Date of Award

Spring 5-2021

Document Type

DNP Project

Project Team Faculty Member

Bernadette Sobczak

Project Team Faculty Member

Terri Furfaro


cognitive behavioral therapy, CBT, applications, pediatrics, adolescents, adjunct therapy


Cognitive behavioral therapy (CBT) is a mainstay of treatment for problems such as anxiety and depression. However, access to this form of psychotherapy treatment is limited in rural areas, especially in pediatrics. The purpose of this project was to increase access to CBT through the use of smart phone CBT applications for patients at one rural midwest pediatric clinic. An extensive literature review revealed that mobile cognitive behavioral therapy (CBT) applications can be an effective option for adjunct therapy when provider access is limited. Two CBT mobile applications were selected for the project and training was provided to clinic providers. Patient “CBT homework” sheets were provided as adjunct therapy to patients who presented with anxiety and depression over a three-month period in 2020. Providers assigned seventeen CBT homework sheets over the course of the project, of which twelve patients followed up in clinic and eleven reported using the CBT application. A post project interview with stakeholders and clinic staff found that the “CBT homework” instructions had to be simplified based on the reading level of the parents and patient maturity level. Limitations of the project included inconsistent follow up by patients, choosing the right application for school aged children, decreased follow up due to COVID-19, and limited options for applications for patients to use. For future use, CBT homework sheets should be simplified and include a rationale for how particular techniques work. Future projects should seek to simplify CBT homework sheets and video instructions for the patients.

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