Everyday chats with a conversational AI may treat depression as effectively as weekly sessions with a human therapist. Those are the results of a recent study out of Stanford University and, if they hold true, they could revolutionize the way we approach mental health.
Chatbots are everywhere—online, in our phones, and on our counters. They troll Twitter. They're usually the obstacle between you and a customer service agent. Over the past year they've found a handful of roles in healthcare—analyzing symptoms, offering remedies, and sometimes diagnosing conditions—but they've never been scientifically shown to act as a successful therapist.
The aforementioned study tested a new chatbot called Woebot (which was created by one of the researchers) with 70 participants between the ages of 18 and 28. Half of them chatted with Woebot every day, while the other half read excerpts from an e-book about mental health. The group who used Woebot said they had significant reductions in symptoms of depression compared to people in the control group.
For two weeks, Woebot would check-in on Facebook Messenger randomly throughout the day. It would ask participants if now was a good time to talk and prompt them with questions about their mood and energy level. When participants responded with negative emotions, Woebot would offer suggestions on how to change their perspective and reframe their feelings. All the while the system gave them nuggets of knowledge about how thoughts, feelings, and behaviors are all related, and how influencing one can improve the others.
These nuggets and intimate inquiries—in fact, Woebot's whole approach to counseling—are based on cognitive behavioral therapy (CBT), currently the most effective and most rigorously studied method for treating mental disorders. It also happens to be very structured and formulaic, which lends itself well to a chabot whose primary "intelligence" is a decision tree.
Woebot's apparent success as a therapist likely comes from its persistence and the short, punchy sessions it gets. A traditional CBT therapist might meet with a patient for one long session once a week. Woebot checks-in every day at varying times, grabbing participants in their worst or best or most mundane moods, to get an averaged take on their overall state. "The overall dosage is similar to one session because it accumulates to be about 50 minutes over the course of a week but it's in smaller chunks, which seems to be a more effective way to learn," says Alison Darcy, clinical psychologist and founder of Woebot Labs. "And people are accessing and talking to Woebot in vivo, right in the moment when they can most benefit from that kind of learning, being walked through the process of reframing how they're thinking about something."
Woebot may be the first scientifically backed chatbot therapist, but it isn't the first ever or even the best known. Back in the 1960s, an MIT researcher named Joseph Weizenbaum created a program called ELIZA, which simulated the inquisitive style of a Rogerian psychotherapist.
Weizenbaum later admitted that ELIZA was meant to be a joke. In creating the program he'd wanted to point out how ridiculous and superficial communication between humans and machines could be. Instead, users developed intimate connections with ELIZA. According to Weizenbaum's own account, at one point his secretary asked him to leave the room while she was speaking with ELIZA, so as to not disrupt their privacy.
Darcy is not surprised. "As social beings I don't think it's at all strange that we anthropomorphize these machines," she says.
Woebot is available for $39 per month after a two-week trial. This may seem like a lot for a chatbot but Darcy says, "That's less than five percent of the cost of the cheapest CBT therapist and about 40 percent cost of a co-pay," for someone with insurance.
It's also about the principle. Although Darcy acknowledges that Woebot isn't a licensed physician—and suggests that anyone with serious mental health disorders seek professional help—she considers the technology a step towards democratizing healthcare and delivering it to patients who might otherwise go without treatment.
"We want to bring quality help to people who don't have access to therapy," she says. "And so we decided to go direct to consumer to empower them to invest in their own mental health."
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