The Effect of Messaging Therapy for Depression and Anxiety on Employee Productivity
The World Health Organization estimates that more than 300 million people suffer from depression worldwide, and mental and behavioral disorders top the list of the leading categories of diseases and disorders in the USA, coming in second only to cardiovascular disease. Such impact is seen to disproportionately affect the workplace since over 70% of those diagnosed with depression are also employed. Past research has suggested that employee absenteeism can be reduced through treatment for depression and anxiety, yet no study to date has examined the effectiveness of text therapy as a scalable delivery medium. Employing a retrospective within-subjects design, this study evaluated the treatment outcomes of text therapy for depression and anxiety and the impact such treatment had on engagement with employment. Adults seeking text therapy treatment for a variety of disorders were recruited from a text therapy service (N = 51). Clinical outcomes were measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-2 after 14 to 15 weeks of treatment. An additional outcome variable was measured with the Work Productivity and Activity Impairment scale. Treatment acceptability was assessed with ratings of cost-effectiveness and return on investment concerning increased employee productivity. Participants reported significantly less depression and anxiety (PHQ-9, d = 1.34; and GAD-2, d = 1.17) overall. Thirty-one of the 38 participants (84%) with clinically elevated depression and 25 of the 39 participants (64%) with clinically elevated anxiety experienced clinically significant symptom reduction. Participants reported significantly less work missed (d = 0.30), less impairment while at work (d = 1.03), less overall work impairment (d = 0.53), and less impairment in other activities (d = 1.16). Cost-effectiveness analyses suggest that text therapy is 40.0% the cost of face-to-face services and offers increased return on investment. Mobile-enabled asynchronous text therapy with a licensed therapist could be an acceptable and clinically beneficial medium for individuals with depression and anxiety seeking to improve their work productivity.
KeywordsPsychotherapy SMS text Text therapy Mobile health Employee productivity Employee mental health
The first author primarily drafted the paper. The second author designed the study, helped draft the report (except for the “Methods” and “Results” sections), and supplied information regarding the age, gender, and diagnoses of the participants. The third author provided statistical assistance, drafted the “Methods” and “Results” sections, and had access to the data.
Compliance with Ethical Standards
Conflict of Interest
The first author declares no disclosures. The second author is an employee of the sponsor. The third author works for the sponsor as a consultant.
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