A systematic review of artificial intelligence in child and adolescent interventions: from psychotherapy to developmental support

Abstract

The integration of artificial intelligence (AI) into child and adolescent psychotherapy has gained traction in recent years, driven by the increasing demand for accessible and effective mental health services. This systematic review investigates how AI has been applied in child and adolescent psychiatry, particularly as a psychotherapeutic, psychoeducational, or developmental support intervention. To achieve this, we conducted a comprehensive literature search and identified 38 relevant studies. These studies were categorized based on their utilization of conversational agents, game-based platforms, and robotic systems in psychotherapy and developmental support. To clarify the scope, "AI-assisted" interventions were defined as structured interventions rely primarily on rule-based or semi-adaptive mechanisms to support therapeutic processes, whereas 'AI-based' interventions refer to systems that employ core artificial intelligence functionalities, enabling autonomous data processing and context-sensitive response generation. The findings highlight AI's potential to enhance therapeutic outcomes, improve accessibility, and deliver personalized interventions. However, ethical considerations, clinician perspectives, and the maintenance of the therapeutic alliance remain critical challenges. Unlike previous reviews that focused on a single AI-based intervention type, this review takes a comprehensive approach by examining the combined impact of chatbots, game-based therapies, and social robots in child and adolescent mental health care. By synthesizing findings across these AI modalities, this review highlights key synergies, such as multimodal engagement, adaptive learning, seamless support across contexts, reinforcement of therapeutic skills, and comprehensive behavioral monitoring. These synergies illustrate how AI-assisted interventions can complement each other, creating a more personalized, engaging, and effective therapeutic experience. Furthermore, by synthesizing recent advancements, this review underscores the need for interdisciplinary collaboration and rigorous evaluation to optimize AI's role in child and adolescent mental health care. This systematic review is registered with PROSPERO (CRD42025638495, January 27th, 2025).