ArticlePLOS mental health2025
The efficacy, feasibility, and technical outcomes of a GPT-4o-based chatbot Amanda for relationship support: A randomized controlled trial.
Article in PLOS mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Usability and User Experience Assessment of Health Care Conversational Agents Using Validated Subjective Instruments: Systematic Review and Comparative Analysis.JMIR human factors · 2026Pooled it
- Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues.Journal of medical Internet research · 2025Pooled it
- Are You Qualified, ChatGPT? Examining Clinical Skills and Competencies of ChatGPT in Delivering Systemic Interventions.Journal of marital and family therapy · 2026Article
- Conversational AI and Personal Growth: Insights from a Critical Integrative Review.Behavioral sciences (Basel, Switzerland) · 2026Review
- Large language models for psychosocial risk assessment: A multi-method evaluation across suicide, intimate partner violence, and substance misuse.PLOS digital health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This randomized controlled trial evaluated the efficacy, feasibility, and technical outcomes of Amanda, a GPT-4-based chatbot, in delivering single-session relationship interventions. A total of 258 participants were randomly assigned to engage with either Amanda (n = 130) or a writing task (n = 128) focused on conflict reappraisal. Findings demonstrated significant improvements across 13 of 14 outcome variables-including relationship satisfaction, communication patterns, dyadic coping, problem-specific confidence, and individual well-being-over time in both conditions. Improvements emerged immediately after the intervention and were sustained or continued to improve at the two-week follow-up. However, there were no significant group differences for most outcomes, suggesting that both interventions were comparably effective. One significant group-by-time interaction emerged: participants in the chatbot condition reported lower levels of the partner-demand/self-withdraw communication pattern immediately post-intervention. The writing condition was also associated with lower overall distress about the issue. Feasibility outcomes indicated strong participant engagement with Amanda. Usability was rated highly (M = 4.19/5), as were therapeutic skills (M = 3.99/5) and working alliance (M = 4.75/6). Technical evaluation of interaction transcripts supported these findings, with high coder agreement on Amanda's empathy, therapeutic questioning, and coherence. However, limitations were noted: Amanda occasionally produced repetitive or generic responses and did not consistently identify potential safety concerns. Overall, results suggest that Amanda provides a feasible and effective single-session relationship intervention, comparable in impact to an evidence-based writing task. This study highlights the potential for large language model-based chatbots to deliver scalable, accessible relationship support. Future research should assess Amanda's use in multi-session interventions, explore performance in clinical populations, and enhance risk detection capabilities to ensure safe deployment in real-world settings.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.