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Illinois limits the use of AI in therapy and psychotherapy

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Re: Illinois limits the use of AI in therapy and psychotherapy

#21

I was just reading about a suicide tied to AI chatbot 'therapy' uses. This stuff is a nightmare scenario for the vulnerable.

If you want to feel worried, check the Altman AMA on reddit. A lottttt of people have a parasocial relationship with 4o. Not encouraging.

Re: Illinois limits the use of AI in therapy and psychotherapy

#23

Here is what Illinois says: https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/news... I get the impression that it is now illegal in Illinois to claim that an AI chatbot can take the place of a licensed therapist or counselor. That doesn't mean people can't do what they want with AI. It only means that counseling services can't offer AI as a cheaper replacement for a real person. Am I wrong? This sounds good to…

In another comment I wondered whether a general chatbot producing text that was later determined in a courtroom to be "therapy" would be a violation. I can read the bill that way, but IANAL.

That's an interesting question that hasn't been tested yet. I suspect we won't be able to answer the question clearly until something bad happens and people go to court (sadly.) Also IANAL.

Re: Illinois limits the use of AI in therapy and psychotherapy

#25
As far as I can tell, a lot of therapy is just good common-sense advice and a bunch of 'tricks' to get the patient to actually follow it. Basically CBT and "get the patient to think they figured out the solution themselves (develop insight)". Yes, there's some serious cases where more is required and a few (ADHD) where meds are effective; but a lot of the time the patient is just an expert at rejecting helpful advice, often because they insist they're a special case that needs special treatment.

Therapists are more valuable that advice from a random friend (for therapy at least) because they can act when triage is necessary (e.g. send in the men in white coats, or refer to something that's not just CBT) and mostly because they're really good at cutting through the bullshit without having the patient walk out.

AIs are notoriously bad at cutting through bullshit. You can always 'jailbreak' an AI, or convince it of bad ideas. It's entirely counterproductive to enable their crazy (sorry, 'maladaptive') behaviour but that's what a lot of AIs will do.

Even if someone makes a good AI, there's always a bad AI in the next tab, and people will just open up a new tab to find an AI gives them the bad advice they want, because if they wanted to listen to good advice they probably wouldn't need to see a therapist. If doctor shopping is as fast and free as opening a new tab, most mental health patients will find a bad doctor rather than listen to a good one.

Re: Illinois limits the use of AI in therapy and psychotherapy

#26
post #8

Good. It's difficult to imagine a worse use case for LLMs.

Just using an LLM as is for therapy, maybe with an extra prompt, is a terrible idea. On the other hand, I could image some more narrow uses where an LLM could help. For example, in Cognitive Behavioral Therapy, there are different methods that are pretty prescriptive, like identifying cognitive distortions in negative thoughts. It's not too hard to imagine an app where you enter a negative thought on your own and exe…

LLMs would be just as terrible at that usecase as any other kind of therapy. They don't have logic, and can't determine a logical thought from an illogical one. They tend to be overly agreeable, so they might just reinforce existing negative thoughts.

It would still need a therapist to set you on the right track for independent work, and has huge disadvantages compared to the current state-of-the-art, a paper worksheet that you fill out with a pen.

Re: Illinois limits the use of AI in therapy and psychotherapy

#27

Here is what Illinois says: https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/news... I get the impression that it is now illegal in Illinois to claim that an AI chatbot can take the place of a licensed therapist or counselor. That doesn't mean people can't do what they want with AI. It only means that counseling services can't offer AI as a cheaper replacement for a real person. Am I wrong? This sounds good to…

Correct. It is more provider-oriented proscription ("You can't say your chatbot is a therapist.") It is not a limitation on usage. You can still, for now, slavishly fall in love with your AI and treat it as your best friend and therapist. There is a specific section that relates to how a licensed professional can use AI: Section 15. Permitted use of artificial intelligence. (a) As used in this Section, "permitted use…

Yes, but also "An... entity may not provide... therapy... to the public unless the therapy... services are conducted by... a licensed professional".

It's not obvious to me as a non-lawyer whether a chat history could be decided to be "therapy" in a courtroom. If so, this could count as a violation. Probably lots of law around this stuff for lawyers and doctors cornered into giving advice at parties already that might apply (e.g., maybe a disclaimer is enough to workaround the prohibition)?

Re: Illinois limits the use of AI in therapy and psychotherapy

#30

Earlier quoted context omitted.

Correct. It is more provider-oriented proscription ("You can't say your chatbot is a therapist.") It is not a limitation on usage. You can still, for now, slavishly fall in love with your AI and treat it as your best friend and therapist. There is a specific section that relates to how a licensed professional can use AI: Section 15. Permitted use of artificial intelligence. (a) As used in this Section, "permitted use…

Yes, but also "An... entity may not provide... therapy... to the public unless the therapy... services are conducted by... a licensed professional". It's not obvious to me as a non-lawyer whether a chat history could be decided to be "therapy" in a courtroom. If so, this could count as a violation. Probably lots of law around this stuff for lawyers and doctors cornered into giving advice at parties already that might…

Functionally, it probably amounts to two restrictions: a chatbot cannot formally diagnose & a chatbot cannot bill insurance companies for services rendered.
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