Evaluating Knowledge And Barriers To The Use Of Cognitive Behavioral Therapy By Nurse Practitioners In The Treatment Of Depression And Anxiety In Primary Care

Abstract

Depressive and anxiety disorders are the most commonly encountered mental health problems seen in the primary care setting; they represent a serious public health concern, and are inordinately time consuming for the primary care provider. Cognitive behavioral therapy (CBT) is an effective tool for the treatment of both depression and anxiety, and can be delivered in a variety of abbreviated forms appropriate for use in the primary care setting. Despite its apparent benefits, few primary care providers report using CBT in their practices. The purpose of this project was to develop a better understanding of provider knowledge and perceived barriers regarding the use of CBT for the treatment of depression and anxiety in the primary care setting. A better understanding of practitioners' knowledge of CBT and their perceived barriers to its use will establish a baseline for further exploration of the issue, and will help guide the development of strategies to address the gap in practice. A brief questionnaire was provided to a convenience sample of Nurse Practitioners (NP) during a regular meeting of the Southern Arizona Advanced Practice Nurse/Nurse Practitioner Society. The results of the data analysis showed that 90% of the sampled NPs considered themselves to be skilled in detecting depression and anxiety in their patients, and 80% were confident in their abilities to treat patients with these disorders. However, only 30% of sampled NPs currently use CBT in their practices. The sample indicated a broad lack of knowledge related to multiple aspects of CBT including technique, training, implementation, and reimbursement. Education and training were revealed to be the strongest predictors of willingness to use CBT. Only 30% of NPs were introduced to the use of CBT in their NP programs. The results suggest that increased education in the proper technique, process, and billing methods for CBT may contribute to greater utilization by NPs in the primary care setting.