INTERVIEW: Mary Tedesco Schneck, PhD, PNP - Board Member and Project Leader for COPE Project

Posted on August 02, 2023

Dr. Tedesco-Schneck was interviewed by Bates Student Kendra Jiang.

Tell us about yourself. your work at the university, and your work in the pediatric practice.

I am an associate professor at the University of Maine, and I teach undergraduate and graduate students. I practice one day a week at Penobscot Health Center.

What interested you in the COPE Project?

In the past, I spent many years working in a private practice. I saw many kids with mental health issues, and it’s really hard for them to access services that address them. Now I work in walk-in care, where I’ve seen many complaints of stomachaches, headaches, and such – and when you dig deeper, it’s actually a mental health issue. As a pediatric nurse practitioner, I get a journal through my association. I saw an article on COPE in it, and I became interested.

How did you start up the COPE Project in Maine?

I was on the Maine AAP Education Committee, and we were discussing ideas we’d like to have. I told them about COPE, and they said it’d be great if I could get the founder to come speak at the annual Maine AAP conference. So I sent an email to the founder – Bernadette Melnyk – not expecting her to respond at all, since we didn’t know each other at the time. But she responded right away, saying that she’d love to talk at the conference. She was very well-received there.

So, I did what all academics do –I did a literature review! I found many articles about COPE being used in other states. The information on its methods was all online, so I could see what it was all about. I approached the chapter ED, saying it’d be nice to get a grant to train primary care providers in Maine. We applied and after we got the grant, we trained ten providers across Maine on the method using the Echo model.* Since this was during the pandemic, the program was originally delivered via telehealth. Half of the providers are still using it today!

Could you explain a bit more about the COPE method?

The founder of COPE, Bernadette Melnyk, developed this manual-based cognitive behavioral therapy program to be delivered by primary health providers. The providers can get reimbursed for it, which is pretty nice, and the program has been shown to be effective. There have been improvements in week 3 and week 7 of the program. Since COPE is cognitive behavioral therapy, the main goal is to change people’s way of thinking to a more positive perspective. It builds more resilience. Now to be clear, it isn’t about ignoring all the negative aspects of life or pretending everything is great. It follows the idea that your thinking influences your behavior, and COPE teaches you to control that so you can handle situations better.

What benefits have been realized as part of doing this work? How has doing this work changed your perspective?

There came to be many benefits that I didn’t expect. Providers loved it, saying that it’s the best part of their practice. It includes seven sessions, so the practice blocks off seven weeks in a row for around 30 to 45 minutes each. Providers now have something to offer to kids, and it’s been a positive experience for them and very well-received. So that’s the most positive benefit I’ve seen. It can be used for young adults and at universities too. Another unexpected benefit is that, while I went through COPE training myself, people on that site have reached out to me, asking me for help on implementing the COPE program. So I've helped with several practices to get it up and running.

Do you think that COPE has made it easier for kids to access mental health care?

You know, sometimes when you suggest for someone to go to counseling, you can meet a bit of resistance because of all the stigma associated with therapy and such. But with COPE, we’ve found that because the kids already know the provider, they already have the trusting relationship that encourages them to try it out. They’ve seen great improvements.

What do you see as changes or opportunities moving forward? If we could get another round of funding, what progress might we expect to make?

They have another program associated with COPE that is 15 weeks long. The first 7 weeks are cognitive behavioral therapy, and then the other 8 weeks are about exercise, nutrition, sleep, and stress reduction. It’s been used in health education courses in schools, and it could be really preventative. So that’s the next thing I’ve been working on. Funnily enough, one of the providers told me that after a session, a kid said that everybody should have to take it!

Could you expand a bit on this other program in its relation to COPE?

This program is similar to COPE – the first part of it, the therapy, is what COPE is, and the second part with the exercise and such is extra. People at Vanderbilt use it with kids with chronic illnesses. It’s been shown to help with obesity, and there is such an obesity problem in the US – overall, the program seems to be a great fit. So I think some ideal progress would be to extend it further and use the 15-week program at schools as a preventative measure.

Have you seen any challenges to this project thus far?

One problem is with the manuals: they are beautiful and the kids can keep them, but they’re $20 - $23, and insurance doesn’t cover them. That’s one of the barriers, because for some families, $20-$23 can be a little too much. I believe it should be covered by insurance companies – COPE reduces the costs of hospitalizations; insurance companies should be able to pay. I was just listening to NPR, and I heard that Biden has made one of the focuses of his administration on mental health for adolescents and young adults. They were talking about targeting insurance companies to get them to pay for expenses. So I think this would be an ideal step to take – insurance companies will pay for equipment that helps with asthma, so why not educational materials?

Are there any other next steps to this project that you are hoping to take?

We are hoping to move forward. For the next grant, I am hoping to incorporate students in the program. If we are to do the 15-week one, students could help with teaching nutrition and exercise. It’s good learning for them, and it’s considered community service. In 2016, a friend of mine did a similar program with Orono high school students, and they had college students who were trained to help in the program. Students are wonderful to work with – they are so filled with ideas! It would be a great next step to take.

Thank you for your time, Mary!