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This paper is in the following e-collection/theme issue:

Theory and Frameworks in Mental Health (140) Digital Mental Health Interventions, e-Mental Health and Cyberpsychology (3426) Longitudinal and Cohort Studies in Public Health (965) Chatbots and Conversational Agents (1262) Attitudes, Beliefs, and Health Behaviours in Human Factors Research (168)

Published on in Vol 12 (2025)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/76642, first published .
iPhone screen showing a text conversation about emotional range, with mood options like "Meh" and "Calm

The Digital Therapeutic Alliance With Mental Health Chatbots: Diary Study and Thematic Analysis

The Digital Therapeutic Alliance With Mental Health Chatbots: Diary Study and Thematic Analysis

Authors of this article:

Zian Xu1 Author Orcid Image ;   Yi-Chieh Lee2 Author Orcid Image ;   Karolina Stasiak1 Author Orcid Image ;   Jim Warren1 Author Orcid Image ;   Danielle Lottridge1 Author Orcid Image
Article Authors Cited by (38) Tweetations Metrics

Journals

  1. Cui S, Wang S, Deng J, Jia R, Jiang Y. Facilitators and Barriers of Using an Artificial Intelligence Agent in Chronic Disease Management: A Normalization Process Theory-Guided Qualitative Study of Older Patients with COPD. Healthcare 2026;14(2):268 View
  2. Ahmed R, Shaban M. Always online, still alone: A qualitative study of technology-facilitated loneliness and mood symptoms among university students. Archives of Psychiatric Nursing 2026;61:152076 View
  3. Ouyang W, Du H, Han Y, Wang Z, He Y. Eye-Tracked Visual Attention to Anthropomorphic Appearance and Empathic Responses in AI Medical Conversational Agents: Dissociating Trust Gains from Attentional Synergy. Journal of Eye Movement Research 2026;19(2):38 View
  4. Yıldız E. Optimisation Drift and Substitution Risk in Artificial Intelligence–Supported Personalised Mental Health Nursing: A Critical Synthesis on Therapeutic Presence and Care Biography. Journal of Psychiatric and Mental Health Nursing 2026;33(4):641 View
  5. Türk M, Akın R, Şahin D, Demirci S. Büyük Dil Modellerinin Ruh Sağlığı Uygulamaları İçin Performans ve Tutarlılık Analizi. Black Sea Journal of Engineering and Science 2026;9(3):1338 View
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  8. Eken F. PSİKOTERAPİDE YAPAY ZEKÂ: KURAM, UYGULAMA VE ETİK PERSPEKTİFİNDEN BİR DEĞERLENDİRME. Çukurova Üniversitesi Sosyal Bilimler Enstitüsü Dergisi 2026;35 View
  9. Zhang Y, Yue G, Si Z. Therapeutic Twins for Creative Digital Mental Health: A Review Through a Trust-in-Automation Lens. International Journal of Human–Computer Interaction 2026:1 View
  10. Malgir B, Tian Y, Herger E, Milford S, Shaw D, Elger B. Health Care Professionals’ Perspectives on Conversational Mental Health Chatbots: Protocol for a Systematic Review. JMIR Research Protocols 2026;15:e92780 View
  11. Shi E, Pei R, Barceló-Coblijn L. The digital therapist? LLMs and the future of clinical dialogue. Language and Health 2026;4(2):100086 View
  12. Parra-Cabrera G, Rodríguez-Fariñas M, Rodríguez-Martínez A, Pérez-Cano F. A Multimodal Conversational Chatbot for Emotional Support and Daily Assistance in Older Adults: Design, Development and Pilot Usability Evaluation. Healthcare 2026;14(13):1946 View
  13. Bernaerts S, Buelens F, De Witte N, Balaskas A, Colman T, Van Daele T. Exploring Real-World Use of AI Chatbots for Mental Health Support: Cross-Sectional Survey Study. JMIR Mental Health 2026;13:e104316 View
  14. Markiewicz W, Marusińska M, Karpiński M, Parzniewski M, Czyż W, Kolawa S, Ostruszka N, Borowiec A, Pilecka J, Wojciechowski J. PERCEIVED THERAPEUTIC BOND IN INTERACTIONS WITH MENTAL HEALTH CHATBOTS: A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science 2026;1(3(51)) View
  15. Cheng J. Can Large Language Models Support University Counseling? Evidence from Perceived Counseling Alliance, Disclosure Willingness, and Risk Recognition. Behavioral Sciences 2026;16(8):1316 View
  16. Zhou Y, Honary M, Fayoumi A. Design Principles for a Risk-Aware Conversational Agent in Digital Mental Health Information Access: The Case of Cognitive Theatre. Information Systems Frontiers 2026 View
  17. Park S, Song Y, Cho S. A Comparative Evaluation of Human and LLM-Based Counselors: Trust, User Experience, and Design Implications. IEEE Access 2026;14:129120 View
  18. Wu C, Lou N. Optimising AI-mediated wellness interventions’ design, engagement, and adaptation: Introducing the AI-DEA framework for mental health support and psychological change. Journal of Psychology and AI 2026;2(1) View
  19. Bolpagni M, Piffer S, Pozza M, Maminimini M, Gabrielli S. Insights on Designing the MINT (Micro-Interventions for Navigating Tension) Chatbot System for Stress Management: Collaborative Autoethnography. JMIR Human Factors 2026;13:e89876 View
  20. Lan Y, Liu S, Liu C, Chen H. Trust-driven healthy engagement with conversational AI for mental health support in young adults: a mixed methods study. Scientific Reports 2026;16(1) View
  21. Chen J, Meng Y, Nie K. "Not Just Me and My To-Do List": Understanding Challenges of Task Management for Adults with ADHD and the Need for AI-Augmented Social Scaffolds. Proceedings of the ACM on Human-Computer Interaction 2026;10(6):1 View
  22. Akbarzadeh M, Akbarzadeh M. Beyond Alliance Scores: Construct Transport and Measurement Validity in Mental Health Chatbot Research—A Systematic Scoping Review. International Journal of Human–Computer Interaction 2026:1 View
  23. Konopka K, Kozłowska M, Kabat E, Liasota M, Komin Z, Lis M, Juskowiak J, Kwiatkowska A, Kołodziej F, Majchrzak M. CHATBOT-DELIVERED COGNITIVE BEHAVIOURAL THERAPY: A STRUCTURED REVIEW OF EFFICACY, USER ENGAGEMENT, AND EQUITY OF ACCESS. International Journal of Innovative Technologies in Social Science 2026;1(4(52)) View
  24. Miller E, Sanderson L, O’Brien J, Bradford N, Holland-Batt S, Bartlett S, Scharoun L, Caldwell G, Guihot M. Care, code, and consequence: Ethical considerations in the co-design of a conversational AI chatbot for grief. Journal of Responsible Technology 2026;28:100193 View
  25. Charles A, Rennick-Egglestone S, Fortuna K, Coulson N, Bjerrum Moeller S, Geeleher M, Harrison J, Holden M, Slade M, Ng F. A Typology of Moderator Practices and Community Guidelines in Online Mental Health Communities to Establish a Framework for Digital Safety: Systematized Review. Journal of Medical Internet Research 2026;28:e99367 View
  26. Zilio F, Stefanello E. The Empathy Paradox in AI Mental Health Support. AJOB Neuroscience 2026;17(4):401 View
  27. Wei X, Chen X, Jin W, Cai J, Luo X, Deng J. When support becomes dependence: conversational continuity and relational safety in human-AI interaction. Frontiers in Psychiatry 2026;17 View
  28. Nicholls L, Hutto R, Soto Z, Morrin H, Pollak T, Korpan R, Carmichael C. “AI psychosis” in context: how conversation history shapes LLM responses to delusional beliefs. AI and Ethics 2026;6(6) View
  29. Maminimini M, Piffer S, Gabrielli S. Engagement-Supportive Mechanisms in Stress-Focused Digital Mental Health Interventions With Adaptive, Conversational, and Context-Aware Systems: Narrative Review. JMIR Human Factors 2026;13:e90855 View
  30. Schäfer L, Krause T, Köhler S. Engagement, Feasibility, and Perceived Alliance With a Large Language Model–Enabled Mental Health Voice and Chatbot: Exploratory Longitudinal Observational Study. JMIR Formative Research 2026;10:e89708 View
  31. Kvalbein-Olsen L. Can we trust AI as much as our GP?. Tidsskrift for Den norske legeforening 2026 View

Books/Policy Documents

  1. Zhang J, Liu Z. Design, User Experience, and Usability. View
  2. Aziz A, Mukhtar N, Mahmod M, Ishak N, Ghani N, Yee C. Advances and Trends in Artificial Intelligence. Theory and Applications. View
  3. Maulana M. Persuasive Technology. PERSUASIVE 2026 Satellite Events. View

Conference Proceedings

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  2. Xu Z, Lee Y, Stasiak K, Warren J, Lottridge D. Proceedings of the 2026 CHI Conference on Human Factors in Computing Systems. Affective and Goal-Oriented Factors of Relationship Formation in the Digital Therapeutic Alliance: A Longitudinal Study of Mental Health Chatbots View
  3. Xu Z, Warren J, Lottridge D. Proceedings of the 2025 International Conference on Human-Engaged Computing. Exploring the Digital Therapeutic Alliance: A Preliminary Analysis of Mental Health Chatbot Conversations View
  4. Hong J, Seo J, Kim D, Shelton C, Oh H. Proceedings of the 39th Annual ACM Symposium on User Interface Software and Technology. What If You Could Call Your Future Self? NicoCall as a Personalized Future-Self Video Call for Nicotine Cessation View