Implementation of Anxiety UK's Ask Anxia Chatbot Service: Lessons Learned.

Chatbots are increasingly being applied in the context of health care, providing access to services when there are constraints on human resources. Simple, rule-based chatbots are suited to high-volume, repetitive tasks and can therefore be used effectively in providing users with important health information. In this Viewpoint paper, we report on the implementation of a chatbot service called Ask Anxia as part of a wider provision of information and support services offered by the UK national charity, Anxiety UK. We reflect on the changes made to the chatbot over the course of approximately 18 months as the Anxiety UK team monitored its performance and responded to recurrent themes in user queries by developing further information and services. We demonstrate how corpus linguistics can contribute to the evaluation of user queries and the optimization of responses. On the basis of these observations of how Anxiety UK has developed its own chatbot service, we offer recommendations for organizations looking to add automated conversational interfaces to their services.

An evaluation of Anxiety UK's psychological therapy service outcomes.

BACKGROUND: Anxiety and depression are highly prevalent. The aim was to examine the effectiveness of Anxiety UK's national psychological therapy service; benchmarking against NHS IAPT data. METHODS: We examined psychological therapy outcome data for Anxiety UK clients who completed therapy between April 2019 - March 2020 and benchmarked this against NHS Improving Access to Psychological Therapies (IAPT) outcome data for the same period. Anxiety UK clients completed validated measures of anxiety and depression at two time points: the first and last therapy session. Caseness, recovery, reliable improvement and reliable recovery rates were based on IAPT definitions. RESULTS: 957 clients completed at least two psychological therapy sessions with an Anxiety UK Approved Therapist. Recovery, reliable improvement, and reliably recovered rates exceeded IAPT targets. Depression and anxiety reduced from first to last session. Cognitive behavioural therapy produced the greatest change in anxiety over time compared to counselling and hypnotherapy. The more therapy sessions attended, the greater the change in anxiety and depression scores from the first to last session. LIMITATIONS: For some clients, anxiety and depression levels may have alleviated without therapy. No outcome data were collected following therapy cessation. Therefore, conclusions regarding maintenance and long-term effects of therapy cannot be made. CONCLUSION: Anxiety UK provide highly effective psychological therapies for anxiety and depression. Flexibility in the number of therapy sessions provided is recommended for NHS services and those of external organisations.

Standardization of health outcomes assessment for depression and anxiety: recommendations from the ICHOM Depression and Anxiety Working Group.

PURPOSE: National initiatives, such as the UK Improving Access to Psychological Therapies program (IAPT), demonstrate the feasibility of conducting empirical mental health assessments on a large scale, and similar initiatives exist in other countries. However, there is a lack of international consensus on which outcome domains are most salient to monitor treatment progress and how they should be measured. The aim of this project was to propose (1) an essential set of outcome domains relevant across countries and cultures, (2) a set of easily accessible patient-reported instruments, and (3) a psychometric approach to make scores from different instruments comparable. METHODS: Twenty-four experts, including ten health outcomes researchers, ten clinical experts from all continents, two patient advocates, and two ICHOM coordinators worked for seven months in a consensus building exercise to develop recommendations based on existing evidence using a structured consensus-driven modified Delphi technique. RESULTS: The group proposes to combine an assessment of potential outcome predictors at baseline (47 items: demographics, functional, clinical status, etc.), with repeated assessments of disease-specific symptoms during the treatment process (19 items: symptoms, side effects, etc.), and a comprehensive annual assessment of broader treatment outcomes (45 items: remission, absenteeism, etc.). Further, it is suggested reporting disease-specific symptoms for depression and anxiety on a standardized metric to increase comparability with other legacy instruments. All recommended instruments are provided online ( www.ichom.org ). CONCLUSION: An international standard of health outcomes assessment has the potential to improve clinical decision making, enhance health care for the benefit of patients, and facilitate scientific knowledge.