Real-World Effectiveness of Coaching Support on Digital Therapeutic Engagement Among College Students

Bowers, E. M., Klimczak, K. S., & Levin, M. E. (2025). Evaluating the naturalistic implementation of a peer-coaching service to augment online acceptance and commitment therapy for college mental health. Journal of Contextual Behavioral Science, 36, 100897. https://doi.org/10.1016/j.jcbs.2025.100897

Introduction
Can peer coaching bolster student engagement with online interventions when offered outside the confines of a research trial? Bowers and colleagues (2025) examine this critical question in the context of one digital mental health interventions (DMHI): Acceptance and Commitment Therapy (ACT) Guide.

Methods
To test feasibility and effectiveness, the researchers analyzed student data from a six-month rollout of ACT Guide with an optional peer coaching component. The sample included 221 university students who enrolled in the online ACT Guide between August 2022 and January 2023. Of those, 38 students (17.2%) opted into the peer coaching program, which offered weekly 10–15-minute phone calls over a 10-week period. Coaching was delivered by trained undergraduate volunteers who had completed a 28-hour ACT-based training protocol and received weekly group supervision.

The study assessed three primary implementation questions: who signs up for coaching, who follows through, and what effect does coaching have on ACT Guide engagement. Data were drawn from ACT Guide usage logs, self-reported demographics, mental health symptoms (PROMIS Depression and Anxiety short forms), and motivation for using the platform.

Results
Of the 221 students, 17.2% enrolled in coaching, a significantly lower uptake than the 32% observed in prior randomized trials. Men and students with a history of mental health treatment were more likely to sign up. Those who did enroll cited social support and accountability as top reasons for interest.

Among those who signed up, 63.2% completed at least one coaching call, but only 10.5% completed at least 8 calls.

Despite modest uptake and adherence, coaching was associated with significantly greater engagement in ACT Guide. Coached students completed an average of 3.2 modules versus 1.1 in the non-coached group. They were more likely to complete at least one module and more likely to complete the entire 12-module program. Each completed coaching call predicted roughly one additional module completed.

Discussion
Results highlight both promise and limitation. On the one hand, a subset of students clearly valued the human connection and benefited from the added structure: coached students completed more modules and were more likely to finish the program. On the other hand, overall participation was low, and adherence was weaker than in controlled trials.

Recruiting and retaining peer coaches also posed challenges. Although initial volunteer interest was high, half dropped out during training, largely due to scheduling conflicts and time demands.

Peer coaching appears to be a feasible add-on for a small portion of students who seek extra support. However, findings caution against assuming that RCT-based engagement rates will translate to real-world contexts. Interest in coaching is likely contingent on individual preferences and mental health needs, and efforts to scale the model may require alternate delivery methods (e.g., text-based coaching, integration with academic credit) or more targeted outreach.

Implications for Mentoring Programs
Mentoring programs seeking to embed digital mental health components should consider offering coaching as an optional, rather than default, feature. Given the diversity in student preferences, a menu of support types—peer, professional, asynchronous—may be most effective. These findings underscore the need to tailor mentoring and digital support systems to user needs—not just efficacy outcomes. The coaching model holds promise, but its success depends on thoughtful implementation and alignment with students’ motivations, preferences, and schedules.

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