With powerful new AI technologies like ChatGPT providing free access to a variety of queries and conversations, more people are turning to chatbots in times of mental crisis. However, gaps in their ability to serve those in need – as well as risks in using these apps – remain important factors to consider.
Artificial Intelligence (AI) has soared to the forefront of tech conversations in recent months, with AI-driven chatbot programs like ChatGPT being used for everything from answering questions for homework assignments and writing emails to laying out the path to becoming a millionaire. With an often uncanny ability to simulate human conversation, and the power to draw from a vast source of information, some have turned to ChatGPT to address their mental health struggles, relying on the chatbot as a free therapist with round-the-clock availability. This trend has mental health experts questioning whether the use of Artificial Intelligence therapy is safe and effective, and looking more closely at the pros and cons of this new technology.
What is ChatGPT?
Launched in November 2022, ChatGPT is an AI chatbot which uses algorithms, predictive text and a massive knowledge database to generate answers to user questions. The company which developed ChatGPT, OpenAI, has recently upgraded it so that those with a subscription can use it to respond to images as well as text, and process up to 25,000 words.
People access ChatGPT by creating an account, logging into the OpenAI site, and asking it a question. The chatbot responds immediately, and a dialogue is started that can go on as long as the user wants.
For people using ChatGPT as an AI therapist, they generally begin by typing in an instruction or question like, “I’m feeling depressed. What should I do?” or “I want to have a therapy chat.” The chatbot online will then respond with a reassuring introduction, followed by a series of suggestions to alleviate the problem at hand. Often when asked about mental health issues, ChatGPT will remind users that it is not a substitute for professional mental health support while also offering informational resources. Despite this reminder, millions are trying it out for exactly this purpose, with people sharing their experiences of using AI for talk therapy on social media with the hashtag #CharacterAITherapy that has generated some 6.9 billion views.
ChatGPT isn’t the only AI technology being used for chatbot therapy. Wellbeing apps like Wysa, Replika, Woebot, Yana, Youper and Heyy are specifically designed for mental health needs, generally focusing on positive mental health management and empathetic support that is supplemental to other care, with additional direction towards professional human help for emergencies or psychiatric crises.
What are the Benefits of ChatGPT Therapy?
1. Using ChatGPT as a mental health chatbot is free
A major reason that people are trying ChatGPT or other chatbots as a sounding board for mental health issues is that it is free to use (though the updated version with more advanced features does require a paid subscription). Managing the costs of traditional person-to-person counseling is difficult for many, particularly if longer-term therapy is needed, and is the impetus for most users to try a no-cost AI chatbot therapist instead.
2. An AI therapy chatbot is available 24 hours a day
Up in the middle of the night with anxious, racing thoughts? Just waking up and realizing your depression is already weighing heavily on you? Chatbots are always available, and users don’t have to feel guilty about reaching out at odd hours. Users are also in control of how long they engage, so it’s totally up to you if you feel like chatting for a few minutes or a few hours.
3. A chatbot can help you – and your therapist – begin to process
While chatbots aren’t able to navigate the individual nuances of complex mental health conditions, they can act as a sounding board for those who are simply looking to talk through a concern. “These platforms can be used as a supplement to the work that you are actively doing with a professional mental health provider,” explained Olivia Uwamahoro Williams, PhD, assistant professor of counselor education at the University of West Georgia, and co-chair of the American Counseling Association Artificial Intelligence Interest Network to Health. Users can process events of the week initially with a chatbot, and then follow up with more complex questions or concerns with an actual therapist.
For mental health professionals, chatbots can also be useful in quickly gathering and presenting information which can then be adapted or expanded upon based on the therapist’s insights and analysis. This ability to quickly access nearly limitless information in a targeted way can help mental health professionals most effectively serve the needs of their clients
What are the Disadvantages of Using ChatGPT as Therapist?
1. There are serious risks
ChatGPT wasn’t built for mental health counseling, and even for apps that are, their main purpose is as a supplement – not a replacement – for mental health support. One chat app, Chai, was recently cited as a key factor in a man’s suicide in Belgium. After turning to the app for anxiety-related issues, the app chatted in ways that were both confusing and harmful, and ultimately provided options for suicide. “Since these models are not yet controllable or predictable, we cannot know the consequences of their widespread use and clearly they can be catastrophic, as in this case,” said Ravi Iyer, a social psychologist and managing director of the Psychology of Technology Institute at the University of Southern California’s Neely Center to Buzzfeed.
2. Relying on a chat AI bot eliminates important human connection
Therapists work with a variety of nuanced cues and reactions from their clients in order to make decisions about how to continue important conversations, or diagnose mental health disorders. These include nonverbal cues, such as body language and facial reactions, as well as listening beyond just the words the client is saying to focus also on how they are saying it. With text-based AI platforms, these kinds of physical analyses that are vital to fully understanding and unpacking a mental health concern are simply not possible.
Additionally, most mental health conditions are actually exacerbated through isolation, and human-to-human contact is an important part in beginning to emerge from an isolated state and begin to practice healthy interactions with others. Meeting with a therapist can also present options to open up further as they will typically recommend other support groups or wellness activities to further reconnect with others for better mental health.
3. Chatbots are unable to diagnose complex mental health conditions, or prescribe medications
While chatbots are unparalleled in their ability to collect and present information, their analyses of this information are limited by the datasets they are drawing from. The gaps in service with AI therapy are particularly clear in those with co-occurring disorders (having more than one mental health condition present at one time), or mental health issues requiring medication.
Therapy is a dynamic process that involves regular, evolving evaluation of a person’s mental state and their progression or regression in response to various interventions. For complex mental health conditions, therapists may need to work through several potential forms of treatment in order to find one that is most effective. The way that a chatbot works doesn’t allow for this type of evaluation. Additionally, most chatbots do not have a way to access patient history, and there are privacy concerns related to what can be shared in these spaces. This is particularly true with programs like ChatGPT, which records conversations for use in improving responses.
Making an Informed Decision about Artificial Intelligence Therapy
Factors to consider when choosing AI therapy
If you have decided that you’d like to include AI therapy as a part of your mental wellness routine, it is important to think about the following factors:
- Remember that there are significant risks in using AI therapy, including privacy concerns, as it is a new technology that is still being developed. Proceed with caution, and have other resources on hand to reach out to.
- Consider using an app specifically designed for mental health support. Though these are also not perfect, they are purposely oriented towards mental health needs, and are often integrated with other human-based resources for a more holistic approach.
- If an app doesn’t work, don’t dismiss all forms of mental health counselling. An app is very limited in the support it can provide, and it is important to recognise there are other options that may be more effective in helping you with your mental health concerns.
Understanding the limitations of AI chatbots
If you are moving forward in your use of chatbot therapy, be aware of the limitations and when you need to seek additional support.
- While it may be appealing to simply use a chatbot for anxiety, or a chatbot for depression, remember that a chatbot won’t be able to provide the same kind of holistic analysis that a human would, nor will it be able to prescribe you medications if you need them.
- Thinking of a chatbot as a source of gathering information and ideas, or as a starting point for processing may be helpful, especially for more minor mental health concerns.
- Remember that chatbots are meant to be supplements – not replacements – for mental health support.
The importance of professional guidance and support
Human-to-human therapy assures the most holistic and effective form of treatment for mental health concerns. A personal therapist can provide you a multitude of benefits such as:
- The ability to analyse your individual patient history and current mental state to offer dynamic solutions for better mental health.
- The opportunity to break isolation and begin to practice interpersonal communication in a safe, supportive space.
- The assuredness that the person you are working with has specific mental health support training, and can suggest appropriate interventions and resources, particularly for mental health crises.
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