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

• Published in: Journal of pediatric health care Vol. 29; no. 3; pp. 274 - 282
• Main Authors: Kozlowski, Jessica L., Lusk, Pamela, Melnyk, Bernadette M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2015
• Subjects: Adaptation, Psychological; Advanced Practice Nursing; Anxiety; Anxiety - diagnosis; Anxiety - nursing; Anxiety - therapy; Child; Cognitive Therapy; cognitive-behavioral skills building; cognitive-behavioral therapy; Evidence-Based Nursing; Feasibility Studies; Female; Humans; Male; Nurses, Pediatric; Nursing Evaluation Research; Pediatrics; Pilot Projects; Practice Guidelines as Topic; Primary Health Care; Rural Population; treatment; treatment; Anxiety; cognitive-behavioral therapy; cognitive-behavioral skills building; child
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2015.01.009

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.