Optimizing the Coping Power Preventive Intervention for Children with Reactive Aggression By Integrating Mindfulness

Introduction: This paper will present findings from a randomized controlled trial (RCT) comparing an existing preventive intervention (Coping Power, CP) to an enhancement (Mindful Coping Power, MCP). MCP is designed to optimize program effects on children’s emotional reactivity and “hot-blooded” forms of aggression. CP is an evidence-based cognitive-behavioral preventive intervention targeting children at high risk for substance use and delinquency. Eight RCTs show CP to be effective in reducing externalizing behavior, proactive aggression, and substance use. However, relative to proactive aggression, reactive aggression is resistant to change. To illustrate, one study found that the effect size for proactive aggression was more than three times that for reactive aggression (d’s=.48 vs. .15). This innovative study integrates mindfulness into CP to create the MCP program to enhance effects on reactive aggression. Studies indicate that mindfulness has positive effects on reactive aggression’s active mechanisms (attentional, emotional, and cognitive dysregulation). The pathway from proactive aggression to substance use differs from reactive aggression. Thus, adolescent substance use can be best prevented by impacting both types of aggression. Our supposition is that effects of CP can be enhanced by integrating mindfulness and more precisely targeting the active mechanisms of reactive aggression.

Methods: We infused mindfulness strategies into CP by adding new sessions to teach mindfulness skills, adding brief mindfulness practices into every session, and integrating mindfulness into existing CP activities. The sample included 5^th grade students who screened high on teacher-rated Reactive Aggression and their parents. Our first cohort included 45 child/family dyads. The sample was 63% male and 37% female. The child groups included 25 sessions and were held at school. The parent groups included 10 sessions. Latent change score analyses tested differences in child outcomes.

Results: Given the small sample size, effect sizes are reported. Parents of children receiving MCP reported improved social skills (d=.59), decreased attention problems (d=.59), and reduced behavioral self-regulation (d=.65). Children receiving MCP also reported increased self-compassion (d=.64). Results for aggression and externalizing outcomes were not significant. In addition, parent attendance was significantly higher in the MCP groups (d=1.6).

Conclusions: This study represents a unique effort to bridge the conceptual and programmatic strengths of a cognitive-behavioral intervention with mindfulness to reduce reactive aggression, which has a distinct pathway to substance use and is resistant to change. Future analyses will include data from our second cohort. Findings are promising and indicate that integrating mindfulness into CP optimizes its preventive effects.