KokoBot teaches cognitive reappraisal skills and facilitates peer-to-peer interactions through a postresponse platform where users post about a situation and other users respond back. Shim focuses on positive psychology and the components of CBT. Woebot is an automated conversational agent designed to deliver CBT in a brief way, and it also performs mood tracking. Some of the chatbots targeting mental health that have been reported in the literature are Woebot, Shim, KokoBot, Wysa, Vivibot, Pocket Skills, and Tess. Vaidyam et al reported that there is little understanding of the therapeutic effect of chatbots and a lack of consensus in the standards of reporting and evaluation. Abd-alrazaq et al reported that the inconsistency of outcome measures made it difficult to compare the efficacy of chatbots. Ho et al found that interactions with chatbots were as effective as human interactions in offering emotional, relational, and psychological benefits and that they focused on the impact of personal disclosure.Ī total of 2 reviews have covered studies on mental health chatbots in mental health. Chatbots are computer programs that engage in text-based or voice-activated conversations and that respond to users based on preprogrammed responses or artificial intelligence (AI). Ĭhatbots represent a particular type of BIT to address mental health conditions. Several BITs involve the same content as face-to-face CBT programs that allows it to reach larger numbers of people at lower costs. BITs, such as internet interventions for anxiety and depression, have empirical support with outcomes similar to therapist-delivered cognitive behavioral therapy (CBT). Mohr et al suggested that behavioral intervention technologies (BITs) offer a potential solution to overcome barriers that prevent access and expand mental health care.īITs are the application of behavioral and psychological intervention strategies through the use of technology features that address behavioral, cognitive, and affective components that support physical, behavioral, and mental health. To address these challenges, Kazdin and Rabbitt called for new models of delivering psychosocial interventions. More specifically, in primary care settings, 75% of patients with depression have one or more structural or psychological barriers that interfere with access to behavioral treatments. In the United States, 42.6% of adults with mental illness received mental health services in 2017. Many mental health interventions do not reach those in need, with approximately 70% with no access to these services. Major implications for future chatbot design and evaluation are discussed in the paper.Īccording to the World Health Organization, there is a global shortage of health workers trained in mental health. There was large heterogeneity in user engagement across different modules, which appeared to be affected by the length, complexity, content, and style of questions within the modules and the routing between modules.Ĭonclusions: Overall, participants engaged with Tess however, there was a heterogeneous usage pattern because of varying module designs. Results: Users sent a total of 6220 messages, with a total of 86,298 characters, and, on average, they engaged with Tess depression modules for 46 days. Slide plots were also used to analyze the flow across and within modules. Descriptive statistics were used to analyze participant flow through each depression module, including characters per message, completion rate, and time spent per module. ![]() Methods: Interactions of 354 users with the Tess depression modules were analyzed to understand chatbot usage across and within modules. Objective: This study aims to understand how users engage and are redirected through a chatbot for depression (Tess) to provide design recommendations. Understanding the usage patterns of chatbots for depression represents a crucial step toward improving chatbot design and providing information about the strengths and limitations of the chatbots. ![]() Although some chatbots have shown promising early efficacy results, there is limited information about how people use these chatbots. JMIR Bioinformatics and Biotechnology 12 articlesĮmail: Chatbots could be a scalable solution that provides an interactive means of engaging users in behavioral health interventions driven by artificial intelligence.JMIR Biomedical Engineering 58 articles. ![]()
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