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Nurses Trained to use Cognitive Therapy with Children in Low-Income Communities

In a recent Philadelphia area pilot program, thirteen Advanced Practice Nurses (APNs) were trained by the Beck Institute to use Cognitive Therapy techniques to treat mental and behavioral health problems of children and adolescents between the ages of 7 and 18. The APNs were the children’s primary care providers in low-income populations, primary care providers are sometimes the only point of access for mental health care.

For this program, APNs were trained by Dr. Christine Reilly, a psychologist with expertise in Cognitive Therapy, and a nurse herself. The nurses participated in workshops, group supervision conference calls, and individual supervision sessions as needed, during the year-long program. The population served included children and adolescents from the Philadelphia region who presented with a range of problems, including depression, anxiety, behavioral problems, teen pregnancy, obesity, and substance abuse. The pilot program showed that nurses improved their understanding of the Cognitive Therapy model and CT techniques (developed by Aaron T. Beck, M.D. in the 1960s). Patients demonstrated improved outcomes, as assessed using the Beck Youth Inventories at the start and end of the program. Moreover, the nurses saw benefits of the CT training program in other aspects of their practice, including applying CT techniques to patients in other age groups, and improving the nurse/patient relationship.

This pilot program indicates that training nurses in Cognitive Therapy is a practical, feasible way to improve mental health care and patient outcomes among children and adolescents. The program was conducted by the National Nursing Centers Consortium, in partnership with the Beck Institute for Cognitive Therapy and Research, through a generous grant from the van Ameringen Foundation.

What does Cognitive Therapy have to do with Nursing?

As Advanced Practice Nurses (APNs) interact with patients who have health problems, many of them find that their patients also suffer from mental health problems, including depression, anxiety, and other illnesses. So how can APNs best address the mental health needs of their patients? Two articles published this fall in Medscape’s Advanced Practice Nursing ejournal discuss how Cognitive Therapy (CT), also referred to as Cognitive Behavior Therapy (CBT), is an effective, time-limited, clinically tested treatment that is ideal for nursing settings. (To view these articles, you have to be registered with Medscape – registration is free.)

In Cognitive Behavioral Therapy in Advanced Practice Nursing: An Overview, Dr. Sharon Morgillo Freeman, a psychologist and certified Cognitive Therapist, discusses how CBT meets APNs’ need for effective, empirically based treatment — it’s a great overview for any APN interested in CBT, and includes a case example of a depressed patient treated with CBT. In Nurses Integrate Cognitive Therapy Treatment Into Primary Care: Description and Clinical Application of a Pilot Program, Dr. Judith Beck and Dr. Christine Reilly describe a pilot program that trained 12 APNs in CT, and monitored their success in implementing CT with low-income, underserved patients. This pilot program, conducted by the Beck Institute and the National Nursing Centers Consortium (NNCC), showed that APNs were able to integrate CT techniques in their primary care practices, with better patient results. We expect that in the future, we’ll see more and more integration of CT in nurse settings…