Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial

Summary & key facts

This small randomized trial tested a fully automated text-based conversational agent called Woebot as a way to deliver cognitive behavioral therapy to college-age young adults with symptoms of depression and anxiety. Over 2 weeks, the Woebot group (n=34) showed a statistically larger drop in depression scores (PHQ-9) than an information-only control group (n=36). Participants used Woebot often, the study had low drop-out, and the authors say conversational agents appear feasible, engaging, and potentially effective, but the trial was short and preliminary and one author had a financial interest in the Woebot company.

Key facts:

• Total randomized participants: 70 young adults aged 18–28 (mean age 22.2, SD 2.33).
• Randomization: 34 participants were assigned to Woebot and 36 to an information-only control (NIMH ebook).
• Intervention length: 2 weeks, with up to 20 possible text-based sessions; Woebot users averaged 12.14 sessions (SD 2.23).
• Follow-up data were available for 83% of participants (58/70), so attrition was 17%.
• Depression outcome (PHQ-9): intent-to-treat analysis showed a significant group difference favoring Woebot (F=6.47; P=.01).
• Anxiety outcome (GAD-7): in completer analysis both groups showed significant reductions in anxiety (F(1,54)=9.24; P=.004).
• Participant makeup: 67% female (47/70); of 58 respondents reporting ethnicity/race, 93% were non-Hispanic (54/58) and 79% were Caucasian (46/58).
• Conflict of interest: the second author is the founder of Woebot Labs Inc., which created the intervention, and that company covered participant incentives.

Abstract

Conversational agents appear to be a feasible, engaging, and effective way to deliver CBT.

Topics

Digital Mental Health Interventions Impact of Technology on Adolescents Mental Health Research Topics

Categories

Applied Psychology Psychology Social Sciences

Tags

Anxiety Clinical psychology Cognitive behavioral therapy Depression (economics) Economics Internal medicine Macroeconomics Medicine Psychiatry Psychology Randomized controlled trial