Amid therapy waiting lists, new AI coach may be faster option

May 25, 2023 – The growth of artificial intelligence has generated praise as well as fear and skepticism. But researchers at the University of Illinois Chicago and their colleagues have found that their AI app appears to be useful in treating anxiety and depression. And they hope it can soon help to reduce the long waiting list for treatment.

With a pilot study, funded by the National Institute of Mental Health, researchers found that Lumen, an AI-based virtual behavioral therapy coach, altered patients’ brain activity and brought self-reported improvements in depression and anxiety symptoms.

“This is not a replacement [for a therapist] but could be an emergency measure,” said Olusola A. Ajilore, MD, PhD, a professor of psychiatry at the University of Illinois at Chicago and a study co-author. The app works to provide help as soon as possible after people have asked for it.

At his school, Ajilore said, the waiting list for therapy at the height of the pandemic was 8 months. Depression and anxiety have increased since the start of the pandemic, with depression increasing to approx 32% among US adults by 2021 and more than 40 million with anxiety disorders, according to the National Alliance on Mental Illness.

In the eight sessions over 12 weeks (four weekly, then four biweekly), the people in the study, average age 37 and 68% female, used Lumen via an iPad to address their anxiety or depression, using an approach that problem-solving treatment. . Brain imaging to monitor differences in brain activity was done at week 1 and week 16 in all 63 patients.

Lumen is patient-driven, with the voice coach acting as a guide to identify a problem, set a goal, brainstorm solutions, choose one, develop an action plan, execute it and then evaluate it, according to the researchers.

A typical session lasted about 12 minutes; in between, the people using Lumen completed surveys and assessments. Those on the waiting list received text messages to complete surveys and assessments at similar intervals as the others. Eighty-one percent of those using Lumen completed all eight sessions.

“A lot of the burden is on the patients,” Ajilore said. For example, they are given suggestions on how to deal with anxiety, and it is up to them to select one or more suggestions and follow through.

Those in the Lumen group had their scores for depression and anxiety drop compared to the control group. The Lumen group, compared to those on the waiting list, had increased activity in the brain region associated with mastery of thinking skills – the dorsolateral prefrontal cortex – and had improved problem-solving skills.

Now the researchers are recruiting 200 people with anxiety and depression to test the AI ​​voice coach in a larger test clinical trial to better study the effects on anxiety and depression symptoms. The 200 people will be randomly assigned to a Lumen group (with eight sessions over 12 weeks), in-person sessions over the same time period, or a waitlist control group.

Expert input

Ryan Wade, MD, a psychiatrist who is director of addiction services at Silver Hill Hospital in New Canaan, CT, sees many patients with anxiety and depression. He is familiar with the new research results and with AI, but was not part of the research.

He sees the AI ​​virtual coach as a viable option to help people get the help they need in these times of long waiting lists, but he also understands why some of his colleagues are hesitant. “So much of our training is about building rapport with a patient,” he said, and that’s face-to-face.

“It won’t replace the therapist,” he said of the new technology, “but some of their work can be done automatically. This can help people on their way.” AI, he said, is good at finding solutions and solving problems — what he calls the rote or rational parts of therapy. “If we work with it, I think we can find that it can be really effective.”