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.