COPE for the Treatment of Depressed Adolescents

Abstract

Background: Despite a U.S. prevalence of 9%, less than 25% of depressed adolescents receive evidence-based treatment. Objective: To describe lessons learned from implementing the COPE (Creating Opportunities for Personal Empowerment) program in a community mental health practice as part of an evidence-based practice change to improve an advanced practice psychiatric nurse’s clinical practice and provide treatment for depressed teens. Design: A preexperimental one-group pre- and posttest design was used to assess the feasibility and effects of a brief manualized seven-session cognitive-behavioral skills–building intervention titled COPE delivered to 15 depressed adolescents in routine 30-minute mental health medication management outpatient visits. Results: Applying the evidence-based practice model led to improved adolescent outcomes. Adolescents reported significant decreases in depression, anxiety, anger, and destructive behavior as well as increases in self-concept and personal beliefs about managing negative emotions. Challenges (limited organizational resources) needed to be addressed to implement the advanced practice psychiatric nurse’s evidence-based practice change. Conclusions: COPE is a promising brief cognitive-behavioral therapy–based intervention that can be delivered within 30-minute individual outpatient visits. With this intervention, advanced practice nurses can work with current practice limitations and still provide evidence-based treatment for depressed teens. Collaboration between research-focused and clinically based nursing colleagues is a model of clinical scholarship that holds great promise in bridging the gap between research and practice.