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Development and evaluation of an online mental health program for traumatized female college students: A randomized controlled trial. Arch Psychiatr Nurs 2023; 43:118-126. [PMID: 37032005 DOI: 10.1016/j.apnu.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 09/25/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
This study developed and evaluated an online mental health program for female college students who experienced trauma, based on Roy's Adaptation Model. A randomized controlled trial was adopted. Participants completed a survey on trauma and post-traumatic stress symptoms. Data from experimental and control groups (n = 16) were collected over two months. The program reduced post-traumatic stress and depression symptoms and improved functional health and adjustment. This effect was sustained in experimental group participants for one month post-program. The findings revealed the effectiveness of Internet mental healthcare for female students and the crucial role nurses play in it.
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Metsäranta K, Anttila M, Pajamäki T, Holappa H, Välimäki M. Web messaging among young people in online services: A descriptive mixed-methods study. Digit Health 2022; 8:20552076221092534. [PMID: 35433021 PMCID: PMC9008865 DOI: 10.1177/20552076221092534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To describe web messaging patterns and the content of web messages among
young people in a Finnish national online service. Methods A descriptive mixed-method was used. The data consisted of text-based web
messaging communication between young people and a counsellor in a
nationwide online service between 1 January and 31 December 2018. Web
messaging patterns were analysed using descriptive statistics. The content
of the messages was analysed with thematic analysis and qualitative results
were presented. In addition, the factors associated with messaging patterns
and content were analysed. Results A total of 1941 messages were sent by 1354 young people. Most of them were
between 12 and 17 years old and females. Less than one-fifth of young people
had multiple two-way discussions with counsellor. The total period of
two-way discussions and the number of words in each message varied widely.
The number of words was lower in messages sent by males. The content of the
messages was divided into three main themes: interpersonal relationships and
environment (Social relationships), oneself (Construction of self), and
health-related problems and support received from professionals (Health and
wellbeing). The young people’s messages mostly contained topics related to
the main theme of ‘Social environment’. Conclusion Most young people sent one message only. Messages ranged from simple, single
messages to complex texts describing the daily life of young people. Girls
were more active in messaging, and they wrote longer texts.
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Affiliation(s)
- Kiki Metsäranta
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Minna Anttila
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Tatjana Pajamäki
- Child and Youth Phone and Online Services, Mannerheim League for Child Welfare (MLL), Helsinki, Finland
| | - Heidi Holappa
- Child and Youth Phone and Online Services, Mannerheim League for Child Welfare (MLL), Helsinki, Finland
| | - Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Dwyer A, de Almeida Neto A, Estival D, Li W, Lam-Cassettari C, Antoniou M. Suitability of Text-Based Communications for the Delivery of Psychological Therapeutic Services to Rural and Remote Communities: Scoping Review. JMIR Ment Health 2021; 8:e19478. [PMID: 33625373 PMCID: PMC7946577 DOI: 10.2196/19478] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/18/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND People living in rural and remote areas have poorer access to mental health services than those living in cities. They are also less likely to seek help because of self-stigma and entrenched stoic beliefs about help seeking as a sign of weakness. E-mental health services can span great distances to reach those in need and offer a degree of privacy and anonymity exceeding that of traditional face-to-face counseling and open up possibilities for identifying at-risk individuals for targeted intervention. OBJECTIVE This scoping review maps the research that has explored text-based e-mental health counseling services and studies that have used language use patterns to predict mental health status. In doing so, one of the aims was to determine whether text-based counseling services have the potential to circumvent the barriers faced by clients in rural and remote communities using technology and whether text-based communications, in particular, can be used to identify individuals at risk of psychological distress or self-harm. METHODS We conducted a comprehensive electronic literature search of PsycINFO, PubMed, ERIC, and Web of Science databases for articles published in English through November 2020. RESULTS Of the 9134 articles screened, 70 met the eligibility criteria and were included in the review. There is preliminary evidence to suggest that text-based, real-time communication with a qualified therapist is an effective form of e-mental health service delivery, particularly for individuals concerned with stigma and confidentiality. There is also converging evidence that text-based communications that have been analyzed using computational linguistic techniques can be used to accurately predict progress during treatment and identify individuals at risk of serious mental health conditions and suicide. CONCLUSIONS This review reveals a clear need for intensified research into the extent to which text-based counseling (and predictive models using modern computational linguistics tools) may help deliver mental health treatments to underserved groups such as regional communities, identify at-risk individuals for targeted intervention, and predict progress during treatment. Such approaches have implications for policy development to improve intervention accessibility in at-risk and underserved populations.
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Affiliation(s)
- Anne Dwyer
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | | | - Dominique Estival
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | - Weicong Li
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | - Christa Lam-Cassettari
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | - Mark Antoniou
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
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Tudor Car L, Dhinagaran DA, Kyaw BM, Kowatsch T, Joty S, Theng YL, Atun R. Conversational Agents in Health Care: Scoping Review and Conceptual Analysis. J Med Internet Res 2020; 22:e17158. [PMID: 32763886 PMCID: PMC7442948 DOI: 10.2196/17158] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/11/2020] [Accepted: 06/13/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Conversational agents, also known as chatbots, are computer programs designed to simulate human text or verbal conversations. They are increasingly used in a range of fields, including health care. By enabling better accessibility, personalization, and efficiency, conversational agents have the potential to improve patient care. OBJECTIVE This study aimed to review the current applications, gaps, and challenges in the literature on conversational agents in health care and provide recommendations for their future research, design, and application. METHODS We performed a scoping review. A broad literature search was performed in MEDLINE (Medical Literature Analysis and Retrieval System Online; Ovid), EMBASE (Excerpta Medica database; Ovid), PubMed, Scopus, and Cochrane Central with the search terms "conversational agents," "conversational AI," "chatbots," and associated synonyms. We also searched the gray literature using sources such as the OCLC (Online Computer Library Center) WorldCat database and ResearchGate in April 2019. Reference lists of relevant articles were checked for further articles. Screening and data extraction were performed in parallel by 2 reviewers. The included evidence was analyzed narratively by employing the principles of thematic analysis. RESULTS The literature search yielded 47 study reports (45 articles and 2 ongoing clinical trials) that matched the inclusion criteria. The identified conversational agents were largely delivered via smartphone apps (n=23) and used free text only as the main input (n=19) and output (n=30) modality. Case studies describing chatbot development (n=18) were the most prevalent, and only 11 randomized controlled trials were identified. The 3 most commonly reported conversational agent applications in the literature were treatment and monitoring, health care service support, and patient education. CONCLUSIONS The literature on conversational agents in health care is largely descriptive and aimed at treatment and monitoring and health service support. It mostly reports on text-based, artificial intelligence-driven, and smartphone app-delivered conversational agents. There is an urgent need for a robust evaluation of diverse health care conversational agents' formats, focusing on their acceptability, safety, and effectiveness.
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Affiliation(s)
- Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Dhakshenya Ardhithy Dhinagaran
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Bhone Myint Kyaw
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Tobias Kowatsch
- Future Health Technologies programme, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore-ETH Centre, Singapore
- Center for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Center for Digital Health Interventions, Institute of Technology Management, University of St Gallen, St Gallen, Switzerland
| | - Shafiq Joty
- School of Computer Sciences and Engineering, Nanyang Technological University Singapore, Singapore
| | - Yin-Leng Theng
- Centre for Healthy and Sustainable Cities, Nanyang Technological University, Singapore
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
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5
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Abd-Alrazaq AA, Rababeh A, Alajlani M, Bewick BM, Househ M. Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e16021. [PMID: 32673216 PMCID: PMC7385637 DOI: 10.2196/16021] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/30/2019] [Accepted: 12/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background The global shortage of mental health workers has prompted the utilization of technological advancements, such as chatbots, to meet the needs of people with mental health conditions. Chatbots are systems that are able to converse and interact with human users using spoken, written, and visual language. While numerous studies have assessed the effectiveness and safety of using chatbots in mental health, no reviews have pooled the results of those studies. Objective This study aimed to assess the effectiveness and safety of using chatbots to improve mental health through summarizing and pooling the results of previous studies. Methods A systematic review was carried out to achieve this objective. The search sources were 7 bibliographic databases (eg, MEDLINE, EMBASE, PsycINFO), the search engine “Google Scholar,” and backward and forward reference list checking of the included studies and relevant reviews. Two reviewers independently selected the studies, extracted data from the included studies, and assessed the risk of bias. Data extracted from studies were synthesized using narrative and statistical methods, as appropriate. Results Of 1048 citations retrieved, we identified 12 studies examining the effect of using chatbots on 8 outcomes. Weak evidence demonstrated that chatbots were effective in improving depression, distress, stress, and acrophobia. In contrast, according to similar evidence, there was no statistically significant effect of using chatbots on subjective psychological wellbeing. Results were conflicting regarding the effect of chatbots on the severity of anxiety and positive and negative affect. Only two studies assessed the safety of chatbots and concluded that they are safe in mental health, as no adverse events or harms were reported. Conclusions Chatbots have the potential to improve mental health. However, the evidence in this review was not sufficient to definitely conclude this due to lack of evidence that their effect is clinically important, a lack of studies assessing each outcome, high risk of bias in those studies, and conflicting results for some outcomes. Further studies are required to draw solid conclusions about the effectiveness and safety of chatbots. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019141219; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141219
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Affiliation(s)
| | - Asma Rababeh
- Jordan Health Aid Society International, Amman, Jordan
| | - Mohannad Alajlani
- Institute of Digital Healthcare, University of Warwick, Warwick, United Kingdom
| | - Bridgette M Bewick
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
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6
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Navarro P, Sheffield J, Edirippulige S, Bambling M. Exploring Mental Health Professionals' Perspectives of Text-Based Online Counseling Effectiveness With Young People: Mixed Methods Pilot Study. JMIR Ment Health 2020; 7:e15564. [PMID: 32012097 PMCID: PMC7016626 DOI: 10.2196/15564] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/08/2019] [Accepted: 11/19/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Population-based studies show that the risk of mental ill health is highest among young people aged 10 to 24 years, who are also the least likely to seek professional treatment because of a number of barriers. Electronic mental (e-mental) health services have been advocated as a method for decreasing these barriers for young people, among which text-based online counseling (TBOC) is a primary intervention used at many youth-oriented services. Although TBOC has shown promising results, its outcome variance is greater in comparison with other electronic interventions and adult user groups. OBJECTIVE This pilot study aimed to explore and confirm e-mental health professional's perspectives about various domains and themes related to young service users' (YSUs) motivations for accessing TBOC services and factors related to higher and lower effectiveness on these modalities. METHODS Participants were 9 e-mental health professionals who were interviewed individually and in focus groups using a semistructured interview. Thematic analysis of qualitative themes from interview transcripts was examined across the areas of YSU motivations for access and factors that increase and decrease TBOC effectiveness. RESULTS A total of 4 domains and various subthemes were confirmed and identified to be related to YSUs' characteristics, motivations for accessing TBOC, and moderators of service effectiveness: user characteristics (ie, prior negative help-seeking experience, mental health syndrome, limited social support, and perceived social difficulties), selection factors (ie, safety, avoidance motivation, accessibility, and expectation), and factors perceived to increase effectiveness (ie, general therapeutic benefits, positive service-modality factors, and persisting with counseling despite substantial benefit) and decrease effectiveness (ie, negative service-modality factors). CONCLUSIONS Participants perceived YSUs to have polarized expectations of TBOC effectiveness and be motivated by service accessibility and safety, in response to several help-seeking concerns. Factors increasing TBOC effectiveness were using text-based communication, the online counselor's interpersonal skills and use of self-management and crisis-support strategies, and working with less complex presenting problems or facilitating access to more intensive support. Factors decreasing TBOC effectiveness were working with more complex problems owing to challenges with assessment, the slow pace of text communication, lack of nonverbal conversational cues, and environmental and connectivity issues. Other factors were using ineffective techniques (eg, poor goal setting, focusing, and postcounseling direction) that produced only short-term outcomes, poor timeliness in responding to service requests, rupture in rapport from managing service boundaries, and low YSU readiness and motivation.
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Affiliation(s)
- Pablo Navarro
- Kids Helpline, yourtown, Brisbane, Australia
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Jeanie Sheffield
- Centre for Online Health, University of Queensland, St Lucia, Brisbane, Australia
| | - Sisira Edirippulige
- Centre for Online Health, University of Queensland, St Lucia, Brisbane, Australia
| | - Matthew Bambling
- Central School of Medicine, Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, Australia
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7
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Abd-alrazaq AA, Rababeh A, Alajlani M, Bewick BM, Househ M. Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis (Preprint).. [DOI: 10.2196/preprints.16021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
The global shortage of mental health workers has prompted the utilization of technological advancements, such as chatbots, to meet the needs of people with mental health conditions. Chatbots are systems that are able to converse and interact with human users using spoken, written, and visual language. While numerous studies have assessed the effectiveness and safety of using chatbots in mental health, no reviews have pooled the results of those studies.
OBJECTIVE
This study aimed to assess the effectiveness and safety of using chatbots to improve mental health through summarizing and pooling the results of previous studies.
METHODS
A systematic review was carried out to achieve this objective. The search sources were 7 bibliographic databases (eg, MEDLINE, EMBASE, PsycINFO), the search engine “Google Scholar,” and backward and forward reference list checking of the included studies and relevant reviews. Two reviewers independently selected the studies, extracted data from the included studies, and assessed the risk of bias. Data extracted from studies were synthesized using narrative and statistical methods, as appropriate.
RESULTS
Of 1048 citations retrieved, we identified 12 studies examining the effect of using chatbots on 8 outcomes. Weak evidence demonstrated that chatbots were effective in improving depression, distress, stress, and acrophobia. In contrast, according to similar evidence, there was no statistically significant effect of using chatbots on subjective psychological wellbeing. Results were conflicting regarding the effect of chatbots on the severity of anxiety and positive and negative affect. Only two studies assessed the safety of chatbots and concluded that they are safe in mental health, as no adverse events or harms were reported.
CONCLUSIONS
Chatbots have the potential to improve mental health. However, the evidence in this review was not sufficient to definitely conclude this due to lack of evidence that their effect is clinically important, a lack of studies assessing each outcome, high risk of bias in those studies, and conflicting results for some outcomes. Further studies are required to draw solid conclusions about the effectiveness and safety of chatbots.
CLINICALTRIAL
PROSPERO International Prospective Register of Systematic Reviews CRD42019141219; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141219
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Navarro P, Bambling M, Sheffield J, Edirippulige S. Exploring Young People's Perceptions of the Effectiveness of Text-Based Online Counseling: Mixed Methods Pilot Study. JMIR Ment Health 2019; 6:e13152. [PMID: 31271149 PMCID: PMC6636236 DOI: 10.2196/13152] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/17/2019] [Accepted: 06/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Young people aged 10-24 years are at the highest risk for mental health problems and are the least likely to seek professional treatment. Owing to this population's high consumption of internet content, electronic mental (e-mental) health services have increased globally, with an aim to address barriers to treatment. Many of these services use text-based online counseling (TBOC), which shows promising results in supporting young people but also greater variance in outcomes compared with adult comparators. OBJECTIVE This pilot study qualitatively explored the characteristics of users aged 15-25 years accessing TBOC services, their motivations for access, and their perceptions about factors believed to influence the effectiveness of these modalities. METHODS E-surveys were administered naturalistically to 100 young service users aged 15-25 years who accessed webchat and email counseling services via an Australian e-mental health service. Thematic analysis of qualitative themes and quantitative descriptive and proportional data presented in electronic surveys were examined across the areas of user characteristics, motivations for selecting TBOC modalities, and their perceptions of TBOC effectiveness. RESULTS Participants were predominately female high school students of Caucasian or European descent from middle socioeconomic status, living with their parents in major cities. Four domains and various themes and subthemes were related to participants' reasons for accessing TBOC and perceptions of its effectiveness: user characteristics (ie, physical and mental health syndrome and perceived social difficulties), selection factors (ie, safety, avoidance motivation, accessibility, and expectation), factors perceived to increase effectiveness (ie, general therapeutic benefits, positive modality and service factors, and persisting with counseling to increase benefit), and factors perceived to decrease effectiveness (ie, negative modality and service factors, and persisting with counseling despite benefit). CONCLUSIONS Participants were motivated to use TBOC to increase their sense of safety in response to negative perceptions of their social skills and the response of the online counsellor to their presenting problem. By using TBOC services, they also sought to improve their access to mental health services that better met their expectations. Factors that increased effectiveness of TBOC were the counsellor's interpersonal skills, use of text-based communication, and persisting with beneficial counseling sessions. Factors that reduced TBOC effectiveness were poor timeliness in response to service requests, experiencing no change in their presenting problem, not knowing what postcounseling action to take, and persisting with ineffective counseling sessions.
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Affiliation(s)
- Pablo Navarro
- School of Psychology, The University of Queensland, Brisbane, Australia
- Kids Helpline, Yourtown, Brisbane, Australia
| | - Matthew Bambling
- Central School of Medicine, Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, Australia
| | - Jeanie Sheffield
- School of Psychology, The University of Queensland, Brisbane, Australia
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9
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Rickwood D, Wallace A, Kennedy V, O'Sullivan S, Telford N, Leicester S. Young People's Satisfaction With the Online Mental Health Service eheadspace: Development and Implementation of a Service Satisfaction Measure. JMIR Ment Health 2019; 6:e12169. [PMID: 30994470 PMCID: PMC6492057 DOI: 10.2196/12169] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Online youth mental health services are an expanding approach to meeting service need and can be used as the first step in a stepped-care approach. However, limited evidence exists regarding satisfaction with online services, and there is no standardized service satisfaction measure. OBJECTIVE This study implemented an online youth mental health service satisfaction questionnaire within eheadspace, an online youth mental health service. The aims were to test the questionnaire's psychometric properties and identify current levels of satisfaction among service users, as well as to identify client and service contact characteristics that affect satisfaction. METHODS Data were collected from 2280 eheadspace clients via an online questionnaire advertised and accessed through the eheadspace service platform between September 2016 and February 2018. Client and service contact characteristics, potential outcomes, and session and service feedback data were collected. RESULTS The service satisfaction questionnaire demonstrated high internal consistency for the overall satisfaction scale (alpha=.95) and its three subscales: session satisfaction, potential outcomes, and service satisfaction. A three-factor model was the best fit to the data, although including a higher order unidimensional construct of overall satisfaction was also a reasonable fit. Overall, young people were very satisfied with eheadspace (mean 3.60, SD 0.83). Service characteristics, but not client characteristics, were significantly associated with satisfaction. Young people were more satisfied with eheadspace when they had greater engagement as evident through receiving esupport rather than briefer service provision, having a longer session and greater interaction with the clinician, and not previously attending a face-to-face headspace center. CONCLUSIONS The online youth mental health service satisfaction questionnaire developed for and implemented in eheadspace showed good psychometric properties. The measure is brief, has good internal consistency, and has a clear factor structure. The measure could be adapted for use in other online youth mental health services. The young people using eheadspace and completing the feedback survey were highly satisfied. Greater engagement with the online service was shown to be associated with greater satisfaction. No specific client demographic groups were shown to be more or less satisfied.
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Affiliation(s)
- Debra Rickwood
- headspace National Youth Mental Health Foundation, Melbourne, Australia.,University of Canberra, Canberra, Australia
| | - Alison Wallace
- headspace National Youth Mental Health Foundation, Melbourne, Australia
| | - Vanessa Kennedy
- headspace National Youth Mental Health Foundation, Melbourne, Australia
| | | | - Nic Telford
- headspace National Youth Mental Health Foundation, Melbourne, Australia
| | - Steven Leicester
- headspace National Youth Mental Health Foundation, Melbourne, Australia
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10
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Hoermann S, McCabe KL, Milne DN, Calvo RA. Application of Synchronous Text-Based Dialogue Systems in Mental Health Interventions: Systematic Review. J Med Internet Res 2017; 19:e267. [PMID: 28784594 PMCID: PMC5595406 DOI: 10.2196/jmir.7023] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/05/2017] [Accepted: 05/16/2017] [Indexed: 01/04/2023] Open
Abstract
Background Synchronous written conversations (or “chats”) are becoming increasingly popular as Web-based mental health interventions. Therefore, it is of utmost importance to evaluate and summarize the quality of these interventions. Objective The aim of this study was to review the current evidence for the feasibility and effectiveness of online one-on-one mental health interventions that use text-based synchronous chat. Methods A systematic search was conducted of the databases relevant to this area of research (Medical Literature Analysis and Retrieval System Online [MEDLINE], PsycINFO, Central, Scopus, EMBASE, Web of Science, IEEE, and ACM). There were no specific selection criteria relating to the participant group. Studies were included if they reported interventions with individual text-based synchronous conversations (ie, chat or text messaging) and a psychological outcome measure. Results A total of 24 articles were included in this review. Interventions included a wide range of mental health targets (eg, anxiety, distress, depression, eating disorders, and addiction) and intervention design. Overall, compared with the waitlist (WL) condition, studies showed significant and sustained improvements in mental health outcomes following synchronous text-based intervention, and post treatment improvement equivalent but not superior to treatment as usual (TAU) (eg, face-to-face and telephone counseling). Conclusions Feasibility studies indicate substantial innovation in this area of mental health intervention with studies utilizing trained volunteers and chatbot technologies to deliver interventions. While studies of efficacy show positive post-intervention gains, further research is needed to determine whether time requirements for this mode of intervention are feasible in clinical practice.
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Affiliation(s)
- Simon Hoermann
- Positive Computing Laboratory, School of Electrical and Information Engineering, The University of Sydney, Sydney, Australia
| | - Kathryn L McCabe
- Positive Computing Laboratory, School of Electrical and Information Engineering, The University of Sydney, Sydney, Australia.,Psychiatry and Behavioral Sciences, University of California, Davis, CA, United States
| | - David N Milne
- Positive Computing Laboratory, School of Electrical and Information Engineering, The University of Sydney, Sydney, Australia
| | - Rafael A Calvo
- Positive Computing Laboratory, School of Electrical and Information Engineering, The University of Sydney, Sydney, Australia
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