{"title":"数字治疗联盟存在吗?综合审查。","authors":"Amylie Malouin-Lachance, Julien Capolupo, Chloé Laplante, Alexandre Hudon","doi":"10.2196/69294","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders significantly impact global populations, prompting the rise of digital mental health interventions, such as artificial intelligence (AI)-powered chatbots, to address gaps in access to care. This review explores the potential for a \"digital therapeutic alliance (DTA),\" emphasizing empathy, engagement, and alignment with traditional therapeutic principles to enhance user outcomes.</p><p><strong>Objective: </strong>The primary objective of this review was to identify key concepts underlying the DTA in AI-driven psychotherapeutic interventions for mental health. The secondary objective was to propose an initial definition of the DTA based on these identified concepts.</p><p><strong>Methods: </strong>The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for scoping reviews and Tavares de Souza's integrative review methodology were followed, encompassing systematic literature searches in Medline, Web of Science, PsycNet, and Google Scholar. Data from eligible studies were extracted and analyzed using Horvath et al's conceptual framework on a therapeutic alliance, focusing on goal alignment, task agreement, and the therapeutic bond, with quality assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.</p><p><strong>Results: </strong>A total of 28 studies were identified from an initial pool of 1294 articles after excluding duplicates and ineligible studies. 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While the DTA shows promise in enhancing accessibility and engagement in mental health care, further research and innovation are needed to address challenges such as personalization, ethical concerns, and long-term impact.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e69294"},"PeriodicalIF":5.8000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830484/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does the Digital Therapeutic Alliance Exist? 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引用次数: 0
摘要
背景:精神健康障碍对全球人口产生重大影响,促使人工智能(AI)聊天机器人等数字精神卫生干预措施兴起,以解决获得护理方面的差距。本综述探讨了“数字治疗联盟(DTA)”的潜力,强调同情、参与和与传统治疗原则的一致性,以提高用户的效果。目的:本综述的主要目的是确定人工智能驱动的心理健康心理治疗干预中DTA的关键概念。第二个目标是根据这些已确定的概念提出DTA的初步定义。方法:采用PRISMA (Preferred Reporting Items for Systematic Reviews and meta - analysis)进行范围评价,采用Tavares de Souza的综合评价方法,包括在Medline、Web of Science、PsycNet和谷歌Scholar上进行系统文献检索。从符合条件的研究中提取数据,并使用Horvath等人的治疗联盟概念框架进行分析,重点关注目标一致性、任务一致性和治疗联系,并使用纽卡斯尔-渥太华量表和Cochrane偏倚风险工具评估质量。结果:在排除重复和不符合条件的研究后,从1294篇文章的初始库中共确定了28项研究。这些研究为DTA概念框架的发展提供了信息,包括目标一致性、任务协议、治疗联系、用户参与以及影响治疗结果的促进因素和障碍等关键要素。干预措施主要集中在人工智能聊天机器人、数字心理治疗和其他数字工具上。结论:这一综合综述的发现为DTA的概念提供了一个基础框架,并报告了其在人工智能驱动的心理治疗工具中复制关键治疗机制(如共情、信任和协作)的潜力。虽然DTA在提高精神卫生保健的可及性和参与度方面显示出希望,但需要进一步的研究和创新来应对个性化、伦理问题和长期影响等挑战。
Does the Digital Therapeutic Alliance Exist? Integrative Review.
Background: Mental health disorders significantly impact global populations, prompting the rise of digital mental health interventions, such as artificial intelligence (AI)-powered chatbots, to address gaps in access to care. This review explores the potential for a "digital therapeutic alliance (DTA)," emphasizing empathy, engagement, and alignment with traditional therapeutic principles to enhance user outcomes.
Objective: The primary objective of this review was to identify key concepts underlying the DTA in AI-driven psychotherapeutic interventions for mental health. The secondary objective was to propose an initial definition of the DTA based on these identified concepts.
Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for scoping reviews and Tavares de Souza's integrative review methodology were followed, encompassing systematic literature searches in Medline, Web of Science, PsycNet, and Google Scholar. Data from eligible studies were extracted and analyzed using Horvath et al's conceptual framework on a therapeutic alliance, focusing on goal alignment, task agreement, and the therapeutic bond, with quality assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.
Results: A total of 28 studies were identified from an initial pool of 1294 articles after excluding duplicates and ineligible studies. These studies informed the development of a conceptual framework for a DTA, encompassing key elements such as goal alignment, task agreement, therapeutic bond, user engagement, and the facilitators and barriers affecting therapeutic outcomes. The interventions primarily focused on AI-powered chatbots, digital psychotherapy, and other digital tools.
Conclusions: The findings of this integrative review provide a foundational framework for the concept of a DTA and report its potential to replicate key therapeutic mechanisms such as empathy, trust, and collaboration in AI-driven psychotherapeutic tools. While the DTA shows promise in enhancing accessibility and engagement in mental health care, further research and innovation are needed to address challenges such as personalization, ethical concerns, and long-term impact.
期刊介绍:
JMIR Mental Health (JMH, ISSN 2368-7959) is a PubMed-indexed, peer-reviewed sister journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175).
JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.