The Effectiveness of the Coping Cat Program on Anxiety, Emotion Regulation, and Resilience of Anxious Children

Extended Abstract
 
Introduction and Objectives: Anxiety disorders are among the most common psychological problems in childhood and can have significant consequences on children’s emotional, social, and academic development. The persistence of anxiety in childhood not only disrupts the child’s daily functioning but also increases the risk of psychological disorders in adolescence and adulthood. Therefore, identifying and implementing effective, evidence-based therapeutic interventions for anxious children is of particular importance.
Cognitive-behavioral therapy (darmān-i shinākhtī-raftārī) is considered one of the most effective approaches in treating childhood anxiety, and structured protocols have been developed in this area, among which the “Coping Cat” program (Barnāmih-ʾi Gurbih-Muqābilihʾī) is one of the most well-known. This program is designed with a focus on teaching cognitive and behavioral skills, identifying dysfunctional thoughts, gradual exposure to anxiety-provoking situations, and strengthening self-efficacy (khwudkārāmdī).
In recent years, new approaches in the field of child mental health have emphasized going beyond merely reducing pathological symptoms and have considered positive psychological variables such as resilience and emotion regulation as important outcomes of therapeutic intervention. Resilience (tābāvarī) refers to the child’s ability to adapt effectively to stressful conditions and plays an important protective role against the negative consequences of anxiety. Emotion regulation (tanẓīm-i hiʿjān) is also one of the fundamental components of children’s emotional development, and deficits in it are closely related to the severity and persistence of anxiety.
Despite abundant evidence on the effectiveness of the Coping Cat program in reducing childhood anxiety, few studies have simultaneously examined the effect of this intervention on resilience and emotion regulation, and this research gap is even more pronounced in the Iranian cultural context. Accordingly, the aim of the present study was to investigate the effectiveness of cognitive-behavioral therapy based on the Coping Cat program on anxiety, resilience, and emotion regulation in children aged 8 to 12 years.
Method: This research was a quasi-experimental study (nīmi-tajribī) with a pre-test, post-test, and three-month follow-up design with a control group. The statistical population consisted of children aged 8 to 12 years with anxiety symptoms residing in Qom during the 2023-2024 academic year.
Initial screening: The Spence Children’s Anxiety Scale (SCAS; parent and child forms) was used. Children who scored above the cut-off point for this scale were entered into the next stage.
Participants: After reviewing inclusion and exclusion criteria, 24 eligible children were randomly assigned to two groups: experimental and control (12 children per group).
Inclusion criteria: age range of 8 to 12 years and the presence of anxiety symptoms.
Exclusion criteria: children with comorbid psychological disorders or those receiving other concurrent treatments were excluded from the study.
Intervention: The experimental group received cognitive-behavioral therapy based on the Coping Cat program in the form of 16 individual sessions. The sessions included teaching emotion identification, cognitive restructuring (bāzsāzī-yi shinākhtī), teaching coping skills, gradual exposure practice to anxiety-provoking situations, and strengthening problem-solving skills.
Control group: The control group was placed on a waiting list during the research period and received no intervention.
Research instruments:

Spence Children’s Anxiety Scale (SCAS)
Child and Youth Resilience Measure (CYRM)
Cognitive Emotion Regulation Questionnaire for Children (CERQ-K)

Data collection: Data were collected at three stages: pre-test, post-test, and three-month follow-up.
Data analysis: Mixed analysis of variance with repeated measures (taḥlīl-i wāriāns-i āmīkhtih bā andāzihgīrī-i mukarrar) was used.
Results: Anxiety: The results of data analysis showed that cognitive-behavioral therapy based on the Coping Cat program had a significant effect on reducing anxiety in the experimental group compared to the control group at the post-test stage, and this reduction was maintained at the three-month follow-up stage. This finding indicates the sustained effectiveness of this intervention in reducing anxiety symptoms in children aged 8 to 12 years.
Resilience: The results related to resilience showed that resilience scores in the experimental group increased compared to the control group at the post-test stage, although this difference was at the borderline level of statistical significance (P = 0.051). However, at the three-month follow-up stage, the increase in resilience in the experimental group reached a statistically significant level, and a significant difference was observed with the control group.
Emotion regulation: The results regarding emotion regulation showed that although emotion regulation scores in the experimental group showed relative improvement compared to the control group at the post-test and follow-up stages, these changes were not statistically significant. These findings indicate that the Coping Cat program, in its current implementation, did not have a significant effect on improving children’s emotion regulation, although a trend toward improvement was observed.
Discussion and Conclusion: Anxiety: The findings showed that cognitive-behavioral therapy based on the Coping Cat program is an effective intervention in reducing anxiety symptoms in children aged 8 to 12 years, and this effectiveness was maintained at the three-month follow-up stage. This result is consistent with a large body of previous research confirming the effectiveness of cognitive-behavioral therapies as the first-line intervention for childhood anxiety disorders. It seems that teaching skills such as emotion identification, cognitive restructuring, and gradual exposure to anxiety-provoking situations plays an important role in reducing avoidance, increasing the sense of control, and reducing anxious arousal in children.
Resilience: The results regarding resilience showed that the effect of Coping Cat therapy was at the borderline level of significance at the post-test stage but reached statistical significance at the three-month follow-up stage. This pattern may indicate the gradual nature of resilience formation. Unlike anxiety symptoms, which may respond relatively quickly to intervention, resilience is a complex and process-oriented construct that requires time for practice, generalization, and internalization of skills in real-life situations. Therefore, the significant increase in resilience at the follow-up stage may indicate that after the end of therapy sessions, children gradually used the learned skills in interaction with stressful situations and experienced more effective adaptation abilities.
Emotion regulation: The absence of a significant effect of the Coping Cat program on children’s emotion regulation is a noteworthy finding. Although relative improvement was observed in the mean scores of emotion regulation, these changes did not reach statistical significance. This result may indicate that although the Coping Cat program indirectly addresses some emotional aspects, it does not specifically focus on teaching emotion regulation skills. Therefore, to achieve significant improvement in this construct, supplementary interventions with a direct emphasis on teaching emotion identification, acceptance, and regulation may be needed.
Overall conclusion: The results of this study emphasize the importance of using structured cognitive-behavioral interventions in the treatment of childhood anxiety and show that the Coping Cat program, in addition to reducing anxiety, can contribute to increasing children’s resilience in the long term. These findings can provide practical guidance for therapists, counselors, and child mental health specialists in designing more effective interventions and pave the way for future research toward combining this program with emotion regulation-enhancing approaches.
Acknowledgement: We hereby express our gratitude to all the children and parents who made this research possible through their participation, as well as to the Counseling Center of the Qom Province Education Department. This research was conducted without specific financial support.
Conflict of Interest: The authors of this article declare that there is no conflict of interest in conducting and publishing this research.