Center for Injury Research and Prevention

Friend to Friend: Reducing Relational Aggression In School Settings

Friend to Friend (F2F) is a school-based intervention program designed to reduce relational aggression among high-risk girls as well as improve the broader classroom climate in urban schools. Relational aggression is nonphysical behavior characterized by manipulating social relationships through gossip and social exclusion. Research has established that relational aggression in schools is associated with a host of negative psychosocial outcomes for youth, and can also have a negative broader impact on classroom climate and student-teacher relationships.

F2F was developed by researchers at Children's Hospital of Philadelphia (CHOP) beginning in the early 2000’s. In the first studies of F2F, the program was conducted by CHOP facilitators in partnership with a classroom teacher. In 2017, F2F transitioned to a school-led program, where school counselors and teachers run the program with training and coaching from CHOP. Because relational aggression in schools is particularly prevalent among girls and occurs frequently among youth in urban school settings, F2F is uniquely designed for that target population.

How F2F Works

The Community We Serve

F2F Impact on Relational Aggression in Schools

Towards a Replicable Model

Recommended Reading

F2F Blog Posts

CHOP Research on F2F

How F2F Works to Reduce Relational Aggression in Schools

The primary component of F2F is a small group pull-out intervention for relationally aggressive 3rd-5th grade girls. Over a number of weeks, girls learn strategies to understand different types of friendship problems (i.e., physical, verbal, social, and cyber), identify feelings, use calming strategies, interpret others’ intentions accurately, and make careful choices for responding to aggression. They also learn strategies for effectively entering peer groups and for handling social conflicts such as rumors. The pull-out group includes both girls identified as being relationally aggressive and prosocial role models (typically at a 3:1 ratio, respectively) who are selected based on a peer-report procedure.

After the group participants have completed half of the small-group sessions, participants’ leadership skills are reinforced by having them co-facilitate classroom sessions to train their peers in the problem-solving strategies they have learned. The classroom lessons offer girls a positive leadership role in order to shift how they are viewed by teachers and classmates, increase their use of prosocial behaviors, and in turn, improve classroom climate. A unique aspect of the F2F small-group and classroom curriculum is that it addresses the importance of the unstructured school settings (such as the playground, lunchroom, and hallways) in which aggression and bullying most frequently occur.

The Community We Serve

To create a culturally specific and empirically supported intervention, the F2F curriculum and unique teaching modalities (cartoons, videos, and role-plays) were developed through an extensive participatory research framework that combines best practice science with feedback from a diverse range of community stakeholders. Specifically, CHOP researchers integrated psychological theory and prior research on existing empirically supported school-based group interventions for physically aggressive boys in urban school settings with feedback gleaned through partnerships with girls and their teachers, parents, and community members. This approach ensures that F2F is scientifically grounded and developmentally appropriate and relatable for 3rd to 5th grade girls attending schools in urban under-resourced settings (see Leff et al., 2007 and Leff et al., 2009 below).

F2F Impact on Relational Aggression in Schools

A series of studies have been implemented with youth from the School District of Philadelphia. A randomized control trial of the program with 144 relationally aggressive girls from six elementary schools found that in comparison to a psychoeducational group intervention, relationally aggressive girls in the F2F intervention demonstrated decreases in relational aggression and increases in knowledge of social problem-solving skills, with findings maintained one year after the conclusion of the program. Further, the F2F program was rated as extremely acceptable and engaging by participating students and teachers, and was able to be implemented with high levels of procedural and process integrity. Read the press release.

Using data from the same randomized control trial, CHOP researchers also examined the broader effects of F2F by determining the impact of the program on 665 classmates of the relationally aggressive girls. These classmates did not participate in the small-group sessions, but were exposed to the program through the classroom lessons that the F2F girls helped to run. It was found that after the intervention, boys within these girls' classrooms scored higher in peer ratings of positive friendships and being nice, and scored lower in peer ratings of rumor-spreading, exclusion, and fighting, compared to boys in the control classrooms. The boys also had more positive relationships with their teachers. Even girls in the F2F classrooms who were not involved in the small-group intervention were rated by peers as being higher in positive friendships and being nice compared to girls in the control classrooms. Read the press release.

Towards a Replicable Model

Given the demonstrated effectiveness, acceptability and feasibility of F2F, there is great promise for replicability in the real world. Thus, CHOP researchers are working towards scaling up the program to be conducted by school staff with coaching support from the research team. This will enable schools to deliver F2F on their own and outside the parameters of a research study.

To this end, with two years of support from Kohl’s Cares® (2017-2019), the CHOP aggression/bullying prevention team provided training and coaching counselors and 3rd-5th grade teachers in five Philadelphia schools to run F2F independently. Strong results were found for students participating in F2F during first two years of Kohl’s funding. Specifically, of the 38 girls identified as relationally aggressive who participated in the small group intervention, 84.2% of the girls improved by at least 20% on one or more of the outcomes. In addition, 445 classmates of the aggressive girls participated in a series of F2F classroom sessions. Of those classmates with complete pre- and post-data, 68.2% improved by at least 20 percent on one or more of the outcomes. 

In our second round of funding from Kohl’s Cares (2019-2021), we are building upon the significant impact made in the first two years to refine and implement an innovative program sustainability model in two schools, where CHOP is identifying and training teachers and counselors to be “program champions.” This will maximize the reach of F2F with coaching to include additional students and equip those champions with skills to sustain the program into the future. This model addresses a key challenge facing many urban schools – the long-term ability to sustain best practice prevention programs.

To further advance the empirical support for the coaching model of Friend to Friend, the research team has been awarded a 5-year R01 grant from the National Institutes of Health (2019-2024). In this 40 school clinical trial, 20 schools will receive Friend to Friend with Coaching and 20 schools will follow standard school practice for managing aggressive behaviors, with the goal to examine the effectiveness of Friend to Friend with Coaching for indicated relationally aggressive girls and their classmates. Further, the team will explore mediators and moderators of program success (for whom and under what conditions the program works best) and factors associated with staff adoption and implementation of the program with more limited support from CHOP. Overall, this study will provide valuable information for a broader roll out of the program and future scale-up efforts in urban under-resourced schools.

Kohl's Cares | Reducing relational aggression in schools

Recommended Reading

F2F Blog Posts

CHOP Research on Friend to Friend