Accepted for/Published in: JMIR Mental Health
Date Submitted: Mar 27, 2019
Date Accepted: Jul 18, 2019
Relational agents in the treatment of mental health problems: A mixed methods systematic review
ABSTRACT
Background:
The use of relational agent interventions in mental health is growing at pace. Recent existing reviews have focussed exclusively on a subset of embodied relational agent interventions despite other modalities aiming to achieve the common goal of improved mental health.
Objective:
This study aimed to review the use of relational agent interventions in the treatment of mental health problems.
Methods:
A systematic search was performed using relevant databases (MEDLINE, EMBASE, PsycINFO, Web of Science and Cochrane library). Studies were included if they reported on an autonomous relational agent that simulated conversation and reported on a mental health outcome.
Results:
A total of 13 studies were included in the review. Four full-scale 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. Controlled studies demonstrated significant reductions in psychological distress compared to control conditions. Broader utility in promoting wellbeing in non-clinical populations was unclear.
Conclusions:
The efficacy and acceptability of relational agent interventions for mental health problems is promising. However, 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 maximise reach. Clinical Trial: The protocol for this systematic review was registered at PROSPERO. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=106652 Registration number: CRD42018106652
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