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A chatbot for mental health support: exploring the impact of Emohaa on reducing mental distress in China
Open accessAbstract
Introduction The growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. To this end, we introduce Emohaa, a conversational agent that provides cognitive support through CBT-Bot exercises and guided conversations. It also emotionally supports users through ES-Bot, enabling them to vent their emotional problems. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress. Methods and Results Following the RCT design, the current study randomly assigned participants into three groups: Emohaa (CBT-Bot), Emohaa (Full), and control. With both Intention-To-Treat ( N = 247 ) and PerProtocol ( N = 134 ) analyses, the results demonstrated that compared to the control group, participants who used two types of Emohaa experienced considerably more significant improvements in symptoms of mental distress, including depression ( F [ 2 , 244 ] = 6.26 , p = 0.002 ), negative affect ( F [ 2 , 244 ] = 6.09 , p = 0.003 ), and insomnia ( F [ 2 , 244 ] = 3.69 , p = 0.026 ). Discussion Based on the obtained results and participants’ satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.
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“For example, Jeong [99] reported 0.30 SD for depression, McFadyen et al [61] reported 0.26 SD for anxiety, Sabour [64] reported 0.33 SD for depression.”
From Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues (2025) · cites this paper as [64]
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Metadata
- Authors
- Sabour, S., Zhang, W., Xiao, X., Zhang, Y., Zheng, Y., Wen, J., Zhao, J., & Huang, M.
- Affiliations
- State Key Laboratory of Intelligent Technology and Systems (CN)
- Beijing Normal University (CN)
- Tsinghua University (CN)
- Corresponding author
- Sabour, Sahand
- Huang, Minlie
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2023-05-04
- Volume
- 5
- Pages
- 1133987-1133987
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC10193040
- OpenAlex
- W4377565325
- Cited by
- 102
- References
- 44
- Citations by year
- 2026: 31 · 2025: 36 · 2024: 25 · 2023: 10
- FWCI
- 26.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Physical Sciences › Computer Science › Artificial Intelligence › Emotion and Mood Recognition
- Keywords
- chatbots, mental health support, cognitive behavioral therapy, depression, negative affect, insomnia, emotional support, psychological distress, China
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