A digital therapeutic alliance in digital mental health

Kaveladze, Benjamin; Schueller, Stephen M.

doi:10.1016/b978-0-323-90045-4.00009-5

Cited by 2 publications

(3 citation statements)

References 38 publications

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“…For example, a large meta‐analysis of over 30,000 patients found that a strong therapeutic alliance was associated with moderate to large effects on clinical outcomes even after accounting for intervention modality, assessment type, and who completed the assessments (Flückiger et al., 2018). Because less is known about the digital therapeutic alliance (Kaveladze & Schueller, 2023), clinical and epidemiological studies will be required to more rigorously evaluate how therapist‐related factors are associated with the long‐term effectiveness of DMHIs that incorporate patient monitoring by licensed clinicians (Goldberg et al., 2022; Kessler & Luedtke, 2021).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal outcomes of a therapist‐supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study

Pettitt,

Nelson,

Forman‐Hoffman

et al. 2024

Psychol Psychother

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PurposeThis study examined treatment outcomes (depression and anxiety symptoms) up to 24 months after completion of a therapist‐supported digital mental health intervention (DMHI).MethodsThe sample consisted of 380 participants who participated in an eight‐week DMHI from February 6, 2017 to May 20, 2019. Participants reported depression and anxiety symptoms at eight timepoints from baseline to 24 months. Mixed‐effects modelling was used to investigate symptom changes over time. The proportion of participants meeting criteria for treatment response, clinically significant change, and remission of depression and anxiety symptoms were calculated, including proportions demonstrating each outcome sustained up to each timepoint.ResultsMultivariate analyses yielded statistically significant reductions in depression (β = −5.40) and anxiety (β = −3.31) symptoms from baseline to end of treatment (8 weeks). Symptom levels remained significantly reduced from baseline through 24 months. The proportion of participants meeting criteria for clinical treatment outcomes remained constant over 24 months, although there were linear decreases in the proportions experiencing sustained clinical outcomes.ConclusionsTreatment gains were made for depression and anxiety symptoms at the end of treatment and up to 24 months. Future studies should determine the feasibility of integrating post‐treatment programmes into DMHIs to address symptom deterioration.

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Section: Discussionmentioning

confidence: 99%

Longitudinal outcomes of a therapist‐supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study

Pettitt,

Nelson,

Forman‐Hoffman

et al. 2024

Psychol Psychother

View full text Add to dashboard Cite

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“…4 While it might be impossible to achieve a genuine therapeutic relationship (based on warmth, empathy, and acceptance) with a CAI, at least certain aspects of the therapeutic alliance might be reconstructed in an interaction with a chatbot. Thus, following Bordin ( 101 ), Kaveladze and Schueller ( 102 ) define the digital therapeutic alliance (DTA) as “ a user-perceived alliance (composed of a bond, agreement on the tasks directed toward improvement, and agreement on therapeutic goals)” [ emphasis added , pp. 88–89], which, at least to some extent, can occur in interaction with CAI.…”

Section: The Problem Of a Non-human Therapistmentioning

confidence: 99%

“…In general, there is now an increasing body of research on the digital therapeutic alliance, and its overall influence on the efficacy of help provided by mental health chatbots ( 51 , 52 , 54 , 56 , 102–112 ). These studies, including randomized controlled trials, reveal varying strengths of the effects: from small up to comparable or even outperforming these found in therapy delivered by humans (as measured on traditional scales designed for assessing the strength of working alliance formed between a client and a human therapist).…”

Section: The Problem Of a Non-human Therapistmentioning

confidence: 99%

Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence

Grodniewicz

Hohol

2023

Front. Psychiatry

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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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A digital therapeutic alliance in digital mental health

Cited by 2 publications

References 38 publications

Longitudinal outcomes of a therapist‐supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study

Longitudinal outcomes of a therapist‐supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study

Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence

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