Dr. Shannon M. Bennett and Dr. Renae Beaumont

What youngster could resist joining a club named the Secret Agent Society? As it turns out, Renae Beaumont, PhD, was onto something in her creation of the Secret Agent Society, a remarkably effective multimodal therapeutic program for improving children’s emotion regulation and social skills. Since its inception in 2008, the program has been employed in treating more than 10,000 children, ages eight to 12, in nine countries around the world.

The Secret Agent Society (SAS) grew out of Dr. Beaumont’s doctoral project at The University of Queensland, Australia. In findings reported in her original paper, Dr. Beaumont and a colleague demonstrated impressive improvement in participants: 76 percent showed marked and sustained growth in emotional control and social interactions. Since then, SAS has been tested in multiple university and community trials. There have been several papers demonstrating that SAS is among the most effective programs of its kind in helping children with Autism Spectrum Disorder learn to manage their lives and socialize with others beyond the consultation room. Several iterations of the program have been carried out in school settings, and one trial registered success when parents were trained as facilitators.

“The opportunity to learn and practice social skills while also learning emotional and behavioral control skills is quite unique.”

— Dr. Shannon M. Bennett

Having heard of the Secret Agent Society program through colleagues, Shannon M. Bennett, PhD, Co-Director of the Weill Cornell Pediatric OCD, Anxiety, and Tic Disorders Program, was drawn to its dual focus on social skills and emotional regulation skills. “It was innovative and took a different approach from other social skills programs,” says Dr. Bennett. “Children with a variety of common mental health conditions, such as anxiety and ADHD, need emotional regulation skills and behavioral control skills to manage the symptoms or behaviors associated with these conditions. In addition, anxiety and ADHD often have social consequences for different reasons. The opportunity to learn and practice social skills while also learning emotional and behavioral control skills is quite unique, and we were interested in being able to offer this program to our patients. We contacted Dr. Beaumont and she was interested in providing training to us and collaborating on research.”

“The Secret Agent Society program was developed for what is now called level one autism spectrum disorder, previously identified as high functioning autism or Asperger’s disorder,” says Dr. Beaumont, who joined Weill Cornell Medicine in 2015 as a visiting senior research fellow. “It was designed for children with an IQ within the average range and whose verbal skill is age appropriate. When I came here to Weill Cornell, we wanted to see if the program also had potential for children who aren’t on the autism spectrum, but who still struggle socially.”

Childhood and adolescent anxiety and ADHD may grow from a very different cause as compared to high-functioning autism, notes Dr. Beaumont, but social struggle and its consequences are similarly significant in its impact on individual development. Broadening the Secret Agent Society’s use of engaging methods, integrating computer technology and therapeutic process, to the treatment of other childhood developmental conditions and mental health disorders would appear a logical next step in the program’s evolution.

SAS in Action

With its tagline, Solving the Mystery of Social Encounters, the Secret Agent Society uses multimedia to teach emotion recognition, emotion management, and social skills. In groups of three to six children, ages eight to 12, the SAS program engages the children in “missions” rather than assignments. Its therapeutic curriculum — spy themed — includes a multilevel computer game; a Secret Message Transmission Device game that teaches children to recognize emotions from voice tone clues; and a Challenger board game that serves as social practice. Many of these games are played during weekly child club meetings where the children can practice their new skills and learn others.

“This study is not simply examining the teaching and learning of social skills. We also want to see if there is improvement in the core diagnostic features.”

— Dr. Renae Beaumont

“At the same time, parents are involved in a parallel group so that they can learn about what their kids are learning, enabling them to serve as coaches, which is really important,” says Dr. Bennett. “And teachers are provided with tip sheets, so they, too, know the skills that the children are learning and practicing. In this way, the children have opportunities for coaching and support in different environments throughout their day and week, and to practice and implement the skills they are learning. That is what makes behavioral therapy effective. If you don’t practice those skills, they are hard to retain and realize a sustainable benefit.”

Dr. Bennett describes the program as providing an in vivo type practice in which the participants are embedded in a group of their peers and provided with many opportunities for naturalistic learning. “The board game enables them to practice being a good winner or a good loser, taking turns, complimenting others, having differences of opinion, or coping with disappointment, for example,” notes Dr. Bennett. “A therapist serves as a facilitator, guiding the children through experiences that may be similar, though not identical, to what may occur on the playground or in the classroom.”

In October 2015, Dr. Bennett, who serves as Principal Investigator, Dr. Beaumont, and their colleagues at Weill Cornell began a randomized controlled pilot trial to evaluate the program’s effectiveness for an estimated 90 children with anxiety disorder, attention deficit hyperactivity disorder, and autism spectrum disorder, including those who may have a combination of these diagnoses. “The study compares children who go through the Secret Agent Society program with those in other treatment programs,” says Dr. Beaumont. “Many of the children are receiving weekly, individual therapy and are managed with medications. So, it’s quite a rigorous benchmark. This study is not simply examining the teaching and learning of social skills. We also want to see if there is improvement in the core diagnostic features. So do we see improvement in ADHD and anxiety symptoms, as well as social skills?”

The Secret Agent Society’s child club meetings use a variety of program materials geared to enhancing social skills.

Specifically, the study, which is expected to be completed toward the end of 2018, is seeking to determine if the SAS program produces improvements in emotion regulation skills, especially anxiety, ADHD symptomatology, and social skills.

Dr. Beaumont acknowledges that there is a certain amount of professional skepticism when it comes to social skills training for children. “Children might improve in the actual therapy session,” she says, “but do they take what they learn and use it where they need it?” Dr. Beaumont believes that a main premise and foundation of the SAS program is that working with a support team around the child — parents, teachers, therapists — who speak the same lingo can raise the skill level of the child and empower the child to use these skills when they need them.

“In addition to the benefits the SAS program provides for patients and families, our trainees in psychiatry and psychology have also learned quite a bit about group therapy, family dynamics, parent training, behavior therapy, and social skills training,” adds Dr. Bennett.

“Anxious youth and anxious adolescents often avoid common social situations that are important to social development,” continues Dr. Bennett. “If you go to college and haven’t had those experiences navigating, ‘How do I interact with a roommate? How do I meet kids in class? How do I make a new group of friends in a new setting?’ — that can be very hard. Young people not only feel anxious, but they also feel like they don’t have the necessary social skills. They feel that they’ve missed out on learning important social and developmental skills because they’ve been taken out of these activities due to their anxiety. So, we hope to collaborate with Dr. Beaumont and faculty from our Center for Youth Mental Health (formerly known as the Youth Anxiety Center) to develop a similar social skills program for older adolescents and college age youth.”