REAL-WORLD OUTCOMES AND PSYCHOLOGICAL PREDICTORS IN AN 8-WEEK HYBRID DIGITAL CLINIC FOR DEPRESSION AND ANXIETY

Hybrid digital care models combining clinician support with mobile health technology may improve access and outcomes for depression, yet real-world data on mechanisms of change remain limited. This study evaluated symptom outcomes and psychological process variables in an eight-week Digital Clinic integrating clinician sessions, Digital Navigator support, and the mindLAMP smartphone application. The objectives were twofold: to describe real-world clinical outcomes associated with this hybrid model using PHQ-9 and GAD-7 scores, and to examine psychological factors, specifically self-efficacy and emotional self-awareness, as predictors of symptom improvement. Participants were 50 adults receiving hybrid care for mild to moderate depression and/or anxiety (analytic sample representing 78.1% of the enrolled cohort). Depressive and anxiety symptoms were assessed weekly using the PHQ-9 and GAD-7, respectively. Psychological processes assessed at intake and completion included self-efficacy (PROMIS) and emotional self-awareness (ESQ). Paired t-tests evaluated change over time; correlations and regression analyses examined associations between process changes and symptom improvement. Participants demonstrated significant and clinically meaningful reductions in depressive symptoms (d = 0.64) and anxiety symptoms (d = 0.71) over the eight-week treatment period. Correlational analyses indicated that symptom change was associated with improvements in psychological resources. For depressive symptoms, greater PHQ-9 reduction was associated with larger improvements in self-efficacy (ρ = −.47, p < .001) and emotional self-awareness (ρ = −.27, p = .029). Similarly, GAD-7 change was negatively correlated with self-efficacy change (ρ = −.55, p < .001) and modestly correlated with emotional self-awareness change (ρ = −.20, p = .050). These findings support the effectiveness of hybrid digital care in producing clinically meaningful symptom improvements, supporting its integration within psychopharmacology care pathways. Importantly, self-efficacy showed the most consistent association with symptom reduction across outcomes, emerging as a potential key mechanism of change. This advances the field by identifying a modifiable target for intervention optimization. Routine measurement of psychological process variables within digital care platforms may support personalization by helping clinicians monitor mechanisms of change and tailor interventions accordingly. These results provide actionable evidence for scaling hybrid models while maintaining focus on therapeutic processes that drive improvement.