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Wrightson-Hester AR, Anderson G, Dunstan J, McEvoy PM, Sutton CJ, Myers B, Egan S, Tai S, Johnston-Hollitt M, Chen W, Gedeon T, Mansell W. An Artificial Therapist (Manage Your Life Online) to Support the Mental Health of Youth: Co-Design and Case Series. JMIR Hum Factors 2023; 10:e46849. [PMID: 37477969 PMCID: PMC10403793 DOI: 10.2196/46849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/26/2023] [Accepted: 06/17/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The prevalence of child and adolescent mental health issues is increasing faster than the number of services available, leading to a shortfall. Mental health chatbots are a highly scalable method to address this gap. Manage Your Life Online (MYLO) is an artificially intelligent chatbot that emulates the method of levels therapy. Method of levels is a therapy that uses curious questioning to support the sustained awareness and exploration of current problems. OBJECTIVE This study aimed to assess the feasibility and acceptability of a co-designed interface for MYLO in young people aged 16 to 24 years with mental health problems. METHODS An iterative co-design phase occurred over 4 months, in which feedback was elicited from a group of young people (n=7) with lived experiences of mental health issues. This resulted in the development of a progressive web application version of MYLO that could be used on mobile phones. We conducted a case series to assess the feasibility and acceptability of MYLO in 13 young people over 2 weeks. During this time, the participants tested MYLO and completed surveys including clinical outcomes and acceptability measures. We then conducted focus groups and interviews and used thematic analysis to obtain feedback on MYLO and identify recommendations for further improvements. RESULTS Most participants were positive about their experience of using MYLO and would recommend MYLO to others. The participants enjoyed the simplicity of the interface, found it easy to use, and rated it as acceptable using the System Usability Scale. Inspection of the use data found evidence that MYLO can learn and adapt its questioning in response to user input. We found a large effect size for the decrease in participants' problem-related distress and a medium effect size for the increase in their self-reported tendency to resolve goal conflicts (the proposed mechanism of change) in the testing phase. Some patients also experienced a reliable change in their clinical outcome measures over the 2 weeks. CONCLUSIONS We established the feasibility and acceptability of MYLO. The initial outcomes suggest that MYLO has the potential to support the mental health of young people and help them resolve their own problems. We aim to establish whether the use of MYLO leads to a meaningful reduction in participants' symptoms of depression and anxiety and whether these are maintained over time by conducting a randomized controlled evaluation trial.
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Affiliation(s)
- Aimee-Rose Wrightson-Hester
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | | | - Joel Dunstan
- Curtin Institute for Data Science, Curtin University, Perth, Australia
| | - Peter M McEvoy
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Nedlands, Australia
| | - Christopher J Sutton
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Parow, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sarah Egan
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sara Tai
- Department of Clinical Psychology, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | | | - Wai Chen
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Mental Health Service, Fiona Stanley Hospital, Perth, Australia
- Curtin Medical School, Curtin University, Perth, Australia
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Tom Gedeon
- Optus-Curtin Centre of Excellence in AI, School of Electronic Engineering, Computing and Mathematical Sciences, Curtin University, Perth, Australia
| | - Warren Mansell
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Department of Clinical Psychology, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
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