Published on in Vol 25 (2023)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/43862, first published .
Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials

Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials

Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials

Journals

  1. Garcia Valencia O, Suppadungsuk S, Thongprayoon C, Miao J, Tangpanithandee S, Craici I, Cheungpasitporn W. Ethical Implications of Chatbot Utilization in Nephrology. Journal of Personalized Medicine 2023;13(9):1363 View
  2. Swartz H. Artificial Intelligence (AI) Psychotherapy: Coming Soon to a Consultation Room Near You?. American Journal of Psychotherapy 2023;76(2):55 View
  3. Grodniewicz J, Hohol M. Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence. Frontiers in Psychiatry 2023;14 View
  4. Balcombe L. AI Chatbots in Digital Mental Health. Informatics 2023;10(4):82 View
  5. Moons P. For better or for worse: when chatbots influence human emotions and behaviours. European Journal of Cardiovascular Nursing 2024;23(5):e49 View
  6. Kiuchi K, Otsu K, Hayashi Y. Psychological insights into the research and practice of embodied conversational agents, chatbots and social assistive robots: a systematic meta-review. Behaviour & Information Technology 2024;43(15):3696 View
  7. Ulrich S, Gantenbein A, Zuber V, Von Wyl A, Kowatsch T, Künzli H. Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial. Journal of Medical Internet Research 2024;26:e50132 View
  8. Li H, Zhang R, Lee Y, Kraut R, Mohr D. Systematic review and meta-analysis of AI-based conversational agents for promoting mental health and well-being. npj Digital Medicine 2023;6(1) View
  9. Linardon J, Torous J, Firth J, Cuijpers P, Messer M, Fuller‐Tyszkiewicz M. Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta‐analysis of 176 randomized controlled trials. World Psychiatry 2024;23(1):139 View
  10. Herbener A, Klincewicz M, Damholdt M. A narrative review of the active ingredients in psychotherapy delivered by conversational agents. Computers in Human Behavior Reports 2024;14:100401 View
  11. Grodniewicz J, Hohol M. Therapeutic Chatbots as Cognitive-Affective Artifacts. Topoi 2024;43(3):795 View
  12. Ramos G, Hernandez-Ramos R, Taylor M, Schueller S. State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services. Behavior Therapy 2024;55(6):1364 View
  13. Laymouna M, Ma Y, Lessard D, Schuster T, Engler K, Lebouché B. Roles, Users, Benefits, and Limitations of Chatbots in Health Care: Rapid Review. Journal of Medical Internet Research 2024;26:e56930 View
  14. Zhong W, Luo J, Zhang H. The therapeutic effectiveness of artificial intelligence-based chatbots in alleviation of depressive and anxiety symptoms in short-course treatments: A systematic review and meta-analysis. Journal of Affective Disorders 2024;356:459 View
  15. Ferrario A, Sedlakova J, Trachsel M. The Role of Humanization and Robustness of Large Language Models in Conversational Artificial Intelligence for Individuals With Depression: A Critical Analysis. JMIR Mental Health 2024;11:e56569 View
  16. Chen J, Li C, An K, Dong X, Liu J, Wu H. Effectiveness of telemedicine on common mental disorders: An umbrella review and meta-meta-analysis. Computers in Human Behavior 2024;159:108325 View
  17. Ulrich S, Lienhard N, Künzli H, Kowatsch T. A Chatbot-Delivered Stress Management Coaching for Students (MISHA App): Pilot Randomized Controlled Trial. JMIR mHealth and uHealth 2024;12:e54945 View
  18. Sari A, Widiyarta A. Efektivitas Program Perpustakaan Digital “dJatim” Pada Provinsi Jawa Timur. Indonesian Journal of Public Administration Review 2024;1(4):11 View
  19. Wu P, Summers C, Panesar A, Kaura A, Zhang L. AI Hesitancy and Acceptability—Perceptions of AI Chatbots for Chronic Health Management and Long COVID Support: Survey Study. JMIR Human Factors 2024;11:e51086 View
  20. Khorev V, Kiselev A, Badarin A, Antipov V, Drapkina O, Kurkin S, Hramov A. Review on the use of AI-based methods and tools for treating mental conditions and mental rehabilitation. The European Physical Journal Special Topics 2024 View
  21. Heissler R, Jonáš J, Carre N, Mostovoy K, Bunge E, McDaniel B. Can AI Digital Personas for Well‐Being Provide Social Support? A Mixed‐Method Analysis of User Reviews. Human Behavior and Emerging Technologies 2024;2024(1) View
  22. Sanjeewa R, Iyer R, Apputhurai P, Wickramasinghe N, Meyer D. Empathic Conversational Agent Platform Designs and Their Evaluation in the Context of Mental Health: Systematic Review. JMIR Mental Health 2024;11:e58974 View
  23. Roehrer E, Pokawinkoon P, Watters P, Sauer J, Scanlan J. Adolescent-Centric Design of an Online Safety Chatbot. Journal of Computer Information Systems 2024:1 View
  24. Yu H, Fan L, Li L, Zhou J, Ma Z, Xian L, Hua W, He S, Jin M, Zhang Y, Gandhi A, Ma X. Large Language Models in Biomedical and Health Informatics: A Review with Bibliometric Analysis. Journal of Healthcare Informatics Research 2024;8(4):658 View
  25. Kotov A, Idalski Carcone A, Towner E. Neural Conversational Agent for Weight Loss Counseling: Protocol for an Implementation and Feasibility Study. JMIR Research Protocols 2024;13:e60361 View
  26. Frischholz K, Tanaka H, Shidara K, Onishi K, Nakamura S. Examining the Effects of Cognitive Behavioral Therapy With a Virtual Agent on User Motivation and Improvement in Psychological Distress and Anxiety: Two-Session Experimental Study. JMIR Formative Research 2024;8:e55234 View
  27. Siddals S, Torous J, Coxon A. “It happened to be the perfect thing”: experiences of generative AI chatbots for mental health. npj Mental Health Research 2024;3(1) View
  28. Asanov A, Asanov I, Buenstorf G. A low-cost digital first aid tool to reduce psychological distress in refugees: A multi-country randomized controlled trial of self-help online in the first months after the invasion of Ukraine. Social Science & Medicine 2024;362:117442 View
  29. Zhang Z, Wang J. Can AI replace psychotherapists? Exploring the future of mental health care. Frontiers in Psychiatry 2024;15 View
  30. Yuan J, Peng X, Liu Y, Wang Q. “Don't look at me!”: The role of avatars' presentation style and gaze direction in social chatbot design. Computers in Human Behavior 2025;164:108501 View
  31. Langhammer T, Hilbert K, Wasenmueller R, Praxl B, Ertle A, Asbrand J, Lueken U, Liu X. Evaluation of a CBT‐Based Program for Mental Health in the General Population During the COVID‐19 Pandemic: A Stepped‐Care Approach Using a Chatbot and Digitized Group Intervention. Depression and Anxiety 2024;2024(1) View
  32. Koltcov S, Surkov A, Koltsova O, Ignatenko V. Using large language models for extracting and pre-annotating texts on mental health from noisy data in a low-resource language. PeerJ Computer Science 2024;10:e2395 View
  33. Leung W, Lam S, Ng F, Yip C, Chan C. Effectiveness of chatbot-based interventions on mental well-being of the general population in Asia: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Health & Care Informatics 2024;31(1):e101148 View
  34. Foran H, Kubb C, Mueller J, Poff S, Ung M, Li M, Smith E, Akinyemi A, Kambadur M, Waller F, Graf M, Boureau Y. An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial. Journal of Medical Internet Research 2024;26:e53829 View
  35. Park J, Singh V, Wisniewski P. Current Landscape and Future Directions for Mental Health Conversational Agents for Youth: Scoping Review. JMIR Medical Informatics 2025;13:e62758 View
  36. Yang Q, Cheung K, Zhang Y, Zhang Y, Qin J, Xie Y. Conversational agents in physical and psychological symptom management: A systematic review of randomized controlled trials. International Journal of Nursing Studies 2025;163:104991 View
  37. Sobowale K, Humphrey D. Evaluating the Quality of Psychotherapy Conversational Agents: Framework Development and Cross-Sectional Study. JMIR Formative Research 2025;9:e65605 View
  38. Rządeczka M, Sterna A, Stolińska J, Kaczyńska P, Moskalewicz M. The Efficacy of Conversational AI in Rectifying the Theory-of-Mind and Autonomy Biases: Comparative Analysis. JMIR Mental Health 2025;12:e64396 View
  39. Tekin Ş, Delehanty M. Beyond Doomsday Fears: Why We Need to Consider the Potential Harms of AI Psychotherapy. The American Journal of Bioethics 2025:1 View
  40. Wu X, Liew K, Dorahy M. Trust, Anxious Attachment, and Conversational AI Adoption Intentions in Digital Counseling: A Preliminary Cross-Sectional Questionnaire Study. JMIR AI 2025;4:e68960 View
  41. Escoredo M, Mostovoy K, Schickler R, Bechtel A, Shagan J, Bunge E. Enhancing parental skills through artificial intelligence‐based conversational agents: The PAT Initiative. Family Relations 2025;74(3):1250 View
  42. MacNeill A, Luke A, Doucet S. Individual differences in views toward healthcare conversational agents: A cross-sectional survey study. DIGITAL HEALTH 2025;11 View
  43. Rony M, Das D, Khatun M, Ferdousi S, Akter M, Khatun M, Begum M, Khalil M, Parvin M, Alrazeeni D, Akter F. Artificial intelligence in psychiatry: A systematic review and meta-analysis of diagnostic and therapeutic efficacy. DIGITAL HEALTH 2025;11 View
  44. Feng Y, Hang Y, Wu W, Song X, Xiao X, Dong F, Qiao Z. Effectiveness of AI-Driven Conversational Agents in Improving Mental Health Among Young People: Systematic Review and Meta-Analysis. Journal of Medical Internet Research 2025;27:e69639 View
  45. Wang R, Zhang X, Zhu L, Teng H, Zhang D, Qiu B. The Double-Edged Sword Effect of Empathic Concern on Mental Health and Behavioral Outcomes: The Mediating Role of Excessive Adaptation. Behavioral Sciences 2025;15(4):463 View
  46. Huang Y, Wang W, Zhou J, Zhang L, Lin J, Liu H, Hu X, Zhou Z, Dong W. Integrative modeling enables ChatGPT to achieve average level of human counselors performance in mental health Q&A. Information Processing & Management 2025;62(5):104152 View
  47. Zhang Z, Sun S, Moradbakhti L, Hall A, Mougenot C, Chen J, Calvo R. Health Care Professionals' Engagement With Digital Mental Health Interventions in the United Kingdom and China: Mixed Methods Study on Engagement Factors and Design Implications. JMIR Mental Health 2025;12:e67190 View
  48. Teo J, Yoong S, Chan Y, Jiang Y. The Effects of Commercial Conversational Agents on Older Adults’ Mental Health: A Scoping Review. Journal of the American Medical Directors Association 2025;26(6):105523 View
  49. Torous J, Linardon J, Goldberg S, Sun S, Bell I, Nicholas J, Hassan L, Hua Y, Milton A, Firth J. The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality. World Psychiatry 2025;24(2):156 View
  50. Sharp G, Dwyer B, Randhawa A, McGrath I, Hu H. The Effectiveness of a Chatbot Single-Session Intervention for People on Waitlists for Eating Disorder Treatment: Randomized Controlled Trial. Journal of Medical Internet Research 2025;27:e70874 View
  51. Bal F. Artificial Intelligence and Psychotherapy. Psikiyatride Güncel Yaklaşımlar 2025;17(4):643 View
  52. Hipgrave L, Goldie J, Dennis S, Coleman A. Balancing risks and benefits: clinicians’ perspectives on the use of generative AI chatbots in mental healthcare. Frontiers in Digital Health 2025;7 View
  53. Guglielmucci F, Di Basilio D. Predicting Engagement With Conversational Agents in Mental Health Therapy by Examining the Role of Epistemic Trust, Personality, and Fear of Intimacy: Cross-Sectional Web-Based Survey Study. JMIR Human Factors 2025;12:e70698 View
  54. Semenova N, Martynyuk K. Classification of risks of using artificial intelligence systems in the field of mental health. Медицинская этика 2025;(2025(2)) View
  55. Mayor E. Chatbots and mental health: a scoping review of reviews. Current Psychology 2025;44(15):13619 View
  56. Pareek S, Jain G. Perceived Authorship and Conversational Evaluations: A Study on AI-Generated vs. Human Therapist Dialogue. Journal of Technology in Behavioral Science 2025 View
  57. Li J, Li Y, Hu Y, Ma D, Mei X, Chan E, Yorke J. Chatbot‐Delivered Interventions for Improving Mental Health Among Young People: A Systematic Review and Meta‐Analysis. Worldviews on Evidence-Based Nursing 2025;22(4) View
  58. Sedlakova J, Lucivero F, Pavarini G, Kerasidou A. Human-Like Epistemic Trust? A Conceptual and Normative Analysis of Conversational AI in Mental Healthcare. The American Journal of Bioethics 2025:1 View
  59. Dong W, Wang W, Han X, Huang J, Li L, Huang Y. Can GPT-4 provide human-level emotion support? Insights from machine learning-based evaluation framework. Computers in Biology and Medicine 2025;196:110789 View
  60. Reilly E, Grigorian H, Heapy A, Etingen B, Kelly M, Wolkowicz N, Girouard C, Hogan T, Bernice K, Bickmore T. Assessment of Two Online Interventions for Veterans With Chronic Pain: Protocol for a Randomized Controlled Efficacy Trial. JMIR Research Protocols 2025;14:e70601 View
  61. Sha S, Loveys K, Francis I, Ji E, Lyu L, Krpan D, Galizzi M, Taylor M. Self-disclosure and relational agents for mental health: a scoping review protocol. BMJ Open 2025;15(8):e100613 View
  62. Fukuoka Y, Kim D, Zhang J, Hoffmann T, DeVon H, Sagae K. AI HeartBot to Increase Women’s Awareness and Knowledge of Heart Attacks: Nonrandomized, Quasi-Experimental Study. JMIR Cardio 2025;9:e80407 View
  63. Zhao Y, Qian W, Chen Y, Wu D, Luo Y, Gao C, Wu K, Liu Z. Effect of an AI agent trained on a large language model (LLM) as an intervention for depression and anxiety symptoms in young adults: A 28‐day randomized controlled trial. Applied Psychology: Health and Well-Being 2025;17(5) View
  64. Kabrel N. When can AI psychotherapy be considered comparable to human psychotherapy? Exploring the criteria. Frontiers in Psychiatry 2025;16 View
  65. Vowels L, Vowels M, Sweeney S, Hatch S, Darwiche J, Li L. The efficacy, feasibility, and technical outcomes of a GPT-4o-based chatbot Amanda for relationship support: A randomized controlled trial. PLOS Mental Health 2025;2(9):e0000411 View
  66. Zhang R, Meng H, Neubronner M, Lee Y. Computational and ethical considerations for using large language models in psychotherapy. Nature Computational Science 2025;5(10):854 View
  67. Huys Q, Browning M. Trials for computational psychiatry. Nature Computational Science 2025;5(10):841 View
  68. Lee C, Joung E, Koh Y, Kim E, Son S, Kwon S, Lee U. 'In That Small Space with Just the Two of Us': User Experiences with Cumpa in a Robotic Counseling Center. Proceedings of the ACM on Human-Computer Interaction 2025;9(7):1 View
  69. Albers N, Neerincx M, Brinkman W. Reinforcement learning for proposing smoking cessation activities that build competencies: Combining two worldviews in a virtual coach. BMC Medical Informatics and Decision Making 2025;25(1) View
  70. Kim D, Zhang J, Sagae K, Devon H, Hoffmann T, Rountree L, Fukuoka Y. Human-Delivered Conversation Versus AI Chatbot Conversation in Increasing Heart Attack Knowledge in Women in the United States: Quasi-Experimental Studies. Journal of Medical Internet Research 2025;27:e73184 View
  71. Lim S, Yang Q, Meng J, Rains S. The role of communication in health-focused conversational AI: a review of systematic reviews examining conversational features, design characteristics, and interaction functions. Behaviour & Information Technology 2025:1 View
  72. Qin J, Nan Y, Li Z, Meng J. Effectiveness of Communication Competence in AI Conversational Agents for Health: Systematic Review and Meta-Analysis. Journal of Medical Internet Research 2025;27:e76296 View
  73. Hessel H, Hynes K, He Y, Gizzi S. A Framework for Ethical Considerations in the Integration of AI and Systemic Therapy. International Journal of Systemic Therapy 2025:1 View
  74. Zhang Q, Zhang R, Xiong Y, Sui Y, Tong C, Lin F. Generative AI Mental Health Chatbots as Therapeutic Tools: A Systematic Review and Meta-Analysis of their Role in Reducing Mental Health Issues (Preprint). Journal of Medical Internet Research 2025 View
  75. Suzuki H, Zhang J, Kim D, Sagae K, DeVon H, Fukuoka Y. AI or Human? Message Humanness Predicts Perceiving AI as Human: A Secondary Data Analysis of the HeartBot Study (Preprint). JMIR AI 2024 View
  76. Romeo V. Immersive Virtual Reality Environments as Psychoanalytic Settings: A Conceptual Framework for Modeling Unconscious Processes Through IoT-Based Bioengineering Interfaces. Bioengineering 2025;12(11):1257 View
  77. Feng X, Tian L, Ho G, Yorke J, Hui V. The Effectiveness of AI Chatbots in Alleviating Mental Distress and Promoting Health Behaviors Among Adolescents and Young Adults: Systematic Review and Meta-Analysis. Journal of Medical Internet Research 2025;27:e79850 View
  78. Herbener A, Damholdt M. A theoretical framework of the processes of change in mental health interventions delivered by artificial therapists. Journal of Psychology and AI 2025;1(1) View
  79. Turner S, Yadav P, Morrin H, Bhat A. The future of psychiatry: clinical practice, diagnosis, and treatment. International Review of Psychiatry 2025:1 View
  80. Huynh A, Roy T, Jackson K, Lee A, Liaw W, Hossain M. Applications of artificial intelligence-based conversational agents in healthcare: A systematic umbrella review. International Journal of Medical Informatics 2026;207:106204 View

Books/Policy Documents

  1. de Bruijn G, Jabeen F, Bosse T. The Handbook of Mental Health Communication. View
  2. Zimmer C, Kruse L, Rolvien L, Gallinat J, Geiger C. Extended Reality. View
  3. Vieira Sousa J, Campos P, Bala P. Interactive Storytelling. View

Conference Proceedings

  1. Vieira Sousa J, Campos P, Bala P. Proceedings of the 27th International Academic Mindtrek Conference. College Tales: Pilot Study on Large Language Models Generated Narratives for Mental Health Literacy View
  2. Fang C, Guo F, Belpaeme T. 2025 34th IEEE International Conference on Robot and Human Interactive Communication (RO-MAN). How Conversation Type and Presumed Message Source Influence Users’ Trust towards Mental Health Conversational Agents: The Mediator Effect of Intentional Stance View
  3. di Bona K, Ijaz K, Ahmadpour N. Proceedings of the 37th Australian Conference on Human-Computer Interaction. "AI that’s so good it almost seems human:" Risk and Hype Cycles of AI and Chatbots in Mobile Mental Health Apps View
  4. Shao S, Qin X, Wu S, Lin G, Zhang Y, Chen L. 2025 International Joint Conference on Neural Networks (IJCNN). FEMA: Emotion-Driven Personification in Generative Agents View