Center for Responsible and Effective AI Technology Enhancement Treatments for PTSD - Nearly 7% of the U.S. population experiences post-traumatic stress disorder (PTSD), which has a substantial impact on quality of life and physical health, and results in high costs to society. While several evidence-based psychotherapies (EBPs) have demonstrated effectiveness in treating PTSD, most individuals with PTSD do not receive these treatments. Access to EBPs is very limited in public and rural mental health contexts that grapple with severe financial constraints while treating a high volume of individuals with PTSD. Innovation is needed to promote the uptake and effective delivery of EBPs in such settings. Large language models (LLMs), a form of Artificial Intelligence (AI), are promising tools to support EBP delivery. They have the potential to provide scalable and just-in-time support to administrators seeking to implement EBPs, therapists who use them, and to support patients between sessions. However, given the unique risks and considerations for mental health intervention, there is an urgent need to meet essential criteria before such tools can be deployed and scaled in an effective and responsible manner. Our team’s Readiness Evaluation for AI Deployment and Implementation (READI) framework posits that these interventions must be safe, private, engaging, and effective; developed and deployed with attention to user experience/perceptions and effective implementation. We propose the Center for Responsible and Effective AI Technology Enhancement of Treatments for PTSD (CREATE), a multidisciplinary center to develop and evaluate LLM-based tools that can address insufficient capacity for EBP implementation, activate key mechanisms of change, and support EBP delivery. CREATE’s Methods Core will bring together experts in clinical psychology, implementation science, computer science (AI, human-computer interaction), tailored PTSD treatment, ethics, biostatistics, and economics. Across three exploratory projects and a signature project, we will develop and evaluate tools to support effective and engaging EBP delivery across the care delivery continuum in VA and community treatment settings. We will develop and evaluate a chatbot to facilitate the development of an implementation plan and support teams as they implement EBPs in public and under-resourced treatment settings (EP#1). We will also design LLM-based tools to support therapists as they learn new EBPs through simulation after initial workshop training (Signature Project), and to provide ongoing consultation and support on specific cases and challenges (EP#3). Finally, we will develop and evaluate a tool to provide support for patients as they complete EBP homework between sessions (EP#4). We will apply the READI evaluation framework to the development, refinement, and evaluation of these tools and conduct project-level and cross-project evaluations on their effectiveness, their costs, and their potential for safe and effective implementation. CREATE’s resulting products and the pilot funding, resources, training, and mentorship provided through our Administrative Core will foster advancement in the emerging field of LLM-based mental health interventions.
