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Licensed healthcare professionals rated ChatGPT's responses as significantly higher in quality and more empathetic than physician responses. In 78.6% of the 585 evaluations, the informants preferred the LLM responses. The authors suggest that AI can be helpful in assisting with drafting answers to patient questions."},{"key":"10.1016\/j.copsyc.2025.102263_bib55","unstructured":"This study is particularly relevant because it compared perceived empathy in texts generated by an AI chatbot and text written by human psychotherapists, in responses to 150 health questions on a Reddit forum. Each question was answered by a human therapist and by AI, so a total of 300 responses. The AI scored significantly higher regarding perspective-taking and empathetic concern, and the AI's interventions were perceived as more supportive. The responses from therapists were more directed towards advice and information and asking for more clarification. The authors enlarge on potential explanations of these findings and on AI's strengths and weaknesses in comparison with human therapists."},{"key":"10.1016\/j.copsyc.2025.102263_bib56","unstructured":"This recent study evaluates the effectiveness of therapy chatbot Woebot (no longer in use as of July 2025, cf. supra) in relieving symptoms of anxiety and depression over a period of eighteen weeks. The sample consisted of 42 MA students who participated in group counselling courses. The anxiety and depressions levels did not reduce significantly. The respondents also experienced technical defects and language barriers."},{"key":"10.1016\/j.copsyc.2025.102263_bib57","unstructured":"This study focuses on the use of the smartphone app Woebot-LIFE; the sample included 256 adults who were seeking mental health support. Over eight weeks, the researchers observed 1) significant reductions in perceived stress and burn-out, and 2) a significant increase in resilience. Despite these promising results, we need to be critical of the methodology, because of the limited sample, the short-term set-up, and the use of self-report."},{"key":"10.1016\/j.copsyc.2025.102263_bib58","unstructured":"This article systematically reviews nineteen articles on empathy in conversational agents (CAs), that include both rule-based systems, such as Woebot, and LLM engines. The review also compares rule-based systems to LLM engines and discusses their advantages and disadvantages. All reviewed studies included self-report. The review indicates that CAs can evoke empathy within mental healthcare. The authors also discuss several limitations and risks."},{"key":"10.1016\/j.copsyc.2025.102263_bib59","unstructured":"The researchers compared written responses to patient questions (drawn from a public online forum) on cancer generated by three LLM engines (GPT-3.5, GPT-4, and ClaudeAI) with responses from licensed physicians. All responses to, in total, 200 patient questions were rated by six oncologists. Although ClaudeAI performed best, the oncologists rated all the chatbot responses higher than those of the licensed physicians in terms of empathy, quality, and readability. The authors suggest that physician-AI collaboration might be useful for providing empathetic response templates to physicians, although further research is required."},{"key":"10.1016\/j.copsyc.2025.102263_bib60","unstructured":"This study focuses on empathy in the context of peer-to-peer mental health support. The researchers developed and evaluated an AI tool that helped untrained peer supporters with writing more empathetic responses: Human\u2013AI coLlaboration approach for EmpathY (HAILEY). The respondents consisted of 300 TalkLife peer supporters. Results show that the human-AI collaboration improved the empathetic quality of the responses."},{"key":"10.1016\/j.copsyc.2025.102263_bib61","unstructured":"This article incorporates a large sample of 830 respondents who turned out to have difficulties with distinguishing between ChatGPT responses and those written by therapists in a vignette-study about couple therapy. In addition, ChatGPT's responses were overall rated higher in key psychotherapy principles including empathy and cultural competence. 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