Programs that Work
Reaching Educators, Children, and Parents (RECAP)
Healthy and Safe Children
Children and youth not engaging in violent behavior or displaying serious conduct problems
Age of Child
Early Childhood (0-8)
Middle Childhood (9-12)
Type of Setting
Child Care / Preschool
Type of Service
Type of Outcome Addressed
Evidence Level (What does this mean?)
The Reaching Educators, Children, and Parents (RECAP) program is a semi-structured, school-based skills training program that lasts for one academic year. It is a comprehensive program designed for children experiencing co-occurring internalizing problems (e.g., withdrawn, anxious, and depressed behavior) and externalizing problems (e.g., aggressive, oppositional, and impulsive behavior). The program consists of four components. These include (a) support for a structured classroom environment via teacher training and in-classroom consultation on implementation, (b) classroom lessons focusing on skills training, (c) individual and small-group sessions with students, and (d) parent training. The primary goal of the program is to reduce the level of children's psychological problems, as well as preventing the development of more serious problems among children who are not referred for formal mental health services.
The pre-K RECAP program is a universal intervention program working toward the goals of increasing children's social skills and reducing their internalizing and externalizing problems. Pre-K RECAP includes (a) a classroom-based curriculum and behavior management system, (b) weekly site-based teacher training and consultation on implementation, and (c) a biweekly parent group meeting.
Preschoolers and elementary school students in grade four
Two studies have examined the impact of the RECAP program. The fourth grade program was evaluated by Weiss et al. (2003) in a sample of 93 children from three schools that served predominantly low-income students. Mental health screening data were obtained from assessments conducted at the end of grade three, and 113 children with elevated internalizing and externalizing problems, and overall psychopathology were found to be eligible for program enrollment. Ninety-three (72 percent) of the families enrolled in the program, and school principals randomly allocated students across two treatment classrooms (62 students) and one control classroom (31 students). Somewhat more of the children were male (63 percent), 56 percent were African American, and 38 percent were Caucasian. Student outcome assessments were conducted at baseline, twice mid-treatment during the fourth grade school year, at post-treatment at the end of the school year, and at follow-up approximately one year later. Eighty-nine students (96 percent) completed participation in the program. Five sources of data were used for the outcome assessment: reports of child emotional and behavioral problems from the child; his or her parents, teachers, and peers; and grade point average averaged across academic subjects. Treatment and control groups were compared on demographic variables and baseline outcome measures, and they were found to differ on one variable — family income — with treatment group parents reporting higher annual incomes than control group parents ($21,480 versus $14,720, respectively). Income was significantly related to treatment outcome for self-reports of externalizing problems, so income was included as a covariate in those analyses.
The pre-kindergarten adaptation of RECAP was evaluated by Han et al. (2005). Participants were selected from 12 pre-K classrooms in six public schools that served children from low-income backgrounds. Of the six schools, three were randomly assigned to receive the intervention (six classrooms total), and three schools were randomly assigned to the control condition (also a total of six classrooms). Of the 220 children in the 12 classrooms, 166 (75 percent) children and their parents agreed to participate in the study and completed the pretest assessment. The final evaluation sample consisted of 149 children whose parents provided both pre- and posttest data (90 percent of those who agreed to participate). The average age of the children was 4.4 years, 56 percent of the sample was female, 89 percent was African American, 6 percent was Caucasian, and 5 percent was of another racial/ethnic background. The average annual family income was $16,200 in 2005 dollars. Assessments of treatment and control group students at baseline found that the groups differed significantly on annual household income, with parents in the comparison group reporting a significantly higher level of income than those in the treatment group. Additionally, treatment group children scored significantly higher than control group children for teacher-reports of total problems, internalizing problems, and externalizing problems, whereas treatment group children scored significantly lower than the control group in assertion skills. Comparisons between study dropouts and completers showed there were significantly more males and children living in two-parent households among dropouts than among completers. In addition, teachers rated dropouts as having higher levels of total problems and lower levels of total skills than completers. Post-treatment data were collected in the spring of the academic year, and they included both parent and teacher ratings of children's behavior problems and social skills.
Key Evaluation Findings
Weiss et al. (2003) found the following results for fourth-grade children's internalizing problems, measured across the five time points:
- Treatment group children had significantly better rates of improvement than control group children for teacher-, parent- and self-reports but not for peer-reports.
- There was an increasing treatment efficacy as assessed by parent-reported internalizing problems for those children with higher initial problem levels.
- Treatment group children had significantly better rates of improvement than control group children for peer- and child self-reports of externalizing behaviors, and a marginally significant effect for teacher-report. The effect for parent-reports of externalizing problems was non-significant.
- For peer reports, higher initial levels of behavior problems were associated with lower levels of treatment efficacy.
- Child outcomes were unrelated to parents’ symptoms of psychopathology.
- Of the eight tests of the effect of gender on outcomes for the RECAP program, only the test involving child self-reported externalizing problems was significant, with boys but not girls showing a significant positive treatment effect.
- No significant treatment effects were found for grade point average.
- Teacher ratings of children’s behavior problems showed that children in the treatment group had significantly greater improvement in both internalizing and externalizing behavior problems than children in the comparison group.
- Follow-up analyses also indicated significant benefits for the treatment group for decreases in emotional reactivity, withdrawn behavior, and attention problems.
- No significant differences were found between groups for anxious/depressive symptoms, physical complaints, or aggressive behavior.
- Teacher ratings for child social skills demonstrated some positive treatment effects, with treatment group children showing significantly greater improvement in skills related to cooperation and assertion (but not self-control) than children in the comparison group.
- No significant differences were found between groups for parent reports of children’s behavior problems or social skills.
Public and private preschools and elementary schools
Funding for the evaluations of RECAP has been provided in part by grants from the National Institute of Mental Health, the Vanderbilt Institute for Public Policy Studies, the Byrne Foundation, the Memorial Foundation, the Kroger Foundation, Centerstone Community Mental Health Centers, and the Tennessee Department of Mental Health & Developmental Disabilities.
The RECAP program encompasses three broad treatment approaches: (a) coping skills training, (b) problem-solving skills training, and (c) parent training. Previous implementations of the RECAP program have taken measures to encourage participation of low-income parents in the weekly meetings at the school by helping coordinate between families with and without cars, providing taxi service, offering child care, raffling gift certificates to attendees, etc.
Child components of the fourth-grade RECAP program focus on social skills (e.g., making friends and avoiding involvement with negative peer behavior), reattribution training for hostile attributions of others’ intentions as well as unrealistic self-appraisals, communication skills, self-monitoring and self-control improvement, recognition and expression of emotions, and relaxation. Parent and teacher components of the fourth grade program focus on using appropriate praise and punishment, improving adult-child communication, strengthening the adult-child relationship, and supporting children in their use of RECAP skills. Parent and child groups meet once per week, and classroom lessons are taught once or twice a week.
The pre-K RECAP program emphasizes the remediation of children’s skills deficits at both the cognitive and behavioral levels, and it focuses on training in social skills, emotional regulation (e.g., awareness, labeling, and monitoring of emotions), and problem solving. The parent and teacher components of the program emphasize positive reinforcement, appropriate use of negative consequences, clear communication and expectations, and strengthening of adult-child relations.
In the pre-K program, classroom lessons are taught by teachers two to three times per week and are reinforced daily by teachers using positive reinforcement tokens, modeling and mediation of problem-solving steps, and discussion of behavioral and emotional consequences of behavior choices. Program consultants spend one day per week in the classroom for ongoing training and consultation with teachers and teaching assistants, and observation of teachers' program implementation. The parent-training component is administered by the program consultant in a group format with 16 biweekly sessions at the school.
In previous implementations of the RECAP program, master's level clinicians (e.g., psychologists, social workers, and psychiatric nurses) have served as program consultants to teachers and the group leaders for the parent group. Half-time graduate student assistants helped with the group and classroom sessions.
Comprehensive training of consultants was provided by the program developers. Initial training involved two full-day sessions, which focused on discussing the conceptual and clinical background of RECAP, the importance of staying within the framework, forms of flexibility acceptable within the model, and how to handle clinical issues within the context of the model.
Clinical personnel received 1.5 hours of group supervision per week, which focused on resolving clinical issues and maintaining treatment integrity. Additional individual supervision was provided as necessary.
Issues to Consider
This program received a "promising" rating. Significant treatment effects were found for reducing children's levels of both internalizing and externalizing problem behaviors, although findings were somewhat mixed across study outcomes. Issues to note include that the program developer served as an evaluator on both of the RECAP studies and that the program has been evaluated in only low-income schools in one Southern U.S. city, limiting the ability to generalize findings to other populations.
It is important to consider that pre-K RECAP is a universal prevention program, and fourth-grade RECAP is designed for children with a range of severity of psychopathology. In other words, the samples evaluated were not limited to participants that met specific, clinical diagnostic criteria. Around half of the fourth grade sample scored in the clinical range for teacher-reported internalizing problems (48 percent), and teacher-reported externalizing problems (54 percent). In the pre-K study, in which students were not selected for elevated problem levels, 11 percent and about 20 percent of children at pretest had behavior problem scores that were in the clinical range, based on parent and teacher reports, respectively.
The pre-K RECAP evaluation (Han et al., 2005) found significant treatment effects for teacher reports of child behavior problems, but not for parent reports. The study authors' interpretation of these discrepant findings is that the program may be more effective at changing behavior at school than at home, perhaps because pre-K RECAP is a universal program targeting the whole classroom, which makes it efficient in creating behavioral norms to guide individuals' overt behavior. Furthermore, attendance at the parent meetings was very low, with less than 5 percent of parents in the treatment group attending any of the meetings. The lack of parent participation may have decreased program effectiveness at influencing child behavior at home.
Dr. Susan Han
Vanderbilt Institute for Public Policy Studies
1207 18th Avenue South
Nashville, TN 37212
phone: (615) 343-1671
fax: (615) 322-3839
None at this time
Han, Susan S., Thomas Catron, Bahr Weiss, and Kristen K. Marciel, "A Teacher-Consultation Approach to Social Skills Training for Pre-Kindergarten Children: Treatment Model and Short-Term Outcome Effects,"
Journal of Abnormal Child Psychology,
Vol. 33, No. 6, 2005, pp. 681-693.
Weiss, Bahr, Vicki Harris, Thomas Catron, and Susan S. Han, "Efficacy of the RECAP Intervention Program for Children with Concurrent Internalizing and Externalizing Problems," Journal of Consulting and Clinical Psychology, Vol. 71, No. 2, 2003, pp. 364-374.