Addressing the Gap: Real-World Evidence of Technology-Enabled Coaching Services for Mental Health.

Abstract

A quarter of US adults face mental health challenges, yet less than half receive treatment, partly due to therapist shortages. Scaling trained paraprofessionals to provide effective care could address this gap. We evaluated the impact of evidence-based coaching within a real-world blended care digital mental health platform. 266 working adults (62% women, M_age=33 years, 40% people of color) newly enrolled (2021-2022) in the platform (Modern Health) completed surveys at baseline and 3-months. Participants primarily engaged with certified professional coaches and could also access therapy and digital resources. We examined pre-post changes in outcomes and differences by baseline clinical status. Participants used an average of 2.5 coaching sessions and improved in distress tolerance (+ 4.1%), perceived stress (-8.4%), self-compassion (+ 5.9%), and mindfulness (+ 2.6%) (ps < 0.01). Although elevated risk users (vs. lower risk) reported descriptively greater improvements in distress tolerance (+ 4.7% vs. +3.7%), perceived stress (-10% vs. -3.7%), self-compassion (+ 7.6% vs. +5.2%), and mindfulness (+ 3.3% vs. +2.1%), these differences were not statistically significant (ps > 0.05). Depression (-22.5%) and anxiety (-12%) improved (ps < 0.001), with elevated risk users reporting greater reductions (b=-3.15, p < .001 for depression; b=-2.61, p < .001 for anxiety). Among elevated risk users, 71.7% improved or recovered from depression or anxiety and 96.1% of lower risk users maintained lower depression and anxiety. Technology-enabled coaching, as part of a blended care platform, improved depression, anxiety, and transdiagnostic emotional processes. Participants with higher baseline depression and anxiety reported greater improvements, highlighting coaching's effectiveness for people with elevated needs. By redefining care and leveraging technology, coaching may be a scalable treatment solution.