AI-Facilitated Cognitive Re#Appraisal via Socrates 2.0: Mixed Methods Feasibility Study
Background: Innovative, scalable #MentalHealth tools are needed to address systemic provider shortages and accessibility barriers. Large language model (LLM)-based tools can provide real-time, tailored feedback to help users engage in cognitive re#Appraisal outside traditional therapy sessions. Socrates 2.0 is a multi-agent artificial intelligence (AI) tool that guides users through Socratic dialogue. Objective: Using a mixed method #Approach, this study examined the feasibility, acceptability, and potential for symptom reduction of Socrates 2.0. Methods: Sixty-one adults enrolled in a four-week mixed-methods pre-clinical feasibility study. Participants used Socrates 2.0 as desired and completed self-report measures of #depression, social #anxiety, posttraumatic stress, and obsessive-compulsive symptoms at baseline and one-month follow-up. Feasibility, acceptability, and #Appropriateness along with usability and working alliance were assessed via validated measures. Semi-structured interviews explored user experiences and perceptions. Results: Participants engaged with Socrates 2.0 an average of 6.70 (SD=4.57) times over four weeks. Feasibility (mean=4.26, SD=0.67), acceptability (mean=4.16, SD=0.84), and usability ratings were high. Participants reported moderate reductions in #depression (effect size d=0.30), social #anxiety (d=0.25), obsessive-compulsive (d=0.33), and posttraumatic stress (d=0.28) symptoms. Working alliance scores suggested a moderately strong perceived bond with the AI tool. Qualitative feedback indicated that the nonjudgmental, on-demand nature of Socrates 2.0 encouraged self-reflection and exploration. Some users critiqued the repeated questioning style and limited conversation depth. Conclusions: Socrates 2.0 was perceived as feasible, acceptable, and moderately helpful for self-guided cognitive re#Appraisal, demonstrating potential as an adjunct to traditional therapy. Further research, including randomized trials, is needed to determine effectiveness across different populations, optimize personalization, and address repetitive conversational loops. Clinical Trial: Held P, Pridgen S, Chen Y, Akhtar Z, Amin D, Pohorence S A Novel Cognitive Behavioral Therapy–Based Generative AI Tool (Socrates 2.0) to Facilitate Socratic Dialogue: Protocol for a Mixed Methods Feasibility Study JMIR Res Protoc 2024;13:e58195 URL: https://www.researchprotocols.org/2024/1/e58195 DOI: 10.2196/58195