The effect of personalizing a psychotherapy conversational agent on therapeutic bond and usage intentions

Abstract

While 33.6% of college students suffer from mental health problems, only 24.6% of these students with symptoms would seek professional help due to their personal attitudes or costs associated with therapy. Psychotherapy chatbots may offer a solution as they are always available, anonymous, and cost-effective. Research has shown that these chatbots can significantly reduce symptoms of anxiety and depression. However, there is a lack of understanding about the personalization preferences of users and the effects of personalization on health outcomes. To investigate this, we developed a personalizable psychotherapy chatbot designed to provide personalized help. In a randomized controlled trial (n = 54), participants were either assigned to a personalizable condition or a non-personalizable control condition. After 1 week of usage, participants had a significantly higher therapeutic bond with the personalized version compared to the baseline. In fact, the therapeutic bond was similar to that between a psychologist and his client. This is a promising result, as a high therapeutic bond has been linked to therapeutic success in psychotherapy. Participants reported that the therapy style, personality, and avatar were the most important personalizable aspects of the chatbot. Participants also liked the chatbot's usage of their name and the transparency about what the chatbot had learned about them. These features are likely important for establishing a strong therapeutic bond with users. However, the ability to personalize the chatbot had no impact on the usage intentions of the participants. This can be explained by the fact that users from both conditions equally reported that the chatbot was able to help them with their mental health. 53 participants also indicated that they would be willing to use a psychotherapy chatbot when integrated with a human therapist. These findings indicate the potential of psychotherapy chatbots and the need for further research on their integration with traditional psychotherapy.