Approximately one in every four to five adolescent youth are affected by anxiety or depression yet fewer than 25% of adolescent youth are getting the mental health treatment they need (Foy, 2010). Without the ability to manage stress and cope effectively many youth are plagued with life-long disability. Researchers hypothesize that the underdevelopment of areas of the pre-frontal cortex and limbic systems during adolescence may render teens less able to successfully regulate emotions placing them at greater risk for anxiety, depression, and stress disorders (Ahmed, Bittencourt-Hewitt, & Sebastian, 2015). Due to the brain development that occurs during adolescence, research has suggested that teens may have a heightened propensity for learning and flexibility. Adolescence, therefore, may be a critical phase for the development of emotional regulation strategies and positive coping skills (Ahmed et al, 2015). The purpose of this practice improvement project was to implement and evaluate an evidence-based mental health prevention and treatment program, Creating Opportunities for Personal Empowerment (COPE), focused on the development of healthy behaviors and positive coping skills to improve the mental health and resiliency of rural North Dakota youth. The COPE program was offered to students at Wahpeton High School in Wahpeton, ND. COPE, a previously developed, seven-session, cognitive behavioral therapy skills building intervention was offered to eligible and interested students once weekly for seven weeks. Pre-and post-program evaluations, surveys, and screening tools were administered; prior to beginning the first session and immediately following the final session to ensure completion. Although not statistically significant, participant and facilitator feedback of the COPE intervention was encouraging. More than half of the participants showed improvement in depression and anxiety scores from baseline, and all participants reported newly learned skills for managing thoughts, feelings, and behaviors in response to stress. Reviews of the program by participants were positive, with most students indicating that they would recommend the program to other students. Based on results of the evaluation, the COPE program has the potential to be an effective program and is well-accepted in helping to improve the mental health and resiliency of rural North Dakota youth.