Amid therapy waiting lists, the new AI Coach can be a faster solution
May 25, 2023 – The rise of artificial intelligence has drawn praise as well as anxiety and skepticism. However, researchers at the University of Illinois at Chicago and their colleagues have found that their use of artificial intelligence appears to be useful in treating anxiety and depression. And they hope it could soon help reduce the long waiting list for treatment.
In a pilot study, Researchers funded by the National Institute of Mental Health found that Lumen, an AI voice-based behavioral therapy virtual coach, changed patients’ brain activity and self-reported improvement in depression and anxiety symptoms.
“This is not a replacement [for a therapist] but it’s a stopgap measure,” said Olusola A. Ajilore, MD, PhD, professor of psychiatry at the University of Illinois at Chicago and co-author of the study. The app works to provide help as soon as possible after people contact it.
Ajilore said the waiting list for therapy at her school was eight months at the height of the epidemic. Depression and anxiety have increased since the beginning of the epidemic, and depression has increased by approx 32% among US adults by 2021, and by more than 40 million anxiety disorders, according to the National Association on Mental Illness.
In recent years, a number of AI-driven mental health programs have emerged that combine computing and data sets to solve problems, such as Wysawhich the company says has more than 5 million users; Replica, which aims to help people cope with stress; and mood quest, which, according to the developers, aims to help users overcome depression and anxiety.
One of the distinguishing features of the new app is the evidence linking clinical responses to brain imaging findings, Ajilore said. Although many such mental health applications have been developed, “high-quality clinical research on their therapeutic potential is currently lacking,” the researchers wrote.
Experimental study results
In the pilot study, 42 people with mild to moderate anxiety or depression used the app in eight sessions; another 21 were in the waiting list control group. The app, developed by Ajilore and colleagues, works as a skill for Amazon’s Alexa program.
Over eight sessions over 12 weeks (four times a week and then four times a fortnight), the people in the study, average age 37 and 68% female, used Lument via iPad to treat their anxiety or depression, using an approach called problem-solving treatment . . All 63 patients underwent brain imaging to track differences in brain activity at weeks 1 and 16.
Lumen acts as a patient-driven, voice-coach guide in problem identification, goal setting, solution development, choice, action plan development, execution, and evaluation, the researchers said.
A typical session was about 12 minutes; between people who use Lument have done surveys and reviews. Those on the waiting list received text messages to complete surveys and surveys at similar intervals as the others. 81 percent of Lument users completed all eight sessions.
“A lot of the burden is on patients,” Ajilore said. They are given suggestions for things like dealing with anxiety, and it’s up to them to pick one or more suggestions and follow them.
The Lumen group had reduced depression and anxiety scores compared to the control group. Compared to those on the waiting list, the Lumen group showed increased activity in the area of the brain related to the control of thinking abilities – in the dorsolateral prefrontal cortex – and improved problem-solving ability.
The researchers are now recruiting 200 people with anxiety and depression to test the AI voice coach in a larger clinical examination a more detailed study of the effects on anxiety and depression symptoms. The 200 people will be randomly assigned to a Lumen group (with eight sessions over 12 weeks), face-to-face sessions during the same period, or a wait-list control group.
Ryan Wade, MD, a psychiatrist who is director of addiction services at Silver Hill Hospital in New Canaan, sees many patients with anxiety and depression. He is aware of the new study findings and MI, but was not involved in the research.
He sees an AI virtual coach as a viable option to help people get help during long waiting lists, but he also understands why some of his colleagues might be hesitant. “A lot of our training is about building a relationship with the patient,” he said, and it’s face-to-face.
“It doesn’t replace the therapist,” he said of the new technology, “but some of their work can be done in an automated way.” It can help people get started.” He said AI is good at finding solutions and solving problems — what he calls the conventional or rational parts of therapy. “If we work with him, I think we can find that he can be really effective.”