A guided chatbot-based psychological intervention for psychologically distressed older adolescents and young adults: a randomised clinical trial in Jordan

This randomised controlled trial compared a 10-session chatbot intervention with 5 weekly brief support calls (STARS) to enhanced usual care (EUC) in distressed young adults in Jordan (N = 344). Primary outcome was change in anxiety and depression severity assessed at baseline by the Hopkins Symptom Checklist (HSCL), 1-week posttreatment, and 3 months after treatment (primary outcome timepoint), as well as secondary outcome measures of psychological distress, personally identified problems, functional impairment, wellbeing and perceived agency. At the 3-month assessment, relative to EUC participants enrolled in STARS reported greater reductions of anxiety (effect size, 0.70) and depression (size, 0.61), as well as greater reductions in psychological distress, personally identified problems, functional impairment and greater improvement in wellbeing and sense of agency. Similar levels of efficacy were retained even for those with more severe symptom levels. This guided chatbot offers a scalable psychological intervention that can be implemented to increase access to evidence-based mental health care. Trial Registration: The trial was prospectively registered on ISRCTN on 02/11/2022 ( https://doi.org/10.1186/ISRCTN19217696 ).