Internet-Based Cognitive-Behavioral Therapy for Employees With Anxiety, Depression, Social Phobia, or Insomnia: Clinical and Work Outcomes

Abstract

This applied study profiled four self-directed behavioral health support tools from Learn to Live, Inc., when offered as an employee benefit. Each of these automated online programs featured eight structured lessons that emphasized cognitive-behavioral therapy techniques. Archival operational information collected across multiple employers in the United States was analyzed for 1,297 unique participants with longitudinal program use data. Significant reductions were found on validated measures of clinical symptoms specific to each program: Depression (d = 0.93, n = 268; Patient Health Questionnaire–nine-item scale [PHQ-9]), Insomnia (d = 0.69, n = 295; Medical Outcomes Study [MOS] Sleep), Social Anxiety (d = 0.53, n = 170; Social Phobia Inventory [SPIN]), and Stress, Anxiety, & Worry (d = 0.50, n = 633; Generalized Anxiety Disorders–seven-item scale [GAD-7]). Moderators of improvement included greater initial clinical severity and greater engagement in the programs (more lessons used and use of optional live support from a coach or friend/family). Follow-up survey results (n = 290) revealed high satisfaction and improved work absenteeism and job performance. Financial return to the employer from improved work productivity was estimated at US$2,431 per employee user.