Literature DB >> 36150049

A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study.

Yenushka Goonesekera1, Liesje Donkin1,2.   

Abstract

BACKGROUND: An increase in health anxiety was observed during the COVID-19 pandemic. However, due to physical distancing restrictions and a strained mental health system, people were unable to access support to manage health anxiety. Chatbots are emerging as an interactive means to deliver psychological interventions in a scalable manner and provide an opportunity for novel therapy delivery to large groups of people including those who might struggle to access traditional therapies.
OBJECTIVE: The aim of this mixed methods pilot study was to investigate the feasibility, acceptability, engagement, and effectiveness of a cognitive behavioral therapy (CBT)-based chatbot (Otis) as an early health anxiety management intervention for adults in New Zealand during the COVID-19 pandemic.
METHODS: Users were asked to complete a 14-day program run by Otis, a primarily decision tree-based chatbot on Facebook Messenger. Health anxiety, general anxiety, intolerance of uncertainty, personal well-being, and quality of life were measured pre-intervention, postintervention, and at a 12-week follow-up. Paired samples t tests and 1-way ANOVAs were conducted to investigate the associated changes in the outcomes over time. Semistructured interviews and written responses in the self-report questionnaires and Facebook Messenger were thematically analyzed.
RESULTS: The trial was completed by 29 participants who provided outcome measures at both postintervention and follow-up. Although an average decrease in health anxiety did not reach significance at postintervention (P=.55) or follow-up (P=.08), qualitative analysis demonstrated that participants perceived benefiting from the intervention. Significant improvement in general anxiety, personal well-being, and quality of life was associated with the use of Otis at postintervention and follow-up. Anthropomorphism, Otis' appearance, and delivery of content facilitated the use of Otis. Technical difficulties and high performance and effort expectancy were, in contrast, barriers to acceptance and engagement of Otis.
CONCLUSIONS: Otis may be a feasible, acceptable, and engaging means of delivering CBT to improve anxiety management, quality of life, and personal well-being but might not significantly reduce health anxiety. ©Yenushka Goonesekera, Liesje Donkin. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.10.2022.

Entities:  

Keywords:  COVID-19; anthropomorphism; conversational agent; health anxiety; iCBT; illness anxiety disorder; user experience

Year:  2022        PMID: 36150049      PMCID: PMC9586257          DOI: 10.2196/37877

Source DB:  PubMed          Journal:  JMIR Form Res        ISSN: 2561-326X


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