Effectiveness of AI-delivered Cognitive Behavioral Therapy Interventions for Anxiety and Depressive Symptoms: A Systematic Review

Depression and anxiety significantly contribute to the global mental health crisis. AI-delivered CBT (AI CBT) offers a scalable solution, yet existing evidence is fragmented and lacks diversity. This systematic review aims to address this gap and provide an updated and rigorous assessment of AI CBTs. We conducted a systematic review using Web of Science, PubMed, and PsycINFO, including RCTs from 2016 onward that evaluated AI CBT for anxiety or depressive symptoms. Of 208 studies screened, 16 met the criteria and were thematically synthesized. AI CBT showed limited effectiveness for anxiety, with only 1 of 14 studies reporting significant improvements. Third-wave CBT and interventions targeting youths appeared more promising in reducing anxiety. For depressive symptoms, only 4 of 16 studies showed significant improvements. Across both conditions, interventions were largely ineffective for older adults. Additionally, personalization and human support did not reliably enhance outcomes. There were concerns due to study quality.