Family Nurse Practitioners' Use of Cognitive Behavioral Therapy Treatment for Depression in Adolescents

Abstract

Background: Cognitive behavioral therapy (CBT) is an effective treatment modality for adolescents suffering from depression. Yet, it is often under-utilized among family nurse practitioners (FNPs) in the primary care setting. Known barriers exist within the realm of providers' lack of use of CBT in the primary setting, however, there is little research specifically on FNPs usage of the modality. Purpose: This paper seeks to understand FNPs' use of CBT in the primary care setting to treat adolescents with depression. Method and Sampling: A qualitative design was used to understand FNPs' use of CBT for adolescents suffering from depression. A faculty member and I recruited FNP participants through email. Ten FNPs currently working in the primary care setting with experience ranging from one to ten years participated in the study. Two focus group interviews were conducted in order to have a deeper understanding of the use of CBT in practice to treat adolescent depression. The interviews were audio taped and analyzed to reveal emerging themes. Results: After analyzing the audio recordings two common themes emerged: Unpreparedness and role conflict. Subthemes emerged within the area of unpreparedness that included knowledge regarding screening for depression in the adolescent population, utilization of clinical practice guidelines, available community resources and referrals, and the application of CBT in the treatment of adolescent depression. The theme of role conflict was associated with time constraints within the allotted time frame per patient and the conflict of providing mental health services when feeling as though their primary training is that of a family practice provider. Conclusion: The findings showed that the lack of use of CBT is multifactorial with knowledge being the greatest inhibiting factor. CBT is a recommended, first-line treatment option within the clinical practice guidelines for the treatment of adolescent depression. However, FNPs are not currently utilizing CBT in their practice to treat adolescent depression. There is much to be learned about adolescent depression in its entirety prior to incorporating CBT into practice.