Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 14, 2021
Date Accepted: Sep 19, 2021
Outcomes of a Blended Care Coaching Program for Clients Presenting with Moderate Levels of Anxiety and Depression: Pragmatic Retrospective Study
ABSTRACT
Background:
Depression 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.
Objective:
To evaluate the outcomes of a blended care coaching program for clients presenting with moderate levels of anxiety and depression in real-world settings.
Methods:
This study examined retrospective data from US-based individuals (N=1496) presenting with moderate levels of depression and anxiety symptoms, 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.
Results:
Approximately 75.94% demonstrated reliable improvement, and 88.64% recovered based on either the GAD-7 (anxiety) or PHQ-9 (depression). On average, clients exhibited a significant decline in anxiety and depression symptoms during the initial weeks of treatment, 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 (Ps<0.001).
Conclusions:
The blended care coaching program demonstrated strong outcomes in decreasing symptomology for clients presenting with moderate levels of anxiety and depression. When clients had 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. Clinical Trial: N/A
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