Promoting Alternative Thinking Strategies (PATHS) is an intervention program for children with behavioral and emotional deficits, designed for use, and shown to be effective when used in the classroom a minimum of 3 times per week. However, in some settings, as in the current study, PATHS is being used just once per week. The purpose of this quantitative study was to determine whether PATHS was beneficial in helping elementary school aged children improve their behavioral and emotional health when implemented once per week in a group therapy setting. PATHS was developed based on cognitive behavioral theory, which focuses on improving internalizing symptoms of mental health disorders (thoughts) as well as the externalizing symptoms (behaviors). A one-way, repeated measures ANOVA was utilized to analyze archival data of 193 scores, collected over a single school year. Results indicated that elementary school aged children who received PATHS once per week in a group setting showed a decrease in aggression and disruptive behaviors, and an increase in concentration and attention as well as social and emotional competence. Social change implications could involve the results of the study informing how we might promote overall emotional and behavioral well-being in children. At the organizational level, the expansion of the use of PATHS at reduced costs and time within other settings will extend these benefits to more children with behavioral and emotional deficits. Future studies are suggested to examine further the effectiveness of PATHS when implemented in other programs and alternative ways.