Bot to the Rescue? Effects of a Fully Automated Conversational Agent on Anxiety and Depression: A Randomized Controlled Trial

Abstract

Web-based conversational agents powered by Artificial Intelligence (AI) and rooted in cognitive-behavioral therapy have been proven efficacious in alleviating the symptoms of anxiety and depression, when compared to passive controls. However, the benefits of a fully automated agent vs. active controls have not yet been examined. Furthermore, the potential impact of such interventions on the transdiagnostic factors underlying anxiety and depression is not known. To elucidate this, 95 adults were randomized to receive (1) a 2-week intervention with an AI-powered chatbot (Woebot) (n=39) or (2) regular psychoeducational materials (n=54). In completers’ analyses, significant main effects of time were obtained for one of the primary outcomes, anxiety, and for the secondary outcomes, transdiagnostic factors, with both groups showing decreased anxiety and intolerance of uncertainty and increased rumination, selfcompassion, guilt and shame. No group by time interaction effects were found for either of the primary outcomes, depression and anxiety, or for the secondary outcomes. Intent-to-Treat analyses also revealed no significant effects of group on the primary or secondary outcomes. Our findings point to the necessity of further research to better understand the areas where chatbots might bring benefits superior to those obtained through simple and inexpensive strategies.