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However, most studies on how to design chatbots to treat depression have focused on adult populations or prevention in the general population.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the problems faced by youth with depression and their adaptive coping strategies, as well as attitudes, expectations, and design preferences for chatbots designed to treat depression.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a qualitative study, consisting of a semistructured interview and a concurrent think-aloud session, in which participants interacted with a chatbot prototype with 14 youth with a current or remitted depressive episode.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The participants reported a wide range of problems beyond core depressive symptoms, such as interpersonal challenges, concerns about school and the future, and problems with human therapists. Adaptive coping strategies varied, with most seeking social support or engaging in pleasant activities. Attitudes toward chatbots for depression treatment were predominantly positive, with participants expressing less anxiety about using a chatbot than about seeing a human therapist. Participants showed diverse and partially contradictory design preferences, which included diverse dialogue topics, such as discussing daily life, acute problems, and therapeutic exercises, as well as various preferences for personality, language use, and personalization of the chatbot.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our study provides a comprehensive foundation for designing chatbots that meet the unique needs and design preferences of youth with depression. These findings can inform the design of engaging and effective chatbots tailored to this vulnerable population.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/66632","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T17:56:13Z","timestamp":1743443773000},"page":"e66632-e66632","source":"Crossref","is-referenced-by-count":12,"title":["Designing Chatbots to Treat Depression in Youth: Qualitative Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1032-6982","authenticated-orcid":false,"given":"Florian Onur","family":"Kuhlmeier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8034-3326","authenticated-orcid":false,"given":"Luise","family":"Bauch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1423-1777","authenticated-orcid":false,"given":"Ulrich","family":"Gnewuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-276X","authenticated-orcid":false,"given":"Stefan","family":"L\u00fcttke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.jaac.2018.07.896","article-title":"Systematic review and meta-analysis: adolescent depression and long-term psychosocial outcomes","volume":"58","author":"Clayborne","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"9820","key":"R2","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S0140-6736(11)60871-4","article-title":"Depression in adolescence","volume":"379","author":"Thapar","journal-title":"Lancet"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2018.12.008","article-title":"Effectiveness of CBT for children and adolescents with depression: a systematic review and meta-regression analysis","volume":"57","author":"Oud","journal-title":"Eur Psychiatry"},{"issue":"7","key":"R4","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1097\/MLR.0b013e31803bb4c1","article-title":"Help-seeking and access to mental health care in a university student population","volume":"45","author":"Eisenberg","journal-title":"Med Care"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1782","article-title":"Barriers of mental health treatment utilization among first-year college students: first cross-national results from the WHO World Mental Health International College student initiative","volume":"28","author":"Ebert","journal-title":"Int J Methods Psychiatr Res"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-244X-10-113","article-title":"Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review","volume":"10","author":"Gulliver","journal-title":"BMC Psychiatry"},{"issue":"2","key":"R7","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s00787-019-01469-4","article-title":"Why do children and adolescents (not) seek and access professional help for their mental health problems? 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