Abstract
BackgroundDepression and anxiety are leading causes of disability worldwide, but access to quality mental health care is limited by myriad factors. Cognitive-behavioral coaching is rooted in evidence-based principles and has the potential to address some of these unmet care needs. Harnessing technology to facilitate broader dissemination within a blended care model shows additional promise for overcoming barriers to care.ObjectiveThe aim of this study is to evaluate the outcomes of a blended care coaching (BCC) program for clients presenting with moderate levels of anxiety and depression in real-world settings.MethodsThis study examined retrospective data from US-based individuals (N=1496) who presented with moderate levels of depression and anxiety symptoms and who received blended care coaching services. Using a short-term framework, clients met with coaches via a secure video conference platform and also received digital video lessons and exercises. To evaluate the effectiveness of the BCC program, mixed effects modeling was used to examine growth trajectories of anxiety and depression scores over the course of care.ResultsOut of the total sample of 1496 clients, 75.9% (n=1136) demonstrated reliable improvement, and 88.6% (n=1326) recovered based on either the Generalized Anxiety Disorder-7 scale (anxiety) or Patient Health Questionnaire-9 (depression). On average, clients exhibited a significant decline in anxiety and depression symptoms during the initial weeks of coaching, with a continued decline over subsequent weeks at a lower rate. Engaging in a coaching session was associated with lower anxiety (b=–1.04) and depression (b=–0.79) symptoms in the same week, as well as lower anxiety (b=–0.74) and depression (b=–0.91) symptoms the following week (P<.001).ConclusionsThe BCC program demonstrated strong outcomes in decreasing symptomology for clients presenting with moderate levels of anxiety and depression. When clients received coaching sessions, significant decreases in symptoms were observed, reflecting the importance of session attendance. Additionally, the steepest declines in symptoms tended to occur during the initial weeks of coaching, emphasizing the importance of client buy-in and early engagement. Collectively, these findings have implications for addressing unmet mental health care needs in a more accessible, cost-effective manner.
Highlights
Depression and anxiety are leading causes of disability worldwide and incur significant societal costs [1,2]
Clients presenting with moderate levels of anxiety and depression exhibited a significant decrease in symptomology over the course of coaching, with close to 90% of clients with moderate anxiety and/or depression achieving reliable improvement or recovery
These findings suggest that cognitive-behavioral coaching is a promising method for managing these symptoms within a blended care context, assuming appropriate client selection
Summary
Depression and anxiety are leading causes of disability worldwide and incur significant societal costs [1,2]. The stigma associated with receiving psychotherapy, cost of seeing out-of-pocket providers, long waitlists, and limited access to quality providers all contribute to delays in seeking and receiving treatment [3,6] To bridge this gap, coaching has emerged as a contender to address some of these unmet mental health care needs. Methods: This study examined retrospective data from US-based individuals (N=1496) who presented with moderate levels of depression and anxiety symptoms and who received blended care coaching services. The steepest declines in symptoms tended to occur during the initial weeks of coaching, emphasizing the importance of client buy-in and early engagement These findings have implications for addressing unmet mental health care needs in a more accessible, cost-effective manner
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