Date of Award

Spring 5-5-2023

Document Type

DNP Project

Project Team Faculty Member

Dr. Bernadette K. Sobczak

Project Team Faculty Member

Dr. Tracy Pacini

Project Team Faculty Member

Dr. Valerie Griffin


Anxiety, depression, CBT technology, CBT apps, digital therapies, mental health shortage



Digital therapy is a growing healthcare intervention improving limited access to specialty care for specific populations and geographic areas. Cognitive Behavioral Therapy (CBT) applications focus on treating anxiety and depression and assist pediatric and adolescent patients in learning behavioral techniques as they wait for 3-6 months or longer to see a mental health provider. Such delays are attributed to the national shortage of mental health practitioners and the further scarcity of fewer psychiatric providers in rural areas, causing the potential for adverse patient outcomes. The setting for this 8-week quality improvement project was a pediatric care clinic that sees an average of 30 to 60 patients a day. The practice had four providers at project commencement, but the number of providers unexpectedly reduced to two, dramatically decreasing project participation. Several pediatric patients aged 11-18 were referred to the CBT applications, but only one patient accessed the app, used it, and found benefits. The remaining three patients were lost to follow-up. The execution of this intervention is straightforward for providers to incorporate into their practice. Providers can suggest smartphone CBT apps to patients, knowing it may take months to complete an initial mental health referral and evaluation. Future considerations include more significant support from all providers and clinic staff, applying this intervention in a larger clinic, and re-tooling the project for primary care patients across the lifespan who present with symptoms of anxiety or depression.

Keywords: Anxiety, depression, CBT technology, CBT apps, digital therapies, mental health shortage

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