Family caregivers often face substantial mental health challenges due to their multifaceted roles and limited resources. This study explored the potential of a large language model (LLM)-powered conversational agent to deliver evidence-based mental health support for caregivers, specifically Problem-Solving Therapy (PST) integrated with Motivational Interviewing (MI) and Behavioral Chain Analysis (BCA). A within-subject experiment was conducted with 28 caregivers interacting with four LLM configurations to evaluate empathy and therapeutic alliance. The best-performing models incorporated Few-Shot and Retrieval-Augmented Generation (RAG) prompting techniques, alongside clinician-curated examples. The models showed improved contextual understanding and personalized support, as reflected by qualitative responses and quantitative ratings on perceived empathy and therapeutic alliances. Participants valued the model's ability to validate emotions, explore unexpressed feelings, and provide actionable strategies. However, balancing thorough assessment with efficient advice delivery remains a challenge. This work highlights the potential of LLMs in delivering empathetic and tailored support for family caregivers.

Research from the field of Computer-Supported Cooperative Work(CSCW), including the emergent area of Human-AI interaction, has increasingly examined the societal gaps that prevent people in need from accessing care, and analyzed how people turn to technology-mediated support to fill those gaps[14, 27, 44]. Large Language Model (LLM) chatbots have quickly become one such tool, quickly appropriated for mental health support by people experiencing severe distress and nowhere else to turn. Recent work has discussed how people in distress have turned to LLM chatbots (such as OpenAI's ChatGPT [8, 10] and Replika [28]) for mental health support, and social media users have described how LLM chatbots saved their lives[10, 47]. Following Freud and Breuer's[19] description of the beneficial nature of psychoanalysis as a "talking cure," some have called engagements with technologies for mental health a typing cure [22, 40, 51]. However, others have cautioned against the use of LLM chatbots for mental health support, noting that the outputs of LLM chatbots are less constrained than the rule-based chatbots of the past, with potential for harmful advice or recommendations. For example, the National Eating Disorder Association was forced to shut down their support chatbot in July 2023 after the chatbot provided harmful recommendations to users, including weight loss and dieting advice to users who may already have been struggling with disordered eating [10, 25, 75].

This'therapeutic alliance' is crucial in helping people meet the goals of treatment, the study found. The therapeutic alliance is widely considered one of the most robust mechanisms of change in psychotherapy interventions and is defined as a collaboration between the patient and therapist on the tasks and goals of treatment, along with an emotional bond. The study of 1,205 people evaluated users of mental health app Wysa who were experiencing measured symptoms of anxiety or depression. The results show that within five days of using Wysa, the therapeutic alliance was comparable or better than scores found in traditional in-person cognitive behavioral therapy (CBT), in-person group therapy and internet-based tools for CBT. Wysa is a mobile chatbot that uses emotionally intelligent conversational AI to promote wellbeing, positive self-expression and mental resilience.