Washington State Institute for Public Policy
Stop Now and Plan (SNAP)
Children's Mental Health: Disruptive Behavior
Benefit-cost estimates updated May 2017.  Literature review updated December 2015.
Stop Now and Plan (SNAP) is a program to reduce problem behavior and prevent criminal activity in children ages 6-11 with serious disruptive behavior problems. There are separate SNAP programs for girls and boys. SNAP includes a 12-week group program for children and parents. The group sessions are designed to teach children cognitive behavioral skills and give children structured time to practice to apply their skills in specific situations. In separate group sessions, parents learn parenting skills and strategies to cope with their own emotions. After the group sessions, SNAP provides additional services to meet individual family needs such as family counseling, school advocacy, or tutoring.
BENEFIT-COST
META-ANALYSIS
CITATIONS
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2016). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $567 Benefits minus costs ($3,177)
Participants $414 Benefit to cost ratio $0.05
Others $483 Chance the program will produce
Indirect ($1,305) benefits greater than the costs 4 %
Total benefits $160
Net program cost ($3,337)
Benefits minus cost ($3,177)
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
Crime $42 $0 $113 $21 $177
Labor market earnings associated with high school graduation $177 $390 $179 $179 $925
K-12 grade repetition $5 $0 $0 $2 $7
K-12 special education $201 $0 $0 $101 $302
Health care associated with disruptive behavior disorder $162 $53 $200 $81 $495
Costs of higher education ($19) ($29) ($9) ($10) ($66)
Adjustment for deadweight cost of program $0 $0 $0 ($1,680) ($1,680)
Totals $567 $414 $483 ($1,305) $160
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $4,795 2012 Present value of net program costs (in 2016 dollars) ($3,337)
Comparison costs $1,567 2011 Cost range (+ or -) 20 %
SNAP is a 12-week program. We estimated the cost of the treatment group using cost estimates in Farrington and Koegl, 2014 and the licensing and training costs described in SNAP Schedule C licensing description (Leena Augimeri, personal communication, September 18, 2015). The cost of the control group was calculated based on the units of wraparound services received by participants in the comparison group in Burke & Loeber, 2014. As reported in Burke & Loeber, 2014, 13.1% of the comparison group received 7.9 units of wraparound services during the first three months, and 35% of the comparison group received wraparound services in the subsequent year. We estimated that the average per-participant units of wrap around services remained the same for the next year. To estimate per-unit cost of wrap around services we used the individual treatment reimbursement rate from Mercer, (2013). Behavioral Health Data Book for the State of Washington for Rates Effective January 1, 2014. All costs were converted from Canadian dollars to US dollars using the average exchange rate from the year the costs were measured. (http://www.canadianforex.ca/forex-tools/historical-rate-tools/yearly-average-rates). Farrington, D.P., & Koegl, C.J. (2014). Monetary benefits and costs of the Stop Now And Plan Program for boys aged 6–11, based on the prevention of later offending. Journal of Quantitative Criminology, 31(2), 263-287. Burke, J.D., & Loeber, R. (2014). The effectiveness of the Stop Now And Plan (SNAP) Program for boys at risk for violence and delinquency. Prevention Science, 16(2), 242-253
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Primary or secondary participant No. of effect sizes Treatment N Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
Externalizing behavior symptoms 2 150 -0.167 0.119 10 -0.079 0.070 13 -0.450 0.001
Internalizing symptoms 2 150 -0.118 0.119 10 -0.086 0.099 12 -0.318 0.008
Citations Used in the Meta-Analysis

Burke, J.D., & Loeber, R. (2015). The Effectiveness of the Stop Now and Plan (SNAP) program for boys at risk for violence and delinquency. Prevention Science, 16(2), 242-253.

Pepler, D., Walsh, M., Yuile, A., Levene, K., Jiang, D., Vaughan, A., & Webber, J. (2010). Bridging the gender gap: interventions with aggressive girls and their parents. Prevention Science: the Official Journal of the Society for Prevention Research, 11(3), 229-38.

For more information on the methods
used please see our Technical Documentation.
360.664.9800
institute@wsipp.wa.gov