Beatty Clare, Malik Tanya, Meheli Saha, Sinha Chaitali
Department of Psychology, Stony Brook University, Stony Brook, NY, United States.
Wysa Inc., Boston, MA, United States.
Front Digit Health. 2022 Apr 11;4:847991. doi: 10.3389/fdgth.2022.847991. eCollection 2022.
The present study aims to examine whether users perceive a therapeutic alliance with an AI conversational agent (Wysa) and observe changes in the t'herapeutic alliance over a brief time period. A sample of users who screened positively on the PHQ-4 for anxiety or depression symptoms ( = 1,205) of the digital mental health application (app) Wysa were administered the WAI-SR within 5 days of installing the app and gave a second assessment on the same measure after 3 days ( = 226). The anonymised transcripts of user's conversations with Wysa were also examined through content analysis for unprompted elements of bonding between the user and Wysa ( = 950). Within 5 days of initial app use, the mean WAI-SR score was 3.64 (SD 0.81) and the mean bond subscale score was 3.98 (SD 0.94). Three days later, the mean WAI-SR score increased to 3.75 (SD 0.80) and the mean bond subscale score increased to 4.05 (SD 0.91). There was no significant difference in the alliance scores between Assessment 1 and Assessment 2.These mean bond subscale scores were found to be comparable to the scores obtained in recent literature on traditional, outpatient-individual CBT, internet CBT and group CBT. Content analysis of the transcripts of user conversations with the CA (Wysa) also revealed elements of bonding such as gratitude, self-disclosed impact, and personification. The user's therapeutic alliance scores improved over time and were comparable to ratings from previous studies on alliance in human-delivered face-to-face psychotherapy with clinical populations. This study provides critical support for the utilization of digital mental health services, based on the evidence of the establishment of an alliance.
本研究旨在检验用户是否感知到与人工智能对话代理（Wysa）建立了治疗联盟，并观察在短时间内治疗联盟的变化。对数字心理健康应用程序（应用）Wysa中在PHQ-4焦虑或抑郁症状筛查呈阳性的用户样本（n = 1205）在安装应用后的5天内进行了沃里克-爱丁堡心理健康量表（WAI-SR）测评，并在3天后对同一量表进行了第二次评估（n = 226）。还通过内容分析检查了用户与Wysa对话的匿名记录，以寻找用户与Wysa之间自发形成的联系元素（n = 950）。在首次使用应用后的5天内，WAI-SR平均得分为3.64（标准差0.81），平均联系子量表得分为3.98（标准差0.94）。三天后，WAI-SR平均得分增至3.75（标准差0.80），平均联系子量表得分增至4.05（标准差0.91）。第一次评估和第二次评估之间的联盟得分没有显著差异。这些平均联系子量表得分与近期关于传统门诊个体认知行为疗法、互联网认知行为疗法和团体认知行为疗法的文献中获得的得分相当。对用户与对话代理（Wysa）对话记录的内容分析还揭示了感恩、自我披露的影响和拟人化等联系元素。用户的治疗联盟得分随时间推移有所提高，与之前对临床人群进行的面对面心理治疗中联盟评级相当。基于联盟建立的证据，本研究为数字心理健康服务的利用提供了关键支持。
