Job Coaching and Smartphone-Based Cognitive Behavioral Techniques for Returning to Work and Coping With Unemployment (DRIVEN): Randomized Controlled Trial
Journal of Medical Internet Research ·
Background: Unemployment has economic consequences and is associated with emotional distress and impairment. Joblessness is often associated with depression, leading to a vicious cycle of reduced drive to seek work, deepening financial stress, and worsening depression. Few scalable interventions exist that integrate job-search strategies with cognitive behavioral techniques. Objective: The study aimed to determine the efficacy of a Distress-Informed Return-to-Work Intervention (DRIVEN). The primary hypothesis was that DRIVEN would be more efficacious than the control condition in improving job-search behavior. Secondary analyses examined job attainment, depression, and positive affect. Methods: A randomized controlled trial was conducted from August 2023 to September 2024. Assessments were at baseline, weeks 1 through 6, and 8 and 16 weeks postintervention. Participants were a nationwide sample of unemployed job seekers aged 18 years or older who had never earned more than US $100,000 in a year. Participants received either (1) DRIVEN, which included 6 weeks of cognitive behavioral exercises in a mobile app combined with three 1-hour coaching sessions over videoconference or (2) emailed articles containing job-search advice. Primary outcome measures were subscales of a modified Job Search Behavior Scale (preparatory and active job search). Secondary outcomes included job attainment and mental health outcomes. Results: Participants were a nationwide sample (N=126; mean age 33.6, SD 6.6 y), including 62 (49.2%) females. During the acute treatment phase, mixed-effects linear models showed that for DRIVEN, preparatory job-search behavior increased by an estimated 0.053 (95% CI 0.031-0.076) units per day from baseline, which was a larger effect than in the control condition (0.011, 95% CI −0.011 to 0.033 units per day; =.008). Active job-search behavior increased by 0.061 (95% CI 0.038-0.084) units per day from baseline, which was significantly larger than in the control group (point estimate: 0.025, 95% CI 0.001-0.047; =.03). Depression decreased more in the DRIVEN group vs control (DRIVEN point estimate=−0.214, 95% CI −0.255 to −0.172 vs control group point estimate=−0.122, 95% CI −0.163 to −0.081; =.002), and participants were more likely to get a job in the DRIVEN group (68.3% vs 50.8%; =.046). Self-report outcomes did not significantly differ during the follow-up periods. Conclusions: DRIVEN was superior to emailed job-search advice for the primary outcome (job-search behavior) and secondary outcomes (job attainment, depression, and positive affect). This intervention may be beneficial for distressed unemployed individuals seeking work. Trial Registration: ClinicalTrials.gov NCT06026280; https://clinicaltrials.gov/study/NCT06026280 International Registered Report Identifier (IRRID): RR2-10.2196/62715