Translation, Adaptation and Implementation of Coping Cat Program with Pakistani Children

Background: Pakistan is a Lower and Middle Income Country with a scarcity of resources for mental health services but high prevalence of mental health problems particularly anxiety and depression. Cognitive behavioral therapy (CBT) has been deemed an empirically supported treatment for anxiety disorders among children, but evidence is lacking from countries like Pakistan. Objective: The present project translated and adapted the Coping Cat Program, a CBT based program for children and adolescents having anxiety disorders, for Pakistani children. Method: The translated (Urdu) version of Coping Cat program was tested (N = 24) using repeated measure and a between group design in an orphanage school setting over a period of 6 months. The outcome measures were the Screen for Children Anxiety Related Disorders and the Childhood Anxiety Sensitivity Index. Results: Intent-to-Treat analysis indicated significant decreases in self-reported anxiety sensitivity (n[superscript 2] = 0.69); anxiety (n[superscript 2] = 0.50); generalized anxiety disorder (n[superscript 2] = 0.44) and panic disorder (n[superscript 2] = 0.30) in the treated group from pre- to follow-up compared to the control group. Therapists rated treatment protocol as easy to implement and 80% of participants rated the treatment manual as useful and effective. Conclusion: The Coping Cat program appeared culturally appropriate for this group, has implementation feasibility and clinical utility for the children having anxiety related problems. Further research is needed to evaluate its effectiveness as an indicated preventive intervention for Pakistani children.