Quality Improvement Project Impacting Provider Self-efficacy and Use of CBT for Depression Treatment
Degree Name
Nursing Practice, DNP
Publication Date
9-30-2025
First Advisor
Lisa Drake
Second Advisor
Paige Wimberley
Abstract
This Doctor of Nursing Practice (DNP) quality improvement project was conducted at a mid-sized outpatient psychiatric clinic in Hempstead, New York, focusing on strengthening providers’ self-efficacy in delivering Cognitive Behavioral Therapy (CBT) to young adults (aged 19–35) diagnosed with Major Depressive Disorder (MDD). Rather than targeting MDD directly, the initiative aimed to impact provider self-efficacy and skill in CBT to improve access to evidence-based treatment and reduce the need for external referrals. Employing Bandura’s Social Cognitive Theory and the ADKAR change model, the project used a quasi- experimental, one-group pre-test/post-test design. Six advanced practice providers participated in a structured, interactive CBT education program, with self-efficacy evaluated before and after using Grundy’s Confidence Scale (C-Scale), and CBT usage rates monitored via anonymized chart reviews. The Plan-Do-Study-Act (PDSA) framework guided implementation and ongoing assessment. Findings showed significant improvements in provider self-efficacy (Wilcoxon rank test, W = 21, n = 6, p = .031), all post-intervention scores surpassed 76%, and individual gains ranged from 32% to 56%. CBT utilization in the clinic tripled following the intervention. Continuous improvement was tracked using Grundy’s C-Scale (Cronbach’s alpha = 0.68). The results suggest that systematic provider education can successfully increase self-efficacy and in-house CBT delivery, meeting patient needs for nonpharmacological depression care. The project advances nursing knowledge by embedding evidence-based practice and measurement into staff development and service delivery, establishing a replicable model for sustainable quality improvement in outpatient depression management. Future projects should involve broader samples, longer observation periods, and direct patient outcome measurement to improve generalizability.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Orafunam, Tony, "Quality Improvement Project Impacting Provider Self-efficacy and Use of CBT for Depression Treatment" (2025). Doctor of Nursing Practice Projects. 225.
https://arch.astate.edu/dnp-projects/225
