Promoting Alternative Thinking Strategies (PATHS)

Program Developer/Owner

Mark Greenberg and Carol Kusché Co-developersPrevention Research CenterPenn State UniversityUniversity Park, PA 16802-6504(814) 863-0112mxg47@psu.educkusche@comcast.net

Program Outcomes

• Antisocial-aggressive Behavior
• Conduct Problems
• Externalizing

Program Specifics

Program Type

• Cognitive-Behavioral Training
• School - Individual Strategies
• Skills Training
• Social Emotional Learning

Program Setting

• School

Continuum of Intervention

• Universal Prevention

Program Goals

A classroom-based social emotional learning program for elementary school students to reduce aggression and behavior problems.

Population Demographics

PATHS is implemented with elementary school age youth (grades K-6). A modified version to be age-appropriate for preschool students (called Head Start REDI) is treated separately by Blueprints. PATHS has been shown to be effective for both males and females, different ethnic and socio-demographic populations, and a wide variety of populations, including students in regular education and special needs settings.

Target Population

Age

• Late Childhood (5-11) - K/Elementary

Gender

• Both

Race/Ethnicity

• All

Subgroup Analysis Details

Subgroup differences in program effects by race, ethnicity, or gender (coded in binary terms as male/female) or program effects for a sample of a specific racial, ethnic, or gender group:

• Study 7 (Malti et al., 2011, 2012) tested for subgroup differences in program effects and found equal benefits for boys and girls and for parents differing in family economic disadvantage (i.e., reported having or not having financial difficulties).

Sample demographics including race, ethnicity, and gender for Blueprints-certified studies:

• The Study 7 sample was 47.5% female. About 16.5% of the parents reported having financial difficulties.

Other Risk and Protective Factors

Risk: poor self-control, lack of commitment to school, favorable attitudes toward problem behavior and early initiation, impulsiveness, and peer rejection.

Protective: prosocial orientation, positive peer relations, bonding to school.

Risk/Protective Factor Domain

• Individual
• School
• Peer

Risk/Protective Factors

Risk Factors

Individual: Antisocial/aggressive behavior*, Early initiation of antisocial behavior, Favorable attitudes towards antisocial behavior, Hyperactivity*

School: Low school commitment and attachment, Repeated a grade

Protective Factors

Individual: Clear standards for behavior, Problem solving skills, Prosocial behavior, Skills for social interaction

Peer: Interaction with prosocial peers

School: Opportunities for prosocial involvement in education, Rewards for prosocial involvement in school

*Risk/Protective Factor was significantly impacted by the program

See also: Promoting Alternative Thinking Strategies (PATHS) Logic Model (PDF)

Brief Description of the Program

The PATHS curriculum is a comprehensive program for promoting emotional and social competencies and reducing aggression and behavior problems in elementary school-aged children (grades K-6) while simultaneously enhancing the educational process in the classroom. The evaluation of the preschool version, called Head Start REDI, is treated separately by Blueprints.

The Grade Level PATHS Curriculum consists of separate volumes of lessons for each grade level (K - 6), all of which include developmentally appropriate pictures, photographs, posters, and additional materials. Five conceptual domains, integrated in a hierarchical manner, are included in PATHS lessons at each grade level: self-control, emotional understanding, positive self-esteem, relationships, and interpersonal problem-solving skills. Throughout the lessons, a critical focus of PATHS involves facilitating the dynamic relationship between cognitive-affective understanding and real-life situations. PATHS is designed to be taught two to three times per week (or more often if desired, but not less than twice weekly), with daily activities to promote generalization and support ongoing behavior. PATHS lessons follow lesson objectives and provide scripts to facilitate instruction, but teachers have flexibility in adapting these for their particular classroom needs. Although each unit of PATHS focuses on one or more skill domains (e.g., emotional recognition, friendship, self-control, problem solving), aspects of all five major areas are integrated into each unit. Moreover, each unit builds hierarchically upon and synthesizes the learning which preceded it.

The PATHS curriculum is designed to be used by educators and counselors in a multi-year, universal prevention model. To encourage parent involvement and support, parent letters, home activity assignments, and information are also provided.

Description of the Program

The PATHS curriculum is a comprehensive program for promoting emotional and social competencies and reducing aggression and behavior problems in elementary school-aged children (grades K-6) while simultaneously enhancing the educational process in the classroom.

PATHS is now available by grade level in the following grades: Kindergarten, Grade 1, Grade 2, Grade 3, Grade 4, and Grade 5/6. The original multi-year version is also available from the publisher. The grade level versions maintain all key elements of the original version and now organize them more discretely by grade levels. The preschool version of the program, called Head Start REDI, is treated separately by Blueprints.

PATHS targets five major conceptual domains: (1) self control; (2) emotional understanding; (3) positive self-esteem; (4) relationships; and (5) interpersonal problem solving skills. In addition, a 30-lesson non-mandatory supplementary unit reviews and extends PATHS concepts that are covered in other units.

The PATHS curriculum is designed for use by regular classroom teachers. Lessons are sequenced according to increasing developmental difficulty and designed for implementation in approximately 20-30 minutes 2 to 3 times per week. The curriculum provides detailed lesson plans, exact scripts, suggested guidelines, and general and specific objectives for each lesson. However, the curriculum has considerable flexibility so that it can also be integrated with an individual teacher's style. Lessons include such activities as dialoguing, role-playing, story-telling by teachers and peers, social and self-reinforcement, attribution training, and verbal mediation. Learning is promoted in a multi-method manner through the combined use of visual, verbal, and kinesthetic modalities.

Theoretical Rationale

PATHS incorporates seven factors considered critical for effective, school-based SEL curricula. These included the use of:

• an integration of a variety of successful approaches and promising theories
• a developmental model, including neuropsychological brain development
• a multi-grade level paradigm
• a strong focus on the role of emotions and emotional development
• generalization of skills to everyday situations
• ongoing training and support for implementation
• multiple measures of both process and outcome for assessing program effectiveness

PATHS is based on five conceptual models. The first, the ABCD (Affective-Behavioral-Cognitive-Dynamic) Model of Development focuses on the promotion of optimal developmental growth for each individual. The ABCD model places primary importance on the developmental integration of affect (i.e., emotion, feeling, mood) and emotion language, behavior, and cognitive understanding to promote social and emotional competence. The second model incorporates an eco-behavioral systems orientation and emphasizes the manner in which the teacher uses the curriculum model and generalizes the skills to build a healthy classroom atmosphere (i.e., one that supports the children's use and internalization of the material they have been taught). The third model involves the domains of neurobiology and brain structuralization/organization. PATHS incorporates strategies to optimize the nature and quality of teacher-child and peer-peer interactions that are likely to impact brain development as well as learning. The fourth paradigm involves psychodynamic education (derived from Developmental Psychodynamic Theory) which aims to coordinate social, emotional, and cognitive growth. Finally, the fifth model includes psychological issues related to emotional awareness, or as it is more popularly labeled, emotional intelligence. As such, a central focus of PATHS is encouraging children to discuss feelings, experiences, opinions, and needs that are personally meaningful, and making them feel listened to, supported, and respected by both teachers and peers. As a result, the internalization of feeling valued, cared for, appreciated, and part of a social group is facilitated, which, in turn, motivates children to value, care for, and appreciate themselves, their environment, their social groups, other people, and their world.

Theoretical Orientation

• Skill Oriented
• Cognitive Behavioral
• Biological - Neurobiological
• Self Efficacy
• Social Learning

Brief Evaluation Methodology

Primary Evidence Base for Certification

Of the 19 studies Blueprints has reviewed, one (Study 7) meets Blueprints evidentiary standards (specificity, evaluation quality, impact, dissemination readiness). Study 7 was conducted by independent evaluators.

Study 7

Malti et al. (2011, 2012) and Averdijk et al. (2016) used a cluster randomized controlled trial with 56 public primary schools in Zurich assigned to four treatment conditions: PATHS (n = 442), Triple-P (n = 422), PATHS+Triple-P (n = 397), and control (n = 414). The program was implemented with grades K-2, and students were followed for eight years, from ages 7-8 to when the children were 11 years old (grade 4; Malti et al., 2011, 2012) to age 13 and age 15 (Averdijk et al., 2016). Assessments measured externalizing behavior and social competence (Malti et al., 2011, 2012) and delinquency (Averdijk et al., 2016).

Outcomes (Brief, over all studies)

Primary Evidence Base for Certification

Study 7

Malti et al. (2012) found that, relative to students in the control schools, students in the intervention schools had significantly fewer externalizing behaviors (e.g., aggression) and ADHD symptoms by the beginning of grade 5 (more than two years after program commencement).

Outcomes

Primary Evidence Base for Certification

Study 7 (Malti et al., 2012) found that by the beginning of grade 5 (just over two years after program commencement), the intervention condition, relative to a control group, showed:

• Fewer externalizing behaviors (e.g., aggression)
• A reduction in ADHD symptoms

Effect Size

In Study 7 (Malti et al., 2012), the effect sizes of significant results were small to moderate. Specifically, compared to a control group, PATHS significantly reduced aggressive behavior (effect size = 0.42) and ADHD symptoms (effect size = 0.46).

Generalizability

One study Blueprints standards for high-quality methods with strong evidence of program impact (i.e., "certified" by Blueprints): Study 7 (Malti et al., 2011, 2012; Averdijk et al., 2016). The study examined a sample of elementary schools in Zurich, Switzerland, in which the treatment group was compared to a business-as-usual control group.

Potential Limitations

Additional Studies (not certified by Blueprints)

Studies 1-2 (Greenberg et al., 1995; Riggs et al., 2006)

Sample attrition in the first year of implementation was high and reduced the sample size significantly, thus reducing the power to accurately detect differences. High levels of student mobility further limited comparisons between students receiving one or two years of the intervention. No analysis of differential attrition or mobility was conducted for the full sample (although this was done for the regular classroom subsample), which would further inform the interpretations of the analyses.

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.

Riggs, N. R., Greenberg, M. T., Kusché, C. A., & Pentz, M. A. (2006). The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: Effects of the PATHS curriculum. Prevention Science, 7, 91-102.

Studies 3-6 (Kam et al., 2004; Greenberg & Kusche, 1998; Kam et al., 2003; Curtis & Norgate, 2007)

Small sample sizes within treatment groups make it difficult to generalize the outcomes to larger, more diverse populations. No analyses of differential attrition were performed.

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

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

Kam, C., Greenberg, M. T., & Walls, C. T. (2003). Examining the role of implementation quality in school-based prevention using PATHS curriculum. Prevention Science, 4,55-63.

Curtis, C., & Norgate, R. (2007). An evaluation of the Promoting Alternative Thinking Strategies curriculum at key stage 1. Educational Psychology in Practice, 23, 33-44.

Study 8 (Seifert et al., 2004)

• No pretest assessment, assessment of baseline equivalence, or information on attrition
• The comparisons across cohorts may be confounded by time
• Only outcomes based on interviewer ratings reached significance, not outcomes based on child self-reports
• Interviewers rating children likely were not blinded to the condition
• Reports of teacher dissatisfaction with the program suggest implementation problems

Seifert, R., Gouley, K., Miller, A. L., & Zabriski, A. (2004). Implementation of the PATHS curriculum in an urban elementary school. Early Education & Development, 15(4), 471-486.

Study 9 (Bierman et al., 2010)

• A concurrent intervention for high-risk students meant that the sample excluded the worst behaving students and that the other ongoing intervention might have influenced the program outcomes
• Baseline tests for equivalence compared schools but not children
• Teachers who delivered the intervention also did ratings of classroom children, and results proved stronger for teacher ratings than child ratings
• Attrition was high because the study was limited to children who had stayed in the same school for all three years, and differential attrition was apparent on several baseline measures
• Contrary to intent-to-treat procedures, only students who participated in the program for all three years were followed and used in the analysis

Bierman, K. L., Coie, J. D., Dodge, K. A., Greenberg, M. T., Lochman, J. E., McMahon, R. J., & Pinderhughes, E. (2010). The effects of a multiyear universal social-emotional learning program: The role of student and school characteristics. Journal of Consulting and Clinical Psychology, 78(2), 156.

Study 10 (Crean & Johnson, 2013; SCDRC, 2010)

• Teachers who delivered the program also provided some student measures
• Models adjusted for clustering but may have too few schools to obtain reliable estimates
• No effects on independent behavioral outcomes
• Some evidence of iatrogenic effects on conduct problems in first two years of the program

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.

Social and Character Development Research Consortium (SCDRC) (2010). Efficacy of schoolwide programs to promote social and character development and reduce problem behavior in elementary school children (NCER 2011-2001). Washington, DC: National Center for Education Research, Institute of Education Sciences, U.S. Department of Education.

Study 11 (Little et al., 2012; Berry et al., 2016)

• Randomized 64 schools but eight dropped out before baseline
• Most measures of children came from teachers who delivered the program
• Measures validated by others but no study-specific figures
• Incomplete tests for differential attrition
• No significant effects on behavioral outcomes

Little, M., Berry, V., Morpeth, L., Blower, S., Axford, N., Taylor, R., . . . Tobin, K. (2012). The impact of three evidence-based programmes delivered in public systems in Birmingham, UK. International Journal of Conflict and Violence, 6(2), 260-272.

Berry, V., Axford, N., Blower, S., Taylor, R. S., Edwards, R. T., Tobin, K., . . . Bywater, T. (2016). The effectiveness and micro-costing analysis of a universal, school- based, social-emotional learning programme in the UK: A cluster-randomised controlled trial. School Mental Health, 8, 238-256.

Study 12 (Schonfeld et al., 2015)

• Not an intent-to-treat study - excluded those not participating in all four program years
• No tests for baseline equivalence of outcomes
• No controls for baseline scores
• Tests for differential attrition incomplete
• Sample from one large, urban school district

Schonfeld, D. J., Adams, R. E., Fredstrom, B. K., Weissberg, R. P., Gilman, R., Voyce, C., ... & Speese-Linehan, D. (2015). Cluster-randomized trial demonstrating impact on academic achievement of elementary social-emotional learning. School Psychology Quarterly, 30(3), 406.

Study 13 (Fishbein et al., 2016)

• No information on student-level attrition
• No information on reliability/validity provided for 8 of the 14 outcome measures
• Teachers who delivered the program also completed the assessments (with effects in favor of the treatment on 13 of the 13 teacher-rated measures)
• There was an effect on 15 out of 23 measures, but only 2 of these effects were assessed using independent measures (and it still wasn't clear whether those collecting these data were blind to condition)
• Small sample size (n = 4 schools, and schools were the unit of assignment)
• Incorrect level of analysis with no adjustment for unit of randomization (schools)

Fishbein, D. H., Domitrovich, C., Williams, J., Gitukui, S., Guthrie, C., Shapiro, D., & Greenberg, M. (2016). Short-term intervention effects of the PATHS curriculum in young low-income children: Capitalizing on plasticity. Journal of Primary Prevention, 37, 493-511.

Study 14 (Goossens et al., 2012)

• Non-random assignment of schools
• Many student measures came from teachers who delivered the program
• Adjusted for clustering, but the sample of 18 clusters may be too small for reliable estimates
• Tests for baseline equivalence showed many differences
• No reliable program effects

Goossens, F., Gooren, E., Orobio de Castro, B., Overveld, K., Buijs, G., Monshouwer, K., … Paulussen, T. (2012). Implementation of PATHS through Dutch municipal health services: A quasi-experiment. International Journal of Conflict and Violence, 6, 234-248.

Study 15 (David, 2014)

• Non-random assignment of schools with only one control school
• Some student measures came from teachers who delivered the program
• Low reliabilities for some measures
• Incorrect level of analysis
• No tests for differential attrition
• No significant program effects
• Small sample of only three schools

David, M. D. (2014). The effect of Promoting Alternative THinking Strategies on social competence and reading achievement in elementary school children. Master's Thesis. Halifax, Nova Scotia: Mount Saint Vincent University.

Study 16 (Barlow et al., 2015; Hennessey & Humphrey, 2020; Humphrey et al., 2016; Humphrey, Barlow, & Lendrum, 2018; Humphrey, Hennessey et al., 2018; Panayiotou et al., 2020)

• Some posttest child measures provided by teachers who delivered the program
• Evidence of differential attrition
• Few ITT effects at posttest, though stronger effects in QED complier analysis
• No program effects at long-term follow-up

Barlow, A., Wigelsworth, M., Lendrum, A., Pert, K., Joyce, C., Stephens, E., . . . Humphrey, N. (2015). Promoting Alternative Thinking Strategies (PATHS): Evaluation report and executive summary. The Education Endowment Fund. Available online: https://files.eric.ed.gov/fulltext/ED581278.pdf.

Hennessey, A., & Humphrey, N. (2020). Can social and emotional learning improve children's academic progress? Findings from a randomised controlled trial of the Promoting Alternative Thinking Strategies (PATHS) curriculum. European Journal of Psychology of Education, 35(4), 751-774.

Humphrey, N., Barlow, A., & Lendrum, A. (2018). Quality matters: Implementation moderates student outcomes in the PATHS curriculum. Prevention Science, 19, 197-208.

Humphrey, N., Barlow, A., Wigelsworth, M., Lendrum, A., Pert, K., Joyce, C., . . . Turner, A. (2016). A cluster randomized controlled trial of the Promoting Alternative Thinking Strategies (PATHS) curriculum. Journal of School Psychology, 58, 73-89.

Humphrey, N., Hennessey, A., Lendrum, A., Wigelsworth, M., Turner, A., Panayiotou, M., . . . Calam, R. (2018). The PATHS curriculum for promoting social and emotional well-being among children aged 7-9 years: A cluster RCT. Public Health Research, 6(10), 1-116.

Panayiotou, M., Humphrey, N., & Hennessey, A. (2020). Implementation matters: Using complier average causal effect estimation to determine the impact of the Promoting Alternative Thinking Strategies (PATHS) curriculum on children's quality of life. Journal of Educational Psychology, 112(2), 236-253.

Study 17 (Novak et al., 2017)

• Teachers who delivered the program provided all child measures
• Adjusted for clustering within classrooms but not within schools, the unit of randomization
• No significant baseline differences for outcomes but no tests for sociodemographic characteristics
• No significant main effects at posttest, only effects for a low-risk subgroup

Novak, M., Mihic, J., Bašic, J., & Nix, R. L. (2017). PATHS in Croatia: A school-based randomised-controlled trial of a social and emotional learning curriculum. International Journal of Psychology, 52(2), 87-95.

Study 18 (Hindley & Reed, 1999)

• Non-random assignment of schools/units (n = 7)
• Some measures came from teachers who delivered the program
• No reliability or validity information
• Unclear if used intent-to-treat sample
• Incorrect level of analysis
• Incomplete tests for baseline equivalence
• No tests for differential attrition

Hindley, P., & Reed, H. (1999). Promoting alternative thinking strategies: Mental health promotion with deaf children in school. In S. Decker, S. Kirby, A. Greenwood, & D. Moore (Eds.), Taking children seriously (pp. 113-130). London: Cassel Publications.

Study 19 (Ross, Sheard et al., 2011; Ross, Cheung et al., 2011)

• Cluster RCT but one of 13 schools dropped out right after assignment and comparison schools adopted the program before the posttest
• Teachers who delivered programs provided behavioral measures of children
• Little information on reliability and validity of measures
• Did not attempt to follow the oldest students after they left middle school
• Incorrect level of analysis
• Baseline controls not always used
• Some baseline differences between conditions
• Incomplete tests for differential attrition
• No significant effects on independently measured behavioral outcomes

Ross, S. M., Cheung, A., Slavin, R., Sheard, M. K., & Elliott, L. (2011). Promoting primary pupils' social-emotional learning and pro-social behaviour: Longitudinal evaluation of the Together 4 All Programme in Northern Ireland. Effective Education, 3, 61-81.

Ross, S. M., Sheard, M. K., Slavin, R., Elliott, L., Cheung, A., Hanley, P., & Tracey, L. (2011). Evaluation of Together 4 All programme for schools. Institute for Effective Education, The University of York.

Notes

A preschool version of PATHS called Head Start REDI is treated as a separate program in Blueprints.

 

Endorsements

Blueprints: Promising
Crime Solutions: Effective
OJJDP Model Programs: Effective
SAMHSA : 2.6-3.2

Peer Implementation Sites

Denine Goolsby
Executive Director Humanware
Cleveland Public Schools
1111 Superior Avenue
Cleveland, OH 44114
PH: 216-838-0107

Flavia Hernandez, Principal
McCormick Elementary School
Chicago Public Schools
2712 S. Sawyer Avenue
Chicago, IL 60623
PH: 773-535-7252

Carmen Navarro, Principal
Mariano Azuela Elementary School
Chicago Public Schools
3707 W. Marquette Road
Chicago, IL 60629
PH: 773-535-7395

Caroline Boxmeyer, Associate Professor University of Alabama
Hale County/Sawyerville Head Start Center
850th 5th Avenue East
Box 870326
Tuscaloosa, Alabama
PH: 205-348-1325

Program Information Contact

For curriculum and materials:
PATHS^® Program
Phone: 1-877-71PATHS or 1-877-717-2847
pathsprogram.com

For training:
PATHS^® Training
pathstraining.com

Also see:

SEL Worldwide
selworldwide.org 
Contact: Dorothy Morelli
dorothy@selw.org
dorothygm@hotmail.com
Phone: 615-364-6606