Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 15, 2023
Date Accepted: Nov 27, 2023
Exploring the number of web-based behavioral health coaching sessions associated with symptom improvement in youth: Observational retrospective analysis
ABSTRACT
Background:
Web-based behavioral health coaching is considered an effective treatment for anxiety and depressive symptoms in children and adolescents. However, more research is necessary to determine the number of web-based coaching sessions that confer clinically significant improvements in anxiety and depressive symptoms in youth.
Objective:
The current study uses data from a pediatric DMHI to explore the number of web-based coaching sessions required to confer symptom improvements among children and adolescents with moderate or moderately severe symptoms of anxiety and depression.
Methods:
Children and adolescents who engaged in three or more sessions of exclusive behavioral health coaching for moderate to moderately severe symptoms of anxiety (N=66) and depression (N=59) were included in analyses. Analyses explored whether participants showed reliable change (a decrease in symptom scores that exceeds a clinically established threshold) and stable reliable change (at least two successive assessments of reliable change). Kaplan-Meier survival analyses were performed to determine the median number of coaching sessions when the first reliable change and stable reliable change occurred for anxiety and depressive symptoms.
Results:
Reliable change in anxiety symptoms was observed after a median of two sessions (95% CI [2, 3]), and stable reliable change in anxiety symptoms was observed after a median of six sessions (95% CI [5, 8]). Reliable change in depressive symptoms was observed after a median of two sessions (95% CI [1, 3]), and stable reliable change in depressive symptoms was observed after a median of six sessions (95% CI [5, 7]). Children improved one to two sessions earlier than adolescents.
Conclusions:
Findings from this study will inform caregivers and youth seeking mental health care by characterizing the typical time frame in which current participants show improvements in symptoms. Moreover, by suggesting that meaningful symptom improvement can occur within a relatively short time frame, these results bolster the growing body of research that indicates web-based behavioral health coaching is an effective form of mental health care for young people.
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