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Development Of Evidence-Based Clinical Practice Guidelines For Pediatric Preoperative Anxiety, Whitney R. Stant May 2025

Development Of Evidence-Based Clinical Practice Guidelines For Pediatric Preoperative Anxiety, Whitney R. Stant

Doctor of Nursing Practice Scholarly Projects

Preoperative anxiety is a problem that occurs frequently in pediatric patients. Preoperative anxiety creates physical and psychological changes that impact a child’s surgical experience. Pediatric patients who experience preoperative anxiety may also experience prolonged postoperative care, long-term psychological complications, and increased postoperative pain. Sedating medications are often administered to prevent and treat preoperative anxiety. Commonly, midazolam is administered intranasally to prevent preoperative anxiety. Midazolam increases the risk of cognitive impairment and respiratory depression. Dexmedetomidine is an effective alternative to midazolam. Dexmedetomidine is a highly selective alpha-2 agonist and provides arousable sedation without respiratory depression. Dexmedetomidine is safe and effective at …


Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers Apr 2024

Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers

Doctor of Nursing Practice Scholarly Projects

The nurse anesthesia specialty is highly stressful, with educational training being no exception. High didactic demands and intensive clinical experiences are placed on student registered nurse anesthetists (SRNAs), increasing stress and anxiety in their personal and professional lives. High levels of psychological distress can lead to inadvertent consequences in students’ mental, emotional, and physical health and can contribute to illness, burnout, substance use, and compromise in patient safety. Some degree of stress is necessary for motivation to succeed and perform at high levels, and encountering stress while enrolled in a doctoral nurse anesthesia program is expected and unavoidable. A search …


The Anatomical Embodiment Of Morning Routines In The Reduction Of Anxiety: An Intervention, Natalie Wright Apr 2024

The Anatomical Embodiment Of Morning Routines In The Reduction Of Anxiety: An Intervention, Natalie Wright

Expressive Therapies Capstone Theses

The topic under investigation is whether physically embodying a morning routine that was designed through the lens of Laban Bartenieff Movement Analysis (LBMA) will reduce daily symptoms of individuals diagnosed with Generalized Anxiety Disorder.

Since morning routines play a significant part in one’s preparation for the day, I created an individualized LBMA morning routine for a specific client to embody. In addition to the routine, the client documented the process of their anxiety levels on a weekly basis. This client was a white, female, 19-year-old, lesbian college student who was previously diagnosed with Generalized Anxiety Disorder (GAD). The movement analysis …


Pediatric Anxiety Disorders And Their Accommodation In The Classrom, Olivia Hobson Apr 2024

Pediatric Anxiety Disorders And Their Accommodation In The Classrom, Olivia Hobson

Honors Theses

This project is an exploration of the origins, neurology and impacts of pediatric anxiety disorders, as well as the research-backed best practices for their accomodation within the school classroom setting.


The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali Mar 2024

The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali

Theses & Dissertations

Introduction: Pediatric oncology nurses in Pakistan are at the forefront of caring for young cancer patients. In Pakistan, thousands of children are diagnosed with cancer every year, however the country's healthcare system lacks a comprehensive National cancer registry. Pediatric oncology nurses face high stress levels due to the demanding nature of their work, lack of specialized training, and communication challenges with patients and families. This study aims to explore the prevalence of stress and its predictors among these nurses in Pakistan, addressing a significant research gap.
Purpose: The purpose for the study was to measure stress and identify its predictors …


The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King Feb 2024

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …


Utilizing A Structured Music Therapy Program For Adolescents With Anxiety And Depression, Amy Haagen Jan 2024

Utilizing A Structured Music Therapy Program For Adolescents With Anxiety And Depression, Amy Haagen

West Chester University Doctoral Projects

Anxiety and depression are two of the most common mental health issues that affect children and adolescents. It has been noted that twenty percent of adolescents will have a depressive episode or be affected by anxiety by the time they are 18 years old. Mental health issues affecting children and adolescents majorly impact all aspects of their lives, most notably academic success, behavior, growth, and development (Porter et al., 2017). Current treatments for mental disorders, including depression and anxiety, include pharmacological and psychotherapeutic treatments. In the adolescent population, there are conflicting opinions on the use of antidepressants due to risks …


Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford Dec 2023

Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford

Theses and Graduate Projects

Background: Traumatic Brain Injury (TBI) is one of the leading causes of physical and cognitive disability worldwide. TBI can negatively impact cognitive, physical, social, and psychological functioning.

Objective: This study investigated interactions between TBI severity, mental health symptom severity, and community engagement among older adults. Specific aims included investigating 1) the relationship between TBI severity at the time of injury and psychiatric symptom severity at one-year post-TBI; 2) the relationship between TBI severity and community engagement at one-year post-TBI; and 3) whether mental health symptom severity moderated the relationship between TBI and post-injury community engagement.

Methods: Archival data was analyzed …


A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo Dec 2023

A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo

Doctor of Nursing Practice (DNP) Projects

Background: This Quality Improvement project sought to determine if a brief progressive muscle relaxation (PMR) session could decrease patient anxiety before receiving intramuscular (IM) injections for ketamine-assisted therapy. Problem: The Kerstin Helgason, NP clinic does ketamine-assisted therapy, and many patients express anxiety beforehand, either due to a fear of needles or nerves surrounding the medication treatment. Intervention: This project implemented a brief progressive muscle relaxation therapy for patients with anxiety before receiving their IM injection. Measures: The patient’s anxiety levels were measured before and after the PMR therapy using a five-point Likert scale ranging from none to very severe. Results: …


Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti Dec 2023

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …


A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll Dec 2023

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …


Self-Reflections Through A Screen: Self-Identity, Social Media, And Psychological Well-Being, Jeremy J. Serio Dec 2023

Self-Reflections Through A Screen: Self-Identity, Social Media, And Psychological Well-Being, Jeremy J. Serio

Undergraduate Honors Thesis Collection

Social media use among emerging adults is assumed to be related to a variety of negative psychological outcomes and has, in recent years, become a widely studied phenomenon (Kim, 2017, Pew Research Center, 2018). Despite the widespread assumption, the results from empirical studies of the effects of social media use on mental health in this population have been inconsistent and inconclusive (Keles et al., 2020, Yang et al., 2021). Several meta-analyses (e.g., Keles et al., 2020) demonstrate these inconsistent results across studies and point to the need to consider individual difference factors when researching this issue. Different self-identity styles have …


Prevalence Of Type A And Type B Personality Among Undergraduate Nursing Students At Private School Of Nursing Karachi Pakistan: A Cross-Sectional Analytical Study, Farhana Shaheen Nov 2023

Prevalence Of Type A And Type B Personality Among Undergraduate Nursing Students At Private School Of Nursing Karachi Pakistan: A Cross-Sectional Analytical Study, Farhana Shaheen

Theses & Dissertations

Background: Academic institutions strive for exceptional graduates. However, personality and learning psychology affect student performance. Type A personality students may develop heart palpitations due to impatience and stress. They are less sociable than Type B personalities but more idealistic, competitive, and deadline oriented. These disparities among personalities may impair their academic and job success, especially in healthcare, where interpersonal skills are vital.
Aims: The primary aim of the study was to find out the prevalence of Type A and Type B personality among undergraduate nursing students and to find the association between personality Types and academic years.
Methodology: In this …


Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab Nov 2023

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …


Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor Nov 2023

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …


A Post Pandemic Analysis Of Covid-19 And The Impact On Mental Health Of High School Student-Athletes—Today, More Than Ever Minds Matter, Pastora Hernandez Barbee Aug 2023

A Post Pandemic Analysis Of Covid-19 And The Impact On Mental Health Of High School Student-Athletes—Today, More Than Ever Minds Matter, Pastora Hernandez Barbee

Ed.D. Dissertations in Practice

The cancellation of sporting opportunities during the COVID-19 pandemic caused many student-athletes to feel deprived of the only outlet they had, which held a significant component of their personal and athletic identities (Grubic et al. 2021). This study aimed to answer the following research question: What are the experiences of high school student-athletes in a Pacific Northwest school district with access and support for holistic wellness in a post-pandemic COVID-19 school environment? The research methodology used was the wellness theory framework (Adams, Bezner, & Steinhardt, 1997). A total of seven student-athletes participated in the study through in-depth interviews. From the …


Expanding Clinical Knowledge And Awareness To Non-Benzodiazepine Treatments By Providing An Educational Intervention: A Quantitative Study, Alexander Labrador Jul 2023

Expanding Clinical Knowledge And Awareness To Non-Benzodiazepine Treatments By Providing An Educational Intervention: A Quantitative Study, Alexander Labrador

Doctor of Nursing Practice Scholarly Project

This study examined the effectiveness of an educational intervention for healthcare clinicians to increase knowledge and awareness of non-benzodiazepine treatments for the treatment of anxiety and panic disorders. The target population were healthcare clinicians in a metropolitan area that commonly treat anxiety and panic disorders. Clinicians from different specialties were recruited to participate and evaluated on their knowledge of benzodiazepines on a 3-question pretest survey using a Likert scale. The clinician was then given a 30-minute educational intervention that covered the risks and dangers of benzodiazepines and a review of alternative, non-benzodiazepine treatment options. The clinician then self-evaluated themselves using …


Evaluation Of Dirfloortime® On Mother’S Depression, Anxiety, And Stress, Hailey Vanderleest Jul 2023

Evaluation Of Dirfloortime® On Mother’S Depression, Anxiety, And Stress, Hailey Vanderleest

Dissertations

This paper reports the results of a retrospective record review and qualitative questionnaires of mothers of children with neurocognitive disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The aim was to examine the relationship between DIRFloortime® use in children with ASD and ADHD and PHQ-8 scores for depression, GAD-7 scores for anxiety, and PSS-10 scores for perceived stress among the children’s mothers. The results showed no statistical significance between DIRFloortime® use in children and PHQ-8, GAD-7, and PSS-10 scores for mothers. Qualitative questionnaires did report improvements in quality of life. Implications for the need of evidence-based developmental …


Increasing Music Therapy Referrals In A Surgical Intensive Care Unit., Brandi Cecil Jul 2023

Increasing Music Therapy Referrals In A Surgical Intensive Care Unit., Brandi Cecil

Doctor of Nursing Practice Papers

Medications have been the primary intervention in intensive care unit patients due to the fact that the patients are often unconscious, critically medically ill, or unable to actively participate in nonpharmacological treatment. Researchers have found the integration of music therapy in patient care has helped ease pain, anxiety, and stress, and has been useful in vital control, such as decreasing heart rate and respiration count. A study was conducted in a surgical intensive care unit (SICU) to examine the benefits of increasing music therapy consults. Critical care nurses were educated on the advantages of utilizing interdisciplinary care by consulting music …


Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas Jul 2023

Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas

Doctor of Nursing Practice Papers

Background: People affected by cancer often experience psychological distress that ultimately decreases their health, adherence to treatment, overall well-being, and quality of life. Research has shown that MBIs can reduce psychological distress, depression, and anxiety and increase quality of life. A needs assessment conducted within a local cancer support organization, Gilda’s Club Kentuckiana, has expressed the need for providing a more comprehensive range of accessible MBIs in their programming to meet their psychosocial goals by reducing psychological distress in their members. PMR is an MBI not currently used by GCK that has been proven effective at reducing anxiety, depression, and …


Using The Buzzy Device To Decrease Pain, Fear, And Anxiety With Venipunctures And Injections, Lisa Santiago Sauls Jul 2023

Using The Buzzy Device To Decrease Pain, Fear, And Anxiety With Venipunctures And Injections, Lisa Santiago Sauls

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Anxiety, fear, and pain related to initiating peripheral venous access or injections are a high priority in the ambulatory infusion clinic setting for both children and adult populations.

Purpose: To determine if the Buzzy device will decrease anxiety, fear, and pain related to adult patients undergoing peripheral venous access or injections in ambulatory infusion clinics.

Methods: Age, sex, route of medication the patient is receiving. A post-procedure questionnaire assessed the participant's satisfaction with the Buzzy device. Pain, fear, anxiety, and patient satisfaction were all measured using a visual analog scale.

Inclusion Criteria: Patients aged eighteen and above receive …


Role Of Chronic Stress-Induced Neuroinflammation In Rodent Locus Coeruleus Physiology And Anxiety-Like Behaviors, Arthur Anthony Alfonso Reyes Jun 2023

Role Of Chronic Stress-Induced Neuroinflammation In Rodent Locus Coeruleus Physiology And Anxiety-Like Behaviors, Arthur Anthony Alfonso Reyes

Graduate School of Biomedical Sciences Theses and Dissertations

The locus coeruleus (LC), the primary site of brain norepinephrine (NE), is a key anatomical brain region implicated in the stress response. Stress is a neuroendocrine physiologic response to a stressor that promotes organism survival through adaptive change and restoration of homeostasis. The central stress response, which drives behavioral and physiological change, is primarily mediated by activating the hypothalamic-pituitary-adrenal (HPA) axis. While advantageous in the short term, chronic stress exposure can lead to HPA axis and LC dysregulation, which are thought to contribute to the etiology of anxiety disorders. Previous studies demonstrate the effects of acute stress in increasing LC …


Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint May 2023

Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint

Doctor of Nursing Practice Final Manuscripts

Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.

Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …


The Benefits Of Art Therapy On Stress And Anxiety Of Oncology Patients During Treatment, Helen Shiepe May 2023

The Benefits Of Art Therapy On Stress And Anxiety Of Oncology Patients During Treatment, Helen Shiepe

Expressive Therapies Capstone Theses

Within the last ten years research on art therapy and its positive impact on oncology patients’ stress and anxiety during treatment has been minimal. Oncology patients whether they are children or adults when diagnosed experience similar reactions due to their diagnosis, treatment, and in some cases end of life care. The current question is whether or not art therapy does have a positive impact on decreasing the stress and anxiety with oncology patients while undergoing treatment. Deane, Fitch & Carmen (2000), discussed art therapy as a healing art that is “intended to integrate physical, emotional, and spiritual care by facilitating …


Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel May 2023

Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel

Honors Theses

Background. NCAA Division I female student-athletes are underrepresented in mental health research; existing research among female athletes tends to focus only on disordered eating and body appearance. This study aims to 1) describe the prevalence of mental health issues (i.e., anxiety, depression, and stress) among female Division I college athletes, and 2) assess the association between mental health issues and the student-athlete experience (i.e., athletic and academic performance).

Methods. This was a quantitative, cross-sectional study that used a self-administered online survey. The participants were NCAA Division I female student-athletes, mainly from the University of Mississippi. Demographics and sample characteristics were …


The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin May 2023

The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin

Honors Theses

Adolescents spend a large amount of time on social media sites. This is notable, as adolescence is a crucial time for body image development. Additionally, recent findings suggest that using image-oriented social media sites, such as Facebook and Instagram, is associated with more body dissatisfaction and disordered eating. Among previous studies, certain social media motivations have been found to have an association with poor body satisfaction and well-being in adolescents. To our knowledge, no studies have directly examined the association between social media motivations and eating disorder, body dysmorphic disorder, and anxiety and depression symptoms in adolescents. The current study …


A Study Of First-Generation College Students At The University Of Mississippi, Brady Suttles May 2023

A Study Of First-Generation College Students At The University Of Mississippi, Brady Suttles

Honors Theses

First-generation college students (FGCS) are a distinct sub-population within higher education. In comparison to their peers, FGCS report increased levels of anxiety, depression, and stress along with lower levels of social support and academic attainment. Considering the unique context and history of the University of Mississippi (UM), it is crucial to understand the specific needs of FGCS enrolled at UM. The aims of this study were to: 1) assess the associations between FGCS status and mental health and academic achievement, and 2) determine whether sense of belonging moderates these associations.

First-generation college students had higher mean levels of depression symptoms …


Links Between Mental Health And Employment Outcomes Among Adults With Autism Spectrum Disorder, Emma Atkinson May 2023

Links Between Mental Health And Employment Outcomes Among Adults With Autism Spectrum Disorder, Emma Atkinson

Honors Theses

Problem: Mental health outcomes related to Autism Spectrum Disorder (ASD) have been extensively researched, although most research in the area is on children with ASD. Studies on adults with ASD are scarcer. More specifically, studies that analyze the association between mental health and work-life balance (WLB) as well as mental health and job satisfaction (JS) among employed adults with ASD is limited. The purpose of this study was to analyze the association between mental health and WLB among adults with ASD, the association between mental health and perceived JS among adults with ASD, and whether or not ASD severity moderates …


A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings May 2023

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …


Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi May 2023

Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi

Doctor of Nursing Practice Projects

Abstract

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 …