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Effect and Mechanisms of a Voice-based Coach using AI on Psychological Distress: A Phase 2 Randomized Trial
Medrxiv : the Preprint Server for Health Sciences
|January 8, 2026
Summary
Artificial Intelligence (AI) voice coaching effectively reduced psychological distress in adults with moderate depression and/or anxiety compared to a waitlist control. AI-powered problem-solving treatment (PST) showed comparable results to human coaching, suggesting a viable new treatment option.
Area of Science:
- Digital Health and Mental Healthcare
- Artificial Intelligence in Clinical Applications
- Psychiatry and Behavioral Sciences
Background:
- Artificial Intelligence (AI) voice applications show promise for treating depression and anxiety, but their therapeutic effectiveness is not well-established.
- There is a need to explore novel, accessible treatment modalities for individuals with untreated, moderate depression and/or anxiety.
Purpose of the Study:
- To evaluate the efficacy and underlying mechanisms of Lumen, an AI-driven voice coach delivering problem-solving treatment (PST).
- To compare Lumen-coached PST against human-coached PST and a waitlist control group in adults with moderate depression and/or anxiety.
Main Methods:
- A Phase 2, 3-arm randomized clinical trial involving 200 adult participants with moderate depression and/or anxiety.
- Participants were assigned to Lumen-coached PST, human-coached PST, or a waitlist control.
- PST was delivered via an AI voice application or human videoconferencing over 8 weeks; outcomes were assessed at 18 weeks using the Hospital Anxiety and Depression Scale and measures of problem-solving abilities.
Main Results:
- Lumen-coached PST significantly reduced psychological distress, depression, and anxiety symptoms compared to the waitlist control (Cohen's d=0.49, 0.19, and 0.61, respectively).
- No statistically significant differences were found between Lumen-coached and human-coached PST for any symptom reduction.
- Both coaching methods improved problem-solving abilities and negative problem orientation, correlating with reduced psychological distress and anxiety.
Conclusions:
- AI-driven voice coaching delivering PST (Lumen) appears to be a viable treatment option for moderate depression and/or anxiety.
- Further confirmation of clinical efficacy through Phase 3 trials is warranted.
- AI voice coaching offers a potentially scalable solution to address unmet mental health treatment needs.
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