Examining the Potential of Social Robots to Increase Adherence in Internet-based CBT

Internet-based applications of Cognitive Behavioral Therapy (iCBT) are promising to alleviate mood problems and depression. However, versions without personal support (i.e., unguided) still fall short in establishing meaningful therapeutic relationships, despite recent versions also embedding virtual avatars, potentially resulting in low levels of adherence. The current paper systematically examined whether a physically present embodied social robot, automatically operating (i.e., no WOz), may yield stronger therapeutic alliance and increase adherence compared to screen-based therapeutic interventions through experimental research designs. In two separate experiments, participants were randomly assigned to either a robot intervention or screen-based control condition with or without an avatar, addressing mild mood issues in three subsequent intervention sessions. Overall, results showed the social robot intervention to increase therapeutic alliance, adherence, and satisfaction compared to the same screen-based intervention, with alliance in a mediating role, but did not significantly improve participants' mood. Future research is warranted with larger samples suffering mental health issues. The studies highlight the potential of social robots to act as guidance in unguided iCBT interventions and enhancing its effectiveness.

The online version contains supplementary material available at 10.1007/s12369-026-01417-8.