The Feasibility and Acceptability of Automated Feedback and Deliberate Practice in Psychological Therapies for Anxiety and Depression

Deliberate Practice (DP) for psychological therapists involves using objective, corrective feedback to identify and improve individualised skill deficits, alongside iterative practice opportunities separate from clinical care. Automated, prognostic feedback from transcripts of session contents could enhance personalisation of DP for application across psychological therapy professions and modalities.This study assessed the feasibility, acceptability and initial clinical utility of a 10-week therapist intervention integrating automated feedback on predicted prognosis with DP of individualised therapeutic skill deficits.Participants were 97 therapy clients seen by nine therapists in the 10 weeks preceding intervention and 79 clients seen by the same therapists during the 10-week intervention period. Participating therapists, representing diverse professional backgrounds, invited their clients to consent to have sessions recorded and automatically assessed for predicted prognosis. Prognostic feedback was integrated into DP training and practice, comprising a total of 32 hours intervention. Assessments of intervention feasibility, acceptability, credibility, outcome expectancy, and therapists’ therapeutic skills were taken alongside qualitative interviews at baseline, 5- and 10-week follow-up. Reliable improvement and deterioration in depression and anxiety were compared between clients receiving therapy in the pre-intervention and intervention periods. Findings indicated improvements in intervention feasibility, acceptability, therapist skills, and clinical outcomes from pre- to post-intervention. However, client uptake of automated feedback was low due to concerns about artificial intelligence. Automated feedback and DP become more acceptable to therapists through engagement, potentially improving therapeutic skills and effectiveness. However, addressing client concerns about how technology is used for automated feedback would be essential to enhance participation.