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A therapy chatbot and app for depression and anxiety

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Re: A therapy chatbot and app for depression and anxiety

#21

Post by sbpayne »

kingkawn wrote: post #12

The notion that the impact of talk therapy comes purely from the intellectual discourse seems to me severely misguided. It is the experience of being with the other person and their acceptance of your pain that does so much of the work. To reduce it to the intellect divorced from all physicality seems like a travesty that will only alleviate symptoms experienced while alone, and will do nothing to reacclimate you to…

Woebot is not for talk therapy; it applies cognitive behavioral therapy. Since it's a skill based approach, I don't think it's crazy to think a chat bot could effectively approximate that type of therapy. It's much less open ended than talk therapy.

I don't think we'll see effective talk therapy chat bots for quite some time.

Re: A therapy chatbot and app for depression and anxiety

#23

Post by spuz »

azinman2 wrote: post #20
spuz wrote: post #2

> The students were split into two groups — one was assigned to chat with Woebot over two weeks, while the other was directed to read an e-book about depression. Unlike the students in the e-book group, those using Woebot said they saw a significant reduction in their depressive symptoms. It sounds interesting. It also reminds me of ELIZA[1] a chat bot designed in the 60s to demonstrate the superficiality of human co…

Clearly you haven’t tried Woebot. There is no free form dialog. It’s basically a scripted book plus videos that uses the UI of chat but gives you no freedom of expression.

No I haven't tried it. I am making the assumption that a chatbot allows you to input freeform text for it to analyse and process? Is that not how it works?

Re: A therapy chatbot and app for depression and anxiety

#25

Post by spuz »

AnIdiotOnTheNet wrote: post #16
moh_maya wrote: post #9

Earlier quoted context omitted.

This! I parrot this on every thread that is remotely relevant. Depression and anxiety are complex problems that are incredibly personal (in the sense that they are unique to the individual). More so than most other disorders. Ergo: 1) No off the shelf solution like popping an ibuprofen for body aches 2) what works for others may not work for you 3) one needs to try multiple solutions 4) and most important, have a pro…

On the other hand, having lived most of my life in varying states of depression and having seen doctors when it was at its worst and I was diagnosed with major clinical depression, it is my considered opinion that treating depression is one of those things that doctors are really crap at. The problem seems to me to be that they have a high confidence in a model that isn't very good. Which isn't to say that drugs can'…

> Which isn't to say that drugs can't help, just that they're very much treating the symptoms and not at all the underlying cause.

This is obviously not true for some people. If you have a genetic condition that means you cannot produce certain essential chemicals (let's say Vitamin D) and your deficiency is causing your brain to function inefficiently making you feel depressed then the genetic condition is the cause and the drugs are the cure. You seem to be refuting "what works for you might not work for others" by saying that drugs cannot treat the underlying cause of depression.

Re: A therapy chatbot and app for depression and anxiety

#26

Post by pattisapu »

kingkawn wrote: post #12

The notion that the impact of talk therapy comes purely from the intellectual discourse seems to me severely misguided. It is the experience of being with the other person and their acceptance of your pain that does so much of the work. To reduce it to the intellect divorced from all physicality seems like a travesty that will only alleviate symptoms experienced while alone, and will do nothing to reacclimate you to…

I saw a therapist for some time who was taught by an old German psychotherapist who, when asked about whether he could do it over the phone, responded no -- it must be in person -- "If you can't kill them or fuck them, you can't do the work!"

Re: A therapy chatbot and app for depression and anxiety

#27

Post by eivarv »

kingkawn wrote: post #12

The notion that the impact of talk therapy comes purely from the intellectual discourse seems to me severely misguided. It is the experience of being with the other person and their acceptance of your pain that does so much of the work. To reduce it to the intellect divorced from all physicality seems like a travesty that will only alleviate symptoms experienced while alone, and will do nothing to reacclimate you to…

What do you base that on? The studies I've read about remote CBT seem promising

I'm very skeptical of apps and products that claim to be based on CBT or "mindfulness" and/or claim to cure various mental illnesses (mostly because these commercial actors use buzzwords rather than conform with the formal definitions used in research), but I don't think we should offhandedly discount all possibilities.

Re: A therapy chatbot and app for depression and anxiety

#28

Post by fragmede »

spuz wrote: post #23
azinman2 wrote: post #20

Earlier quoted context omitted.

Clearly you haven’t tried Woebot. There is no free form dialog. It’s basically a scripted book plus videos that uses the UI of chat but gives you no freedom of expression.

No I haven't tried it. I am making the assumption that a chatbot allows you to input freeform text for it to analyse and process? Is that not how it works?

That's the dream, unfortunately, the limitations on the analysis and processing part were immediately apparent when I tried messaging Woebot (paraphrased):

    Woebot: Write a negative thought

    Me: Testing abc

    Woebot: Would you like to work on Testing abc?
Or especially worse for someone who is so hurt about being ignored that they're seeking counseling via a bot online, is being ignored by a bot:

    Woebot: Can you think of a time when...

    Me: Well, so...

    Woebot: *Blindly replies with the next line in the script.*

Re: A therapy chatbot and app for depression and anxiety

#29

Post by randomdrake »

Study: Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial

Citation: Fitzpatrick KK, Darcy A, Vierhile M. JMIR Ment Health 2017; 4(2):e19.

Link: https://doi.org/10.2196/mental.7785

DOI: 10.2196/mental.7785

Abstract:

Background: Web-based cognitive-behavioral therapeutic (CBT) apps have demonstrated efficacy but are characterized by poor adherence. Conversational agents may offer a convenient, engaging way of getting support at any time.

Objective: The objective of the study was to determine the feasibility, acceptability, and preliminary efficacy of a fully automated conversational agent to deliver a self-help program for college students who self-identify as having symptoms of anxiety and depression.

Methods: In an unblinded trial, 70 individuals age 18-28 years were recruited online from a university community social media site and were randomized to receive either 2 weeks (up to 20 sessions) of self-help content derived from CBT principles in a conversational format with a text-based conversational agent (Woebot) (n=34) or were directed to the National Institute of Mental Health ebook, “Depression in College Students,” as an information-only control group (n=36). All participants completed Web-based versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Positive and Negative Affect Scale at baseline and 2-3 weeks later (T2).

Results: Participants were on average 22.2 years old (SD 2.33), 67% female (47/70), mostly non-Hispanic (93%, 54/58), and Caucasian (79%, 46/58). Participants in the Woebot group engaged with the conversational agent an average of 12.14 (SD 2.23) times over the study period. No significant differences existed between the groups at baseline, and 83% (58/70) of participants provided data at T2 (17% attrition). Intent-to-treat univariate analysis of covariance revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms of depression over the study period as measured by the PHQ-9 (F=6.47; P=.01) while those in the information control group did not. In an analysis of completers, participants in both groups significantly reduced anxiety as measured by the GAD-7 (F1,54= 9.24; P=.004). Participants’ comments suggest that process factors were more influential on their acceptability of the program than content factors mirroring traditional therapy.

Conclusions: Conversational agents appear to be a feasible, engaging, and effective way to deliver CBT.

Re: A therapy chatbot and app for depression and anxiety

#30

Post by dalbasal »

kingkawn wrote: post #12

The notion that the impact of talk therapy comes purely from the intellectual discourse seems to me severely misguided. It is the experience of being with the other person and their acceptance of your pain that does so much of the work. To reduce it to the intellect divorced from all physicality seems like a travesty that will only alleviate symptoms experienced while alone, and will do nothing to reacclimate you to…

..depends what you consider this in contrast to. As an alternative to writing a journal (for example), it might be useful.
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