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

J Pediatr Health Care. 2015 May-Jun;29(3):274-82. doi: 10.1016/j.pedhc.2015.01.009. Epub 2015 Mar 20.

Abstract

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.

Keywords: Anxiety; child; cognitive-behavioral skills building; cognitive-behavioral therapy; treatment.

MeSH terms

  • Adaptation, Psychological*
  • Anxiety / diagnosis
  • Anxiety / nursing
  • Anxiety / therapy*
  • Child
  • Cognitive Behavioral Therapy*
  • Evidence-Based Nursing
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Nurses, Pediatric*
  • Nursing Evaluation Research
  • Pilot Projects
  • Practice Guidelines as Topic
  • Primary Health Care*
  • Rural Population