An Implementation of a Computerized Cognitive Behavioral Treatment Program to Address Student Mental Health Needs: A Pilot Study in an Afterschool Program

Added March 18, 2019

Many elementary aged students are either diagnosed with an anxiety disorder or display symptoms that indicate they are at-risk, which can negatively impact academic and social-emotional progress within school. Schools, particularly school counselors, often provide the primary mental health support to address student needs. Therefore, it is imperative that schools and school counselors have access to the best evidence-based practices in order to provide appropriate interventions and services to students in need. One of the best supported modes of psychotherapy to treat anxiety is cognitive behavior therapy (CBT). CBT addresses maladaptive behaviors and erroneous thoughts through coping statements and strategies that improve the self-regulation of feelings and behaviors. CBT is typically delivered through individualized sessions, which while effective, can be unrealistic in a school setting, given the number of students school counselors are responsible for supporting. One method for expanding the access of CBT to students in need is through computerized CBT (CCBT). CCBT is delivered primarily through computerized lessons with counselors delivering varying degrees of direct support.  

One version of CCBT is Camp Cope-A-Lot, a CBT program with lessons including emotion identification, somatic management strategies, cognitive restructuring, and problem solving. CCAL has previously been used to address anxiety among students, with results indicating a reduction in symptomology. The pilot study presented in this article evaluated the feasibility and effectiveness of an abridged version of CCAL in an afterschool setting for elementary students identified as at risk for anxiety and other behavior problems. An abridged version was chosen because a portion protocol (specifically the exposure lessons and parent sessions) required resources outside of what was available to the research team. The research team included a counselor educator, special education profession, two school counseling interns, and three special education doctoral students. During the study, 26 children who met inclusion criteria were randomly assigned to CCAL, or a wait-list control condition. Students completed self-report measures (Beck Anxiety Inventory and BASC-3 Behavioral and Emotional Screening System) as the pre- and posttreatment assessment. Students in the treatment condition completed six lessons, lasting approximately 30 minutes. At posttreatment, CCAL children showed significantly better gains than controls on the BESS internalizing risk index with high levels of social validity.

Specifically, the article discusses: (a) how the CCAL program was received by both participants and implementers; (b) how the counselor education involved in the study was able to use the results to demonstrate the potential impact of elementary school counselors in the school district; and (c) how CCAL could be utilized by school counselors to address anxiety symptomology among students.



Sara Sanders, EdD, Jessica J. Lane, PhD, Mickey Losinski, PhD, Jessica Nelson, Abdullah Asiri, Samantha M.K. Holloway, Elizabeth Rogers