The Overlooked Role of Coaches in High-Acuity Mental Health Support
Wave’s care model is transdiagnostic, meaning it focuses on the processes that drive distress, not just the labels attached to it. Whether someone meets criteria for generalized anxiety, major depression, or burnout, the same core skills can help them move forward.
Coaching Is More Than Wellness Advice
When people hear the term mental health coaching, they often think of motivation tips, journaling prompts, or productivity hacks. Coaching is sometimes seen as something for people who are already doing well, just trying to perform a little better. It’s rarely seen as something that can help someone struggling with anxiety, depression, or burnout.
That assumption couldn’t be more outdated.
Mental health coaching has evolved dramatically in the past decade. Today’s best programs are built on evidence-based frameworks, delivered by certified professionals, and supported by data systems that monitor progress in real time. Yet many employers and health plans still see coaching as a “light-touch” solution, useful for prevention or wellness but not for real mental health care.
This perception has consequences. Because while millions of people meet criteria for anxiety or depression, most never make it into therapy. They face stigma, long wait times, or network barriers. In the U.S., the average wait to see a therapist is now more than seven weeks, and it can take even longer for in-network care. For employees in distress, that delay can mean months without help.
That’s where coaching comes in. When done right, coaching isn’t a replacement for therapy. It’s the front line of care and the first real human connection someone may have when they need help the most.
The Truth: Coaching Often Reaches People Therapy Doesn’t
Even the most generous benefits program can’t make an impact if people don’t actually use it. Traditional EAPs reach less than 5 percent of eligible employees, and digital self-help tools often see only brief engagement before people drop off.
Coaching changes that story.
At Wave, engagement ranges from 15 to 25 percent, which is five times higher than the industry average. Once people begin, they stay. Eighty-eight percent of members engage with their care plan, and retention rates continue to outperform every other digital mental health benchmark.
Why? Because coaching feels accessible. It’s immediate, relational, and stigma-free.
Immediate access: Members can connect with a Wave coach the same or next day. No long waits, no state licensure hurdles, no confusion about where to start.
Low stigma: Coaching doesn’t carry the weight of a diagnosis. It feels like support, not treatment, which opens the door for people who might otherwise avoid care.
Consistent connection: Coaches build ongoing relationships, guiding members through challenges over time instead of offering a one-time session or static tool.
For many people, that kind of ongoing support becomes the bridge to recovery. One Wave member put it simply:
“I thought coaching would be surface-level, but my coach helped me notice patterns I never caught before. It actually helped me make changes I’d struggled to make even in therapy.”
This is the quiet revolution happening in mental health. Coaching reaches the people who otherwise slip through the cracks and it does so quickly, safely, and at scale.
What “High Acuity” Really Means and Why Coaches Can Help
When people hear high acuity, they often imagine complex, crisis-level needs that require specialized clinical care. And sometimes that’s true. But in most real-world settings, “high acuity” describes not just diagnoses, but the degree of distress or impairment someone is facing.
The key insight from Wave’s clinical research is that most high-symptom cases share a handful of common, transdiagnostic patterns. These include things like avoidance, emotional dysregulation, rumination, and perfectionism. In other words, the same behavioral and cognitive mechanisms show up across many diagnoses.
Coaches are uniquely positioned to address those mechanisms.
Wave’s care model is transdiagnostic, meaning it focuses on the processes that drive distress, not just the labels attached to it. Whether someone meets criteria for generalized anxiety, major depression, or burnout, the same core skills can help them move forward. Coaches teach and reinforce those skills through structured, evidence-based frameworks drawn from CBT, ACT, and DBT.
A Wave coach might help a member practice mindfulness of thoughts to reduce rumination, build distress-tolerance skills for emotion regulation, or set small values-based goals to re-engage in meaningful activities. These are the same mechanisms that underpin effective therapy, and they can produce measurable change when practiced consistently.
That’s why Wave doesn’t draw a hard line between “low” and “high” acuity. Instead, coaches and clinicians work within a shared framework of care, supported by supervision, escalation protocols, and continuous measurement. If someone’s risk increases, the coach can escalate instantly to Wave’s licensed clinicians or trusted partners with no gaps and no lost time.
How Wave Coaches Are Trained to Handle Complexity
Quality at scale doesn’t happen by accident. It’s designed from the ground up.
Wave built Coach University (Coach U) to ensure every coach is trained, supervised, and supported to deliver care safely and effectively. Developed by a Stanford professor of psychiatry and clinical psychologist, Coach U is both an educational program and a quality system that keeps the entire network aligned.
Every Wave coach:
Completes a rigorous training pathway designed to prepare them for NBHWC certification
Receives ongoing clinical supervision and structured feedback
Participates in weekly case reviews, including for high-acuity or complex cases
Works within defined escalation and referral protocols that follow gold-standard safety tools like the Columbia Protocol
Wave also uses safe and responsible AI to support coaches behind the scenes. The platform’s “Recommengine” helps identify which digital skills, videos, or exercises are most relevant for a member based on real-time data. Coaches can see progress trends, risk indicators, and engagement levels, all while maintaining full control of care decisions.
This combination of human expertise and responsible technology makes Wave’s coaching model uniquely scalable without compromising quality. It ensures that every member receives personalized support and that every coach has the structure to deliver it safely.
Real Results, Even for High-Symptom Users
Data is where the misconceptions about coaching finally break down.
Wave’s outcomes are measured continuously using validated tools like the DASS-21, which captures symptoms of depression, anxiety, and stress. Across tens of thousands of data points, the results are remarkably consistent:
72 percent of members improve within eight weeks of starting coaching
Anxiety and depression symptoms are reduced by up to 50 percent
49 percent of members show measurable improvement within 30 days
Improvements are consistent across income levels and racial or ethnic backgrounds
And these results hold true even for members who begin care with moderate or severe symptoms. Wave’s continuous measurement model tracks every session, every digital interaction, and every skill practiced. That means members aren’t just logging in; they’re actually making progress.
Unlike typical digital apps that lose most users within two weeks, Wave maintains engagement ten times longer. Members don’t just start coaching. They stay, learn, and keep applying the skills they’ve built, which compounds improvement over time.
Why Employers and Health Plans Should Rethink Coaching
Coaching provides faster access, better continuity, and measurable outcomes, all at a fraction of the cost of traditional outpatient therapy. For one national health plan, Wave’s modeled impact projected three billion dollars in savings by Year 5. That’s largely because early, skills-based coaching reduced downstream demand for higher-cost services.
Wave’s approach also solves the quality gap that has plagued EAPs for decades. Every session is tied to evidence-based outcomes. Every member’s progress is visible in real time. And every escalation happens within a structured, clinically supervised framework.
For employers, that translates into fewer lost workdays, better retention, and lower disability claims. For health plans, it means higher member satisfaction, measurable ROI, and scalable population health impact.
In a system where therapists are in short supply and costs keep climbing, coaching isn’t a fallback. It’s the foundation of a sustainable, stepped-care model that works.
The real risk isn’t letting coaches do too much. It’s continuing to underestimate what they already do best: reaching people early, supporting them consistently, and helping them get better faster.
FAQ
Can coaching really help people with significant anxiety or depression?
Yes. Coaching targets the same transdiagnostic mechanisms that underlie anxiety, depression, and stress. By focusing on skills like emotion regulation, cognitive flexibility, and behavioral activation, Wave coaches help members build lasting change.
How do you keep coaching safe for high-acuity users?
Wave coaches are trained through Coach U and supervised by licensed clinicians. They follow clear safety and escalation protocols, using validated tools to assess risk and refer members to higher levels of care when needed.
Does Wave replace therapy?
Sometimes. Coaching serves as the front door to care, offering same- or next-day access and continuous monitoring. When therapy is indicated for certain conditions, members are seamlessly guided to the right provider.
What makes Wave’s coaching model different from generic coaching apps?
Wave combines human expertise, continuous measurement, and responsible AI. Every coach is trained, supervised, and supported by clinical leadership, ensuring consistency and safety at scale.
Do outcomes really hold up across populations?
Yes. Wave’s data show no significant differences in improvement rates by race, ethnicity, or income level. The model is effective across diverse groups and workplace settings.
🌊 Ready to See the Full Picture?
Wave’s coaching-first model delivers measurable outcomes across the mental health spectrum, from mild stress to high-symptom cases. It’s fast, safe, and scalable and it’s already transforming how employers and health plans think about care.
👉 See how Wave’s coaching model supports real clinical outcomes across the spectrum: Book a demo.