Julie Prescott

Aim
The purpose of this paper was to critically evaluate the use of chatbots as an eHealth resource for substance use disorder. It considers their past, present and future use, including the progression of the new wave of generative chatbots.
Findings
This paper finds chatbots for substance use disorder to be an underutilised resource, noting that there are few solutions and that these have limitations. It identifies that, along with limitations with general chatbot design, there are also serious ethical concerns given the vulnerabilities of the target population.
Discussion
How a collaborative design can address some of the limitations is discussed, as well as the restrictions this could pose to leveraging the latest technological advances. The ethical concerns presented in the applied use of both existing and prospective chatbots are explored, and how there is a need to safeguard users in matters of mental health support.

The use of chatbots in healthcare is an area of study receiving increased academic interest. As the knowledge base grows, the granularity in the level of research is being refined. There is now more targeted work in specific areas of healthcare, for example, chatbots for anxiety and depression, cancer care, and pregnancy support. The aim of this paper is to systematically review and summarize the research conducted on the use of chatbots in the field of addiction, specifically the use of chatbots as supportive agents for those who suffer from a substance use disorder (SUD). A systematic search of scholarly databases using the broad search criteria of ("drug" OR "alcohol" OR "substance") AND ("addiction" OR "dependence" OR "misuse" OR "disorder" OR "abuse" OR harm*) AND ("chatbot" OR "bot" OR "conversational agent") with an additional clause applied of "publication date" ≥ January 01, 2016 AND "publication date" ≤ March 27, 2022, identified papers for screening. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to evaluate eligibility for inclusion in the study, and the Mixed Methods Appraisal Tool was employed to assess the quality of the papers. The search and screening process identified six papers for full review, two quantitative studies, three qualitative, and one mixed methods. The two quantitative papers considered an adaptation to an existing mental health chatbot to increase its scope to provide support for SUD. The mixed methods study looked at the efficacy of employing a bespoke chatbot as an intervention for harmful alcohol use. Of the qualitative studies, one used thematic analysis to gauge inputs from potential users, and service professionals, on the use of chatbots in the field of addiction, based on existing knowledge, and envisaged solutions. The remaining two were useability studies, one of which focussed on how prominent chatbots, such as Amazon Alexa, Apple Siri, and Google Assistant can support people with an SUD and the other on the possibility of delivering a chatbot for opioid-addicted patients that is driven by existing big data. The corpus of research in this field is limited, and given the quality of the papers reviewed, it is suggested more research is needed to report on the usefulness of chatbots in this area with greater confidence. Two of the papers reported a reduction in substance use in those who participated in the study. While this is a favourable finding in support of using chatbots in this field, a strong message of caution must be conveyed insofar as expert input is needed to safely leverage existing data, such as big data from social media, or that which is accessed by prevalent market leading chatbots. Without this, serious failings like those highlighted within this review mean chatbots can do more harm than good to their intended audience. [Abstract copyright: © 2022 S. Karger AG, Basel.]

The current researchers carried out a large online survey on 18 March 2020 and unintentionally provided a ‘snap shot’ of how the British population was responding in the early stages of the Covid-19 pandemic. This paper aims to investigate the relationship between loneliness and mental health at the early stages of the global crisis. This cross-sectional study was carried out using Prolific, an online participant recruitment platform that allowed 1608 responses in just 2 hr. Participants completed measures of Personal Well-being, Psychological Distress, Flourishing and Loneliness. Numerous associations between loneliness and mental health were found. A multiple regression found that 43% of the variance in loneliness can be accounted for by age, psychological distress and flourishing. Responses were also categorised into three groups: the non-lonely (n = 311), averagely lonely (n = 1054) and the severely lonely (n = 243), with analysis indicating that poorer well-being was associated with increased loneliness. Due to the cross sectional nature of this research, determining the direction of causality is not possible. It remains uncertain whether increased loneliness negatively impacted on mental health, whether poor mental health lead to increased loneliness, or both in fact. Current findings suggest that severely lonely individuals may be particularly vulnerable to psychological distress and that individuals with poor mental health may be especially prone to loneliness. Individuals experiencing loneliness and/ or poor mental health will almost certainly need additional support during and beyond the pandemic

The interest in student mental health and wellbeing has increased in recent years. Additionally, there is a rising volume of students seeking support. Numerous online resources have been developed to meet this need, including anonymous web-based therapy. To date, there has been little focus upon how students may utilise such a service, and this study examines routine evaluation data (solicited from a Goal-based Outcome Measure) from a United Kingdom based service provider. Over the course of one academic year (2018–2019), 211 students articulated therapeutic goals within Kooth Student, a web-based therapy and support service for individuals in higher education. These goals were examined for key trends. The students identified a total of 625 goals to work on in therapy, with individuals setting an average of three goals each. The most common goals focused upon obtaining additional support within the service and exploring their emotions. The results suggested that female students were more likely to move towards achieving their goals, with goals that did move shifting an average of 7.74 on a 10-point scale. Practical goals that focused upon getting more help, both inside and outside the service, were most likely to be achieved. In contrast, self-help/self-care goals were less likely to be achieved. These results provide a helpful insight into how students made use of therapy and highlight the importance of the interaction that web-based services have with other provision (web-based and in-person). They also demonstrate the challenge of capturing meaningful outcome data in anonymous services.

The purpose of this study is to explore what belonging to Alcoholics Anonymous (AA) means to its international membership. The aim is to gain a collective view of the opinions held by those accessing the services offered by AA globally. This paper focuses on the study of AA entirely from the perspective of its members, without being attentive to the AA approach to recovery, or the 12-step programme it advocates. An online survey was distributed as a link on Facebook groups accessed by members of AA. Responses (N=182) were received from members accessing AA services in 11 different countries. These were analysed using thematic analysis. The findings convey a positive message for what belonging to AA means, demonstrating that members accomplish more than sobriety and sustained abstinence.
They develop a positive outlook, feel connected and accepted into a unique community, that offers a platform for achieving personal and spiritual growth.

The purpose of this paper is to review the 16 published non-student Recovery Heroes and Remarkable Lives accounts published in this journal, using the CHIME (Connection, Hope, Identity, Meaning and Empowerment) framework.
All 16 accounts were rated independently by four researchers and evaluated in terms of whether each account met the five criteria for the CHIME model.
All accounts met the criteria for the CHIME model, with the exception of one, which still met four of the five criteria. Evidence was presented which suggests that the model can be extended to C-CHIME, to incorporate creativity.
While a certain level of subjectivity is required in deciding how each account meets the CHIME criteria, there were high levels of inter-rater reliability within the research team. Creativity had a central place in all the accounts.
While a certain level of subjectivity is required in deciding how each account meets the CHIME criteria, there were high levels of inter-rater reliability within the research team. Creativity had a central place in all the accounts.
The recovery model privileges both professional and lived experience perspectives on recovery. The current review highlights how much we can benefit from the wisdom contained in first person accounts.
The recovery model privileges both professional and lived experience perspectives on recovery. The current review highlights how much we can benefit from the wisdom contained in first person accounts.

Both meaning in life (MIL) and perceived self-competence (PSC) have been linked to a sense of calling, and better well-being. To the authors' knowledge, no study has examined MIL or PSC in counselling students. Current counselling students (N = 292) were asked whether studying counselling brought them MIL, and completed the Meaning in Life Questionnaire, and an adapted Perceived Competence Scale for Counselling Students (PCS-CS). Results showed that students with a higher sense of MIL had a higher level of PSC. Over 95% of participants found meaning in their study of counselling, implying that many found it to be a calling. The PCS-CS was found to be reliable, and implications include its potential usefulness in future research on PSC in counselling populations. With MIL and PSC being linked to better workplace wellbeing, this study implies that trainee counsellors have high levels of these protective factors, with further research warranted to establish whether this is also the case for counselling professionals.