TY  - JOUR
AU  - Gaffney, Hannah
AU  - Mansell, Warren
AU  - Tai, Sara
PY  - 2019
DA  - 2019/10/18
TI  - Conversational Agents in the Treatment of Mental Health Problems: Mixed-Method Systematic Review
JO  - JMIR Ment Health
SP  - e14166
VL  - 6
IS  - 10
KW  - artificial intelligence
KW  - mental health
KW  - stress, pychological
KW  - psychiatry
KW  - therapy, computer-assisted
KW  - conversational agent
KW  - chatbot
KW  - digital health
AB  - Background: The use of conversational agent interventions (including chatbots and robots) in mental health is growing at a fast pace. Recent existing reviews have focused exclusively on a subset of embodied conversational agent interventions despite other modalities aiming to achieve the common goal of improved mental health. Objective: This study aimed to review the use of conversational agent interventions in the treatment of mental health problems. Methods: We performed a systematic search using relevant databases (MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane library). Studies that reported on an autonomous conversational agent that simulated conversation and reported on a mental health outcome were included. Results: A total of 13 studies were included in the review. Among them, 4 full-scale randomized controlled trials (RCTs) were included. The rest were feasibility, pilot RCTs and quasi-experimental studies. Interventions were diverse in design and targeted a range of mental health problems using a wide variety of therapeutic orientations. All included studies reported reductions in psychological distress postintervention. Furthermore, 5 controlled studies demonstrated significant reductions in psychological distress compared with inactive control groups. In addition, 3 controlled studies comparing interventions with active control groups failed to demonstrate superior effects. Broader utility in promoting well-being in nonclinical populations was unclear. Conclusions: The efficacy and acceptability of conversational agent interventions for mental health problems are promising. However, a more robust experimental design is required to demonstrate efficacy and efficiency. A focus on streamlining interventions, demonstrating equivalence to other treatment modalities, and elucidating mechanisms of action has the potential to increase acceptance by users and clinicians and maximize reach. 
SN  - 2368-7959
UR  - https://mental.jmir.org/2019/10/e14166
UR  - https://doi.org/10.2196/14166
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31628789
DO  - 10.2196/14166
ID  - info:doi/10.2196/14166
ER  -