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Intervention Summary

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Peaceful Alternatives to Tough Situations (PATTS)

Peaceful Alternatives to Tough Situations (PATTS) is a school-based aggression management program designed to help students increase positive conflict resolution skills, increase the ability to forgive transgressions, and reduce aggressive behavior. PATTS features three separate curricula (for kindergarten through grade 2, grades 3 through 5, and middle and high school), each of which is delivered in nine weekly, 1-hour sessions. The program teaches cognitive skills, peer refusal skills, appropriate conflict resolution skills, identification and verbalization of emotions, recognition of anger cues, calming techniques, and forgiveness. Sessions are highly interactive and use group discussion, role-playing, games, and skills review. In addition, parents and teachers receive training informing them about the skills taught to students and encouraging them to support the use of the skills at home and in the classroom. PATTS is designed to be delivered by teachers, guidance counselors, and graduate or undergraduate mental health counselors.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: March 2008
1: Psychological aggression
2: Physical assault
3: Forgiveness of others
Outcome Categories Family/relationships
Violence
Ages 6-12 (Childhood)
13-17 (Adolescent)
Genders Male
Female
Races/Ethnicities Black or African American
White
Race/ethnicity unspecified
Settings School
Geographic Locations Urban
Suburban
Implementation History Since its inception in 1993, PATTS has been implemented in 7 school districts in a total of 46 schools. PATTS has also been used in a wide variety of other settings serving youth, including alternative public schools for children who are academically delayed due to behavioral problems, group homes, psychiatric facilities, and outpatient mental health agencies. To date, approximately 9,800 youth have participated in PATTS.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research
Review Date: March 2008

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Williams, E., Johnson, J. L., & Bott, C. (2008). Evaluation of a program for reduction of childhood aggression. Psychological Reports, 103, 347-357.

Outcomes

Outcome 1: Psychological aggression
Description of Measures Use of psychological aggression was measured by self-report using the Psychological Aggression subscale of the Conflict Tactics Scale--Revised.
Key Findings Compared with students in the wait-list control group, students who participated in PATTS had lower scores on use of psychological aggression at posttest (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.9 (0.0-4.0 scale)
Outcome 2: Physical assault
Description of Measures Use of physical assault was measured by self-report using the Physical Assault subscale of the Conflict Tactics Scale--Revised.
Key Findings Compared with students in the wait-list control group, students who participated in PATTS had lower scores on use of physical assault at posttest (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.9 (0.0-4.0 scale)
Outcome 3: Forgiveness of others
Description of Measures The forgiveness of others construct was measured by self-report using the Cynicism, Negative Attitudes Toward Others, and Passive Aggressive Behavior subscales of the Mauger Forgiveness Scale. Higher scores on forgiveness of others indicate lower levels of vengeful behavior and thoughts.
Key Findings Compared with students in the wait-list control group, students who participated in PATTS had higher scores on forgiveness of others at posttest (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.3 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 6-12 (Childhood)
13-17 (Adolescent)
74% Male
26% Female
69% Black or African American
31% White
1% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Psychological aggression 4.0 4.0 1.5 0.5 1.0 0.5 1.9
2: Physical assault 4.0 4.0 1.5 0.5 1.0 0.5 1.9
3: Forgiveness of others 2.0 2.0 1.5 0.5 1.0 0.5 1.3

Study Strengths

The intervention addresses an important problem and has a good theoretical foundation. The outcome measures selected are widely used and have established reliability and validity.

Study Weaknesses

A number of potential confounding variables resulted from reliance on a single, small, nonrandomized study. Little information was provided about the sociodemographic characteristics of the sample, and minimal effort was made to assess treatment fidelity and account for attrition and missing data. Given the small sample size of the students included in the study, more appropriate analytic techniques should have been used.

Readiness for Dissemination
Review Date: March 2008

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Conflict Resolution Quiz

Curriculum-specific materials (one set for each of three curricula: kindergarten through grade 2, grades 3 through 5, and middle and high school):

  • PATTS Fidelity Scale
  • PATTS Parent/Guardian Training Session Guide
  • PATTS Parent/Guardian Training Slides
  • PATTS Program Overview
  • PATTS Teacher Training Session Guide
  • PATTS Teacher Training Slides

Diversity Quiz

PATTS Web site, http://kidsandfamilies.com/patts.html

Replication overview

Williams, E. (n.d.). Peaceful Alternatives to Tough Situations: A 9-week modularized program for children K-12 [PowerPoint presentation]. Hampton, VA: Center for Child and Family Services.

Williams, E. (n.d.). Peaceful Alternatives to Tough Situations (PATTS): Kindergarten to 2nd grade. Hampton, VA: Center for Child and Family Services.

Williams, E. (n.d.). Peaceful Alternatives to Tough Situations (PATTS): 3rd to 5th grade. Hampton, VA: Center for Child and Family Services.

Williams, E. (n.d.). Peaceful Alternatives to Tough Situations (PATTS): Middle and high school. Hampton, VA: Center for Child and Family Services.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.0 2.4 2.6 2.7

Dissemination Strengths

Program manuals flow logically, use clear, simple language, and focus primarily on hands-on learning. Implementation roles are clearly defined. The required training clearly parallels the program curricula. Evaluation of student behavior before and after participation is an integral part of the execution of the program. A fidelity scale is provided to support quality assurance.

Dissemination Weaknesses

Little information is available on how to introduce and manage the program at the organizational level. It is unclear who conducts the training and whether a 1.5-day training is sufficient to train implementers adequately. Very limited information is provided on how implementers should use the fidelity scale and interpret the results.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Program curriculum (includes pre- and posttest survey materials) $650-$800 each Yes
1.5-day, on-site training $2,500 for up to 20 participants, plus travel expenses No
1.5-day training in Hampton, VA $1,500 for up to 20 participants No
Webinar training (two 1-hour sessions) $500 for up to 30 participants No
Phone consultation 6 months after program purchase Free (only with purchase of training) No
Research consultation $100 per hour No
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Ann-Marie Long, CFT
(757) 838-1960 ext 315
amlong@kidsandfamilies.com

To learn more about implementation or research, contact:
Ellen Williams, LCSW
(757) 838-1960 ext 313
ewilliams@kidsandfamilies.com

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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