Artificial intelligence (AI) is everywhere. Google maps. Amazon recommendations. Netflix’s top picks for you. Siri, Apple’s virtual assistant. Uber arrival time recommendations. However you feel about AI, most of us rely on it these days for something, whether it is picking our movies, helping us find where we want to go, or communicating with our smartphones via voice commands. But would you get therapy from a robot?
Counselling by AI sounds like something out of science fiction, but it’s closer than you might think.
Woebot, a therapy chatbot, based on cognitive behavioural therapy (CBT) principles, is now available through Facebook messenger and on iphones, ipad and android smartphones. Users message Woebot, and Woebot responds, asking about feelings, commiserating, prompting more critical thinking about emotions or situations, and sending additional resources. Woebot will even crack jokes with you. Apparently it has a ‘dad’ sense of humour.
There are already, of course, many existing online programmes that offer CBT for anxiety and depression. For example, in New Zealand the online CBT ‘Beating the Blues’ programme is available via a GP prescription. However, a standard online programme without AI lacks interactivity. Some engagement can be produced by careful course design, for example by including videos and getting the viewer to do offline tasks and to fill in comment boxes during the lesson. Yet this is far removed from the instant messaging offered by a chatbot.
It seems incredible that talking to a chatbot about your feelings could work, but evidence thus far suggests that it does. In a Stanford and Woebot Labs study of 70 college students, researchers found that using Woebot for two weeks substantially reduced the incidence of depression, compared to the control group. (There were, however, no significant improvements in anxiety.) The study’s limited scope should be noted: participant numbers were low, the period of using Woebot was short and no follow-up checks were done to see if the improvement was sustained over a longer period. Nonetheless, the results are interesting and certainly show the potential of chatbots in mental health treatment.
Given Facebook’s attitude towards privacy and data collection, I find this concerning. In real world space, therapy records are treated with strict confidentiality. It’s alarming that virtual world conversations dealing with similar issues and with similar content should have such different levels of privacy and protection.
Woebot is quick to say that it’s not trying to replace ‘real’ offline therapy, that it offers an additional resource, not a substitute. For people seeking tools to tackle depression, having another option is good, particularly one targeted at young people.
However, with a mental health system stretched to breaking point and chronically underfunded, it is easy to see a future in which a cheaper option like AI therapy begins to replace the real thing. Counselling in New Zealand can already be difficult to access through the public system and private sessions with a therapist are prohibitively expensive for many. We need radical change in the mental health system, and AI may be a useful part of that change. However, the availability of technology such as Woebot shouldn’t become an excuse to avoid properly funding human professionals in health care.
By all means, let’s talk to the robots about our feelings. But let’s make sure that we still can talk to people too.
Julia Wells graduated with an M.A. in the field of medical history and a BSc in chemistry from Victoria University of Wellington in 2016. She now works in history and contemporary issues publishing. She is the author of a number of academic articles on tropical medical history and colonial African history.
Read Dressing Well for Going Troppo by Julia, on Corpus, here.