Social-Emotional Screening Protocol Implementation: A Trauma-Informed Response for Young Children in Child Welfare.

Adverse childhood experiences in young children result in negative outcomes as trauma affects brain development. In child welfare services, early recognition of delayed social-emotional skills and treatment referral is essential in reducing the effects of trauma. This quality improvement pilot project implemented an evidence-based social-emotional screening protocol using the Ages and Stages Questionnaire: Social Emotional-2 screening tool for very young children placed in out-of-home care through the county's child welfare system. Findings showed significant improvement in identification of children younger than 3 years with social-emotional concerns (p < .0001) and significant improvement in referral of those children positively identified (p = .0130). Ongoing use of the protocol was recommended, because it showed improved identification and referral for young children in the child welfare system with social-emotional concerns that were potentially trauma related. Further collaboration between child protective services, pediatric medical systems, and pediatric mental health systems is needed to facilitate trauma-informed care for children in the child welfare system.

Decreasing Depression and Anxiety in College Youth Using the Creating Opportunities for Personal Empowerment Program (COPE).

BACKGROUND: College is a time of major transition in the lives of many young adults. Roughly 30% of college students have reported that anxiety and depressive symptoms negatively affect their lives and academic functioning. Currently, anxiety has surpassed depression as the reason college students seek help at counseling centers. Unfortunately, only one third of students receive treatment for anxiety and only 25% of students receive treatment for their depression. OBJECTIVES: The objectives of this pilot project were to (a) assess levels of depression and anxiety in identified "at risk" college students who present to the college Student Health Services (Primary Care), (b) implement a new cognitive behavioral therapy-based intervention titled "Creating Opportunities for Personal Empowerment" (COPE), and (c) evaluate the effectiveness of the intervention on students' levels of depression and anxiety as well as satisfaction with the intervention. DESIGN: A one group pre- and post-test design was used. RESULTS: Students who received COPE demonstrated clinically meaningful improvement in depressive and anxiety symptoms as measured by the Beck Depression Inventory-II and the State-Trait Anxiety Inventory. CONCLUSION: COPE is an effective brief program for reducing depression and anxiety in college-age youth. Implementation of evidenced-based programs into the college experience could lead to less severe depression and anxiety and better academic performance, ultimately increasing the likelihood of students successfully completing their academic programs.

A Successful Model for Clinical Training in Child/Adolescent Cognitive Behavior Therapy for Graduate Psychiatric Advanced Practice Nursing Students.

BACKGROUND: Graduate faculty in advanced practice nursing programs seek to provide clinical training in psychotherapy for psychiatric mental health nurse practitioner (PMHNP) students and prepare them for practice with patients across the lifespan, including children and adolescents. OBJECTIVE: To develop a clinical training model for child/adolescent cognitive behavior therapy (CBT) that is adaptable to all graduate nursing programs including online, classroom, and blended programs. DESIGN: Clinical training included a didactic 4-hour workshop and 7 small group practice sessions utilizing Creating Opportunities for Personal Empowerment (COPE), a manualized CBT program for teens. Students completed post-clinical training evaluations. Using qualitative design, responses to the open-ended questions were analyzed and common themes identified. RESULTS: One hundred seven PMHNP students completed evaluations. Four themes emerged from the data: (a) therapeutic understanding of adapting CBT for children and adolescents, (b) therapeutic skills and techniques for use with children/adolescents, (c) improved level of confidence through participation in the CBT program, and (d) therapeutic benefits of being in a group. CONCLUSIONS: Positive PMHNP student evaluations indicated that this clinical training model is feasible both online and face-to-face and acceptable for providing clinical training in CBT for children and adolescents.

Perceptions of Interdisciplinary Communication Among Correctional Health Care Providers.

Collaborative practice is a health care standard that improves patient outcomes through maximizing the use of resources and mutual work of all health care providers. Since collaborative practice depends on interdisciplinary communication, effective communication training for health care participants is imperative for success. This article presents the results of research that studied perceptions of interdisciplinary communication and collaborative practice among 24 health care personnel in three correctional facilities in Orange County, California. The research explored different approaches in terms of team structure, mutual support, situation monitoring, leadership, and communication practices. The study used questionnaires to examine the perceptions of teamwork and interdisciplinary communication and how they can be impacted by one educational session. The study results are discussed in terms of modern approaches to health care, including evidence-based practice, along with nationwide initiatives for improving the health of inmates with psychiatric issues.

Pediatric Nurse Practitioner Management of Child Anxiety in a Rural Primary Care Clinic With the Evidence-Based COPE Program.

INTRODUCTION: Anxiety is the most common mental health disorder in children. Many communities have shortages of mental health providers, and the majority of children with anxiety are not receiving the evidence-based treatment they need. The purpose of this pilot study was to assess the feasibility and effects of a brief seven-session cognitive behavioral skills-building intervention, Creating Opportunities for Personal Empowerment (COPE), which was delivered to anxious children by a pediatric nurse practitioner in a primary care setting. METHODS: A pre-experimental, one-group, pretest and post-test design was used. RESULTS: Children who participated had a significant decrease in anxiety symptoms (13.88 points, SD = 17.96, 95% confidence interval [CI] = -1.13-28.89), as well as an increase in knowledge of cognitive-behavioral coping skills (M = 11.38, CI = 5.99-8.26, p = .00) and improved functioning (at school and at home). Evaluations by parents and children were positive. DISCUSSION: COPE is a promising evidence-based intervention for children with anxiety with feasible delivery by pediatric nurse practitioners in primary care.

Outcomes and Feasibility of a Manualized Cognitive-Behavioral Skills Building Intervention: Group COPE for Depressed and Anxious Adolescents in School Settings.

PROBLEM: Despite the increasing prevalence of depressive and anxiety disorders in adolescents, less than 25% of affected teens receive any treatment. METHODS: A preexperimental one-group pre- and posttest pilot study design with 4-week follow-up was used to assess the feasibility and preliminary effects of the COPE (Creating Opportunities for Personal Empowerment) brief-focused manualized seven-session cognitive-behavioral skills building group intervention delivered in two high schools to 16 adolescents referred by a school-based nurse practitioner for depression or elevated anxiety symptoms. FINDINGS: Adolescents reported significant decreases in depression and anxiety on the Beck Youth Inventory as well as increases in personal beliefs about managing negative emotions. Evaluations indicated that the group COPE intervention was a positive experience for the teens. CONCLUSIONS: COPE is a promising brief-focused cognitive behavioral therapy-based intervention that can be delivered effectively to teens in school settings using a group format.

COPE for depressed and anxious teens: a brief cognitive-behavioral skills building intervention to increase access to timely, evidence-based treatment.

TOPIC: Evidence-based cognitive-behavioral therapy skills building intervention--Creating Opportunities for Personal Empowerment (COPE)--for depressed and anxious teens in brief 30 min outpatient visits. PURPOSE: Based on COPE training workshops, this article provides an overview of the COPE program, its development, theoretical foundation, content of the sessions, and lessons learned for best delivery of COPE to individuals and groups in psychiatric settings, primary care settings, and schools. SOURCES: Published literature and clinical examples. CONCLUSION: With the COPE program, the advanced practice nurse in busy outpatient practice can provide timely, evidence-based therapy for adolescents and use the full extent of his/her advanced practice nursing knowledge and skills.

COPE for the treatment of depressed adolescents: lessons learned from implementing an evidence-based practice change.

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.

The brief cognitive-behavioral COPE intervention for depressed adolescents: outcomes and feasibility of delivery in 30-minute outpatient visits.

BACKGROUND: Despite a U.S. prevalence of 9%, less than 25% of depressed adolescents receive treatment because of time constraints in clinical practice and lack of mental health providers available to deliver it. OBJECTIVE: To assess the feasibility and effects of a brief manualized seven-session cognitive-behavioral skills building intervention entitled COPE (Creating Opportunities for Personal Empowerment) delivered to 15 depressed adolescents in routine 30-minute mental health medication management outpatient visits. STUDY DESIGN: A preexperimental one group pre- and posttest design was used. RESULTS: 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. Evaluations indicated that COPE was a positive experience for teens and parents. CONCLUSION: COPE is a promising brief cognitive-behavior therapy-based intervention that can be delivered within 30-minute individual outpatient visits. With this intervention, advanced practice nurses can work with practice time limitations and still provide evidence-based treatment for depressed teens.