AI-Enhanced Remote Therapy for Adolescent Violence
Recruiting in Palo Alto (17 mi)
+3 other locations
Age: < 65
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Michigan
Disqualifiers: Non-English speakers, Mental incompetence, Incarceration, Medical instability, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This study will use a randomized control trial (RCT) design to administer two versions of a multisession remote behavioral intervention for youth seeking Emergency Department care for a violent injury with the goal to reduce their violence involvement and associated negative behaviors and consequences. The study examines two versions of the remote therapy intervention - a standard RTI (S-RTI) and an Artificial Intelligence RTI (AI-RTI). The application of a just-in-time adaptive strategy to address youth violence is an important and novel direction for this research, particularly given the need to understand best practices for delivering behavioral interventions among lower-income populations.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment AI-Enhanced Remote Therapy for Adolescent Violence?
Research shows that AI-based methods, like chatbots, can enhance psychological treatments by providing real-time recommendations, leading to positive outcomes and high satisfaction rates. Additionally, AI applications in psychiatry have been used to teach emotional coping mechanisms and support communication, which may be beneficial in addressing adolescent violence.
12345Is AI-enhanced remote therapy generally safe for humans?
The study on the AI behavioral coaching chatbot, Tess, used for adolescent weight management and prediabetes, showed that it was well-received and viewed as helpful by participants, indicating it is generally safe for use in humans.
23567How is the AI-Enhanced Remote Therapy for Adolescent Violence treatment different from other treatments?
This treatment is unique because it uses artificial intelligence to enhance remote therapy, making it more accessible and potentially more engaging for adolescents. It combines AI with remote behavioral interventions, which can provide continuous support and personalized interactions, unlike traditional in-person therapy sessions.
24689Eligibility Criteria
This trial is for young people aged 14-24 who have been treated in the emergency department for a violent injury and own a smartphone. They must understand English and be able to consent. Those with mental incompetence, without a guardian if under 18, or involved in certain crimes like sexual assault are excluded.Inclusion Criteria
I am aged 14-24, was injured in violence, own a smartphone with text and internet.
Exclusion Criteria
Youth will be excluded if they do not understand English, cannot provide informed consent due to mental incompetence, incarceration or medical instability (unstable patients will be recruited if they stabilize within 72 hours), are 14-17 years old and presenting without an accessible parent/guardian, are presenting for suicide attempt/intent, sexual assault, and/or child abuse (due to high intensity of social services needed for such patients during their ED visit).
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Initial Remote Therapy Session
Youth receive an initial remote therapy session in the Emergency Department
1 session
1 visit (in-person)
Adaptive Remote Therapy
The RL system determines the intensity of subsequent therapy sessions over 11 weeks
11 weeks
Bi-weekly sessions (remote)
Follow-up
Participants are monitored for changes in victimization and aggression at 6 and 12 months
12 months
Assessments at 6 and 12 months
Participant Groups
The study compares two remote therapy interventions aimed at reducing violence among adolescents: one standard version (S-RTI) and another enhanced by Artificial Intelligence (AI-RTI). It's set up as a randomized control trial where participants are randomly assigned to either intervention.
3Treatment groups
Experimental Treatment
Active Control
Group I: Remote Therapy InterventionExperimental Treatment1 Intervention
Youth will receive the maximal dose of six S-RTI therapy sessions delivered by a remote therapist with no alteration in intensity
Group II: Artificial Intelligence Remote Therapy InterventionExperimental Treatment1 Intervention
Youth will first receive a remote therapy session in the Emergency Department (ED). The RL system will then make decisions about the intensity of each subsequent therapy session (the initial decision is seven days post ED visit and bi-weekly \[i.e., every other two weeks\] thereafter) for the next 11 weeks. Potential treatment decisions include a 30-minute remote therapy session delivered via phone or video chat (mirroring the S-RTI), a less intensive tailored Motivational Interviewing (MI)-adherent electronic remote therapy (delivered by an electronic robot), or an assessment only without intervention.
Group III: Enhanced Usual CareActive Control1 Intervention
The youth's retaliatory risk will be assessed and a pamphlet with referrals for violence, substance use, and mental health services will be provided.
Artificial Intelligence Remote Therapy Intervention is already approved in United States for the following indications:
🇺🇸 Approved in United States as AI-RTI for:
- Reducing adolescent violence involvement
- Negative behaviors and consequences associated with violent injuries
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Ascension St. John HospitalDetroit, MI
HUP and PPMCPhiladelphia, PA
Grady Health SystemAtlanta, GA
Hurley Medical CenterFlint, MI
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Who Is Running the Clinical Trial?
University of MichiganLead Sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)Collaborator
References
Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review. [2022]Emotional disorders are the most common mental disorders globally. Psychological treatments have been found to be useful for a significant number of cases, but up to 40% of patients do not respond to psychotherapy as expected. Artificial intelligence (AI) methods might enhance psychotherapy by providing therapists and patients with real- or close to real-time recommendations according to the patient's response to treatment. The goal of this investigation is to systematically review the evidence on the use of AI-based methods to enhance outcomes in psychological interventions in real-time or close to real-time. The search included studies indexed in the electronic databases Scopus, Pubmed, Web of Science, and Cochrane Library. The terms used for the electronic search included variations of the words "psychotherapy", "artificial intelligence", and "emotional disorders". From the 85 full texts assessed, only 10 studies met our eligibility criteria. In these, the most frequently used AI technique was conversational AI agents, which are chatbots based on software that can be accessed online with a computer or a smartphone. Overall, the reviewed investigations indicated significant positive consequences of using AI to enhance psychotherapy and reduce clinical symptomatology. Additionally, most studies reported high satisfaction, engagement, and retention rates when implementing AI to enhance psychotherapy in real- or close to real-time. Despite the potential of AI to make interventions more flexible and tailored to patients' needs, more methodologically robust studies are needed.
Remotely delivering real-time parent training to the home: An initial randomized trial of Internet-delivered parent-child interaction therapy (I-PCIT). [2022]Remote technologies are increasingly being leveraged to expand the reach of supported care, but applications to early child-behavior problems have been limited. This is the first controlled trial examining video-teleconferencing to remotely deliver behavioral parent training to the home setting with a live therapist.
Effectiveness of an Internet-Based Machine-Guided Stress Management Program Based on Cognitive Behavioral Therapy for Improving Depression Among Workers: Protocol for a Randomized Controlled Trial. [2021]The effect of an unguided internet-based cognitive behavioral therapy (iCBT) stress management program on depression may be enhanced by applying artificial intelligence (AI) technologies to guide participants adopting the program.
Artificial Intelligence and Chatbots in Psychiatry. [2022]The utilization of artificial intelligence (AI) in psychiatry has risen over the past several years to meet the growing need for improved access to mental health solutions. Additionally, shortages of mental health providers during the COVID-19 pandemic have continued to exacerbate the burden of mental illness worldwide. AI applications already in existence include those enabled to assist with psychiatric diagnoses, symptom tracking, disease course prediction, and psychoeducation. Modalities of AI mental health care delivery include availability through the internet, smartphone applications, and digital gaming. Here we review emerging AI-based interventions in the form of chat and therapy bots, specifically conversational applications that teach the user emotional coping mechanisms and provide support for people with communication difficulties, computer generated images of faces that form the basis of avatar therapy, and intelligent animal-like robots with new advances in digital psychiatry. We discuss the implications of incorporating AI chatbots into clinical practice and offer perspectives on how these AI-based interventions will further impact the field of psychiatry.
Therapeutic engagement in robot-assisted psychological interventions: A systematic review. [2022]Therapeutic engagement is a key component of psychological interventions. Robot-assisted psychological interventions appear to have therapeutic benefits for service users that are challenging to engage. However, engagement with robots in robot-assisted psychological interventions is not well understood. The aim of this systematic review is to evaluate the quality of therapeutic engagement in robot-assisted psychological interventions (PROSPERO: 122437).
Feasibility of pediatric obesity and prediabetes treatment support through Tess, the AI behavioral coaching chatbot. [2020]Behavioral intervention technologies (BITs) are unique ways to incorporate the benefits of technology and psychology to address differing health needs through various media, including Internet interventions, mobile apps, and video games. BITs present several possible benefits, including increased dissemination and accessibility, cost-effectiveness, increased engagement, and decreased stigma, especially among youth. A behavioral coaching chatbot, Tess, addresses different facets of behavioral health, such as depression and anxiety. Available 24/7, Tess delivers customized integrative support, psychoeducation, and interventions through brief conversations via existing communication channels (i.e., SMS text messaging and Facebook Messenger). This study assessed the feasibility of integrating Tess in behavioral counseling of adolescent patients (n = 23; Mage = 15.20 years; Rangeage = 9.78-18.54 years; 57% female) coping with weight management and prediabetes symptoms. Tess engaged patients via a preferred method of communication (SMS text messaging) in individualized conversations to promote treatment adherence, behavior change, and overall wellness. Adolescent patients reported experiencing positive progress toward their goals 81% of the time. The 4,123 messages exchanged and patients' reported usefulness ratings (96% of the time) illustrate that adolescents engaged with and viewed this chatbot as helpful. These results highlight the feasibility and benefit of support through artificial intelligence, specifically in a pediatric setting, which could be scaled to serve larger groups of patients. As a partner to clinicians, Tess can continue the therapeutic interaction outside office hours while maintaining patient satisfaction. Due to Tess's capacity for continuous learning, future iterations may have additional features to increase the user experience.
Robot-Mediated Imitation Skill Training for Children With Autism. [2023]Autism spectrum disorder (ASD) impacts 1 in 68 children in the U.S., with tremendous individual and societal costs. Technology-aided intervention, more specifically robotic intervention, has gained momentum in recent years due to the inherent affinity of many children with ASD towards technology. In this paper we present a novel robot-mediated intervention system for imitation skill learning, which is considered a core deficit area for children with ASD. The Robot-mediated Imitation Skill Training Architecture (RISTA) is designed in such a manner that it can operate either completely autonomously or in coordination with a human therapist depending on the intervention need. Experimental results are presented from small user studies validating system functionality, assessing user tolerance, and documenting subject performance. Preliminary results show that this novel robotic system draws more attention from the children with ASD and teaches gestures more effectively as compared to a human therapist. While no broad generalized conclusions can be made about the effectiveness of RISTA based on our small user studies, initial results are encouraging and justify further exploration in the future.
Remote Access Therapy for Veterans With Psychological Problems: Current State of the Art. [2021]The past decade has seen both an increase in use and research into ways in which psychological therapy might be delivered remotely. Remote access therapy uses technology to deliver talking therapies. It is important to understand how remote technologies are being used as part of the therapeutic process and consider what effect this has on the success of therapeutic interventions. This review discusses what is currently known about the use of remote access therapy with a veteran population. Moreover, the review summarizes potential benefits and barriers to conducting therapy remotely.
Effectiveness of youth psychotherapy delivered remotely: A meta-analysis. [2022]Reports on remote psychotherapies for youth (e.g., technology-based treatment) suggest it is acceptable, feasible, and useful in overcoming logistical barriers to treatment. But how effective is remote care? To find out, PsycINFO and PubMed were searched from 1960 through 2020, supplemented by journal searches and reference trails, to identify randomized controlled trials of youth psychotherapy for anxiety (including obsessive-compulsive disorder and trauma), depression, attention-deficit/hyperactivity disorder (ADHD), or conduct problems, in which all therapeutic contact occurred remotely. Articles (N = 37) published from 1988 through 2020, reporting 43 treatment-control group comparisons, were identified. Robust variance estimation was used to account for effect size dependencies and to synthesize overall effects and test candidate moderators. Pooled effect size was .47 (95% confidence interval [CI: .26, .67], p < .001) at posttreatment, .44 (95% CI [.12, .76], p < .05) at follow-up-comparable to effects reported in meta-analyses of in-person youth psychotherapy. Effects were significantly (a) larger for remote psychotherapies supported by therapeutic provider contact (.64) than for those accessed by youths, with only logistical support (.22), (b) larger for treatments with phone contact (.65) than for those without (.25), (c) larger for treatment of anxiety (.62) and conduct problems (.78) than ADHD (-.03), and (d) smaller for therapies involving attention/working memory training (-.18) than for those without (.60). Among studies with therapeutic contact, effects were significantly larger when therapists facilitated skill-building (e.g., practicing exposures or problem solving [.68]) than when therapists did not (.18). These findings support the effectiveness of remote psychotherapies for youths, and they highlight moderators of treatment benefit that warrant attention in future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).