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February 1, 2023

ChatGPT and Artificial Intelligence in Therapy and Mental Health

By Jess Spooner, JD, MSW

What is chatbot therapy?

Is there an AI therapist?

Are people really using ChatbotGPT for therapy instead of going to a real therapist?

Recently, you may have heard of ChatGPT (an AI chatbot that mimics human communication created by for-profit lab OpenAI) that people are using to write term papers, draft legal documents, and even for conversation and therapy sessions.

You may be wondering how artificial intelligence (AI) apps and chatbots are being used to assist people with their mental health concerns.

There are many different AI chatbots and apps available and in use today.

AI technology can provide helpful advice and intervention for those experiencing loneliness, social isolation, and mental health issues.

However, it can also raise ethical concerns. 

Before using AI apps in your practice or recommending them to your clients, it’s important to understand the implications involved.

This article explores the pros and cons of using AI in therapy and mental health services.

We’ll also examine the ethical implications so you can make an informed decision about whether or not — or how — you feel comfortable utilizing AI technology in your practice. 

First, What Is Artificial Intelligence?

Artificial intelligence is any technology that mimics human cognition and behavior, including decision-making, problem-solving, and learning.

It’s technology designed to function in a way that’s similar to the human mind.

AI is created to solve problems, make decisions, and complete tasks in a way that resembles the human thought process. It’s commonly used in a variety of industries — including, now, in mental health services.

Artificial intelligence is not just one thing.

There are many different types of AI, including natural language processing (NLP), robotics, machine learning, and computer vision.

Natural language processing is a type of AI that lets computers process language in the same way that humans do. It can be used to generate questions and instructions for therapy, such as by prompting a therapist to ask specific questions at certain times during therapy.

NLP can also be used to automate the process of screening for disorders, such as screening for depression or anxiety, by having clients input their symptoms into an app.

What About People Using Chatbots and ChatGPT for Therapy?

One of the best-known examples of artificial intelligence using NLP are programs called chatbots — which simulate conversation with humans through text or speech.

You may have heard of ChatGPT and how people have been using it to conduct screenings for anxiety and depression and even for their own ad hoc therapy sessions of sorts.

Some initial research shows people interacting with these chatbots are largely comfortable and satisfied with their interactions with the machines.

For example, a 2021 study of about 800 people experiencing self-reported social isolation and oneliness had them interact via text messages with a chatbot. The study
found most users reported they were satisfied and would recommend the chatbot to a friend or colleague.

Some Other Common Artificial Intelligence Used in Mental Health 

In addition to chatbots like ChatGPT, there are many other AI apps available.

Some are more common in mental health services than others.

For example, there are many mood trackers and mood loggers. Most of these apps allow users to respond to prompts about their mood. Mood trackers also collect other data like sleep patterns or activity levels. Mood loggers may also allow users to type in a response to a mood prompt or write about their feelings in

1.Diagnostic Apps

These apps provide screening tests for mental health conditions, not limited to client-answered questions only, and provide a determination on whether someone meets the criteria for specific mental health diagnoses.

2. Cognitive Behavioral Therapy (CBT) Apps

These apps provide CBT exercises for mood management, stress reduction, and other mental health issues.

3. Cognitive Restructuring Apps

These apps help people identify and challenge negative thoughts and feelings.

4. Medication Reminder Apps

These apps remind users to take their medications. They are helpful for people with mental health issues who are taking medication.

5. Meditation Apps

These apps provide guided meditation exercises that users can follow along with on their phone.

6. Mindfulness Apps

These apps provide guided mindfulness exercises that can help people manage their stress and negative thoughts.

Ethical Implications of Using AI in Mental Health

There are many ethical implications to consider around using AI chatbots and apps in mental health services.

First, you should carefully select the AI apps that you use in your practice based on privacy policies, discrimination policies, and app functionality. This can help you avoid
selecting a bad or inappropriate app, which may jeopardize the privacy, confidentiality, or general treatment of your client. 

Second, you should make sure that your clients understand the features and limitations of the apps so that they can get the most out of them.

Third, you should monitor your clients’ progress with the apps so that you can make any necessary adjustments. This can help you ensure that the app is providing optimal
support and assistance. 

And lastly, you should be careful not to over-rely on AI chatbots and apps.

They are helpful tools and can provide better, more relevant support. However, they shouldn’t replace face-to-face therapy, medication, or other important aspects of mental health care.

Many AI chatbots and apps provide information to the user without direct evaluation from a medical or mental health professional.

While this can be helpful to the user, it can also be problematic. Humans are social beings and often benefit from communicating with other people.

Using AI apps alone may reduce the opportunities for social interaction.

In addition, some AI apps are designed to provide feedback without human intervention. This may be helpful for some users, but it can also be problematic for others.

Feedback from a human is often important because it allows the user to learn from their mistakes and correct their behavior as they go along. Without human feedback, a user
may not be aware of their mistakes and won’t have the opportunity to learn from them and improve their skills. 

Additionally, AI chatbots and apps are currently regulated by any professional board. Therefore, those using them for mental health services may not be getting the same level of care they would receive from a licensed mental health professional.

Clients may be using a chatbot or app that was designed by programmers and hasn’t been researched, evaluated, or tested in the same way that a mental health professional would be.

When people use a chatbot or mental health app, they don’t have the same legal protections as they do when they see a licensed mental health professional. Also, chatbots and apps may not be able to provide the same level of care that a mental health professional would provide, which could mean that people may not receive
the support they need.

On the positive side though, chatbots and AI apps could increase access to mental health services.

It’s often difficult to find therapists who are available and accepting new clients.

If a person needs to talk to a mental health professional right away and they are not able to get an appointment — an AI chatbot — such as ChatGPT, may give them immediate access to mental health support when they need it.

Chatbots and AI apps may also help people who may experience stigma or discomfort with seeking traditional therapy for their mental health concerns.

Clearly, chatbots and AI apps have both benefits and drawbacks, and more research is needed.

It’s essential to use your own clinical and ethical judgment before recommending or helping a client use a chatbot or AI app. 

Helping Your Clients Understand the Use of Artificial Intelligence in Mental Health

If you do decide to use AI apps in your practice, there are a few things you can do to help your clients benefit from them.

First, be sure to explain the benefits and drawbacks of the AI chatbots and apps to your clients.

Let them know that while they can be helpful, they’re not a real person. This can help them understand the app better and reduce any social stigma they may feel towards it.

Also, make sure your clients understand that while the app can provide helpful feedback, it does not replace human contact. Encourage them to use the app in conjunction with other activities, therapy, and support groups. 

You can also encourage your clients to modify the AI app, if possible, to meet their needs.

While many AI apps are designed to provide generic advice and feedback to a wide variety of people, many can usually be customized to help each individual client.

If your client is using an AI chatbot or app, you can help them modify it so that it provides the appropriate advice for their needs. In doing so, you can provide your clients with the best possible mental health support. This can help your clients get the most out of the apps, and it can free you up to focus on other important aspects of therapy that the chatbots or apps can’t provide.

Artificial intelligence has the potential to provide helpful, supportive tools for people to use with their mental health.

As we discussed, however, these AI chatbots and apps do pose some ethical concerns.

Most importantly, they’re not regulated by a professional mental health board. And, additionally, they’re often not required to have a licensed mental health professional
on staff.
You can carefully weigh the pros and cons of using AI chatbots and apps, and make the decision whether or not to recommend them or use them based on your individual clients and their unique needs.

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