Evaluating the Therapeutic Alliance With a Free-Text CBT Conversational Agent (Wysa): A Mixed-Methods Study

The anonymised transcripts of user’s conversations with Wysa were also examined through content analysis for unprompted elements of bonding between the user and Wysa

These mean bond subscale scores were found to be comparable to the scores obtained in recent literature on traditional, outpatient-individual CBT, internet CBT and group CBT. Content analysis of the transcripts of user conversations with the CA (Wysa) also revealed elements of bonding such as gratitude, self-disclosed impact, and personification. The user’s therapeutic alliance scores improved over time and were comparable to ratings from previous studies on alliance in human-delivered face-to-face psychotherapy with clinical populations. This study provides critical support for the utilization of digital mental health services, based on the evidence of the establishment of an alliance.