Summary: Researchers conducted a pioneering pilot study, utilizing an AI voice-based virtual coach, Lumen, for behavioral therapy. The study showed promising results, with improved depression and anxiety symptoms in patients alongside notable changes in brain activity.
The study brings hope for the use of virtual therapy to mitigate issues related to mental health care access. While not intended to replace traditional therapy, the technology could serve as an essential interim solution for patients awaiting treatment.
- Lumen, an AI voice assistant, was used to deliver a form of psychotherapy in a pilot study, which led to improved depression and anxiety symptoms in patients.
- The UIC study reported changes in the brain activity of patients, particularly increased activity in the dorsolateral prefrontal cortex, an area associated with cognitive control.
- The researchers emphasize that while Lumen and similar technology can’t replace human therapists, they can help bridge the gap between supply and demand in mental health care.
Source: University of Illinois
Artificial intelligence could be a useful tool in mental health treatment, according to the results of a new pilot study led by University of Illinois Chicago researchers.
The study, which was the first to test an AI voice-based virtual coach for behavioral therapy, found changes in patients’ brain activity along with improved depression and anxiety symptoms after using Lumen, an AI voice assistant that delivered a form of psychotherapy.
The UIC team says the results, which are published in the journal Translational Psychiatry, offer encouraging evidence that virtual therapy can play a role in filling the gaps in mental health care, where waitlists and disparities in access are often hurdles that patients, particularly from vulnerable communities, must overcome to receive treatment.
“We’ve had an incredible explosion of need, especially in the wake of COVID, with soaring rates of anxiety and depression and not enough practitioners,” said Dr. Olusola A. Ajilore, UIC professor of psychiatry and co-first author of the paper.
“This kind of technology may serve as a bridge. It’s not meant to be a replacement for traditional therapy, but it may be an important stop-gap before somebody can seek treatment.”
Lumen, which operates as a skill in the Amazon Alexa application, was developed by Ajilore and study senior author Dr. Jun Ma, the Beth and George Vitoux Professor of Medicine at UIC, along with collaborators at Washington University in St. Louis and Pennsylvania State University, with the support of a $2 million grant from the National Institute of Mental Health.
The UIC researchers recruited over 60 patients for the clinical study exploring the application’s effect on mild-to-moderate depression and anxiety symptoms, and activity in brain areas previously shown to be associated with the benefits of problem-solving therapy.
Two-thirds of the patients used Lumen on a study-provided iPad for eight problem-solving therapy sessions, with the rest serving as a “waitlist” control receiving no intervention.
After the intervention, study participants using the Lumen app showed decreased scores for depression, anxiety and psychological distress compared with the control group. The Lumen group also showed improvements in problem-solving skills that correlated with increased activity in the dorsolateral prefrontal cortex, a brain area associated with cognitive control. Promising results for women and underrepresented populations also were found.
“It’s about changing the way people think about problems and how to address them, and not being emotionally overwhelmed,” Ma said. “It’s a pragmatic and patient-driven behavior therapy that’s well established, which makes it a good fit for delivery using voice-based technology.”
A larger trial comparing the use of Lumen with both a control group on a waitlist, and patients receiving human-coached problem-solving therapy is currently being conducted by the researcher. They stress that the virtual coach doesn’t need to perform better than a human therapist to fill a desperate need in the mental health system.
“The way we should think about digital mental health service is not for these apps to replace humans, but rather to recognize what a gap we have between supply and demand, and then find novel, effective and safe ways to deliver treatments to individuals who otherwise do not have access, to fill that gap,” Ma said.
Co-first author of the study is Thomas Kannampallil at Washington University in St. Louis.
Other co-investigators include Aifeng Zhang, Nan Lv, Nancy E. Wittels, Corina R. Ronneberg, Vikas Kumar, Susanth Dosala, Amruta Barve, Kevin C. Tan, Kevin K. Cao, Charmi R. Patel and Emily A. Kringle, all of UIC; Joshua Smyth and Jillian A. Johnson at Pennsylvania State University; and Lan Xiao at Stanford University.
About this AI and psychology research news
Original Research: Open access.
“Effects of a virtual voice-based coach delivering problem-solving treatment on emotional distress and brain function: a pilot RCT in depression and anxiety” by Olusola A. Ajilore et al. Translational Psychiatry
Effects of a virtual voice-based coach delivering problem-solving treatment on emotional distress and brain function: a pilot RCT in depression and anxiety
Consumer-based voice assistants have the ability to deliver evidence-based treatment, but their therapeutic potential is largely unknown.
In a pilot trial of a virtual voice-based coach, Lumen, delivering problem-solving treatment, adults with mild-to-moderate depression and/or anxiety were randomized to the Lumen intervention (n = 42) or waitlist control (n = 21).
The main outcomes included changes in neural measures of emotional reactivity and cognitive control, and Hospital Anxiety and Depression Scale [HADS] symptom scores over 16 weeks.
Participants were 37.8 years (SD = 12.4), 68% women, 25% Black, 24% Latino, and 11% Asian. Activation of the right dlPFC (neural region of interest in cognitive control) decreased in the intervention group but increased in the control group, with an effect size meeting the prespecified threshold for a meaningful effect (Cohen’s d = 0.3).
Between-group differences in the change in activation of the left dlPFC and bilateral amygdala were observed, but were of smaller magnitude (d = 0.2). Change in right dlPFC activation was also meaningfully associated (r ≥ 0.4) with changes in self-reported problem-solving ability and avoidance in the intervention.
Lumen intervention also led to decreased HADS depression, anxiety, and overall psychological distress scores, with medium effect sizes (Cohen’s d = 0.49, 0.51, and 0.55, respectively), compared with the waitlist control group.
This pilot trial showed promising effects of a novel digital mental health intervention on cognitive control using neuroimaging and depression and anxiety symptoms, providing foundational evidence for a future confirmatory study.