Social anxiety disorder affects approximately 12% of Western populations. STePS-Ai compares AI-delivered cognitive behavioral therapy (CBT) and psychodynamic therapy (PDT) for social anxiety in a randomized controlled trial. The AI chatbots are programmed to deliver either CBT or PDT protocols, though their adherence to these therapeutic frameworks remains to be evaluated. This study builds on findings from the initial STePS project showing minimal differences between therapist-guided and self-guided interventions.Ninety participants (LSAS-SR ≥30) are randomized 1:1:1 to AI-delivered CBT, AI-delivered PDT, or waitlist control. Both active treatments consist of 4-week smartphone-based interventions where an AI assistant provides daily text-based conversations through end-to-end encrypted applications. The Social Phobia Inventory (SPIN) serves as the primary outcome measure, with additional assessments including LSAS-SR, PHQ-9, GAD-7, Session Alliance Inventory, and Client Satisfaction Questionnaire. Analysis follows intention-to-treat principles using linear mixed models, with response defined as ≥30% reduction in SPIN scores.The study is currently ongoing with the 4-week treatment phase and post-assessment expected to be completed by the conference date, allowing presentation of preliminary findings on the comparative effectiveness of these approaches.This preliminary investigation contributes incrementally to the expanding literature on AI-delivered psychological interventions. Findings should be interpreted with caution given methodological limitations and the need for replication. Future research must systematically examine therapeutic alliance formation, treatment fidelity, and comparative effectiveness against traditional delivery methods across diverse clinical populations. While potentially informative regarding treatment modality differences, results represent only one step in the empirical evaluation of AI-assisted psychological interventions for social anxiety disorder.

Background and aims: Interest in psychedelic research has grown significantly in recent years and the naturally derived substance psilocybin, in combination with therapy, has shown promising results as a treatment for a range of psychiatric conditions. However, the negative effects and risks of psilocybin-assisted treatment are not well-established. The purpose of this study was to investigate the potential negative effects of psilocybin-assisted psychological interventions in both the short and long term.Method: Semi-structured interviews were conducted with eight psychedelic treatment providers and facilitators. Their content was thematically interpreted.Results: Three themes of short-term negative effects were identified. They included negative reactions to psilocybin dosing sessions, undesirable processes in the therapeutic relationship, and difficult self-experiences. Four themes of long-term negative effects were identified. They included destabilization of the client, difficulties adapting to life post-treatment, complications in the treatment relationship, and undesirable outcomes.Conclusions: These results highlight the multifaceted challenges clients may face, emphasizing the need for thorough pre-intervention assessment and post-intervention support. The findings both confirm previous research and highlight new aspects that can contribute to increased safety and be relevant for clinical implementation. Further rigorous research is needed to ensure safety, establish ethical guidelines, and optimize the positive effects of these experimental medicines. Integrating various research approaches and types of measurements will be vital to further our understanding of negative effects of psychedelic-assisted therapy.

Guided self-help is an evidence-based intervention used globally. Self-help is a fundamental part of the stepped care model of mental health services that enables the efficient use of limited resources. Despite its importance, there is little information defining the role of the guide and the key competences required. In this context, the guide is defined as the person who facilitates and supports the use self-help materials. This article sets out the role of the guide in guided self-help. It considers practical issues such as the importance of engagement to motivate clients for early change, personalising the intervention, structuring sessions, how best to use routine outcome monitoring and supervision requirements. Key competences are proposed, including generic competences to build the relationship as well as specific competences such as being able to clearly convey the role of the guide to clients. Guides should be prepared for “self-help drift”, a concept akin to therapist drift in more traditional therapies. Knowing how to identify mental health problems, use supervision and manage risk and comorbidity are all key requirements for guides. The paper concludes by calling for increased recognition and value of the role of the guide within mental health services.

Background: This study assessed the potential effectiveness, acceptability and feasibility of a tailored mindfulness-based intervention (MBI, REMIND 2.0) for personal recovery among people with mental illness during the COVID-19 pandemic. Methods: In this pilot mixed methods randomized controlled trial, participants were assigned to either the MBI (n = 14) or the relaxation training (RT) (n = 14). Quantitative measures were used to assess primary outcomes, including personal recovery, mindfulness, self-compassion, resilience, and secondary outcomes, including depression, stress, anxiety, positive and negative moods, quality of life and general health at baseline (T0), post-intervention (T1) and one-month follow-up (T2). Quantitative interviews were conducted to explore the experiences and perceptions toward the MBI. Results: Results indicated significant group and time interactions for all outcomes except anxiety and stress. MBI participants showed significant improvements in all outcomes at T1, which were maintained at T2, except for positive mood. RT participants showed a significant decline in resilience but significant improvements in all secondary outcomes at T1, but all outcomes significantly declined at T2, except for anxiety and stress. MBI participants were receptive toward the programme in all aspects of personal recovery. Conclusions: The tailored MBI is a potentially effective, feasible and acceptable approach to facilitate personal recovery among people with mental illness. Differences between MBI and RT are discussed.