JMIR Publications

ABSTRACT

Background:

Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI), a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse, has the potential to help fill this need.

Objective:

The aim of the current study was to examine change in depression and anxiety symptoms in a sample of individuals who participated in CBI. We also examined two interpersonal process variables (therapeutic alliance and online social support) as predictors of symptom change.

Methods:

The study sample consists of 127 participants who endorsed clinical levels of depression or anxiety symptoms during their first CBI session and attended at least two sessions. Participants were asked to complete self-report measures of depression symptoms, anxiety symptoms, alliance, and online social support throughout their participation in CBI.

Results:

Participants experienced significant change in their depression (d = 0.58) and anxiety symptoms (d = 0.61) from their first to most recent CBI session. We also found participants’ online social support predicted improvement in depression symptoms, but neither the alliance nor online social support predicted change in anxiety symptoms.

Conclusions:

Participation in CBI is associated with both depression and anxiety symptom improvement. Online social support may play an important role in fostering depression symptom change. Future studies are encouraged to continue examining the process of change in CBI with special attention paid to methods that can elucidate causal mechanisms of change.