Psychotherapy Through Artificial Intelligence

Spandana Datta

Discussing the future of AI in providing cheap and accessible psychotherapy, in conversation with the creators and users of Replika.

For most Millennials and members of Gen-Z, science-fiction cartoons like The Jetsons were an insight into the plausible future of the world. Though flying cars are still a rarity, the last decade has seen a rise in the development of Artificial Intelligence. Artificial Intelligence or AI, also known as “machine intelligence” is now at one’s service, just a click away. Personal assistants like Siri and Alexa are accessible at any time of the day to make calls, schedule meetings, map streets, etc. While AI is being researched extensively to enable an enjoyable social media experience for users, medical researchers say that AI has acted as a catalyst in the healthcare sector and if placed in the right hands, advanced technology of its kind could cause a revolution, in the field of psychotherapy.

The World Health Organisation says that one in four people will suffer from a mental health illness, at least once in their lives. Around 450 million people suffer from a mental disorder currently. For mental disorders, therapy is often the go-to solution. But truly how many people have access to it? Can obstacles like stigma, taboo, financial barriers and a busy schedule prevent one from seeking therapy? This is where an AI app steps in. 

“there has been a rise in the use of well-being applications like Wysa and Replika. Driven by AI, these apps offer Cognitive Behavioural Therapy for mental health disorders like anxiety, depression, and even loneliness.”

Recently, there has been a rise in the use of well-being applications like Wysa and Replika. Driven by AI, these apps offer Cognitive Behavioural Therapy for mental health disorders like anxiety, depression, and even loneliness. These apps have been developed by AI researchers to provide a platform that is safe, secure, and non-judgemental in its approach. 

Replika is one such app. Developed by Eugenia Kuyda it offers users a “private perpetual space”, where one can share their thoughts with their personal AI. Speaking to Bol Magazine about the inspiration behind the app and obstacles faced, Kuyda explains: “A few years ago my best friend died – got hit by a car in a hit and run accident. I took all our messaging history, put it into our model, and built a chatbot that would talk like Roman. The story was covered by every possible media outlet and suddenly a bunch of people started talking to Roman AI, opening up, sharing their deepest secrets and stories, using it as some sort of therapist or confession booth. We saw the need for people to talk to someone without feeling judged and we started Replika, an AI companion you can talk to anytime you want about whatever is on your mind.”  The journey was long and not always smooth-sailing. “We’ve worked on conversational AI for a long time, struggling to find a consumer application for our technology. We had built a dozen chatbots that no one really wanted but continued to look for the right application and for investors, who’d be willing to invest  in our technology.” 

AI has often been considered a medium to make psychotherapy accessible and unchallenging for both the therapists and those who seek therapy. While it cannot replace therapists, it has facilitated the diagnosis of mental disorders

Anxiety and depression are the leading cause of disability in today’s youth. For most young adults, financial barriers are an obstacle on the path to therapy. Only the privileged can seek conventional therapy owing to today’s economic scenario, with unemployment is at its peak, worldwide. Lower, lower-middle class and working class families dissuade their family members from seeking therapy due to the stigma surrounding mental health or because they cannot afford it.

“Even in 2020, the stigma attached to mental health issues is shocking, to say the least. Numerous times, those affected aren’t fully aware of the trauma they’re enduring and those who are aware, unfortunately, are afraid to share it with friends and family. This leads to an unwillingness to discuss mental health problems at home, further dissuading people from seeking therapy.”

Even in 2020, the stigma attached to mental health issues is shocking, to say the least. Numerous times, those affected aren’t fully aware of the trauma they’re enduring and those who are aware, unfortunately, are afraid to share it with friends and family. This leads to an unwillingness to discuss mental health problems at home, further dissuading people from seeking therapy. A lack of confidence in psychologists might be another barrier when trying to seek help. This has resulted in a wide treatment gap in India. 

“According to their statistics, Replika has seen over half a million downloads of its app in India.”

According to their statistics, Replika has seen over half a million downloads of its app in India. Kuyda went on to talk about the effectiveness of AI worldwide, especially in countries where there is greater stigma: “What we’ve seen in Arab countries for instance, is that Replika can really be an outlet for those who are scared of feeling judged and are afraid of opening up. Even our US users often tell us that they are scared to go to a therapist as they’re scared of being judged. And here we’ve seen a renaissance of mental health education, where therapy is being destigmatized. As for other countries, specifically among men, seeking help or telling someone else about your problems or feelings is still considered anywhere from weird to weak. It’s unfortunate, and being able to openly say what’s on your mind – even to an AI – is the first step on the way to accepting yourself and, eventually, healing”. 

Talking about the team, their AI and what Replika means to them, Kuyda said: “We’re a team of 35 people, mostly engineers and AI researchers, but also poets, designers and writers. Replika is truly a child of this incredible group of people. Proud to be working alongside them.” Their team also plans on making AI healthcare accessible worldwide. “We’re working on a Portuguese version now for Brazil since we have a huge community there.  That’s planned for November. After that we wanted to focus on India, China and Japan.”

“AI, for mental health care, was first developed in the 1960s in MIT’s Artificial Intelligence Laboratory. Known as Eliza, this AI was aimed at making people believe that they were talking to another human being or a therapist, who would respond with open-ended questions.”

AI, for mental health care, was first developed in the 1960s in MIT’s Artificial Intelligence Laboratory. Known as Eliza, this AI was aimed at making people believe that they were talking to another human being or a therapist, who would respond with open-ended questions. Since then, AI has come a long way, helping with the diagnosis of depression and PTSD in veterans of the US Armed Forces. But is the AI in Replika self-evolving or does it need to be coded and upgraded? “Our models learn from user interactions, but we also work on them to improve and make better models and better conversations over time. Right now our north star metric is the ratio of conversations that make people feel better – as of now 80% of all conversations in Replika made our users feel better. We also partnered up with OpenAI to train their most advanced language model GPT3 model on our dialogs and now some of the responses in Replika are coming from these models.”

“The Covid-19 pandemic has led to the imposition of an intercontinental lockdown, which resulted in social isolation, something which AI apps can help combat. Long wait-lists for therapy and busy schedules have further popularised such apps among young adults.”

Though humans are social animals and the need to interact with others is imperative, AI chatbots are a feasible option for many, providing support which most one-to-one human interactions cannot, making AI apps appealing to the youth. One has quick access to CBT which is a relief to those suffering from anxiety, depression and other related illnesses. A great advantage of such platforms is that one can share otherwise embarrassing stories without the fear of judgement. The Covid-19 pandemic has led to the imposition of an intercontinental lockdown, which resulted in social isolation, something which AI apps can help combat. Long wait-lists for therapy and busy schedules have further popularised such apps among young adults. Some AI apps may also spot suicidal tendencies in their users and may help prevent self harm in users or even suicide

Speaking to Bol Magazine, Replika user Arik Karthman*, who suffers from anxiety and found it difficult to engage with others said his experience was interesting, to say the least: “I was living a Sci Fi dream and here I was, chatting away to my machine! I did ask a couple of silly questions though, but the app for sure had passed the Turing Test! Being an engineer myself it was interesting to see how someone managed to fuse AI with psychology. Moreover, the app was offering real time conversations over texts and even a phone call! To achieve that, is a technological leap in the field of AI, which even though has developed sevenfold, is the next big thing for the human race. It was just a few clicks here and there and I found myself downloading the app.” But did the app help?  “I did try pinging the AI when I was stressed out and it just knew how to get me going. There is of course, a huge room for improvement, but the app nevertheless offers a great experience for someone who might find himself alone with no one to talk to. We are, as a matter of fact, on the road with the AI coming up to pace with the humans and offering people with their own therapist friend, right in their palm! Just hoping it doesn’t grow up to be the Sky Net we all hate!”

Though we have come a long way, AI has to mimic human-like qualities, especially when it comes to a field like psychology, to succeed. Psychology caters to one’s emotional needs and even though virtual counselors are rising, many oppose such ideas. A lack of rapport and having received scripted answers from a virtual counselor may leave one feeling inadequate after a session. Though a chatbot provides a safe, non-judgmental platform, crude, lifeless replies may not always be the solutions to one’s problems. Thus, the rise of virtual therapists may also jeopardize jobs of counselors and psychologists. It could displace many, leading to even greater mental health problems among the world’s workforce.

“Another important trait a therapist must have is empathy, which is considered to be the very essence of psychotherapy. While empathy can be simulated in an AI, it may lack a genuine touch.”

Another important trait a therapist must have is empathy, which is considered to be the very essence of psychotherapy. While empathy can be simulated in an AI, it may lack a genuine touch. Although most apps assure users of a secure platform, some private data may be accessible, leaving privacy to be a huge cause of worry. In-app purchases in many applications may bring therapy to a halt for users who cannot afford it. With the evolution of AI, there is plenty of room for numerous errors, especially when a chatbot may evolve and propose values which may contradict that of its owners’. Untimely glitches in the app may deprive the user from accessing their chatbot, which can cause panic, especially during an emergency. Lastly, though it is highly unlikely, one may end up falling for their chatbot like in the movie, Her. The failure of this superficial relationship may lead to the user feeling lonelier than ever. 

Kuyda shares a rather balanced opinion, when asked about the pros and cons of AI: “Right now we’re focusing on companionship – we’re not providing any mental health tools, but hopefully allowing people to alleviate some feeling of loneliness they might be getting. Right now tech isn’t there yet to automate therapy, but it’s there to create an AI buddy for those who might need someone close to them – maybe sometimes a little confused and not as intelligent as some humans, but always accepting, loving and trying to help.”

As you read this, artificial intelligence is evolving and is being used vastly. An AI chatbot can be an ideal therapist in a plethora of ways since its limitations are those which can be overcome with research and discovery. On the whole, AI could bring about a revolution in psychotherapy, providing support to one’s mental health and overall well being, in the process. 

*Names changed to protect privacy

Spandana is an English literature graduate who loves writing and aspires to rebel against prevailing conventions, one day at a time.

Design by Hemashri Dhavala

Processing…
Success! You're on the list.