Many researchers are working to address the worldwide mental health crisis by developing therapeutic technologies that increase the accessibility of care, including leveraging large language model (LLM) capabilities in chatbots and socially assistive robots (SARs) used for therapeutic applications. Yet, the effects of these technologies over time remain unexplored. In this study, we use a factorial design to assess the impact of embodiment and time spent engaging in therapeutic exercises on participant disclosures. We assessed transcripts gathered from a two-week study in which 26 university student participants completed daily interactive Cognitive Behavioral Therapy (CBT) exercises in their residences using either an LLM-powered SAR or a disembodied chatbot. We evaluated the levels of active engagement and high intimacy of their disclosures (opinions, judgments, and emotions) during each session and over time. Our findings show significant interactions between time and embodiment for both outcome measures: participant engagement and intimacy increased over time in the physical robot condition, while both measures decreased in the chatbot condition.

Cognitive behavioral therapy (CBT) is a widely used therapeutic method for guiding individuals toward restructuring their thinking patterns as a means of addressing anxiety, depression, and other challenges. We developed a large language model (LLM)-powered prompt-engineered socially assistive robot (SAR) that guides participants through interactive CBT at-home exercises. We evaluated the performance of the SAR through a 15-day study with 38 university students randomly assigned to interact daily with the robot or a chatbot (using the same LLM), or complete traditional CBT worksheets throughout the duration of the study. We measured weekly therapeutic outcomes, changes in pre-/post-session anxiety measures, and adherence to completing CBT exercises. We found that self-reported measures of general psychological distress significantly decreased over the study period in the robot and worksheet conditions but not the chatbot condition. Furthermore, the SAR enabled significant single-session improvements for more sessions than the other two conditions combined. Our findings suggest that SAR-guided LLM-powered CBT may be as effective as traditional worksheet methods in supporting therapeutic progress from the beginning to the end of the study and superior in decreasing user anxiety immediately after completing the CBT exercise.