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Karkosz S, Szymański R, Sanna K, Michałowski J. Effectiveness of a Web-based and Mobile Therapy Chatbot on Anxiety and Depressive Symptoms in Subclinical Young Adults: Randomized Controlled Trial. JMIR Form Res 2024; 8:e47960. [PMID: 38506892 PMCID: PMC10993129 DOI: 10.2196/47960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND There has been an increased need to provide specialized help for people with depressive and anxiety symptoms, particularly teenagers and young adults. There is evidence from a 2-week intervention that chatbots (eg, Woebot) are effective in reducing depression and anxiety, an effect that was not detected in the control group that was provided self-help materials. Although chatbots are a promising solution, there is limited scientific evidence for the efficacy of agent-guided cognitive behavioral therapy (CBT) outside the English language, especially for highly inflected languages. OBJECTIVE This study aimed to measure the efficacy of Fido, a therapy chatbot that uses the Polish language. It targets depressive and anxiety symptoms using CBT techniques. We hypothesized that participants using Fido would show a greater reduction in anxiety and depressive symptoms than the control group. METHODS We conducted a 2-arm, open-label, randomized controlled trial with 81 participants with subclinical depression or anxiety who were recruited via social media. Participants were divided into experimental (interacted with a fully automated Fido chatbot) and control (received a self-help book) groups. Both intervention methods addressed topics such as general psychoeducation and cognitive distortion identification and modification via Socratic questioning. The chatbot also featured suicidal ideation identification and redirection to suicide hotlines. We used self-assessment scales to measure primary outcomes, including the levels of depression, anxiety, worry tendencies, satisfaction with life, and loneliness at baseline, after the 2-week intervention and at the 1-month follow-up. We also controlled for secondary outcomes, including engagement and frequency of use. RESULTS There were no differences in anxiety and depressive symptoms between the groups at enrollment and baseline. After the intervention, depressive and anxiety symptoms were reduced in both groups (chatbot: n=36; control: n=38), which remained stable at the 1-month follow-up. Loneliness was not significantly different between the groups after the intervention, but an exploratory analysis showed a decline in loneliness among participants who used Fido more frequently. Both groups used their intervention technique with similar frequency; however, the control group spent more time (mean 117.57, SD 72.40 minutes) on the intervention than the Fido group (mean 79.44, SD 42.96 minutes). CONCLUSIONS We did not replicate the findings from previous (eg, Woebot) studies, as both arms yielded therapeutic effects. However, such results are in line with other research of Internet interventions. Nevertheless, Fido provided sufficient help to reduce anxiety and depressive symptoms and decreased perceived loneliness among high-frequency users, which is one of the first pieces of evidence of chatbot efficacy with agents that use a highly inflected language. Further research is needed to determine the long-term, real-world effectiveness of Fido and its efficacy in a clinical sample. TRIAL REGISTRATION ClinicalTrials.gov NCT05762939; https://clinicaltrials.gov/study/NCT05762939; Open Science Foundation Registry 2cqt3; https://osf.io/2cqt3.
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Affiliation(s)
- Stanisław Karkosz
- Laboratory of Affective Neuroscience in Poznan, SWPS University, Warsaw, Poland
| | - Robert Szymański
- Laboratory of Affective Neuroscience in Poznan, SWPS University, Warsaw, Poland
| | - Katarzyna Sanna
- Center for Research on Personality Development in Poznan, SWPS University, Warsaw, Poland
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Chiauzzi E, Williams A, Mariano TY, Pajarito S, Robinson A, Kirvin-Quamme A, Forman-Hoffman V. Demographic and clinical characteristics associated with anxiety and depressive symptom outcomes in users of a digital mental health intervention incorporating a relational agent. BMC Psychiatry 2024; 24:79. [PMID: 38291369 PMCID: PMC10826101 DOI: 10.1186/s12888-024-05532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Digital mental health interventions (DMHIs) may reduce treatment access issues for those experiencing depressive and/or anxiety symptoms. DMHIs that incorporate relational agents may offer unique ways to engage and respond to users and to potentially help reduce provider burden. This study tested Woebot for Mood & Anxiety (W-MA-02), a DMHI that employs Woebot, a relational agent that incorporates elements of several evidence-based psychotherapies, among those with baseline clinical levels of depressive or anxiety symptoms. Changes in self-reported depressive and anxiety symptoms over 8 weeks were measured, along with the association between each of these outcomes and demographic and clinical characteristics. METHODS This exploratory, single-arm, 8-week study of 256 adults yielded non-mutually exclusive subsamples with either clinical levels of depressive or anxiety symptoms at baseline. Week 8 Patient Health Questionnaire-8 (PHQ-8) changes were measured in the depressive subsample (PHQ-8 ≥ 10). Week 8 Generalized Anxiety Disorder-7 (GAD-7) changes were measured in the anxiety subsample (GAD-7 ≥ 10). Demographic and clinical characteristics were examined in association with symptom changes via bivariate and multiple regression models adjusted for W-MA-02 utilization. Characteristics included age, sex at birth, race/ethnicity, marital status, education, sexual orientation, employment status, health insurance, baseline levels of depressive and anxiety symptoms, and concurrent psychotherapeutic or psychotropic medication treatments during the study. RESULTS Both the depressive and anxiety subsamples were predominantly female, educated, non-Hispanic white, and averaged 38 and 37 years of age, respectively. The depressive subsample had significant reductions in depressive symptoms at Week 8 (mean change =-7.28, SD = 5.91, Cohen's d = -1.23, p < 0.01); the anxiety subsample had significant reductions in anxiety symptoms at Week 8 (mean change = -7.45, SD = 5.99, Cohen's d = -1.24, p < 0.01). No significant associations were found between sex at birth, age, employment status, educational background and Week 8 symptom changes. Significant associations between depressive and anxiety symptom outcomes and sexual orientation, marital status, concurrent mental health treatment, and baseline symptom severity were found. CONCLUSIONS The present study suggests early promise for W-MA-02 as an intervention for depression and/or anxiety symptoms. Although exploratory in nature, this study revealed potential user characteristics associated with outcomes that can be investigated in future studies. TRIAL REGISTRATION This study was retrospectively registered on ClinicalTrials.gov (#NCT05672745) on January 5th, 2023.
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Affiliation(s)
- Emil Chiauzzi
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Andre Williams
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Timothy Y Mariano
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
- RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sarah Pajarito
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Athena Robinson
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
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Opel DJ, Kious BM, Cohen IG. AI as a Mental Health Therapist for Adolescents. JAMA Pediatr 2023; 177:1253-1254. [PMID: 37843845 DOI: 10.1001/jamapediatrics.2023.4215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
This Viewpoint discusses benefits and risks of using conversational artificial intelligence platforms to deliver psychotherapy to adolescents.
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Affiliation(s)
- Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Brent M Kious
- Department of Psychiatry, University of Utah, Salt Lake City
- Huntsman Mental Health Institute, University of Utah, Salt Lake City
| | - I Glenn Cohen
- Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Cambridge, Massachusetts
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Denecke K, May R, Gabarron E, Lopez-Campos GH. Assessing the Potential Risks of Digital Therapeutics (DTX): The DTX Risk Assessment Canvas. J Pers Med 2023; 13:1523. [PMID: 37888134 PMCID: PMC10608744 DOI: 10.3390/jpm13101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
MOTIVATION Digital therapeutics (DTX), i.e., health interventions that are provided through digital means, are increasingly available for use; in some countries, physicians can even prescribe selected DTX following a reimbursement by health insurances. This results in an increasing need for methodologies to consider and monitor DTX's negative consequences, their risks to patient safety, and possible adverse events. However, it is completely unknown which aspects should be subject to surveillance given the missing experiences with the tools and their negative impacts. OBJECTIVE Our aim is to develop a tool-the DTX Risk Assessment Canvas-that enables researchers, developers, and practitioners to reflect on the negative consequences of DTX in a participatory process. METHOD Taking the well-established business model canvas as a starting point, we identified relevant aspects to be considered in a risk assessment of a DTX. The aspects or building blocks of the canvas were constructed in a two-way process: first, we defined the aspects relevant for discussing and reflecting on how a DTX might bring negative consequences and risks for its users by considering ISO/TS 82304-2, the scientific literature, and by reviewing existing DTX and their listed adverse effects. The resulting aspects were grouped into thematic blocks and the canvas was created. Second, six experts in health informatics and mental health provided feedback and tested the understandability of the initial canvas by individually applying it to a DTX of their choice. Based on their feedback, the canvas was modified. RESULTS The DTX Risk Assessment Canvas is organized into 15 thematic blocks which are in turn grouped into three thematic groups considering the DTX itself, the users of the DTX, and the effects of the DTX. For each thematic block, questions have been formulated to guide the user of the canvas in reflecting on the single aspects. Conclusions: The DTX Risk Assessment Canvas is a tool to reflect the negative consequences and risks of a DTX by discussing different thematic blocks that together constitute a comprehensive interpretation of a DTX regarding possible risks. Applied during the DTX design and development phase, it can help in implementing countermeasures for mitigation or means for their monitoring.
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Affiliation(s)
- Kerstin Denecke
- Department Engineering and Computer Science, Institute Patient-Centered Digital Health, Bern University of Applied Sciences, 3012 Bern, Switzerland
| | - Richard May
- Department of Automation and Computer Science, Harz University of Applied Sciences, 38855 Wernigerode, Germany;
| | - Elia Gabarron
- Norwegian Centre for E-Health Research, University Hospital of North Norway, 9019 Tromsø, Norway;
- Department of Education, ICT and Learning, Østfold University College, 1757 Halden, Norway
| | - Guillermo H. Lopez-Campos
- Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast BT9 7BL, UK;
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Cimino S. Epidemiology, Etiology and Intervention Strategies for Peri-Partum Depression in Mothers. J Clin Med 2023; 12:5822. [PMID: 37762762 PMCID: PMC10531507 DOI: 10.3390/jcm12185822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of peri-partum depression (PPD) varies widely across countries, with rates ranging from 10% to 15% depending on the screening method used and the country studied [...].
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza, University of Rome, Via degli Apuli 1, 00186 Rome, Italy
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Suharwardy S, Ramachandran M, Leonard SA, Gunaseelan A, Lyell DJ, Darcy A, Robinson A, Judy A. Feasibility and impact of a mental health chatbot on postpartum mental health: a randomized controlled trial. AJOG GLOBAL REPORTS 2023; 3:100165. [PMID: 37560011 PMCID: PMC10407813 DOI: 10.1016/j.xagr.2023.100165] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Perinatal mood disorders are common yet underdiagnosed and un- or undertreated. Barriers exist to accessing perinatal mental health services, including limited availability, time, and cost. Automated conversational agents (chatbots) can deliver evidence-based cognitive behavioral therapy content through text message-based conversations and reduce depression and anxiety symptoms in select populations. Such digital mental health technologies are poised to overcome barriers to mental health care access but need to be evaluated for efficacy, as well as for preliminary feasibility and acceptability among perinatal populations. OBJECTIVE To evaluate the acceptability and preliminary efficacy of a mental health chatbot for mood management in a general postpartum population. STUDY DESIGN An unblinded randomized controlled trial was conducted at a tertiary academic center. English-speaking postpartum women aged 18 years or above with a live birth and access to a smartphone were eligible for enrollment prior to discharge from delivery hospitalization. Baseline surveys were administered to all participants prior to randomization to a mental health chatbot intervention or to usual care only. The intervention group downloaded the mental health chatbot smartphone application with perinatal-specific content, in addition to continuing usual care. Usual care consisted of routine postpartum follow up and mental health care as dictated by the patient's obstetric provider. Surveys were administered during delivery hospitalization (baseline) and at 2-, 4-, and 6-weeks postpartum to assess depression and anxiety symptoms. The primary outcome was a change in depression symptoms at 6-weeks as measured using two depression screening tools: Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale. Secondary outcomes included anxiety symptoms measured using Generalized Anxiety Disorder-7, and satisfaction and acceptability using validated scales. Based on a prior study, we estimated a sample size of 130 would have sufficient (80%) power to detect a moderate effect size (d=.4) in between group difference on the Patient Health Questionnaire-9. RESULTS A total of 192 women were randomized equally 1:1 to the chatbot or usual care; of these, 152 women completed the 6-week survey (n=68 chatbot, n=84 usual care) and were included in the final analysis. Mean baseline mental health assessment scores were below positive screening thresholds. At 6-weeks, there was a greater decrease in Patient Health Questionnaire-9 scores among the chatbot group compared to the usual care group (mean decrease=1.32, standard deviation=3.4 vs mean decrease=0.13, standard deviation=3.01, respectively). 6-week mean Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores did not differ between groups and were similar to baseline. 91% (n=62) of the chatbot users were satisfied or highly satisfied with the chatbot, and 74% (n=50) of the intervention group reported use of the chatbot at least once in 2 weeks prior to the 6-week survey. 80% of study participants reported being comfortable with the use of a mobile smartphone application for mood management. CONCLUSION Use of a chatbot was acceptable to women in the early postpartum period. The sample did not screen positive for depression at baseline and thus the potential of the chatbot to reduce depressive symptoms in this population was limited. This study was conducted in a general obstetric population. Future studies of longer duration in high-risk postpartum populations who screen positive for depression are needed to further understand the utility and efficacy of such digital therapeutics for that population.
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Affiliation(s)
- Sanaa Suharwardy
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Maya Ramachandran
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Stephanie A. Leonard
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Anita Gunaseelan
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Deirdre J. Lyell
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Alison Darcy
- Woebot Health, San Francisco, CA (Drs Darcy and Robinson)
| | | | - Amy Judy
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
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Inkster B, Kadaba M, Subramanian V. Understanding the impact of an AI-enabled conversational agent mobile app on users' mental health and wellbeing with a self-reported maternal event: a mixed method real-world data mHealth study. Front Glob Womens Health 2023; 4:1084302. [PMID: 37332481 PMCID: PMC10272556 DOI: 10.3389/fgwh.2023.1084302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Background Maternal mental health care is variable and with limited accessibility. Artificial intelligence (AI) conversational agents (CAs) could potentially play an important role in supporting maternal mental health and wellbeing. Our study examined data from real-world users who self-reported a maternal event while engaging with a digital mental health and wellbeing AI-enabled CA app (Wysa) for emotional support. The study evaluated app effectiveness by comparing changes in self-reported depressive symptoms between a higher engaged group of users and a lower engaged group of users and derived qualitative insights into the behaviors exhibited among higher engaged maternal event users based on their conversations with the AI CA. Methods Real-world anonymised data from users who reported going through a maternal event during their conversation with the app was analyzed. For the first objective, users who completed two PHQ-9 self-reported assessments (n = 51) were grouped as either higher engaged users (n = 28) or lower engaged users (n = 23) based on their number of active session-days with the CA between two screenings. A non-parametric Mann-Whitney test (M-W) and non-parametric Common Language effect size was used to evaluate group differences in self-reported depressive symptoms. For the second objective, a Braun and Clarke thematic analysis was used to identify engagement behavior with the CA for the top quartile of higher engaged users (n = 10 of 51). Feedback on the app and demographic information was also explored. Results Results revealed a significant reduction in self-reported depressive symptoms among the higher engaged user group compared to lower engaged user group (M-W p = .004) with a high effect size (CL = 0.736). Furthermore, the top themes that emerged from the qualitative analysis revealed users expressed concerns, hopes, need for support, reframing their thoughts and expressing their victories and gratitude. Conclusion These findings provide preliminary evidence of the effectiveness and engagement and comfort of using this AI-based emotionally intelligent mobile app to support mental health and wellbeing across a range of maternal events and experiences.
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Affiliation(s)
- Becky Inkster
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Wysa Inc., Boston, MA, United States
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Grodniewicz JP, Hohol M. Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence. Front Psychiatry 2023; 14:1190084. [PMID: 37324824 PMCID: PMC10267322 DOI: 10.3389/fpsyt.2023.1190084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called "general" or "human-like" AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy.
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Chiauzzi E, Robinson A, Martin K, Petersen C, Wells N, Williams A, Gleason MM. A Relational Agent Intervention for Adolescents Seeking Mental Health Treatment: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44940. [PMID: 36867455 PMCID: PMC10024210 DOI: 10.2196/44940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Unmet pediatric mental health (MH) needs are growing as rates of pediatric depression and anxiety dramatically increase. Access to care is limited by multiple factors, including a shortage of clinicians trained in developmentally specific, evidence-based services. Novel approaches to MH care delivery, including technology-leveraged and readily accessible options, need to be evaluated in service of expanding evidence-based services to youths and their families. Preliminary evidence supports the use of Woebot, a relational agent that digitally delivers guided cognitive behavioral therapy (CBT) through a mobile app, for adults with MH concerns. However, no studies have evaluated the feasibility and acceptability of such app-delivered relational agents specifically for adolescents with depression and/or anxiety within an outpatient MH clinic, nor compared them to other MH support services. OBJECTIVE This paper describes the protocol for a randomized controlled trial evaluating the feasibility and acceptability of an investigational device, Woebot for Adolescents (W-GenZD), within an outpatient MH clinic for youths presenting with depression and/or anxiety. The study's secondary aim will compare the clinical outcomes of self-reported depressive symptoms with W-GenZD and a telehealth-delivered CBT-based skills group (CBT-group). Tertiary aims will evaluate additional clinical outcomes and therapeutic alliance between adolescents in W-GenZD and the CBT-group. METHODS Participants include youths aged 13-17 years with depression and/or anxiety seeking care from an outpatient MH clinic at a children's hospital. Eligible youths will have no recent safety concerns or complex comorbid clinical diagnoses; have no concurrent individual therapy; and, if on medications, are on stable doses, based on clinical screening and as well as study-specific criteria. RESULTS Recruitment began in May 2022. As of December 8, 2022, we have randomized 133 participants. CONCLUSIONS Establishing the feasibility and acceptability of W-GenZD within an outpatient MH clinical setting will add to the field's current understanding of the utility and implementation considerations of this MH care service modality. The study will also evaluate the noninferiority of W-GenZD against the CBT-group. Findings may also have implications for patients, families, and providers looking for additional MH support options for adolescents seeking help for their depression and/or anxiety. Such options expand the menu of supports for youths with lower-intensity needs as well as possibly reduce waitlists and optimize clinician deployment toward more severe cases. TRIAL REGISTRATION ClinicalTrials.gov NCT05372913; https://clinicaltrials.gov/ct2/show/NCT05372913. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44940.
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Affiliation(s)
| | | | - Kate Martin
- Woebot Health, San Francisco, CA, United States
| | - Carl Petersen
- Children's Hospital of The King's Daughters, Norfolk, VA, United States
| | - Nicole Wells
- Children's Hospital of The King's Daughters, Norfolk, VA, United States
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