Rule-based chatbot application for adolescents with anxiety: a feasibility study

Abstract

Introduction

Anxiety is one of the most common psychiatric disorders and the symptoms typically onset in adolescence. The symptoms may persist into adulthood, leading to comorbid disorders, poorer life quality and function impairments. Scalable, early interventions may reduce its negative impact on adolescents. The study evaluated the feasibility of a novel, digital health intervention for adolescents with anxiety symptoms to inform future randomized controlled trial.

Methods

This study investigated feasibility aspects, including preliminary clinical outcomes, in an open pre – post design with 1- and 3-month follow-up. The intervention consisted of a therapist-guided, rule-based chatbot mobile application. A total of 25 adolescents aged 13 to 16 participated, including complementary data collection from their parents.

Results

The intervention showed high adherence, with 72 % of participants completing all modules. The intervention demonstrated high acceptability and credibility, with all 17 respondents at post-assessment reporting that they would recommend the application to a friend with similar challenges. The adolescents reported a decrease in anxiety symptoms and functional impairment from pre to post. However, the symptom reduction was not maintained at follow-up. Parent-reported measurements indicated improvement in adolescents’ anxiety and depressive symptoms, as well as improvement in daily functioning.

Discussion

The findings support the feasibility, acceptability and usability of a rule-based chatbot intervention for adolescents with anxiety symptoms. However, temporary symptom reduction reported by adolescents suggests the need for app refinement before progressing to a randomized controlled trial. Adjustments include enhancing engagement in the therapeutic components of the application such as exposure tasks, cognitive restructuring and enhancing parental involvement.