Are Chatbot Therapists Actually Going To Help Us?

 Therapy from your phone. #WATTBA

Therapy from your phone. #WATTBA

From our phones we can find someone to date, order groceries, call a car—and that’s just the beginning.

It’s no surprise that the world wide web's spilling over to mental health care. A growing number of online counseling sites offer a variety of services, from the ability to video-conference with a shrink, anonymously text a therapist, or even direct message an AI chatbot, like WoeBot. But does it actually work? 

At a quick glance, it seems like an amazing idea—a voice of reason right in your pocket whenever stress strikes. A brush with your boss that gave you bad vibes? A sudden case of dread-inducing drama? Instead of picking up your phone to schedule an appointment, your phone will see you now. 

But some experts caution that it’s not possible to order up a good therapy session like you would a pepperoni pizza, suggesting that online counseling may compromise the quality of the mental-health help you’re seeking. Worse: It may not work at all.

There are two main types of digital therapy: Video conferencing offered by licensed therapists (often through reputable agencies or as an extension of the therapist’s practice) and digital sites that allow you to text or chat with someone (not always a licensed professional but a “trained listener” or “life coach.”) Or even, an artificial intelligence program.

In the case of the former, FaceTime can be much like IRL face time. “Video conferencing has not only been shown to have very high satisfaction rates, but very high efficacy rates that are pretty much on par with in-person care,” says Dr. Marlene Maheu, the executive director of the Telebehavioral Health Institute where her focus for decades has been on the ethical risk of using technology to treat mental-health patients.

“But not all online therapy is the same. It’s sort of like, is drinking water good for you? Well yeah, if it’s clean. The same goes for online therapy. It could be a legitimate service that is based on evidence, or it could be someone sitting in their garage claiming to be a therapist.”

What about text or DM therapy? “I don’t know of any research to support someone doing psychotherapy via text messaging,” Maheu says. Other experts, like Dr. Ben Michaelis, a clinical psychologist in New York City who sees patients the old-fashioned way, agrees. “It’s so new, I haven’t seen much data to know if it’s okay to use or if it even works,” he says.

One of the most pockmarked problems with the service, though, is that there’s a key reason a therapist wants to “see” you, Maheu explains. “So much of therapy is in visuals,” she says. “If you’re clenching your teeth or white knuckling the chair and telling me that you’re not upset, I know something is wrong.” A chatbot doesn't quite have that option.

Where with texting or emailing, it’s so easy for things to get lost in translation, and even legit therapists aren’t exactly trained to know when you’re only being emoji-onal or are in need of serious help. 

“Many of these sites have a disclaimer that says if you feel suicidal that you should just call 911, but it’s not that easy when you feel that way,” Maheu warns. “You may be texting about something that seems like a simple problem, but problems have layers and things can get complex. And often when someone starts treatment it’s common to fall apart and start to feel suicidal. And then what?”

But let’s keep it real: There are some serious gaps in mental health care options depending on where you live, and the stigma of asking for help can cause many to stay silent.

It’s for these reasons that Lara Gregorio, L.C.S.W, the director of clinical initiatives at 7 Cups—an online “emotional health and well-being service” that allows you to anonymously chat with a therapist—says services like theirs are necessary.

“Access is an enormous barrier for many individuals seeking treatment — online therapy is accessible and convenient,” Gregorio says. “Clients are able to write to their therapist in the moment of distress, rather than waiting days or weeks to be seen.

"Texting has quickly become the primary means of communication in other areas of life, so it only stands to follow that it will be the form of communication that most feel comfortable with.”

If you do decide to engage in some tech therapy, make sure the person you’re talking with is a licensed mental health care provider in your state, and that the person’s license is in good standing. Chatbots are handy, and definitely novel, but they're not substitute for the real thing.

But you may want to save the online convos for Tinder. Whatever works for you.

If you are experiencing suicidal thoughts, or want to talk to someone, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.

Words: Andrea Stanley