One in three teens is estimated to experience an anxiety disorder between 13 to 18 years of age. Developed mental health burdens in adolescents can go undetected and untreated. About 50% of those with mental health disorders noted in adulthood started by age 14 years. Therefore, adolescence may be a critical phase for developing positive coping mechanisms and one where nurse practitioners can proactively impact outcomes. Cognitive behavioral therapy (CBT) is an evidence-based strategy effective in decreasing mental health burden. Creating Opportunities for Personal Empowerment (COPE) is a program created for pediatrics using CBT strategies to manage emotions and promote healthy lifestyles. The purpose of the practice improvement project (PIP) was to improve resiliency and self-efficacy in junior high students at a rural North Dakota (ND) junior high school through COPE program implementation. Objectives included assessing if adolescent resilience and self-efficacy scores increased after implementation of the program with evaluation to make recommendations based on literature findings and project outcomes. The Integrated Theory of Health Behavior Change (ITHBC) helped guide the PIP and suggests adolescents can be taught to engage in healthy behaviors for effective mental health management through healthy coping skills and behaviors. A logic model helped guide and evaluate the program. The school counselor in a rural ND school became certified in COPE to facilitate and identified five students willing to participate. The COPE Teen seven-session program was implemented with parental consent and IRB approval; each session lasted approximately 30 to 45 minutes weekly in the school. Qualitative and quantitative data were collected via paper pre- and post- surveys for evaluation. Descriptive statistics were used to evaluate objectives. All data collected was entered and stored online in a Qualtrics database to aide security and statistical analyzation. Despite implementation during the COVID-19 pandemic, overall resiliency and self-efficacy scores increased for students after implementation. Students indicated they enjoyed the program and identified learned skills to be beneficial. The COPE program was recommended to continue in the school with further research and larger sample sizes to support proactive approaches to mitigate adolescent mental health care between the NP and school settings.