COPE

SUMMARY OF PROJECT COPE, AN

EVIDENCE BASED INITIATIVE  CONDUCTED BY BBN

 The unmet need for children’s mental health services in the Bronx was well documented in

“Children’s Mental Health Needs Assessment in the Bronx”

(NYC Department of Health and Mental Hygiene, 2003). As part of its mission to promote quality care among member agencies,

the Bronx Behavioral Network sponsored a half day conference on Evidence Based Practice in Child Mental Health in 2004 with

William Pelham Ph.D. as the featured speaker. Subsequent planning meetings were held between leadership of the

Bronx Behavioral Network and the leadership of the Coordinated Children’s Services Initiative to pursue their common interest of

promoting the adoption of evidence based practices in community clinic settings in the Bronx.  

 The participating agencies in this initiative are Fordham Tremont Mental Health Center, Our Lady of Mercy Hospital Center,

Federation Employment and Guidance Service Health and Human Services System,

South Bronx Mental Health Council and Riverdale Mental Health Association. 

 The Center for Children and Families (CCF) at the University at Buffalo (UB) served as consultants to assist BBN

in selecting a family-based intervention for children with Attention-Deficit/Hyperactivity Disorder. 

Of particular importance was selecting an intervention with empirical support, and which would be relevant to a primarily urban,

bilingual population.  The Community Parent Education Program (COPE; Cunningham, 1998) was selected for implementation.

Clinicians sought an evidence-based practice that would treat children with disruptive disorders and improve family functioning

due to family and school concerns about children with a high rate of ADHD and oppositional behavior.

COPE is a model which includes 1) parent skills training groups 2) child social skills training group and 3) coordination with child’s

teachers to monitor target behaviors at home and school.

 The high risk for mental health disorders corresponds to statistics from the NYC Department of Health and Mental Hygiene,

which tracked the high need for mental health services to the Bronx.  According to the 2003 report, nearly 57% of the children

who accessed outpatient mental health services were diagnosed with a serious emotional disturbance. Of these, 41% were diagnosed

with attention deficit hyperactivity disorder, 20% with other disruptive orders, and 45% with co-occurring psychiatric disorders. 

The BBN agencies serve this population.

 Member agencies of BBN have been implementing COPE groups for children and their parents since January of 2006. 

Thus, the program has been implemented and sustained for over one year. A second cycle will be completed Spring 2007.

There are several steps that have been taken to ensure that the intervention is sustainable going forward.  First, senior administrative

staff representing the agencies providing the COPE groups are informed in an ongoing way about the status of the program and they

continue to make clear their support for the program.  Additionally, the clinicians have received face to face as well as monthly group

telephonic supervision with consultants from SUNY Buffalo under the direction of William Pelham, Ph.D. Training is provided to new

agency staff as they come on board to replace staff that were trained but have left their agencies.  This ensures that staff turnover does

 not impede sustainability. In this way, a well-trained and committed group of clinicians continues to be available to provide COPE

services and help to assure that those services are sustained.

 Results of the Study

 The written study of the first cycle of this model was conducted by Dr. Pelham’s Center of Children and Families at SUNY Buffalo

and documents the details of the pre-test and post–test measures which demonstrate the specific improvements in functioning on the

 part of the children who have participated in the COPE program at each of the  agencies that participated in research during  the first

cycle of this model.  Clinicians within the participating agencies were responsible for collecting evaluation data from the participants and

de-identifying the data prior to submitting to CCF for analysis of intervention outcomes. In addition, parents also documented effectiveness

of the program and an increase in their own confidence and skills in managing their children's behavior effectively.  It is often difficult to engage

parents of children with ADHD, but this program has resulted in increased level of attendance and satisfaction on the part of parents. 

The benefits for both children and their parents have been tangible and powerful.

 These results are particularly impressive given the small number of participants at each agency.  The smaller the number of participants,

the more difficult it is to detect clinically significant effects.  Results of the evaluation suggest that the COPE program produced robust

positive effects in the participants.  These results also indicate that COPE is a culturally competent intervention for the population. 

Further, parents largely reported that their child improved by the end of treatment and that they were satisfied with treatment.