JMIR Publications

ABSTRACT

Background:

Digital coaching programs, offering virtually-delivered mental health care by coaches and companion apps, are an increasingly popular care model designed to increase accessibility and reduce strain on traditional mental health care systems. Initial studies suggest these programs can produce a range of positive mental health outcomes; however, methodological limitations and a focus on homogenous, subclinical populations have constrained conclusions about their effectiveness, especially in diverse and clinically severe samples.

Objective:

This study aimed to evaluate the impact of an evidence-based digital mental health coaching program in a clinically and demographically diverse sample. The study compared engagement with app-based content and changes in depression, anxiety, and stress symptoms, over the course of one month, among users who received coaching versus those who used the app alone (controls).

Methods:

Program users (N=64) were categorized as coaching users (attending at least one session) or controls (app-only users). Depression, anxiety, and stress symptoms were assessed using the DASS-21 at baseline and after 30 days. Engagement with app content was also measured. Between-group differences were analyzed using t-tests and mixed ANOVA models.

Results:

Participants were diverse in terms of demographics and clinical severity, with half reporting severe to extremely severe depression and nearly half reporting severe to extremely severe anxiety and/or stress at baseline. Coaching users demonstrated significantly greater reductions in depression, anxiety, and stress compared to controls, with moderate to large effect sizes. Engagement with app-based content did not significantly differ between the groups, suggesting coaching’s effectiveness was not contingent on differential app usage.

Conclusions:

This study demonstrates that digital mental health coaching can significantly improve clinical outcomes, even in diverse and clinically severe populations. These findings challenge the notion that coaching is only effective for subclinical or high-functioning individuals and highlight its potential to extend the reach of mental health care to underserved communities.