Promoting Alternative Thinking Strategies (PATHS)/Preschool PATHS - a comprehensive programme for promoting emotional and social competencies and reducing aggression and behaviour problems

At a glance

Country of origin

  • USA

Last reviewed:

Age group
0-5 years
6-10 years
11-14 years
Target group
Children aged 5-11 years
Programme setting(s)

The PATHS curriculum is a comprehensive programme for promoting emotional and social competencies and reducing aggression and behaviour problems in elementary school-aged children in grades K-6 (5 – 12 years of age) while simultaneously enhancing the educational process in the classroom.

The Grade Level PATHS Curriculum consists of separate volumes of lessons for each grade level from K – 6 (5-12 years of age), 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 on-going behaviour. 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 counsellors in a multi-year, universal prevention model. To encourage parent involvement and support, parent letters, home activity assignments, and information are also provided.


No data

Contact details

Prevention Research Centre
Penn State University, United States of America
Email: mxg47[a]

Overview of results from the European studies

Evidence rating

  • Additional studies recommended
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Studies overview

The programme has been evaluated in several cluster randomised controlled trials, two in the UK - one in Northern Ireland (Ross et al., 2011) three in England (Hennessey et al., 2019, 2021; Panayiotou et al., 2020; Humphrey et al., 2015, 2016; Little et al., 2012) – one in Switzerland (Malti et al., 2011, 2012) and one in Sweden (Eninger et al., 2021). There have also been four quasi-experimental studies, one each in Turkey (Seyhan et al., 2017) and the Netherlands (Goossens et al., 2012) and two in the UK (Curtis & Norgate, 2007; Hughes & Cline, 2014).

One UK trial (Little et al., 2012) was conducted with 5397 children aged 4 to 6 years from 29 schools that were randomised to intervention and 27 schools that were randomised to control. Measures were gathered using five scales from the teacher-completed Strengths and Difficulties Questionnaire and nine scales from the PATHS Teacher Rating Survey. Results indicated that while there were some statistically significant improvements in the intervention group compared to the control group at mid-intervention, these improvements disappeared post-test and no statistically significant differences were observed between groups at immediate post-test.

In another UK trial (Humphrey et al., 2015, 2016), 4516 children aged 7 to 9 years from 45 schools, that were randomly allocated to intervention or control, participated. Of the 14 scales, there was a significant positive intervention effect on 1 measure and a significant negative intervention effect on 2 measures. There was a statistically significant increase in teachers' perceptions of change in children's social–emotional competence in the intervention group. A statistically significant effect favouring the control group was found on SDQ peer problems and SDQ emotional symptoms scales.

Hennessey et al. (2019, 2021) and Panayiotou et al. (2020) used the former sample of (45 schools with 5218 school-aged children). Academic performance was measured with a national curriculum assessment for English, Mathematics and Science. The intervention did not show more effectiveness in improving the academic attainment of children compared to the control group. The results concerning loneliness (KIDSCREEN27) revealed a significant positive effect compared to the control group. Psychological wellbeing, peer social support and school connectedness showed a small, but statistically significant improvement after the PATHS intervention at a 2-year follow-up. However, the intervention had no discernible impact on peer social support and school connectedness.

The study from Northern Ireland (Ross et al., 2011) included 1448 students, aged 4 to 10 years, from 12 primary schools that were evenly randomised to intervention or control. Students were from primary 1 and 2, and 5 and 6; some analysis was reported separately for these groups. For primary 1 and 2, there were no significant effects on teacher-reported behaviour. For primary 5 and 6, there were three significant differences between groups, two of which favoured the control group: reflectivity and perseverance. There was a positive intervention effect on negative affect. There were positive intervention effects that were significant on 4 of 11 observed teacher behaviour: positive behaviour management, supporting peer interaction, supporting mutual respect and understanding, and providing feedback on peer interactions 6 of 20 observed measures of child behaviour also indicated a significant programme effect: compliments others, mutual respect and understanding, involvement, taking turns in play, compliance with playground rules and including others (in play).

The Swiss trial (Malti et al., 2011, 2012) included 1675 first-grade students, with an average age of 7 years, from 56 schools. The trial compared PATHS to Triple P, a group parenting programme. Compared to the control group, children receiving PATHS displayed a significant reduction in aggressive behaviour (based on teacher and parent reports, but not child reports) and in ADHD symptoms (based on teacher reports only, not on parent or child reports). There were no effects on nonaggressive externalising behaviour or on social competence based on any measure. At the two-year follow-up, the effect on teacher-reported aggression and ADHD symptoms was statistically significant, but the effect on prosocial behaviour was not.

The Swedish trial (Eninger et al., 2021), comprised a sample of 285 children, aged 4-5 years from 26 schools. Children were randomly assigned to an intervention group (145 children) or a control group (140 children). The intervention resulted in significant improvements after 6 months in working memory, prosocial play and hyperactive behaviours in the intervention group compared to the control group.

One quasi-experimental study in the UK (Curtis & Norgate, 207) included 287 students, aged 5 to 7 years, from 5 intervention and 3 comparison schools. There were significant intervention effects on all 5 subscales of the SDQ. There was a significant improvement on emotional symptoms, conduct problems, hyperactivity, peer problems, and consideration, for intervention schools but not for the comparison schools. It is important to note that the levels of behavioural and emotional problems were already at a lower level in the comparison schools at pre-test.

The Dutch study (Goossens et al. 2012) included 1333 children aged 5 to 11 years from 18 kindergarten and elementary schools, half of which delivered the intervention and the other half served as control. There was a significant effect on only 1 of 27 outcome measures – emotional awareness - immediately after the intervention.

A quasi-experimental (Hughes & Cline, 2014) evaluated of the Preschool version was conducted in the UK with 57 children, aged 3 to 4 years, from 3 different preschools. One school delivered the full version, while one school delivered an adapted (shortened) version and the third school did not deliver PATHS. There was a significant interaction effect: the full PATHS group significantly improved their receptive emotion vocabulary from pre to post test, while the other groups did not. There was no effect on affective perspective taking skills, or parental measure of behaviour (SDQ). There were significant interaction effects on 6/7 scales of the teacher-reported SDQ: children in the full PATHS version improved significantly while the other two groups did not.

The Turkish study (Seyhan et al., 2017) also evaluated the Preschool version and included 565 children aged 4 to 6 years from 41 classrooms in 4 preschools. There were significant intervention effects on teacher-reported children’s social and emotional skills reflecting interpersonal relationships and emotion regulation, and observed quality of classroom environment. The effect on observed behaviours and management techniques of teachers was not significant. In terms of student-teacher relationship, as reported by teachers, there was no effect on conflict or closeness, but there was a significant effect on dependency. Teachers in intervention group reported significantly more dependency in their relationships with children. Children in the intervention group described their relationships as significantly more positively than did children in the comparison group.

Click here to see the reference list of studies

Countries where evaluated

  • Netherlands,
  • Switzerland,
  • United Kingdom


Protective factor(s) addressed

  • Individual and peers: clear morals and standards of behaviour
  • Individual and peers: individual/peers other
  • Individual and peers: interaction with prosocial peers
  • Individual and peers: opportunities and rewards for prosocial peers involvement
  • Individual and peers: Problem solving skills
  • Individual and peers: skills for social interaction
  • School and work: commitment and attachment to school
  • School and work: opportunities for prosocial involvement in education
  • School and work: rewards and disincentives in school

Risk factor(s) addressed

  • Family: parental attitudes favourable to anti-social behaviour
  • Individual and peers: anti-social behaviour
  • Individual and peers: favourable attitudes towards anti-social behaviour
  • Individual and peers: other
  • School and work: low commitment/attachment to school/workplace
  • School and work: other

Outcomes targeted

  • Emotional well-being
  • Depression or anxiety
  • Emotion regulation, coping, resilience
  • Other behaviour outcomes

Description of programme

The PATHS curriculum is a comprehensive programme for promoting emotional and social competencies and reducing aggression and behaviour problems in elementary school-aged children in grades K-6 (5-11 years of age) while simultaneously enhancing the educational process in the classroom.

PATHS is available by grade level in the following grades: Kindergarten (5 years of age), Grade 1 (6 years of age), Grade 2 (7 years of age), Grade 3 (8 years of age), Grade 4 (9 years of age), and Grade 5/6 (10-12 years of age). 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.

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 who are trained by Educational Psychologists. 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 kinaesthetic modalities.

Implementation Experiences

Feedback date

Contact details

The certified trainers can be found on the following website:

Two trainers from Croatia are also available:
Josipa Mihić, PhD,

and Miranda Novak, PhD,

Main obstacles

With respect to individual professionals

The PATHS programme is delivered by teachers and the level of motivation of some teachers that were involved was rather weak. The reason for that was that the schools were randomly selected to participate in the study.

With respect to social context

The legislation was a big problem since it was hard for teachers to find time to deliver two PATHS lessons per week in their curriculum. Although we had formal support from the Ministry of Science, it was not possible to get special time for the programme’s delivery during the school day. Also, once the project was over, the policymakers did not ensure the sustainability of the programme.

With respect to organisational and economic context

We had no financial problems in delivering the programme, since it was financed through the project. However, once the project was over, the Ministry of Science did not provide financial support for the programme to continue. We see that as a huge obstacle for the delivery of this programme.

How they overcame the obstacles

With respect to individual professionals

During the programme implementation we organised regular meetings with all the teachers delivering the programme to try to motivate them and give them more support in delivering the programme.

With respect to social context

School principals suggested that teachers should deliver the programme within time that was scheduled for leisure and art activities.

With respect to organisational and economic context

In the region of Istra, the local authorities have decided to finance the continuation of the programme.

Lessons learnt

With respect to individual professionals

In the phase of testing the programme’s effectiveness, it might be better to start with motivated teachers. We have also learnt that in order to deliver a comprehensive social-emotional learning (SEL) curriculum, a lot of effort should be invested in preparing teachers and developing their socio-emotional skills. The training course for teachers should, therefore, be longer, and teachers should have regular meetings with programme supervisors.

With respect to social context

We would make a stronger request to the Ministry of Science to assign special time for the programme’s delivery during the school day.

With respect to organisational and economic context

From the ethical perspective, we believe that we should try to test and offer more affordable/free prevention programmes, since our policymakers and key people are not ready to invest any money into the prevention programme’s delivery on a national level. Also, we have learnt that we should offer the programme to local communities willing to invest some funds into prevention.


A great collaboration with scientists from abroad and a motivated group of professionals in Croatia; formal support from the Ministry of Science; financial support from an EU fund.


Not all teachers were motivated to participate (the school principals made that decision for them); the initiative for this programme came from the scientific community, and policymakers were not aware of the importance of prevention.


A great number of teachers were interested in participating, and smaller local communities were ready to finance the continuation of the programme.


Policymakers and key people were only slightly interested, and did not have sufficient knowledge of effective school prevention measures.


With respect to individual professionals

We would suggest offering this programme to motivated teachers and providing them with enough support during the programme delivery, and working with school principals and making them understand the importance of implementing effective prevention programmes.

With respect to social context

Invest in advocating for prevention and increasing key people’s knowledge of effective prevention programmes.

With respect to organisational and economic context

Assure the financial support needed for the delivery of the programme. Once the teachers are trained, you will need money for programme materials and programme licences (a significant cost).

Note from the authors

Implemented in Istria region, cities of Zagreb and Rijeka from 2009

Number of implementations