A large multi-university trial tested a smartphone app combined with personal coaching by text as a way to reduce depression, anxiety and eating disorders in students. More than 6,200 university students took part and the study was published in Nature Human Behavior. Initial campus screening involved 39,194 students, and nearly half were identified as having or being at high risk for one of these conditions.
The students who were offered the app reported fewer symptoms when assessed at six weeks, six months and two years, and they were more likely to be free of any mental health disorder than those who received only a referral to campus services. The app delivers a digital version of cognitive behavioral therapy: users complete interactive psychoeducational modules and exercises, and coaches review progress and send personalized feedback and guidance by text so students can apply what they learn.
Accessibility proved a key advantage. Nearly 75% of students randomly chosen to receive the app used it at least once, while only 30% of those given a referral reported receiving any campus mental health treatment in the following six months. The higher use appeared across student groups, including those from disadvantaged backgrounds. The study notes the app tested here does not use generative artificial intelligence. The authors said the goal is not to replace campus counseling but to remove barriers and make evidence-based care available to more students. The work was supported by the National Institute of Mental Health and funded in whole or in part by the National Institutes of Health. Fitzsimmons-Craft and Wilfley also lead a team on a five-year $3.7 million NIH grant to develop a self-guided, chatbot-based intervention for eating disorders that uses rules-based AI.
Difficult words
- trial — a planned test of a treatment or method
- screening — checking people to find health problems early
- assess — examine or measure someone’s conditionassessed
- referral — advice or action to send someone for care
- cognitive behavioral therapy — therapy that changes thoughts and behaviors
- psychoeducational — providing psychological and educational information
- accessibility — ease of reaching or using a service
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the main benefits and possible limitations of offering a therapy app with text coaching alongside campus services?
- How could higher accessibility of a digital intervention affect students from disadvantaged backgrounds at your university? Give examples.
- The authors say the app is not meant to replace counseling. In which situations might an app be sufficient, and when would in-person counseling still be necessary?
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