intervention children also showed greater quality of planning ahead on a social planning task.  At the two-year follow-up, the intervention group showed lower externalization of problems and higher adaptive functioning than the control group.  Intervention children also had lower rates of conduct problems than the control group.  This study showed that the results achieved immediately after PATHS remained years later.

Kam, C. M., Greenberg, M., & Kusche, C. (2004). Sustained effects of the PATHS curriculum on the social and psychological adjustment of children in social and psychological adjustment of children in special education. Journal of Emotional & Behavioral Disorders, 12(2), 66-78.

Evaluated Population: This study had a total of 133 students (97 male, 36 female) with disabilities (53 with learning disabilities, 23 with mild mental retardation, 31 with emotional and behavioral disorders, 21 with physical disabilities or health impairments, and 5 with multiple handicaps) from 7 elementary schools in the Seattle, Highline, and Shoreline school districts.  The sample included 88 Caucasian students, 27 African-American students, and 18 students of other ethnicities.  Students in the study were in grades 1-3 and the average age of the participants was 8 years 8 months.

Approach: Special education classrooms were assigned at random to control and intervention conditions.  Students in intervention conditions attended 60 PATHS lessons over a period of 24 weeks.  Lessons focused on the self-control, feelings, and problem-solving units of the PATHS curriculum.  After the program, students were assessed on measures of feelings vocabulary, social problem-solving, and depression.  Teacher ratings of problem behavior and social competence were also collected.

Results: The study found PATHS curriculum had a significant impact on teacher reports of externalizing and internalizing problems such that teacher ratings of externalizing behaviors in treatment condition students decreased and teacher ratings of internalizing behavior increased at a slower rate compared to the control condition students.  Also, there were decreases in self-reported and teacher-reported depression in the students in the PATHS group as compared to the control group.  There was a continued reduction in externalizing and internalizing problems two years after intervention for the treatment group, while control group showed an increase in both externalizing and internalizing problems.  The PATHS intervention was associated with significant increases in knowledge of feelings and ability to recognize feelings of others.  The intervention group experienced significant increases in the likelihood of giving nonconfrontational solutions when compared to the control condition.  No impact was found for long-term social competence.  The researchers explain that the short time frame in this PATHS study resulted in an emphasis on basic self-control and understanding, rather than on social competence.

Conduct Problems Prevention Research Group. (2010). The effects of a multi-year universal social-emotional learning program: The role of student and school characteristics. Journal of Consulting and Clinical Psychology78(2),156-168

Evaluated Population: This evaluation followed 2,937 children in urban, suburban, and rural regions across the US from first grade to third grade. Demographically, students in the intervention and control groups were not significantly different. The students were from three high risk, socio-demographically diverse neighborhoods or towns such Nashville, TN (low to middle SES black and white community), Seattle, WA (low to middle SES diverse population), and central PA (rural, mostly white).   In Nashville, slightly over three-quarters of the students received free or reduced-price lunch (FRPL), while approximately half the students in Seattle received FRPL and 40 percent of the students in Pennsylvania received FRPL. In Nashville, 47.3 percent of children in the control group were from minority racial or ethnic groups, along with 61 percent of children in the intervention group. In Seattle, 50.1 percent of children in the intervention group and 53.9 percent of children in the control group were from minority racial and ethnic groups. Meanwhile, only one percent of students in Pennsylvania came from minority racial or ethnic groups. The students whose outcomes were analyzed were students who stayed in the study from beginning to end, excluding those who were transferred out or withdrew or were no longer participating for any reason.

Approach: The evaluation is a longitudinal, cluster randomized control trial examining impact of the Fast Track PATHS curriculum. At each location, 12 elementary schools in high-risk towns or communities were invited to participate in the PATHS Fast Track prevention model. The schools were matched on a number of characteristics and after agreeing to participate were randomized as either an intervention or control school. The control schools maintained their curriculums and did not make any changes. Students in the intervention schools received a different set of lessons in each grade level with a focus on skills on understanding and communicating emotions. Children are taught to recognize external and internal cues of affect, use appropriate terminology to describe feelings, discuss appropriate behavioral responses, and they receive opportunities to practice skills every day. The methods and language are adapted for each grade level.  To assess the impact of the program, teachers provided ratings on behavioral problems. Students rated one another on disruptive behavior and prosocial behavior.

Results: By the end of third grade, significant positive impacts on teacher-reported authority acceptance (d=0.24), cognitive concentration (d=0.12), and social competence (d=0.34) were found when comparing students in PATHS schools with students in the control schools. Higher poverty levels at the schools and worse aggression behavior at the baseline were found to reduce the magnitude of the intervention’s impact on these outcomes, although they remained statistically significant. Unlike the teachers’ ratings of the student behavior, the students’ sociometric peer ratings of each other were analyzed to determine moderation by gender. Boys in the intervention group were significantly less likely to be rated as aggressive (d=.20) or hyperactive (d=0.12), compared with boys in the control group.  The boys in schools assigned to receive the intervention were only marginally more likely to be identified as prosocial than those in control schools. In the sociometric peer ratings, baseline student characteristics and poverty levels were not found to be moderators.  The authors of the study note that generalizability of the universal intervention might be affected by the intervention’s intent to provide high-intensity services to high-risk students by the project staff rather than the teachers.

Crean, H. F, & Johnson, D. B. (2013). Promoting Alternative Thinking Strategies (PATHS) and Elementary School Aged Children’s Aggression: Results from a Cluster Randomized Trial. American Journal of Community Psychology, 52, 56-72.

Evaluated Population: This study enrolled students in third grade and followed them through to fifth grade. The total sample of the study consisted of 779 students; 422 (54 percent) were in the experimental group, and 357 (46 percent) were in the control group. Demographically, 43 percent of the students were male, 51 percent were white/Caucasian, 38 percent were African-American, and the rest identified as other. In addition to this, the students lived in either urban (57 percent) and suburban (43 percent) areas. About half of the students had a head of the household who worked full-time, and 43 percent were below the federal poverty line. Finally, household education levels varied as 11 percent did not have a member with a GED or high school diploma, 19 percent had a high school diploma, a third had “some college” and another third had a college graduate in the household.

Approach:  This evaluation is a cluster randomized trial which sampled first at the school district level, then from within the school district. In the first year of the study, 10 schools were enrolled in the study and by the second year, four more schools were added. Thus, seven schools were in the experimental group and seven were in the control group. Schools that were randomized to be in the control group continued with their traditional curriculums for the grades. Schools that were randomized to be in the experimental group participated in Promoting Alternative Thinking Strategies (PATHS) curriculum, which focused on understanding emotion and effective social problem solving. The program implementation consisted of teacher training and biweekly consultation and classroom observation conducted by education consultants. Using teacher ratings and child self-report, outcomes for aggression, delinquent behavior, victimization at school, and normative believes about aggression were reported.  To assess program fidelity, teachers reported to the education consultants on lessons they presented and implementation was rated. Teacher ratings of conduct problems, acting out, and aggression were completed using the Behavior Assessment Scale for Children -2 (BASC-2).  Finally, children provided ratings using the Child Report, a group administered self-report questionnaire. Students also completed a “What Would I Do?” which examined social problem solving and hostility.

Result:  PATHS was found to be significantly associated with a deceleration in conduct problems over time (p<.05) although similar impacts for aggression and acting out behavior were not found to be statistically significant.  The students also rated their outcomes at the end of every semester they were enrolled in the program. While student self-reports of aggression, delinquency, or victimization at school did not differ significantly between students in intervention and control schools, a significant relationship between being in a PATHS school and decreased aggressive social problem solving (p< 0.05), hostile attribution bias (p< 0.05), and aggressive interpersonal negotiation strategies (p< 0.05). Changes in normative beliefs about aggression, delinquent minor acts, and victimization at school were not statistically significant.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.channing-bete.com/prevention-programs/paths/

References

Greenberg, M. T., & Kusche, C. A. (1993).  Promoting social and emotional development in deaf children: The PATHS project.  Development and Psychopathology, 20, 117-136.

Greenberg, M. T., & Kusche, C. A. (1996).  The PATHS project: Preventative intervention for children.  Final Report to the National Institute of Mental Health, Grant No. R01MH42131.

Greenberg, M. T., & Kusche, C. A. (1997).  Improving children’s emotion regulation and social competence: The effects of the PATHS curriculum.  Paper presented at meeting of the Society for Research in Child Development, Washington D. C.

Greenberg, M. T., & Kusche, C. A. (1998).  Preventative intervention for school-aged deaf children: The PATHS curriculum.  Journal of Deaf Studies and Deaf Education, 3, 49-63.

Greenberg, M. T., & Kusche, C. A. (2002).  The PATHS curriculum: Follow up effects and mediational processes.  Development and Psychopathology, in press.

Greenberg M. T., Kusche C. A., Cook, E. T., & Quamma, J. P. (1995).  Promoting emotional competence in school-aged children: The effects of the PATHS curriculum.  Development and Psychopathology, 7, 117-136.

Kam, C. M., Greenberg, M., & Kusche, C. (2004). Sustained effects of the PATHS curriculum on the social and psychological adjustment of children in social and psychological adjustment of children in special education. Journal of Emotional & Behavioral Disorders, 12(2), 66-78.

Kusche, C. A. (1984).  The understanding of emotion concepts by deaf children: An assessment of an affective education curriculum.  Unpublished doctoral dissertation, University of Washington.

Conduct Problems Prevention Research Group. (2010). The effects of a multi-year universal social-emotional learning program: The role of student and school characteristics. Journal of Consulting and Clinical Psychology78(2),156-168

Crean, H. F, & Johnson, D. B. (2013). Promoting Alternative Thinking Strategies (PATHS) and Elementary School Aged Children’s Aggression: Results from a Cluster Randomized Trial. American Journal of Community Psychology, 52, 56-72.

KEYWORDS: Children (3-11), Elementary, Males and Females (Co-ed), White/Caucasian, Urban, Suburban, School-based, Cost, Manual, Other Social/Emotional Health, Social Skills/Life Skills, Academic Achievement/Grades, Other Education, Other Behavioral Problems, Depression/Mood Disorders, Aggression

Program information last updated 9/29/17.