The efficacy, feasibility, and technical outcomes of a GPT-4o-based chatbot Amanda for relationship support: A randomized controlled trial

This randomized controlled trial evaluated the efficacy, feasibility, and technical outcomes of Amanda, a GPT-4-based chatbot, in delivering single-session relationship interventions. A total of 258 participants were randomly assigned to engage with either Amanda (n = 130) or a writing task (n = 128) focused on conflict reappraisal. Findings demonstrated significant improvements across 13 of 14 outcome variables-including relationship satisfaction, communication patterns, dyadic coping, problem-specific confidence, and individual well-being-over time in both conditions. Improvements emerged immediately after the intervention and were sustained or continued to improve at the two-week follow-up. However, there were no significant group differences for most outcomes, suggesting that both interventions were comparably effective. One significant group-by-time interaction emerged: participants in the chatbot condition reported lower levels of the partner-demand/self-withdraw communication pattern immediately post-intervention. The writing condition was also associated with lower overall distress about the issue. Feasibility outcomes indicated strong participant engagement with Amanda. Usability was rated highly (M = 4.19/5), as were therapeutic skills (M = 3.99/5) and working alliance (M = 4.75/6). Technical evaluation of interaction transcripts supported these findings, with high coder agreement on Amanda's empathy, therapeutic questioning, and coherence. However, limitations were noted: Amanda occasionally produced repetitive or generic responses and did not consistently identify potential safety concerns. Overall, results suggest that Amanda provides a feasible and effective single-session relationship intervention, comparable in impact to an evidence-based writing task. This study highlights the potential for large language model-based chatbots to deliver scalable, accessible relationship support. Future research should assess Amanda's use in multi-session interventions, explore performance in clinical populations, and enhance risk detection capabilities to ensure safe deployment in real-world settings.

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Publication Details

Journal
PLOS mental health.
Published
2025-09-24
DOI
https://doi.org/10.1371/journal.pmen.0000411
Citations
3
Primary Topic
Digital Mental Health Interventions
Type
article
Field-Weighted Citation Impact
4.63
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article

The efficacy, feasibility, and technical outcomes of a GPT-4o-based chatbot Amanda for relationship support: A randomized controlled trial

Matthew J. Vowels, Stephen Hatch, Joëlle Darwiche, Shannon M. Sweeney et al.
3 citations
PLOS mental health.
Digital Mental Health Interventions
4.63
article

The efficacy, feasibility, and technical outcomes of a GPT-4o-based chatbot Amanda for relationship support: A randomized controlled trial

Matthew J. Vowels, Stephen Hatch, Joëlle Darwiche, Shannon M. Sweeney, Laura M. Vowels
article en
3 citations

Abstract

This randomized controlled trial evaluated the efficacy, feasibility, and technical outcomes of Amanda, a GPT-4-based chatbot, in delivering single-session relationship interventions. A total of 258 participants were randomly assigned to engage with either Amanda (n = 130) or a writing task (n = 128) focused on conflict reappraisal. Findings demonstrated significant improvements across 13 of 14 outcome variables-including relationship satisfaction, communication patterns, dyadic coping, problem-specific confidence, and individual well-being-over time in both conditions. Improvements emerged immediately after the intervention and were sustained or continued to improve at the two-week follow-up. However, there were no significant group differences for most outcomes, suggesting that both interventions were comparably effective. One significant group-by-time interaction emerged: participants in the chatbot condition reported lower levels of the partner-demand/self-withdraw communication pattern immediately post-intervention. The writing condition was also associated with lower overall distress about the issue. Feasibility outcomes indicated strong participant engagement with Amanda. Usability was rated highly (M = 4.19/5), as were therapeutic skills (M = 3.99/5) and working alliance (M = 4.75/6). Technical evaluation of interaction transcripts supported these findings, with high coder agreement on Amanda's empathy, therapeutic questioning, and coherence. However, limitations were noted: Amanda occasionally produced repetitive or generic responses and did not consistently identify potential safety concerns. Overall, results suggest that Amanda provides a feasible and effective single-session relationship intervention, comparable in impact to an evidence-based writing task. This study highlights the potential for large language model-based chatbots to deliver scalable, accessible relationship support. Future research should assess Amanda's use in multi-session interventions, explore performance in clinical populations, and enhance risk detection capabilities to ensure safe deployment in real-world settings.

PLOS mental health.Vol. 2(9)
University of Surrey (GB), Mental Health America (US), The Sense Innovation and Research Center (CH), University of Roehampton (GB), University of Lausanne (CH)
Openalex Percentile: Top 5%
Digital Mental Health Interventions
4.63
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