Abstract
Conversational agents or chatbots are a novel, highly accessible, and low-resource method of psychological intervention delivery. The present research aims to compare two brief chatbot interventions that delivered cognitive restructuring and defusion interventions, respectively. It was hypothesized that a defusion chatbot would lead to reduced cognitive fusion and decreased thought believability relative to cognitive restructuring and a nonactive control. Participants (N = 223; M age of 28.01 [SD = 10.29]; 47 identified as male, 174 as female, and 2 as nonbinary) were randomized into one of three conditions (defusion, restructuring, control), engaged for 5 days completing thought and mood measures pre- and postintervention. Sixty-two participants (M age of 25.98; SD = 8.647 years) completed measures again at time 2 (49 identified as female, 12 as male, and 1 as nonbinary). No statistically significant differences were observed among groups on believability of thoughts (F[2, 25] = .79, p = .47, ηp2 = .06), negativity of thoughts (F[2,25] = 1.49, p = .25, η 2 = .11), discomfort associated with thoughts (F[2, 25] = .48, p = .62, ηp2 = .04), and willingness (F[2, 25] = 3.00, p = .07, ηp2 = .19) to have negative self-referential thoughts. Moreover, substantial attrition of 72% was observed. Acceptability and usability of the chatbots employed are discussed as contributing toward the limited effectiveness of interventions and elevated attrition. Various recommendations are presented to support researchers and clinicians in developing engaging and effective chatbots.
Highlights
Conversational agents or chatbots are a novel, highly accessible, and low-resource method of psychological intervention delivery
We compared the effectiveness of two chatbot-delivered interventions to a nonactive control group
It was predicted that the defusion intervention would lead to significantly reduced believability of thoughts and increased willingness to experience and comfort with thoughts relative to both cognitive restructuring and nonactive control while restructuring would significantly reduce negativity of thoughts relative to defusion and control
Summary
Conversational agents or chatbots are a novel, highly accessible, and low-resource method of psychological intervention delivery. Participants (N = 223; M age of 28.01 [SD = 10.29]; 47 identified as male, 174 as female, and 2 as nonbinary) were randomized into one of three conditions (defusion, restructuring, control), engaged for 5 days completing thought and mood measures pre- and postintervention. Cognitive models of psychopathology have long asserted the involvement of negative selfrelevant cognitions, negative cognitions pertaining to the future, and negative appraisals of past events (Beck et al, 1976; Clark & Rhyno, 2005) Such thoughts have been posited to be involved in the onset of myriad psychological conditions including depression, anxiety, psychosis, and body image difficulties (Clark & Rhyno, 2005). Unlike CBT, which aims to reduce negativity and frequency of cognitions, ACT draws upon defusion to alter the relationship with a negative self-referential thought
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