Effectiveness of AI-Assisted Mental Health Interventions in Online Counselling: A Study of Chatbot-Guided Support and Ethical Considerations

Annanya Jayaswal

Vol. 11, Issue 1, Jan-Dec 2025

Page Number: 25 - 33

Abstract:

The integration of Artificial Intelligence (AI) into mental health services has introduced new paradigms in online counselling, particularly through the use of chatbot-guided interventions. This paper explores the effectiveness of AI-assisted mental health interventions, focusing on chatbot-supported counselling, while critically analysing the associated ethical considerations. The study synthesizes evidence from recent randomized controlled trials (RCTs), systematic reviews, and pilot programs evaluating the impact of AI-driven conversational agents (CAs) on mental health outcomes such as depression, anxiety, and psychological distress.

References

• Abd-Alrazaq, A., Rababeh, A., Alajlani, M., Bewick, B. M., & Househ, M. (2020). Effectiveness and safety of using chatbots to improve mental health: Systematic review and meta-analysis. Journal of Medical Internet Research, 22(7), e16021. https://doi.org/10.2196/16021
• Denecke, K., Bamidis, P., Bond, C., Gabarron, E., Househ, M., Lau, A. Y. S., Mayer, M. A., Merolli, M., & Hansen, M. (2015). Ethical issues of social media usage in healthcare. Yearbook of Medical Informatics, 24(1), 137– 147. https://doi.org/10.15265/IY-2015-001
• Fitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017). Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial. JMIR Mental Health, 4(2), e19. https://doi.org/10.2196/mental.7785
• Fulmer, R., Joerin, A., Gentile, B., Lakerink, L., & Rauws, M. (2018). Using psychological artificial intelligence (Tess) to relieve symptoms of depression and anxiety: Randomized controlled trial. JMIR Mental Health, 5(4), e64. https://doi.org/10.2196/mental.9782
• Hailey, H., Majumder, R., Iqbal, A., Manchanda, A., Sachdeva, N., & Ahuja, S. (2022). Human–AI collaboration for supporting empathetic conversations in online peer support. arXiv preprint. https://doi.org/10.48550/arXiv.2203.15144
• Inkster, B., Sarda, S., & Subramanian, V. (2018). An empathy-driven, conversational artificial intelligence agent (Wysa) for digital mental well-being: Real-world data evaluation. JMIR mHealth and uHealth, 6(11), e12106. https://doi.org/10.2196/12106
• Jeyaraman, M., Khanna, R., Srivastava, A., Nagappan, R., & Dhingra, A. (2024). Regulating AI in mental health: Ethics of care perspective and challenges. JMIR Mental Health, 11, e58493. https://doi.org/10.2196/58493
• Li, H., Zhang, R., Lee, Y.-C., Kraut, R. E., & Mohr, D. C. (2023). Conversational agents for mental health and wellbeing: Systematic review and meta-analysis of effectiveness. npj Digital Medicine, 6(1), 236. https://doi.org/10.1038/s41746-023-00979-5
• Mesko, B., Drobni, Z., Bényei, É., Gergely, B., & Győrffy, Z. (2017). Digital health is a cultural transformation of traditional healthcare. mHealth, 3, 38. https://doi.org/10.21037/mhealth.2017.08.07
• Montenegro, J. L. Z., da Costa, C. A., & da Rosa Righi, R. (2019). Survey of conversational agents in health. Expert Systems with Applications, 129, 56–67. https://doi.org/10.1016/j.eswa.2019.03.054
• Saeidnia, H. R., Hashemi Fotami, S. G., Lund, B., & Ghiasi, N. (2024). Ethical considerations in artificial intelligence interventions for mental health and well-being: Ensuring responsible implementation and impact. Social Sciences, 13(7), 381. https://doi.org/10.3390/socsci13070381
• Topol, E. J. (2019). High-performance medicine: The convergence of human and artificial intelligence. Nature Medicine, 25, 44–56. https://doi.org/10.1038/s41591-018-0300-7
• Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019). Chatbots and conversational agents in mental health: A review of the psychiatric landscape. The Canadian Journal of Psychiatry, 64(7), 456– 464. https://doi.org/10.1177/0706743719828977
• Wang, S., Modirshanechi, A., Müller, M., Linder, T., Chien, I. H., & Morency, L. P. (2025). Evaluating a large language model for cognitive restructuring: Results from a user study with mental health professionals. arXiv preprint. https://doi.org/10.48550/arXiv.2501.15599
• Zhong, W., Luo, J., Zhang, H., & Huang, X. (2024). The therapeutic effectiveness of AI-based chatbots in alleviation of depressive and anxiety symptoms in short-course treatments: A systematic review and meta-analysis. Journal of Affective Disorders, 356, 1–12. https://doi.org/10.1016/j.jad.2024.04.057

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