Previously submitted to: JMIR AI (no longer under consideration since Apr 03, 2025)
Date Submitted: Feb 6, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The effectiveness of CBT-based AI-driven conversational agents for mental health intervention: A systematic review and meta-analysis
ABSTRACT
Background:
As an innovative and transformative intelligent intervention tool, Artificial Intelligence (AI) is swiftly gaining prominence in mental health interventions. Concurrently, Cognitive Behavioral Therapy (CBT), widely recognized for its structured and empirically-supported methodology, is increasingly being integrated as a foundational concept into AI-driven intervention frameworks. However, the specific efficacy of this integration still awaits in-depth verification.
Objective:
This study aims to examine the intervention effectiveness of CBT-based AI-driven Conversational Agents (CAs) in various mental health problems, and identify potential moderators for effectiveness.
Methods:
Studies were identified through a systematic search in five main databases: PubMed, Cochrane Library, Web of Science, PsycINFO, and Embase. The quality of these studies, possible publication bias and moderators were then examined. A total of 15 randomized controlled trials with 1,737 participants were included in the analysis.
Results:
The results indicated that AI-driven, CBT-based CAs showed a small to moderate effect on depressive symptoms (g = 0.36, 95% CI 0.20-0.51) and a small effect on negative affect (g = 0.21, 95% CI 0.02-0.39); while the effects on generalized anxiety, stress, and positive affect were not significant after adjusting for publication bias (g = -0.04 to g = 0.18). In addition, multi-modal CAs were more effective than single-modality CAs in reducing depressive symptoms (g = 0.82, 95% CI 0.54-1.09). Younger age was associated with a greater reduction in depressive symptoms (β = -0.02, P < 0.05).
Conclusions:
These findings underscored the potential of CBT-based AI-driven CAs in addressing certain mental health issues and in certain populations.
Citation
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Copyright
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