The Effects of the Courage to Care Program: Teaching Empathy to Rural New Hampshire Seventh Graders

by Rick Alleva, Patrick Shannon, and Malcolm Smith

The Courage to Care program (Smith, Alleva, & Linehan, 2012) is a multifaceted, experiential curriculum developed to promote caring and responsible social and emotional behavior on the part of young adolescents (ages 11 to 13) during their middle school years (grades 6 to 8). The rate at which middle school students appear to use meanness, bullying, and incivility to inflict both physical and emotional harm on one another in the United States and in New Hampshire is a significant concern and has been increasing (Rose, Espelage, & Monda-Amaya, 2009; Wang, Ionnatti, & Nansel, 2009; Blake, Lund, Zhou, Kwok, & Benz, 2012). Such peer victimization can result in many negative consequences for victims, including physical injury, depression, anxiety, substance abuse, suicidal ideation and suicide, decreased self-esteem, and poor educational outcomes.

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There have been many intervention programs designed to reduce bullying behavior, but the most effective approaches are flexible and monitor broader issues in schools that move beyond just how children are getting along (Smith & Brain, 2000; Beaty & Alexeyev, 2008). Effective approaches appear to focus on the moral, social, and emotional competence and climate of the whole school (Ragozzino & O’Brien, 2009). One of the most widely used interventions in the U.S. is one created by Olweus & Limber, (2010) that was brought to this country from Scandinavia in the early 1990s. Olweus programs attempt to change the culture and climate of schools by putting pressure on the negative aspects of bullying and teaching school staff how to recognize and “handle” bullies and victims. In other words, Olweus affects adult change in hopes of effecting student change.

Programs like Olweus attempt to include parents as part of the intervention. This is important because there is evidence that suggests the rise in meanness among young people is linked to parenting practices and to a growing lack of civility in American culture (Hong & Espelage, 2012; Green, Dunn, Johnson, & Molnar, 2011). Thus, it has been acknowledged that for a program to reduce bullying, it must take a systemic approach that includes the life of the student in school, in peer groups, and in the family setting. In contrast to the Olweus approach, the Courage to Care program was designed to promote student-led, organic systemic change. The curriculum emphasizes a positive strength-building approach to social emotional learning that empowers youth to make a difference in their school and their overall relationships with, and attitudes toward, peers (Peterson & Seligman, 2004). Courage to Care attempts to normalize civil behavior by promoting empathy, civility, and other positive social and emotional characteristics as part of a school’s curriculum. The purpose of this study was to examine the effectiveness of the Courage to Care program in teaching pro-social skills associated with reducing antisocial and violence-precursor behaviors to rural 7th grade students.

A Crisis of Empathy

A critical factor that appears to bind both the individual student’s propensity to participate in bullying behavior, either as a bystander or as a perpetrator, and various layers of the ecological climate of the school is the social and emotional skill of empathetic behavior Topcu & Erdur-Baker, 2012; Jolliffe & Farrington, 2006b). One possible explanation for the increase in meanness among students is that empathy-related behaviors, as demonstrated by students, school staff, parents, and peers, seem to be decreasing, while narcissistic behaviors appear to be increasing (Twenge, Campbell, & Freeman, 2012; Twenge, 2013). Empathy, for the purposes of this study, was defined as the ability of a student to experience “an emotional response that stems from another’s emotional state or condition” and “is congruent with the others’ emotional state or situation”(Topcu & Erdur-Baker, 2012). Generally, two types of empathy can be experienced and observed: cognitive empathy and affective empathy (Jolliffe & Farrington, 2006b.) The Basic Empathy Scale (BES) employed in this evaluation is predicated on the concept that affective empathy concerns a student’s “capacity to experience the emotions of another,” while cognitive empathy is the capacity to “comprehend the emotions of another” (Jolliffe & Farrington, 2006a, p. 589). In the context of the school setting, however, a more recent view of how empathy starts and moves on to compassionate behavior is described by Singer and Lamm (2009) as “emotional contagion” or “primitive empathy.” Recently, social media sites have been flooded with videos of babies who start laughing, crying, or dancing and other babies joining in. It appears that the babies reacting are actually feeling what the other babies feel, going beyond mere facial expressions to something deeper.

Recent neurological research seems to support this concept by demonstrating that seeing a sad face actually causes involuntary changes in a person’s pupil size and other neurological changes (Singer, & Lamm, 2009). However, to be an effective human force for good, this “primitive” empathy must be followed by a more complex behavior that is both affective and cognitive, simultaneously. It has been established that empathy promotes pro-social behavior in young people and that empathy is critical to promoting a willingness to intervene as a defender as well as to avoiding acting mean to others who are less fortunate (Espelage, Green, & Polanin, 2012).

The question that seems to be elusive in the literature is, how can we effect meaningful and lasting learning and practice of social and emotional skills, such as empathy and civility, in students? The Courage to Care program was designed to promote such skill development and action among middle-school-age students.

In contrast to the Olweus approach, the Courage to Care program was designed to promote student-led, organic systemic change.

Courage to Care Program

The Courage to Care program is a multifaceted, experiential curriculum developed to promote caring and responsible behavior on the part of young adolescents (ages 11 to 13) during their middle school years (grades 6 to 8). The curriculum was designed to be highly engaging and motivating for middle-school-age boys and girls. Courage to Care is grounded in the field of positive youth development, where building upon personal assets and strengths to make a difference in the lives of young people and their peers, families, schools, and communities is a priority (Silbereisen & Lerner, 2007).

Program Structure/Elements

The program structure includes a nine-lesson format to be facilitated during a planned one-hour weekly session. Each lesson incorporates a number of components, or “elements,” designed to engage and assist students with their Courage to Care experience. These include the following elements, with a few exceptions for setting the stage in the first lesson and final wrap-up in the last lesson:

Lesson Objective. The principal objective for the day’s lesson highlights some of the main themes for the day to help teachers frame the lesson so that it connects all activities and discussions involving that lesson.

Courage Concepts. “I” statements identify awareness, attitudes, and behaviors relative to the lesson topic (four to six per topic). These concepts are framed in first person and read by students as concepts they will strive to adopt as their own. For example, “I try to be caring toward others, not just family and friends” (from Caring for Others, lesson #2). These concepts are posted in the room and contribute to each lesson discussion.

Video Jolt. Each lesson begins with a short video depicting social interactions among middle-school-age youth. These “jolts” provide an emotional and challenging real-life situation related to the day’s topic to spark initial interest and discussion. The jolts are provided to illicit emotional contagion or primitive empathy (Singer and Lamm, 2009), as described earlier. Prompt questions are provided to encourage some sharing among students and set the stage for engaging youth in the remainder of the lesson.

Activity. An interactive social-learning activity provides students with a direct experience that can serve as an example of, or metaphor for, other experiences that participants may encounter. The activity includes processing guidance to encourage reflection.

Lesson Discussion. Small and whole-group discussions allow for students to further explore the ideas presented in the video jolt, activity, courage concepts, and participant experiences. Students are encouraged to share their personal perspectives and any observations to help reflect on and apply their learning experience.

Reading/Inspiration. Thoughtful quotations related to the lesson theme are provided for youth to read, share, and be inspired to express the courage to care through positive actions. Quotes range from Maya Angelou to Harry Potter’s Albus Dumbledore.

Evaluation. Each lesson concludes with an quick student evaluation of the day’s experience. These are short and simple—like, the “thumbometer or 1 to 10,”—with a few brief comments and they empower students to reflect on and share how they feel about the overall lesson experience.

Courage Practice. Students are encouraged to complete a “courage practice” assignment to provide a connection between the day’s lesson and the students’ lives outside the group. This assignment may be an act of kindness, a social observation, or another activity to practice and extend their learning experience.

Courage Book. Each student participant receives their own courage book during the first lesson. This pocket-sized book includes the lesson titles, courage concepts, inspirational quotations, and a courage practice assignment for each lesson. The courage book also contains space for participants to record their practice or other aspects of their experience with the Courage to Care lessons.

Lesson Topics/Themes

While empathy is certainly a complex and difficult concept to illicit, other social and emotional strengths seem to be linked to resisting incivility, meanness, and bullying. With an overall theme of promoting empathy and civility, the lessons taught in the Courage to Care program are based on intersections between social and emotional skills identified in Peterson and Seligman’s (2004) classifications, contained in their handbook Character Strengths and Virtues, and identified areas of social and emotional learning (Kimber, Sandell, & Bremberg, 2008; Ragozinno & O’Brien, 2009). Each of the eight Courage to Care lessons focuses on a particular social/emotional issue or theme, with a final lesson serving a summary and moving-forward focus. The lesson titles and topics are briefly described below:

Understanding Power. Power differentials between bullies and their victims, as well as bullies and their bystanders, have long been documented in the research, so much so that many state legislatures have based their very definition of bullying on the existence of an “imbalance of power” between the bully and their victims (National School Boards Association, 2012). This lesson also strives to have students explore that sometimes power (cultural, social, economic, etc.) can be wielded without a young person’s practical knowledge (i.e., a student who excludes anyone who can’t afford an expensive style of clothing).

Caring for Others. Feelings of empathy and generosity put into behavioral action by children are often referred to as pro-social behaviors (Eisenberg, Fabes, & Spinrad, 2006.) In the Courage to Care curriculum, students are asked to engage in pro-social behavior but also to weigh the costs of pro-social action against the price that action may result with their peers.

Being Mindful. Quick reaction, reactivity, and unsolicited comment are behaviors that social media demands of young people in an environment where how many “hits” or comments one receives on a social post are important to a sense of belonging. Mindfulness or contemplation are skills that allow a student to slow down reactivity, practice patience and deep listening, and appear to enhance compassionate behaviors (Hart, 2004). While “mindfulness” as a practice is an ongoing deep and meditative study, in the Courage to Care curriculum an introduction to the practice is presented, with practice designed to enhance contemplation as a process of compassion.

Being Social. Living in a society means that people place certain expectations on themselves as well as other people, and what we do or don’t do can have a profound effect on others. This lesson introduces the notion of citizenship and the social contracts people make with each other as part of a community.

Being “Cueful” and Having Insight. There is growing evidence that this generation’s early reliance on digital media is reconfiguring the neural networks of young people, contributing to a lack of empathy and social emotional learning that happens face to face (Mullen, 2011). In the activities of the Courage to Care program, a strong emphasis was put on practicing the ability to read body language, facial expressions, and other “cues” exhibited in personal interactions in order to heighten the students’ abilities to understand nonverbal communication.

Groups, Cliques, and Stereotypes. One of the most damaging aspects of bullying is the ostracizing and alienation of the victim from social groups. When asked about their experience with bullying, children report being shunned or left out as one of the most painful experiences of relational bullying and meanness (Thornberg, 2011) . The Courage to Care curriculum was designed to help students explore the feelings associated with alienation and belonging.

Courage in a Cyber Village. Although the playing field has very different rules, social interactions among young people on the Internet have been shown to be riddled with bullying, incivility, and mean behavior that cause very powerful damage to victims (Patchin & Hinduja, 2011). Social emotional learning that applies to social media, texting, and relationships on the Internet are explored by students and teachers together in the Courage to Care program.

The Courage to Care. The concept of courage is linked by Peterson and Seligman (2004) to the behaviors of bravery, persistence, integrity, and vitality (p. 199) and linked to the ability to put pro-social behaviors into action in spite of surmountable odds. The Courage to Care curriculum explores bravery on a very small level—the ability to “stand up” rather than “stand by” and do nothing.

Tag! You’re It! The final lesson in Courage to Care encourages the students and teachers to work together to put their learning into social action. It focuses on continuing to apply the lessons learned over the past weeks and helping to spread the spirit of empathy and civility to the very culture and climate of their school campus and the broader community.


A quasi-experimental pre-/post-test design was used in this study. The independent variable in this study was the Courage to Care program. The dependent variables were the frequency of bullying experiences and basic empathy.


Three rural school districts in New Hampshire were chosen for this project. Teachers, guidance counselors, after-school staff, and administrators were provided a three-day training in the overall design and use of the Courage to Care curriculum. The first day emphasized experiential and youth discovery models of learning, while the second and third days focused on curriculum contents and practice. Twenty educators attended the training and were provided materials, including video “jolts,” posters that emphasized student values of each lesson, called “courage concepts,” as well as plans for all activities and discussions in the program.

The trained educators taught the curriculum over a nine-week period, providing the curriculum approximately one hour per week over the nine-week period. Project staff monitored the application of the experimental group by making weekly site visits or phone calls to the experimental sites and interviewing the teachers with a standardized lesson review form, looking for areas of concern or support. Students in the control group were offered the curriculum following the post-testing of students in each experimental group.

All 7th grade students in each school (n = 240) were invited to participate in the study. The sample consisted of 176 7th grade students from five middle schools across three school districts in New Hampshire, for a response rate of 73.3 percent. The sample consisted of 90 males and 86 females. The overwhelming majority (n = 157) of the respondents were white. The range of participants per school was 32 (21 minimum, 53 maximum). Finally, there was even distribution between the comparison group (n = 87) and the treatment group (n = 89).

Table 1: Mean Comparison between Control Pre- and Post-Test Empathy Using Paired Samples T-test

Boys Girls t p 95% CL
Basic Empathy M SD M SD LL UL
Overall Empathy 3.59 .87 4.02 .68 -3.568 .000 -.674 -.194
Affective Empathy 3.26 1.11 3.83 .82 -.3738 .000 -.868 -.264
Cognitive Empathy 3.99 .78 4.26 .64 -.236 .019 -.483 -.043


The My Life in School Checklist (MLSC) is a 40-item questionnaire developed for youth ages 8–17 that provides data about the frequency of various bullying behaviors experienced by students (Arora & Thompson, 1987). Respondents reported the number of times in the past week that other students engaged in each behavior by indicating on the checklist if it occurred not at all, only once, or more than once. The Bully Victimization Index consists of six key items (i.e., tried to kick me, hit me, threatened to hurt me, demanded money from me, tried to break something of mine, and tried to hurt me). However, because the six key items focus mostly on physical acts of bullying, the test developers recommended adding four additional items that reflect other types of bullying (i.e., was unkind to me, was rude about the way I looked, told a lie about me, and laughed at me meanly) that may be more relevant for girls. Split half reliability for the index is good at .80 and .93 (Hamburger, Basile, & Vivolo, 2011) and convergent validity with the Olweus Bully/Victim Questionnaire is good at .73 (Humphrey & Symes, 2010).

It appears that the positive empathy and civility themes, together with the engaging activities and discussions, moved students to feel more connected and caring towards their peers.

The Basic Empathy Scale (BES) includes 20 items that measure empathetic responsiveness in adolescents (Jolliffe & Farrington, 2006a). Jolliffe and Farrington demonstrated a correlation between empathy and pro-social behavior in adolescents—as empathy increases so do pro-social behaviors. Empathy items in the scale ask respondents to rate their level of agreement with statements using a five-point Likert-type scale, ranging from one (strongly agree) to five (strongly disagree). The scale measures two different types of empathetic responsiveness: affective empathy and cognitive empathy. The affective subscale (11 items) assesses emotional congruence with other people’s emotions, and the cognitive subscale (9 items) measures the ability to understand other people’s emotions. Cronbach’s alpha has been calculated for both subscales (affective subscale = .85 and cognitive = .79 [Albiero, Matricardi, Speltri, & Toso, 2009]). In this study, internal reliability (Cronbach’s alpha) was calculated for the overall BES (.83), affective subscale (.82), and cognitive subscale (.73).


Table 2: Mean Comparison between Treatment Pre- and Post-Test Empathy Using Paired Samples T-test

Pre-Test Post-Test t p 95% CL
Basic Empathy Scale (BES) M SD M SD LL UL
Overall Empathy 3.55 .588 3.98 .712 -4.538 .001 -.611 -2.386
Affective Empathy 3.386 .681 3.72 1.01 -2.678 .01 -.579 -.086
Cognitive Empathy 3.852 .613 4.28 .529 -5.573 .001 -.588 -.278


Basic Empathy Scale

Girls in the treatment and control groups scored significantly higher than boys on all three basic empathy scales. Table 1 presents independent samples t-tests for the BES for boys and girls. Independent samples t-tests show that girls have significantly higher empathy scores on the overall BES (t(164) = -3.568, p>.001), the cognitive subscale (t(164) = -2.363, p>.01), and the affective subscale (t(164) = -3.738, p>.001).

Tables 2 and 3 present paired samples t-tests for the BES treatment and control groups. Students who completed the nine-week Courage to Care curriculum showed a significant increase in overall empathy (t(85) = -4.54, p>.001) as well as its associated subscales, affective empathy (t(85) = -2.678, p>.01) and cognitive empathy (t(85) = -5.573, p>.001). Conversely, students in the control group did not show a significant increase in overall empathy (t(84) = 1.85, p>.07) or the cognitive empathy subscale (t(84) = 1.53 , p>.131). There was a significant difference in the affective empathy subscale (t(84) = 2.24, p>.05); however, affective empathy decreased from pre- to post-test.

Table 3: Mean Comparison between Control Pre- and Post-Test Empathy Using Paired Samples T-test

Pre-Test Post-Test t p 95% CL
Basic Empathy M SD M SD LL UL
Overall Empathy 3.73 .435 3.59 .842 1.85 .068 -.010 .287
Affective Empathy 3.49 .717 3.31 .979 2.24 .028 .020 .339
Cognitive Empathy 3.39 .335 3.41 .434 1.53 .131 -.037 .180


My Life in School Checklist

Participants were asked to reflect on the most recent “unfriendly” or bullying event they experienced and to answer a few questions about the event. Regarding this event, participants reported that the perpetrator was their age (50 percent), older (38.4 percent), or younger (8.1 percent), and a small number reported incidents that involved both (2.1 percent). The most frequent places where the events occurred were outside of school (31.3 percent), school grounds (24.5 percent), classroom (12.9 percent), bathroom (7 percent), hallways (1.4 percent), and other locations (22.7 percent). Most participants reported that they did not report the event to a staff member (77.6 percent), but over half (52.1 percent) did report it to their parents. Of those who did report to either a staff member or a parent, 66.4 percent reported that it did not help. However, 56.4 percent reported that the school does not need to do more to support students.

The six-item victimization index was assessed pre- and post-intervention. The victimization index dropped from pre-test (M = 6.21, SD = 3.48) to post-test (M = 5.66, SD = 3.36); however, the paired samples t-test revealed that change was not statistically significant (t(12) = .559, p>.587). Similarly, the victimization for boys only dropped from pre-test (M = 6.48, SD = 2.98) to post-test (M = 6.29, SD = 3.08) but the difference was not statistically significant. The same pattern was true for girls (pre-test = 6.06, SD = 2.88, and post-test M = 5.92, SD = 2.67). There was almost no change from pre-test (M = 7.54, SD = 3.47) to post-test (M = 7.63, SD = 3.43) (t(102) = -260, p>.795) when the four items that reflected emotional aspects of bullying behavior were added to the victimization index to reflect emotional aspects of bullying.


Findings from this study provide initial support for the Courage to Care program’s impact on how 7th grade students respond to each other emotionally—that is, with increased empathy. It is encouraging that participants experienced significant increases in cognitive, affective, and overall empathy following an intervention of relatively short duration and dosage (i.e., nine sessions over nine weeks). It appears that the positive empathy and civility themes, together with the engaging activities and discussions, moved students to feel more connected and caring towards their peers.

Anecdotal evidence reported by students and teachers suggests that Courage to Care participants got to know each other better, felt more connected, and experienced greater trust of students and teachers as a result of their involvement. During the Courage to Care program, some students expressed care and concern for peers in emotional distress and attributed such speaking up on behalf of a fellow student to their participation in the program. Some students also reported that the program gave them the support and encouragement to be nice to each other, to share compliments, to be civil. No doubt, further qualitative and quantitative research is needed to determine if such connection, trust, and caring are common among students completing the Courage to Care program and if the positive impact on student empathy and civility is able to be maintained over time.

Results are less clear on whether the program has, or will have, a measurable impact on actual peer victimization behavior at school in the short or long term. It is possible that an increase in pro-social behavior and a decrease in peer victimization behaviors may have occurred among students involved in the study but was not able to be captured regarding perceptions of bullying and meanness among the greater school population. It is also possible that a greater mass of students is needed to impact broader school-wide climate and culture, as the Courage to Care program engaged less than 20 percent of the total student population in any of the participating treatment schools.

It is likely that actual student behavior takes longer to change, albeit beginning with changes in how students think and feel about each other. Thus, larger numbers of students may need to be touched by the empathy and civility embodied in the Courage to Care program for a longer duration before students begin to report a noticeable decline in peer victimization at school. Over time, this may take place through increased numbers of students participating in the program, such as a whole grade completing Courage to Care each and every year, as well as through an organic growth of empathy and civility on the part of Courage to Care students affecting others. Thus, it may create a ”pay it forward” movement that could have a positive and lasting impact on the overall school climate and culture. Such positive climate and culture change may take years to accomplish and require concerted youth, adult, and community actions to succeed. However, as more students participate in social and emotional skill development, with a particular focus on empathy and civility, the change process is likely to be expedited. Thus, expanding the Courage to Care intervention to more students in a given school and gathering longer-term impact data regarding peer victimization (bullying and meanness) via the My Life in School Checklist or other tools is clearly indicated.

While this study primarily focused on the impact on students completing the Courage to Care program, anecdotal evidence leads us to believe that a considerable impact was also taking place among the school faculty (teachers, counselors, and principals) who led the Courage to Care lessons with students. School staff reported improved relationships with students and a greater sense of community, as well as a better understanding of how students can learn and practice social and emotional skills. Further research on the Courage to Care teachers’ attitudes and experiences over the course of the program could have implications for other professional development and expanded opportunities to integrate social/emotional skill development into the schools’ curricula.

It is also relevant to acknowledge the important nature of family involvement in the Courage to Care program to date. In addition to securing written permission and providing a description of the program to all parents/guardians, schools offered initial and closing family sessions to orient parents to Courage to Care and to enlist their ongoing support and encouragement for their children’s successful participation. However, only a minority of parents participated in these sessions, and ongoing family communication regarding Courage to Care was rather limited. Moving forward, a stronger family component, suggested activities, and feedback from parents on their perceptions and experiences are directions to be undertaken.

Finally, we are pleased to have piloted the Courage to Care program in rural schools where resources are sparse and bullying and meanness are as prevalent as anywhere else. While there is good cause to believe the positive social and emotional skill development and engaging experiential activities of Courage to Care will translate to other communities and their schools, further research is indicated to determine the effectiveness of Courage to Care in more urban or suburban schools, including those with greater cultural diversity than those in this study. Such an investigation may help to identify if any adaptations or changes in the curriculum should be undertaken.


In an era of exploding incidents of bullying, it is very promising to find a program that may change the landscape of how meanness is addressed in the school setting. However, much more research needs to be done, such as examining the impact on entire middle school populations, conducting longitudinal research to study lasting effects on school climate and bullying incidents, and measuring the program’s effects on particular groups of students, including those with learning challenges and disabilities; additionally, exploring the use of qualitative methods to better understand why and how the program impacts empathy. Finally, exploring better ways to measure school-wide victimization change, including monitoring incident reports following the Courage to Care program, will enhance measurement of program effects.


The Courage to Care program, when used with a middle school population in rural schools, shows positive changes in the empathy levels of its participants. It also demonstrates some strength in reducing antisocial behaviors. The program appears to promote social and emotional learning and certainly warrants continuing study in diverse settings and of geographic and demographic populations as a method of improving civility among young people. The combination of using video “jolts” and experiential modeling and teaching, followed by deeper positive psychological discussions, appears to be an effective teaching method for pro-social skills.

Rick Alleva is an Extension Specialist for Rockingham County, at the University of New Hampshire. Patrick Shannon is Associate Professor of Social Work at UNH. Malcolm Smith is director of the Courage to Care Project and serves on the faculty of Plymouth State University where, among other duties, he serves as educational director of the TIGER civility in the arts project.


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