TY  - JOUR
AU  - Goonesekera, Yenushka
AU  - Donkin, Liesje
PY  - 2022
DA  - 2022/10/20
TI  - A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study
JO  - JMIR Form Res
SP  - e37877
VL  - 6
IS  - 10
KW  - health anxiety
KW  - conversational agent
KW  - illness anxiety disorder
KW  - COVID-19
KW  - iCBT
KW  - user experience
KW  - anthropomorphism
AB  - Background: An increase in health anxiety was observed during the COVID-19 pandemic. However, due to physical distancing restrictions and a strained mental health system, people were unable to access support to manage health anxiety. Chatbots are emerging as an interactive means to deliver psychological interventions in a scalable manner and provide an opportunity for novel therapy delivery to large groups of people including those who might struggle to access traditional therapies. Objective: The aim of this mixed methods pilot study was to investigate the feasibility, acceptability, engagement, and effectiveness of a cognitive behavioral therapy (CBT)–based chatbot (Otis) as an early health anxiety management intervention for adults in New Zealand during the COVID-19 pandemic. Methods: Users were asked to complete a 14-day program run by Otis, a primarily decision tree–based chatbot on Facebook Messenger. Health anxiety, general anxiety, intolerance of uncertainty, personal well-being, and quality of life were measured pre-intervention, postintervention, and at a 12-week follow-up. Paired samples t tests and 1-way ANOVAs were conducted to investigate the associated changes in the outcomes over time. Semistructured interviews and written responses in the self-report questionnaires and Facebook Messenger were thematically analyzed. Results: The trial was completed by 29 participants who provided outcome measures at both postintervention and follow-up. Although an average decrease in health anxiety did not reach significance at postintervention (P=.55) or follow-up (P=.08), qualitative analysis demonstrated that participants perceived benefiting from the intervention. Significant improvement in general anxiety, personal well-being, and quality of life was associated with the use of Otis at postintervention and follow-up. Anthropomorphism, Otis’ appearance, and delivery of content facilitated the use of Otis. Technical difficulties and high performance and effort expectancy were, in contrast, barriers to acceptance and engagement of Otis. Conclusions: Otis may be a feasible, acceptable, and engaging means of delivering CBT to improve anxiety management, quality of life, and personal well-being but might not significantly reduce health anxiety. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2022/10/e37877
UR  - https://doi.org/10.2196/37877
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36150049
DO  - 10.2196/37877
ID  - info:doi/10.2196/37877
ER  -