Agents of change: understanding the therapeutic processes associated with the helpfulness of therapy for mental health problems with relational agent MYLO
Open accessAbstract
OBJECTIVE: To understand the therapeutic processes associated with the helpfulness of an online relational agent intervention, Manage Your Life Online (MYLO). METHODS: Fifteen participants experiencing a mental health related problem used Manage Your Life Online for 2 weeks. At follow-up, the participants each identified two helpful and two unhelpful questions posed by Manage Your Life Online within a single intervention session. Qualitative interviews were conducted and analyzed using thematic and content analysis to gain insight into the process of therapy with Manage Your Life Online. RESULTS: MYLO appeared acceptable to participants with a range of presenting problems. Questions enabling free expression, increased awareness, and new insights were key to a helpful intervention. The findings were consistent with the core processes of therapeutic change, according to Perceptual Control Theory, a unifying theory of psychological distress. Questions that elicited intense emotions, were repetitive, confusing, or inappropriate were identified as unhelpful and were associated with disengagement or loss of faith in Manage Your Life Online. CONCLUSIONS: The findings provide insight into the likely core therapy processes experienced as helpful or hindering and outlines further ways to optimize acceptability of Manage Your Life Online.
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The chatbot MYLO implements the core principles of a transdiagnostic, integrative therapy called Method of Levels (MOL).
“A notable example of one such attempt is the chatbot MYLO (78), which implements the core principles of a transdiagnostic, integrative therapy called Method of Levels (MOL) (79).”
From Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence (2023) · cites this paper as [78]
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“Content analysis is a replicable approach to describing and quantifying data which enables new insights and can facilitate the practical application of findings.(51,52) This approach enabled clear recommendations for the development of MYLO.”
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A Relational Agent for the COVID-19 Patients: Design, Approach, and Implications (Preprint)
Islam, A., & Chaudry, B. (2022) · JMIR Human Factors · doi:10.2196/37734 · Cited by 2 · see citing works
Chatbots as Peer Counselors in Helping Students Manage Stress: Socio-Technical Requirements
Ong, E., Pena, F. G., Sotelo, M. M., Cabredo, I. J., & Pascual, J. A. (2023) · International HCI and UX Conference in Indonesia (CHIuXiD) · doi:10.1109/chiuxid59550.2023.10452735 · Cited by 1 · see citing works
“MYLO, a chatbot that offers a self-help approach using Perceptual Control Theory, was found to be effective in helping individuals cope with stress problems through problem-solving leading to reduction in pain, depression, and anxiety [25].”
MethodA interação homem-máquina na psicoterapia
Melo, S. A. N., de Aguiar, C. L., da Cunha, L. K. S., & Brustolin, J. C. R. (2024) · Prometeica - Revista de Filosofía y Ciencias · doi:10.34024/prometeica.2024.29.16268 · Cited by 1 · see citing works
Wrightson‐Hester, A., Anderson, G., Dunstan, J., McEvoy, P. M., Sutton, C., MYERS, B. J., Egan, S. J., Tai, S., Johnston-Hollitt, M., Chen, W., et al. (2023) · doi:10.31234/osf.io/zjw8p · Cited by 1 · see citing works
Prometeica, R. (2024) · Prometeica - Revista de Filosofía y Ciencias · doi:10.34024/prometeica.2024.29.15900
Therapeutic Alliance and Effectiveness of Digital Mental Health Interventions
Arakkal, M. A., & Thangal, M. R. (2026) · doi:10.1002/9781394429660.ch5
Wan, M. W., Hill, F., Firth, J., & Churchman, A. (2026) · doi:10.2196/preprints.110917
Algorithmic Compassion in Holistic Nursing: A Concept Analysis and Conceptual Model
Narvaez, R. A., Ferrer, M., & Peco, R. A. (2026) · Journal of Holistic Nursing · doi:10.1177/08980101261487731
- Authors
- Gaffney, H., Mansell, W., & Tai, S.
- Affiliations
- University of Manchester (GB)
- Corresponding author
- Gaffney, Hannah
- Venue
- Digital Health
- Publisher
- SAGE Publications
- Published
- 2020-01
- Volume
- 6
- Pages
- 2055207620911580-2055207620911580
- ISSN
- 2055-2076 (ISSN-L)
- PMC
- PMC7079311
- OpenAlex
- W3010449928
- Cited by
- 26
- References
- 66
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 4
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- therapeutic process, perceptual control theory, mental illness, chatbot intervention, acceptability, disengagement, emotional intensity
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