The number of people struggling with symptoms of depression and anxiety continues to grow. The World Health Organization (WHO) predicts that by 2030, depression will be the most common disease in the world. According to estimates, it currently affects approx. 1.2 million people in Poland. Hence the growing need to provide patients - especially adolescents and young adults - with specialist help, which may include psychological support from chatbots.
Fido: A chatbot that speaks Polish
Innovative technologies are a promising solution for relieving psychotherapists, but scientific evidence of their effectiveness in cognitive behavioral therapy (CBT) in languages other than English is limited.
That is why the team led by psychologist Jarosław Michałowski, PhD, a professor at SWPS University, has created a tool that can provide basic psychological support in Polish anywhere and any time, via popular instant messengers. The chatbot is intended to enhance the therapeutic process and provide support outside of therapy.
We wanted basic psychological support to reach places where it is poorly accessible. We were primarily interested in people who would have to wait for treatment to begin or could not reach a therapist. Our goal was also to reach people who were reluctant to seek help.
Jarosław Michałowski, head of the Laboratory of Affective Neuroscience at SWPS University
Chatbot support - how does it work?
Fido uses artificial intelligence algorithms and employs behavioural-cognitive therapy techniques while engaging in a text conversation with the user. The data sets on which the bot's language models were trained were developed by a team of psychotherapists, and the software effectively imitates the language used in instant messengers.
Fido has been trained to recognise several categories of thoughts in the user's statements. It also recognises emotions, situations and suicidal thoughts. In the latter case, its response is to refer the user to helpline numbers to seek support.
The chatbot conducts the dialogue in a way that helps the user recognize their negative thoughts and beliefs underlying their low mood or elevated anxiety. In addition to the dialogue, it also offers educational materials, as well as gratitude practice exercises. Therefore, the main task of the tool is to draw the user's attention to harmful ways of thinking, support the development of beneficial habits and the implementation of techniques for coping with difficult situations.
Depression and anxiety symptoms reduced
The study "Effectiveness of a Web-based and Mobile Therapy Chatbot on Anxiety and Depressive Symptoms in Subclinical Young Adults: Randomized Controlled Trial", described in JMIR Formative Research, involved 81 participants with depression or anxiety symptoms. This is one of the few studies on the effectiveness of a therapy chatbot, and the first such study conducted in Polish. One of the study groups interacted exclusively with a chatbot for two weeks, while the other, control group, received self-help literature to read on their own.
Based on previous clinical trials of chatbots, the researchers hypothesized that the group interacting with the chatbot would report fewer symptoms of depression and anxiety, and demonstrate a higher level of life satisfaction than those using only reading materials. They also assumed that the former group would experience a decrease in the level of perceived loneliness, and that participants would develop a bond with Fido.
The two-week Fido intervention proved effective in reducing symptoms of depression and anxiety. Users also experienced an increase in life satisfaction. The effects remained stable at least a month after the end of the trial. Unlike in some other studies, there was no effectiveness difference between the group interacting with the chatbot and the group using self-help materials. It is worth noting, however, that the bot users spent less time on the intervention than the control group, which means that they achieved similar results faster. This is beneficial considering the possible problems with concentration in people struggling with symptoms of depression.
The researchers also observed a decline in loneliness among participants who used Fido more frequently, an effect that was not observed in the group using self-help materials. Younger respondents declared the strongest bond with Fido.
Among the advantages of Fido, participants most often mentioned the fact that using the bot encouraged them to make a decision about starting traditional therapy.
The creators of Fido recently conducted another study in which they divided participants into three groups. The first group underwent traditional therapy with a psychotherapist, the second group interacted with a chatbot in addition to meetings with a specialist, and the last, control group was not subjected to any intervention. The study lasted five weeks. Its results will be published soon.
Talking to a machine is not a substitute for therapy
It is important to note that while technology - like Fido - can improve well-being, it will not replace a visit to a specialist. It can only complement it or help its users make the decision to start therapy.
It should be clear to users that Fido is not a professional psychotherapist, and that to get professional help, they would have to see a specialist who can use this type of new technology or simply work in a traditional way. Hence the idea of Fido 2, in which there is also a therapist between the patient and the chatbot.
Jarosław Michałowski, head of the Laboratory of Affective Neuroscience at SWPS University
Fido was developed in the project "Chatbot as an automated support tool for psychotherapy, psychological help, and promotion of mental health", financed by the Polish Ministry of Science and Higher Education.
More information in research publication:
Karkosz, S., Szymański, R., Sanna, K., & Michałowski, J. (2023). Effectiveness of a web-based and mobile therapy chatbot on anxiety and depressive symptoms in subclinical young adults: randomized controlled trial. JMIR Formative Research, 8, e47960.