The Use and Evaluation of Behavior Change Theories in Generative Artificial Intelligence Chatbots

Generative AI chatbots for mental health offer great promise in expanding access to evidence-based psychotherapies. A number of recent reports have described chatbots that draw from behavior change theories central to human-delivered treatments. This review details the diversity in theories selected for chatbots, and how chatbots have been evaluated in respect to delivering upon theoretical models. Overall, there was limited adoption of best practices in measurement of treatment fidelity from human therapist trials. Thus, skepticism is frequently warranted regarding claims of alignment with behavior change approaches, yet there is reason for optimism in the role of chatbots in expanding access to evidence-based interventions along with rigorous testing and validation.