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Promoting Alternative Thinking Strategies (PATHS)

Public Health & Prevention: School-based
Benefit-cost methods last updated December 2024.  Literature review updated June 2015.
The Promoting Alternative Thinking Strategies (PATHS) curriculum is a classroom socioemotional learning program designed to improve self-control, emotional understanding, interpersonal relationships, and social problem-solving skills for grades K-6. The program is designed to be a multi-year, school-wide intervention to prevent serious emotional and behavioral problems. The PATHS curriculum provides scripts to guide lessons that classroom teachers or counselors teach two to three times a week.
 
ALL
BENEFIT-COST
META-ANALYSIS
CITATIONS
For an overview of WSIPP's Benefit-Cost Model, please see this guide. The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2023).  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 $2,332 Benefits minus costs $10,332
Participants $5,768 Benefit to cost ratio $24.51
Others $2,954 Chance the program will produce
Indirect ($282) benefits greater than the costs 63%
Total benefits $10,772
Net program cost ($439)
Benefits minus cost $10,332

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on 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. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change 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. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Treatment age No. of effect sizes Treatment N 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
Symptoms of externalizing behavior (e.g., aggressive, hostile, or disruptive behavior) measured on a validated scale.
 6 9 4149 0.033 0.026 6 0.018 0.018 9 0.029 0.281
Internalizing symptoms
Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale.
 6 7 3420 0.015 0.029 6 0.015 0.029 8 -0.007 0.896
Test scores
Standardized, validated tests of academic achievement.
6 2 373 0.130 0.130 6 0.052 0.143 17 0.130 0.265
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
Affected outcome: Resulting benefits:1 Benefits accrue to:
Taxpayers Participants Others2 Indirect3 Total
Test scores Labor market earnings associated with test scores $2,458 $5,789 $3,051 $0 $11,298
Externalizing behavior symptoms Criminal justice system ($10) $0 ($21) ($5) ($36)
K-12 special education ($41) $0 $0 ($21) ($62)
Health care associated with externalizing behavior symptoms ($74) ($21) ($77) ($37) ($209)
Internalizing symptoms K-12 grade repetition $0 $0 $0 $0 ($1)
Program cost Adjustment for deadweight cost of program $0 $0 $0 ($220) ($220)
Totals $2,332 $5,768 $2,954 ($282) $10,772
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Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $119 2012 Present value of net program costs (in 2023 dollars) ($439)
Comparison costs $0 2012 Cost range (+ or -) 10%
The effects of PATHS are based on three years of program participation on average. Our cost estimates are from numbers published by Blueprints for Violence Prevention (http://www.blueprintsprograms.com/program-costs/promoting-alternative-thinking-strategies-paths), based on implementation in a school with 500 students, 20 teachers, and a part-time coach (0.5 FTE, $30,000) in 2012. The ongoing training and support costs for the teachers and the coach are estimated to be $19,500. Curriculum and supplies for 20 classrooms are estimated to be $10,000.
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.
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
Benefits Minus Costs Over Time (Cumulative 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 discounted dollars. 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.

Citations Used in the Meta-Analysis

Conduct Problems Prevention Research Group. (1999). Initial impact of the Fast Track prevention trial for conduct problems: II. Classroom effects. Journal of Consulting and Clinical Psychology, 67(5), 648-657.

Crean, H.F., & Johnson, D.B. (2013). Promoting Alternative Thinking Strategies (PATHS) and elementary school aged children’s aggression: Results from a cluster randomized trial. American Journal of Community Psychology, 52, 56-72.

Domitrovich, C., Cortes, R., & Greenberg, M. (2007). Improving young children's social and emotional competence: A randomized trial of the preschool 'PATHS' curriculum. Journal of Primary Prevention, 28(2), 67-91.

Greenberg, M.T., & Krusche, C.A. (1998). Preventive intervention for school-age deaf children: The PATHS curriculum. Journal of Deaf Studies and Deaf Education, 3(1), 49-63.

Kam, C.-M., Greenberg, M., & Kusche´, C. (2004). Sustained effects of the PATHS curriculum on the social and psychological adjustment of children in special education. Journal of Emotional and Behavioral Disorders, 12(2), 66-78.

Little, M., Berry, V., Morpeth, L., Blower, S., Axford, N., Lehtonen, M., Tobin, K., ... Bywater, T. (2012). The impact of three evidence-based programmes delivered in public systems in Birmingham, UK. International Journal of Conflict and Violence, 6(2), 260-72.

Malti, T., Ribeaud, D., & Eisner, M. P. (2011). The effectiveness of two universal preventive interventions in reducing children's externalizing behavior: a cluster randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 40(5), 677-92.

Morris, P., Mattera, S.K., Castells, N., Bangser, M., Bierman, K., & Raver, C. (2014). Impact findings from the Head Start CARES Demonstration: National evaluation of three approaches to improving preschoolers' social and emotional competence. Executive Summary. OPRE Report 2014-44. MDRC.

Riggs, N., Greenberg, M., Kusch, C., & Pentz, M. (2006). The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: Effects of the PATHS curriculum. Prevention Science, 7(1), 91-102.

Ross, S.M., Sheard, M.K., Slavin, R., Elliot, L., Cheung, A., Hanley, P., & Tracey, L. (2011). Evaluation of the Together 4 All Programme for Schools: Final Report. York: Institute for Effective Education, The University of York.

Schonfeld, D.J., Adams, R.E., Fredstrom, B.K., Weissberg, R.P., Gilman, R., Voyce, C., Tomlin, R., ... Speese-Linehan, D. (2014). Cluster-randomized trial demonstrating impact on academic achievement of elementary social-emotional learning. School Psychology Quarterly.