Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Anna Tabet


Michael D. Moon


Richard P. Diaz


More than one in six Americans will have a diagnosis of a substance use disorder at some time in their life. According to the National Institute on Drug Abuse (2020), those with a substance use disorder will have an increased rate of having a comorbidity of depression or depression symptoms during treatment, leading to poorer outcomes. The purpose of this quality improvement project was to increase provider and staff adherence to the treatment standards outlined in the Veteran’s Affair/Department of Defense Clinical Practice Guideline for the Management of Major Depressive Disorder (Veteran’s Affairs/Department of Defense, 2016). During this 10-week process, providers and staff were educated on the guidelines and were able to put what they learned into practice. Patients who were 18-years and older were screened upon admission to the addiction center for depression using the patient health questionnaire screening tools two and nine for depression. Patients were given treatment by providers and staff based on the Clinical Practice Guidelines. Treatment involved group cognitive behavioral therapy with or without a serotonin reuptake inhibitor, and education on depression. Applicable patients another depression screening was performed prior to discharge. Throughout this project, 100% of staff were educated on the guidelines, and 42 patients were screened for depression. Of the 42 screened, 69% had indications for treatment of depression or depression symptoms. Treating these patients’ depression increased the likelihood of improving outcomes after recovery. It is important to use current practice guidelines in addiction healthcare facilities to help improve patient outcomes for substance.