A new study from Reichman University, published in the prestigious journal JAMA Network Open, has found that an AI-based conversational support platform can significantly reduce symptoms of anxiety and depression, form a meaningful therapeutic alliance with users, and provide round-the-clock emotional support.
Led by Prof. Anat Shoshani of the Baruch Ivcher School of Psychology at Reichman University, and conducted in collaboration with the Kai.ai platform, the study explored whether AI systems could offer an innovative response to the global mental health crisis. Approximately 1,000 Israeli students experiencing emotional distress, anxiety, and depression participated in the study. They were assigned to one of three groups: traditional in-person group therapy with psychologists, a waitlist control group, or a group given access to "Kai," an AI-powered emotional support platform operating within a popular messaging app and available to users at any time.
The study was conducted during a period of prolonged security tensions in Israel, which heightened the need for accessible and immediate mental health support. The "Kai" system is grounded in established scientific protocols, including CBT, ACT, DBT, mindfulness, and positive psychology. It is capable of sustaining ongoing conversations, recalling past interactions, identifying signs of distress, and offering real-time tools for emotional regulation, breathing exercises, and reflective writing.
The findings showed that users of the conversational AI platform experienced a significant reduction in symptoms of anxiety and depression compared to the waitlist group. In reducing anxiety, the system even outperformed human-led group therapy. Notably, approximately 58% of participants who initially presented with clinical levels of anxiety moved into the healthy range following the intervention. Among participants experiencing depression, nearly half reported substantial improvement.
One of the study's most striking findings was the formation of a "therapeutic alliance" — a sense of trust, understanding, and emotional connection between users and the AI platform. Participants rated the system as empathetic, professional, and supportive at levels comparable to human therapists. Many also reported that they found it easier to open up to a digital system, free from concerns about judgment or embarrassment.
Prof. Anat Shoshani of Reichman University's Baruch Ivcher School of Psychology explains: "Anxiety is highly situational. Clinical therapy is invaluable, but it is episodic. AI sits in the user's pocket — on the bus, in the library, and during sleepless nights — providing continuous support precisely when it is needed. The goal is not to create machines that sound more human, but to build systems that help make our society more human. The therapy of the future will be a continuum of support, available where life actually happens."
While many mental health apps experience high dropout rates, the study found that 61% of users continued to engage with the platform throughout the 12-week study, using it on average three days per week. According to the researchers, the sense of continuity, personalized availability, and the system's ability to "remember" users and their personal context fostered a deeper connection that sustained engagement over time.
Notwithstanding these promising findings, the researchers stress that AI is not a substitute for human psychological treatment, particularly in complex conditions such as post-traumatic stress disorder (PTSD). The Kai.ai platform operates within a hybrid model that includes a human support team available 24/7. When the system detects signs of acute distress or risk, it triggers an alert to enable immediate human intervention.
The full study was published on April 14, 2026, in JAMA Network Open, under the title "Efficacy of a Conversational AI Agent for Psychiatric Symptoms and Digital Therapeutic Alliance: A Randomized Clinical Trial."
