Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 21;19(8):e267.
doi: 10.2196/jmir.7023.

Application of Synchronous Text-Based Dialogue Systems in Mental Health Interventions: Systematic Review

Simon Hoermann #  1 , Kathryn L McCabe #  1   2 , David N Milne  1 , Rafael A Calvo  1
Affiliations

Application of Synchronous Text-Based Dialogue Systems in Mental Health Interventions: Systematic Review

Simon Hoermann et al. J Med Internet Res. .

Abstract

Background: Synchronous written conversations (or "chats") are becoming increasingly popular as Web-based mental health interventions. Therefore, it is of utmost importance to evaluate and summarize the quality of these interventions.

Objective: The aim of this study was to review the current evidence for the feasibility and effectiveness of online one-on-one mental health interventions that use text-based synchronous chat.

Methods: A systematic search was conducted of the databases relevant to this area of research (Medical Literature Analysis and Retrieval System Online [MEDLINE], PsycINFO, Central, Scopus, EMBASE, Web of Science, IEEE, and ACM). There were no specific selection criteria relating to the participant group. Studies were included if they reported interventions with individual text-based synchronous conversations (ie, chat or text messaging) and a psychological outcome measure.

Results: A total of 24 articles were included in this review. Interventions included a wide range of mental health targets (eg, anxiety, distress, depression, eating disorders, and addiction) and intervention design. Overall, compared with the waitlist (WL) condition, studies showed significant and sustained improvements in mental health outcomes following synchronous text-based intervention, and post treatment improvement equivalent but not superior to treatment as usual (TAU) (eg, face-to-face and telephone counseling).

Conclusions: Feasibility studies indicate substantial innovation in this area of mental health intervention with studies utilizing trained volunteers and chatbot technologies to deliver interventions. While studies of efficacy show positive post-intervention gains, further research is needed to determine whether time requirements for this mode of intervention are feasible in clinical practice.

Keywords: chat; dialog system; remote psychotherapy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Taxonomy of the use of text-based communication in mental health interventions – spectrum from low volume (left) to high volume text-based interaction (right).
Figure 2
Figure 2
Flow of information through different phases of systematic review.
See this image and copyright information in PMC

References

    1. Barak A, Hen L, Boniel-Nissim M, Shapira N. A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Technol Hum Serv. 2008;26(2-4):109–160. doi: 10.1080/15228830802094429. - DOI
    1. Griffiths KM, Christensen H. Review of randomised controlled trials of internet interventions for mental disorders and related conditions. Clin Psychol. 2006;10(1):16–29. doi: 10.1080/13284200500378696. - DOI
    1. Andersson G, Titov N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry. 2014 Feb;13(1):4–11. doi: 10.1002/wps.20083. doi: 10.1002/wps.20083. - DOI - DOI - PMC - PubMed
    1. Dowling M, Rickwood D. Online counseling and therapy for mental health problems: a systematic review of individual synchronous interventions using chat. J Technol Hum Serv. 2013;31(1):1–21. doi: 10.1080/15228835.2012.728508. - DOI
    1. Calvo RA, Milne DN, Hussain MS, Christensen H. Natural language processing in mental health applications using non-clinical texts. Nat Lang Eng. 2017 Jan 30;:1–37. doi: 10.1017/S1351324916000383. - DOI

Publication types

MeSH terms