Randomized clinical trial comparing the effects of an asynchronous mobile application to guided brief cognitive behavioral therapy for managing anxiety among medical students

Abstract Objective Medical students are a population at increased risk for anxiety due to their demanding schedule and concerns about potential stigmatization, which often discourage them from seeking help. It has been reported that the coronavirus disease (COVID-19) pandemic worsened this issue by restricting social interaction and mobility. An innovative method has been developed to address this problem, known as the asynchronous Digital Cognitive Education Gadjah Mada Anxiety Intervention for Medical Students (DCE GAMA-AIMS). Compared to traditional therapy, this modality can be accessed independently without the guidance of a therapist. The objective of this study was to compare the effectiveness of DCE GAMA-AIMS compared to therapist-guided brief cognitive behavioral therapy (bCBT) for reducing anxiety scores. Methods A non-blinded randomized clinical trial (RCT) was conducted with 66 medical students. The participants were equally divided into two groups, an intervention and a control group. The intervention group was given DCE GAMA-AIMS, while guided bCBT was administered to the controls. The data obtained were analyzed using independent t tests and analysis of variance (ANOVA). Results The application had a significant effect, reducing anxiety scores from the 2nd week (M Taylor Manifest Anxiety Scale [TMAS] = 18) to the 8th week (M TMAS = 13). A faster and more significant improvement was observed in the intervention group from the 1st to the 2nd week compared to the controls, who began to improve in the 4th week. Furthermore, the intervention group had larger effect size (1.32) compared to the control (0.79) from the 1st to 8th weeks. Conclusion Asynchronous DCE GAMA-AIMS and guided bCBT both reduced TMAS scores in medical students with anxiety, but DCE GAMA-AIMS yielded a larger effect size.