# AI Chatots for Mental Health: A Scoping Review of Effectiveness, Feasibility, and Applications
## 3 Results
### Tackling Substance Use and Addiction  
The application of AI chatbots in addressing substance use and addiction has been explored in different studies, demonstrating their potential as accessible and effective interventions. [PERSON] et al. [63] conducted a randomized controlled trial with the Minder mobile app, which integrates an AI chatbot delivering cognitive-behavioral therapy, among university students. While an AI chatbot was a key part of the intervention, it was integrated as one component of a multi-faceted mobile app, rather than being used as a standalone chatbot program. The study evaluated the effects of the full Minder app intervention, not just the chatbot in isolation. The findings highlighted the app's ability to reduce anxiety and depressive symptoms, improve mental well-being, and even decrease the frequency of cannabis use and alcohol consumption. While the effects were small, the self-guided nature and co-development with students make Minder a promising tool for early intervention on university campuses.  
[PERSON] et al. [64] contributed to this domain with their investigation of the Woebot chatbot designed specifically for substance use disorders (W-SUDs). Their 8-week program delivered cognitive-behavioral therapy for substance use problems and was found to be feasible and highly acceptable by participants. Woebot was offered as a standalone intervention; it is worth noting that while W-SUDs was offered as a standalone intervention in this study, the researchers did analyze whether being in concurrent therapy affected outcomes. The automated therapeutic intervention led to significant improvements in self-reported substance use, cravings, mental health outcomes, and confidence to resist urges. The high engagement and positive outcomes suggest that W-SUDs has the potential to provide scalable treatment for individuals struggling with addiction.  
In a similar vein, [PERSON] et al. [65] compared the effectiveness of guided versus unguided chatbot interventions for problem gambling. Their randomized controlled trial evaluated the addition of minimal therapist guidance to the standalone AI chatbot intervention, GAMBOT2. The research specifically aimed to test the isolated effectiveness of the AI-based intervention by varying only the presence of researcher guidance between groups. Both groups showed significant within-group improvements in gambling outcomes, yet there were no significant between-group differences. This indicates that the guidance provided by therapists did not enhance the outcomes beyond the unguided GAMBOT2 intervention. These findings suggest that the standalone intervention is effective and that costly therapist involvement may not be necessary for positive outcomes. However, further investigation is warranted to identify the specific elements that can best or only be provided by a therapist to determine the optimal human-machine balance and synergy in such interventions.  
Furthermore, [PERSON] et al. [66] conducted a pragmatic, multicenter randomized controlled trial comparing an AI chatbot intervention (Dejal@bot) to usual care for smoking cessation in 513 patients across 34 primary care centers in Spain. Dejal@bot was employed as a standalone intervention in this study, replacing usual care. The primary outcome was biochemically-validated 6-month continuous abstinence, which was 26.0% in the chatbot group vs. 18.8% in usual care. The secondary outcomes showed the chatbotgroup had a greater total interaction time, more contacts, and a trend towards higher quality of life, especially among abstinent patients. Patients using the chatbot intensively (>4 contacts, >30 min total) had a 68.6% abstinence rate versus 40.9% for non-intensive users. While limited by a 54.8% overall dropout rate, the study suggests that the chatbot may increase long-term abstinence rates compared to usual care, with efficacy related to greater interaction intensity.