Reducing Stress, Anxiety, and Depression in Nursing Students With a Cognitive-Behavioral Skills-Building Intervention

Background: While it is well known that nursing students experience high levels of stress, few programs provide targeted interventions to minimize the effects of prolonged, excessive stress, including anxiety and depression. Objective: The objective of this project was to evaluate the implementation of an evidence-based intervention aimed to reduce stress, anxiety, and depression in prelicensure nursing students by bolstering coping skills through the delivery of a cognitive-behavioral therapy (CBT)-based skills-building program called MINDSTRONG^© Methods: A total of 21 prelicensure nursing students were recruited on a voluntary basis from both the undergraduate and graduate nursing programs at a large university in Southern California. A program manual was provided, and students participated in seven weekly online interactive sessions, based on key concepts of CBT. Outcomes were measured using the Perceived Stress Scale, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-2. Results: The MINDSTRONG intervention produced statistically significant reductions in anxiety, decreasing scores from moderate to mild levels (p < .00, Cohen's d = 1.0), while depression showed meaningful improvements approaching significance (p = .10, Cohen's d = 0.38) and stress demonstrated positive effects particularly among high-severity participants (Cohen's d = 1.83). Participants with elevated baseline symptoms across all three domains experienced substantial improvements, with effect sizes ranging from 1.28 to 2.77. Conclusion: After receiving MINDSTRONG, participants reported lower stress, anxiety, and depressive symptoms with the largest reductions in students who started the project with elevated symptom levels. Implications for Nursing: Findings suggest that MINDSTRONG is a feasible and effective program to assist prelicensure nursing students to cope with stress, anxiety, and depression. Providing this intervention to all nursing students could prevent serious adverse events in this high-risk population.