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

Arizona State University College of Nursing & Health Innovation, 500 North 3rd Street, Phoenix, AZ, USA.
Journal of the American Psychiatric Nurses Association 05/2011; 17(3):226-36. DOI: 10.1177/1078390311404067
Source: PubMed

ABSTRACT 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.
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.
A preexperimental one group pre- and posttest design was used.
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.
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.

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    • "The sample size also was small , which limits generalizability of the findings . Despite these limitations , this pilot study contributes to the growing body of research that supports COPE as effective management for anxiety , depression , anger , disruptive behavior , and improved functioning in chil - dren and adolescents ( Lusk & Melnyk , 2011a , 2011b , 2013 ; Melnyk et al . , 2007 , 2013 ; Melnyk & Jensen , 2013 ) . "
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    ABSTRACT: 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. A pre-experimental, one-group, pretest and post-test design was used. 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. COPE is a promising evidence-based intervention for children with anxiety with feasible delivery by pediatric nurse practitioners in primary care. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
    Journal of Pediatric Health Care 03/2015; 29(3). DOI:10.1016/j.pedhc.2015.01.009 · 1.97 Impact Factor
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    • ") and England (Department of Health, 2008). Consequently , the reference to, and use of, treatment manuals has grown substantially in recent years in psychotherapy research and practice (Crits-Christoph et al., 2009; Fluckiger et al., 2012; Lusk and Melnyk, 2011; Nelson et al., 2012; Weck et al., 2011). Manuals offer an opportunity to create a replicable and systematized approach to therapeutic interventions, to control extraneous variables and to test the efficacy of new treatments (Crits-Christoph et al., 1990). "
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    ABSTRACT: This article reports a systematic review of the literature examining therapists' views and experiences of utilizing treatment manuals. Key databases were searched and a thematic narrative analysis was conducted. Twelve articles were identified. The literature contains four distinct subthemes: (i) exposure to and use of manuals; (ii) therapists' beliefs about manuals; (iii) therapist characteristics, such as age/gender/training and (iv) characteristics of the work, such as client group. The analysis finds that clinicians who have used manuals appraise them positively, and view them as facilitating flexibility, allowing for therapeutic relationship and keeping therapy on track. The review is a helpful contribution to the literature and is a prompt to practitioners to consider their own views and exposure to manualized treatments and how this relates to generating the ‘hard’ outcome data that governments and service commissioners internationally find credible and persuasive. Practitioner pointsThe positive appraisal of manuals is increased through exposure to them in clinical practice or research settings. Clinicians may wish, therefore, to seek out opportunities to use manuals.Clinicians are rarely exposed to manuals, which presents a potential topic for training courses to address.
    Journal of Family Therapy 03/2014; DOI:10.1111/1467-6427.12036 · 1.02 Impact Factor
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    • "The 15-session COPE Healthy Lifestyles intervention is delivered to all students in selected high school health classes and college courses as a CBSB health promotion program. Results from prior studies with COPE have been published (Lusk & Melnyk, 2011, Melnyk et al., 2007, 2009). The 15-session COPE/Healthy Lifestyles TEEN program is currently being tested in a randomized controlled trial with 779 diverse high school students though funding from the National Institutes of Health/National Institute of Nursing Research (Grant #1R01NR012171) (Melnyk et al., 2013). "
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    ABSTRACT: Despite the increasing prevalence of depressive and anxiety disorders in adolescents, less than 25% of affected teens receive any treatment. 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. 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. 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.
    Journal of Child and Adolescent Psychiatric Nursing 10/2013; 27(1). DOI:10.1111/jcap.12058
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