Program

Jan 16, 2013

OVERVIEW

The RECAP program
was developed as part of the process of establishing a series of school-based
mental health clinics during which a need was recognized for an effective
program for children with concurrent internalizing and externalizing problems.
It serves as both a treatment and prevention program for children having
both internalizing and externalizing problems, and is designed to help
children, parents and teachers address psychopathology and social functioning
of children experiencing concurrent internalizing and externalizing problems.
In an experimental evaluation of the program with random assignment at
the school level, researchers found greater rates of improvement for children
in the treatment groups than in the control for both internalizing and
externalizing problems. A significant treatment impact was found for
internalizing problems, and a significant prevention impact was found for
externalizing problems in the treatment groups.

The pre-RECAP
program was developed as an intervention to meet the need for a classroom-based
program that provides pre-kindergarten teachers with the structure and
materials necessary to promote young children prosocial skills development, and
address pre-school children’s emotional and behavioral problems. In an
experimental evaluation of the program’s impact on children’s
behavior and social skills, a significant treatment impact was found for
teacher reports of social skills and externalizing and internalizing behaviors,
with children in the treatment condition showing greater improvement than
children in the control condition. No significant treatment impacts were found
for parent reports of social skills and externalizing and internalizing
behaviors.

DESCRIPTION OF
PROGRAM

RECAP Target
population: 
elementary schoolchildren in low-income schools with concurrent
internalizing and externalizing problems

RECAP is a
semi-structured, cognitive behavioral skills training program developed for
elementary school children with internalizing and externalizing problems.
The program lasts one academic year, and includes individual sessions; small
group sessions; classroom groups with a peer group; classroom teachers, and
parent group sessions. The treatment aspect of the program emphasizes reduction
of the level of children’s social and psychological problems. The
prevention aspect of the program focuses on preventing the development of more
serious problems among children who have not been referred for mental health
services. In addition, teachers are provided with in-classroom
consultation on program implementation and classroom-wide behavior management
by trained program consultants.

Pre-RECAP Target
population: pre-schoolteachers

Adapted from the
original RECAP program model, the pre-RECAP program was developed as an
intervention to meet the need for a classroom-based program that provides
teachers with the structure and materials to address pre-school children’s
emotional and behavioral problems, and promotes children’s prosocial
skills development. For one full academic year, trained program consultants
spend one day (4-6 hours) per week in classrooms for ongoing teacher training,
observation of teachers, and consultation on implementation. The program
also includes a corresponding component for parents, which consists of 16
bi-weekly group meetings aimed at enhancing parenting skills and reinforcing
the intervention.

EVALUATION(S) OF
PROGRAM

Weiss, B., Harris, V., Catron, T., & Han, S. S. (2003).
Efficacy of the RECAP intervention program for children with concurrent
internalizing and externalizing problems. Journal of Counseling and Clinical
Psychology, 71
, 364-374.

Evaluated
population: 
In this evaluation study, eighty-nine children from
low-income schools participated. Of the total group, 63% of the children were
male, with a mean age of 9.7 years. Fifty-six percent were African American and
thirty-eight percent were Caucasian.

Approach: To evaluate the RECAP program’s
ability to reduce psychopathology and improve the social functioning of
children experiencing concurrent internalizing and externalizing problems,
researchers selected three elementary schools without mental health services
that served high-risk populations. Mental health assessments conducted by the
school system at the end of grade 3 were used as the first step to select children
to participate in the program. Any child scoring at least one standard
deviation above the central tendency measure on the internalizing,
externalizing and overall psychopathology scores for two of three domains was
eligible for enrollment. This selection procedure was used, rather than
one based on diagnostic criteria to ensure that children with a range of
severity of psychopathology were included in the study, as well as to protect
external generalizability. Because individual classrooms were the implementation
site for the RECAP program, principals were asked to randomly distribute
children across two treatment classrooms and one control classroom. The
control group received no treatment.

The evaluation was conducted over one full academic year.In the beginning of the school year, three trained RECAP clinicians
conducted baseline outcome assessments, which included reports from teachers,
parents, peers, and self-reports. Abbreviated assessments were conducted twice
during the school year for teacher- and self-report psychopathology and once
for peer- and parent-report psychopathology. Follow-up post-treatment
assessments were administered to all four units approximately one month before
the end of the school year. Approximately, one year later, parental
satisfaction surveys, and follow-up assessments were conducted with only three
of the four units (parents, teachers, and children). Student academic grades
and school attendance records were also collected.

Results: Analyses of the RECAP program reveal a
significant treatment impact (i.e. amelioration of psychopathology) for
self-reported internalizing problems, a significant prevention impact (i.e.,
prevention of deterioration of functioning) for teacher-reported externalizing
problems, and both for teacher-reported internalizing problems in the treatment
groups. Treatment was also found to decrease negative peer nominations.
However, at final assessment, a substantial proportion of children were not
functioning in the normal range. In addition, no significant treatment impact
was found for academic grades, school attendance, or parental satisfaction.

EVALUATION(S) OF
PROGRAM

Han, S. S., Catron, T., Weiss, B., & Marciel, K. K.
(2005). A teacher-consulation approach to social skills training for
pre-kindergarten children: Treatment model and short-term outcome effects. Journal
of Abnormal Psychology, 33
, 681-693.

Evaluated
population: In this evaluation study, 149 children (aged 4-5 years) and
their parents participated. The average age of the children was 4.4 years, and
56% were female. The parent participants were primarily mothers (80%).
Children attended low-income schools.

Approach: Twelve pre-kindergarten classrooms in six
public schools that serve children were selected to evaluate the efficacy of
the impact of the pre-RECAP program on children’s behavior and social
skills. Random assignment to treatment and control conditions occurred at the
school level. Three schools containing six classrooms were assigned to the
treatment condition, and three schools containing six classrooms were assigned
to the control condition. The control group received no treatment.
Pre-treatment data on child behaviors and social skills were collected from
parents and teachers in the fall, and post-treatment data were collected in the
spring of the academic year. Data collection tools included interviews and
questionnaires.

Results: Using pre- and post-test treatment data
collected from parents and teachers during the academic year, significant
treatment impacts were found for teacher reports. Compared with children
in the control group, children in treatment conditions improved significantly
in their teacher-rated social skills and externalizing and internalizing
problems. No significant treatment impacts were found for social skills, or
externalizing and internalizing problems in parent reports. According to the
researchers, this inconsistent finding was not unexpected. Given the low
parental attendance rate (< 5%) at the group meetings, it is unlikely that
parents would have employed the intervention at home.

Note: Since teachers both implemented the treatment and
provided assessments of children’s behavior, teacher ratings are not
blind. This limitation may explain impacts on teacher reports but not
parent reports. The authors argue, though, that few parents participated
in the intervention and, thus, that there were impacts in the school but not in
the home.

Note: Analyses were not designed to adjust for the effect of
clustering within schools.

SOURCES FOR MORE
INFORMATION

References

Weiss, B., Harris, V., Catron, T., & Han, S. S. (2003).
Efficacy of the RECAP intervention program for children with concurrent
internalizing and externalizing problems. Journal of Counseling and Clinical
Psychology, 71
, 364-374.

Han, S. S., Catron, T., Weiss, B., & Marciel, K. K.
(2005). A teacher-consulation approach to social skills training for
pre-kindergarten children: Treatment model and short-term outcome effects. Journal
of Abnormal Psychology, 33
, 681-693.

KEYWORDS: Children, Preschool, Elementary, Co-ed, African American, School-based, Parent or Family Component, Other Social/Emotional Health, Other Mental Health, Other Behavioral Problems, Social Skills/Life Skills, Aggression, Depression/Mood Disorders

Program information last updated 11/29/2007

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