Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study

BackgroundCognitive 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,...

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Main Authors: Johanna Habicht, Larisa-Maria Dina, Jessica McFadyen, Mona Stylianou, Ross Harper, Tobias U Hauser, Max Rollwage
Format: Article
Language:English
Published: JMIR Publications 2025-03-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e60435
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author Johanna Habicht
Larisa-Maria Dina
Jessica McFadyen
Mona Stylianou
Ross Harper
Tobias U Hauser
Max Rollwage
author_facet Johanna Habicht
Larisa-Maria Dina
Jessica McFadyen
Mona Stylianou
Ross Harper
Tobias U Hauser
Max Rollwage
author_sort Johanna Habicht
collection DOAJ
description BackgroundCognitive 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. ObjectiveThe 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. MethodsWe 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. ResultsPatients 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. ConclusionsOur 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.
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spelling doaj-art-b5fe0d69636d4f3ab62679a099f4e63f2025-08-20T01:57:34ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-03-0127e6043510.2196/60435Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational StudyJohanna Habichthttps://orcid.org/0000-0001-5043-7129Larisa-Maria Dinahttps://orcid.org/0000-0002-2530-2983Jessica McFadyenhttps://orcid.org/0000-0003-1415-2286Mona Stylianouhttps://orcid.org/0009-0008-2268-5019Ross Harperhttps://orcid.org/0000-0002-2403-2088Tobias U Hauserhttps://orcid.org/0000-0002-7997-8137Max Rollwagehttps://orcid.org/0000-0003-4181-3983 BackgroundCognitive 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. ObjectiveThe 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. MethodsWe 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. ResultsPatients 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. ConclusionsOur 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.https://www.jmir.org/2025/1/e60435
spellingShingle Johanna Habicht
Larisa-Maria Dina
Jessica McFadyen
Mona Stylianou
Ross Harper
Tobias U Hauser
Max Rollwage
Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
Journal of Medical Internet Research
title Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
title_full Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
title_fullStr Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
title_full_unstemmed Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
title_short Generative AI–Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study
title_sort generative ai enabled therapy support tool for improved clinical outcomes and patient engagement in group therapy real world observational study
url https://www.jmir.org/2025/1/e60435
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