GPT-Powered Chatbot-Based Positive Psychology Intervention for Well-Being Among Parents of Children With Autism Spectrum Disorder: Single-Arm Mixed Methods Study

TL;DR

A GPT-powered chatbot called Allie was tested to improve well-being in parents of children with autism, showing feasibility and some positive effects on well-being.

Contribution

This study introduces a culturally adapted GPT-powered chatbot delivering positive psychology interventions to parents of autistic children and evaluates its feasibility and acceptability.

Findings

17 out of 19 participants completed all exercises, indicating high procedural feasibility.

The WHO-5 well-being score improved significantly after using the chatbot.

Participants suggested design improvements like natural conversation and autism-specific resources.

Abstract

Parents of autistic children frequently experience elevated stress levels, depressive symptoms, and reduced well-being. Positive psychology interventions (PPIs) can strengthen resilience, and chatbots offer a scalable channel through which such skills can be delivered. However, evidence on the evaluation of large language model–guided PPI-based chatbots for this population is limited.

This study evaluated the feasibility and acceptability of a GPT-powered chatbot (“Allie”). This study was designed to deliver culturally adapted PPIs to parents of autistic children and to explore their preliminary effects on well-being, depression, stress, and health-related quality of life.

We conducted a single-arm mixed-methods pilot study with 19 parents with autistic children. These parents engaged with Allie for 2 weeks to complete 8 structured PPI exercises. The primary outcomes were feasibility (completion, ease of use, and practicality) and acceptability (multidimensional user ratings). Secondary outcomes were the World Health Organization–Five Well-Being Index (WHO-5), Patient Health Questionnaire-9, Perceived Stress Scale-10, and Short Form-12 Health Survey (version 2) Physical and Mental Component Summary scores. Outcomes were analyzed using paired t tests or Wilcoxon signed-rank tests. Optional postintervention interviews were analyzed using reflexive thematic analysis.

A total of 17 (89.5%) participants completed all the exercises, which indicated a high degree of procedural feasibility. There were also high ratings for ease of use and practicality (means 4.47/5, SD 0.70, and 4.32/5, SD 0.67, respectively). Acceptability was favorable (overall satisfaction mean=5.68/7, SD 0.70; prompt response time=6.37/7, SD 0.68). The WHO-5 score improved significantly from 32.84 to 46.11 (t18=2.48, P=.02; Cohen d=0.52). Changes in the Patient Health Questionnaire-9 (z=−0.49, P=.63; r=0.11), Perceived Stress Scale-10 (t18=−0.82, P=.43; Cohen d=0.12), and Short Form-12 Health Survey (version 2) Physical Component Summary (t18=−0.94, P=.36; Cohen d=0.18) and Mental Component Summary (t18=−0.89, P=.39; Cohen d=0.17) scores were not significant. Qualitative feedback (14/19) described benefits aligned with PPI mechanisms such as greater self-reflection, a more positive orientation, perspective-taking, emotional support, and coping skills. However, participants also suggested refinements, such as more natural conversation (colloquial Cantonese), shorter or less repetitive outputs, user-chosen sequencing with reminders and progress tracking, multimodal features, and autism spectrum disorder–specific resources.

This pilot study revealed the feasibility, acceptability, and preliminary improvement in well-being (WHO-5) of a PPI-based GPT-powered chatbot, Allie, among parents of autistic children. Although there was no significant short-term change in other outcomes, the findings provide insights into design priorities, including personalization, conversational naturalness, multimodal content, and autism spectrum disorder–specific guidance. Larger, controlled trials with longer exposures and more diverse samples are needed to establish efficacy and durability.

ClinicalTrials.gov NCT06438120; https://clinicaltrials.gov/study/NCT06438120

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