TY  - JOUR
AU  - Habicht, Johanna
AU  - Dina, Larisa-Maria
AU  - McFadyen, Jessica
AU  - Stylianou, Mona
AU  - Harper, Ross
AU  - Hauser, Tobias U
AU  - Rollwage, Max
PY  - 2025
DA  - 2025/3/10
TI  - Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
JO  - J Med Internet Res
SP  - e60435
VL  - 27
KW  - artificial intelligence
KW  - National Health Service
KW  - NHS Talking Therapies
KW  - mental health
KW  - therapy support tool
KW  - cognitive behavioral therapy
KW  - CBT
KW  - chatbot
KW  - conversational agent
KW  - clinical
KW  - patient engagement
KW  - therapist
KW  - treatment
KW  - medication
KW  - depression
KW  - anxiety disorder
KW  - exercise
KW  - observational study
KW  - control group
KW  - patient adherence
AB  - Background: Cognitive behavioral therapy (CBT) is a highly effective treatment for depression and anxiety disorders. Nonetheless, a substantial proportion of patients do not respond to treatment. The lack of engagement with therapeutic materials and exercises between sessions, a necessary component of CBT, is a key determinant of unsuccessful treatment. Objective: The objective of this study was to test whether the deployment of a generative artificial intelligence (AI)–enabled therapy support tool, which helps patients to engage with therapeutic materials and exercises in between sessions, leads to improved treatment success and patient treatment adherence compared with the standard delivery of CBT exercises through static workbooks. Methods: We conducted a real-world observational study of 244 patients receiving group-based CBT in 5 of the United Kingdom’s National Health Service Talking Therapies services, comparing 150 (61.5%) patients who used the AI-enabled therapy support tool to 94 (38.5%) patients who used the standard delivery of CBT exercises. The groups were equivalent with respect to the content of the CBT materials and the human-led therapy sessions; however, the intervention group received support from the AI-enabled therapy support tool in conducting CBT exercises. Results: Patients using the AI-enabled therapy support tool exhibited greater attendance at therapy sessions and fewer dropouts from treatment. Furthermore, these patients demonstrated higher reliable improvement, recovery, and reliable recovery rates when compared to the control group, which was related to the degree of use of the AI-enabled therapy support tool. Moreover, we found that engagement with AI-supported CBT interventions, relative to psychoeducational materials, predicted better treatment adherence and treatment success, highlighting the role of personalization in the intervention’s effectiveness. To investigate the mechanisms of these effects further, we conducted a separate qualitative experiment in a nonclinical sample of users (n=113). Results indicated that users perceived the AI-enabled therapy support tool as most useful for discussing their problems to gain awareness and clarity of their situation as well as learning how to apply coping skills and CBT techniques in their daily lives. Conclusions: Our results show that an AI-enabled, personalized therapy support tool in combination with human-led group therapy is a promising avenue to improve the efficacy of and adherence to mental health care. 
SN  - 1438-8871
UR  - https://www.jmir.org/2025/1/e60435
UR  - https://doi.org/10.2196/60435
UR  - http://www.ncbi.nlm.nih.gov/pubmed/40063074
DO  - 10.2196/60435
ID  - info:doi/10.2196/60435
ER  -