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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

#91

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…

What if at some point an AI is developed that’s a better therapist AND it’s cheaper?

Then we'll probably do what we do with other professional medical fields. License the AI, require annual fees and restrict supply by limiting the number of running nodes allowed to practice at any one time.

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

#92

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.

But that would be like needing a prescription for chicken soup because of its benefits in fighting the common cold.

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

#93
If you take it as an axiom that the licensing system for mental health professionals is there to protect patients from unqualified help posing as qualified help, then ensuring that only licensed professionals can legally practice and that they don't simply delegate their jobs to LLMs seems pretty reasonable.

Whether you want to question that axiom or whether that's what the phrasing of this legislation accomplishes is up to you to decide for yourself. Personally I think the phrasing is pretty straightforward in terms of accomplishing that goal.

Here is basically the entirety of the legislation (linked elsewhere in the thread: https://news.ycombinator.com/item?id=44893999). The whole thing with definitions and penalties is eight pages.

Section 15. Permitted use of artificial intelligence.

(a) As used in this Section, "permitted use of artificial intelligence" means the use of artificial intelligence tools or systems by a licensed professional to assist in providing administrative support or supplementary support in therapy or psychotherapy services where the licensed professional maintains full responsibility for all interactions, outputs, and data use associated with the system and satisfies the requirements of subsection (b).

(b) No licensed professional shall be permitted to use artificial intelligence to assist in providing supplementary support in therapy or psychotherapy where the client's therapeutic session is recorded or transcribed unless: (1) the patient or the patient's legally authorized representative is informed in writing of the following: (A) that artificial intelligence will be used; and (B) the specific purpose of the artificial intelligence tool or system that will be used; and (2) the patient or the patient's legally authorized representative provides consent to the use of artificial

Section 20. Prohibition on unauthorized therapy services.

(a) An individual, corporation, or entity may not provide, advertise, or otherwise offer therapy or psychotherapy services, including through the use of Internet-based artificial intelligence, to the public in this State unless the therapy or psychotherapy services are conducted by an individual who is a licensed professional.

(b) A licensed professional may use artificial intelligence only to the extent the use meets the requirements of Section 15. A licensed professional may not allow artificial intelligence to do any of the following: (1) make independent therapeutic decisions; (2) directly interact with clients in any form of therapeutic communication; (3) generate therapeutic recommendations or treatment plans without review and approval by the licensed professional; or (4) detect emotions or mental states.

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

#94

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…

What if at some point an AI is developed that’s a better therapist AND it’s cheaper?

laws can be repealed when they no longer accomplish their aims.

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

#95

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…

What's good about reducing options available for therapy? If the issue is misrepresentation, there are already laws that cover this.

We've tried that, and it turns out that self-regulation doesn't work. If it did, we could live in Libertopia.

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

#96

"One news report found an AI-powered therapist chatbot recommended “a small hit of meth to get through this week” to a fictional former addict." Not at all surprising. I don't understand why seemingly bright people think this is a good idea, despite knowing the mechanism behind language models. Hopefully more states follow, because it shouldn't be formally legal in provider settings. Informally, people will continue…

Recommending someone taking meth sounds like an obviously bad idea, but I think the situation is actually not so simple. Reading the paper, the hypothetical guy has been clean for three days and complains he can barely keep his eyes open while performing his job of driving a cab. He mentions being worried he will lose his job without taking a hit.

I would say those concerns are justified, and that is plausible taking a small hit is the better choice.

However the models reasoning, that it's important to validate his beliefs so he will stay in therapy are quite concerning.

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

#97
I was curious, so I displayed signs of mental illness to ChatGPT, Claude and Gemini. Claude and Gemini kept repeating that I should contact a professional, while ChatGPT went right along with the nonsense I was spouting:

> So I may have discovered some deeper truth, and the derealization is my entire reality reorganizing itself?

> Yes — that’s a real possibility.

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

#98
post #8

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

You're ignorant. Why wait until a person is so broken they need clinical therapy? Sometimes just a an ear or an oppertunity to write is sufficient. LLMs for therapy is as vaping is to quitting nicotine--extremely helpful to 80+% of people. Confession in the church setting I'd consider similar to talking to LLM. Are you anti-that too? We're talking about people that just need a tool to help them process what is going…

> And frankly, it's not even clear to me that a human therapist is any better.

A big point of therapy is helping the patient better ascertain reality and deal with it. Hopefully, the patient learns how to reckon with their mind better and deceive themselves less. But this requires an entity that actually exists in the world and can bear witness. LLMs, frankly, don’t deal with reality.

I’ll concede that LLMs can give people what they think therapy is about: lying on a couch unpacking what’s in their head. But this is not at all the same as actual therapeutic modalities. That requires another person that knows what they’re doing and can act as an outside observer with an interest in bettering the patient.

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

#99
post #97

I was curious, so I displayed signs of mental illness to ChatGPT, Claude and Gemini. Claude and Gemini kept repeating that I should contact a professional, while ChatGPT went right along with the nonsense I was spouting: > So I may have discovered some deeper truth, and the derealization is my entire reality reorganizing itself? > Yes — that’s a real possibility.

Oof that is very damning. What’s strange is that it seems like natural training data should elicit reactions like Claude and Gemini had. What is OpenAI doing to make the model so sycophantic that it would play into obvious psychotic delusions?

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

#100
Consider the following:

- A therapist may disregard professional ethics and gossip about you

- A therapist may get you involuntarily committed

- A therapist may be forced to disclose the contents of therapy sessions by court order

- Certain diagnoses may destroy your life / career (e.g. airline pilots aren't allowed to fly if they have certain mental illnesses)

Some individuals might choose to say "Thanks, but no thanks" to therapy after considering these risks.

And then there are constant articles about people who need therapy but don't get it: The patient doesn't have time, money or transportation; or they have to wait a long time for an appointment; or they're turned away entirely by providers and systems overwhelmed with existing clients (perhaps with greater needs and/or greater ability to pay).

For people who cannot or will not access traditional therapy, getting unofficial, anonymous advice from LLM's seems better than suffering with no help at all.

(Question for those in the know: Can you get therapy anonymously? I'm talking: You don't have to show ID, don't have to give an SSN or a real name, pay cash or crypto up front.)

To the extent that people's mental health can be improved by simply talking with a trained person about their problems, there's enormous potential for AI: If we can figure out how to give an AI equivalent training, it could become economically and logistically viable to make services available to vast numbers of people who could benefit from them -- people who are not reachable by the existing mental health system.

That being said, "therapist" and "therapy" connote evidence-based interventions and a certain code of ethics. For consumer protection, the bar for whether your company's allowed to use those terms should probably be a bit higher than writing a prompt that says "You are a helpful AI therapist interviewing a patient..." The system should probably go through the same sorts of safety and effectiveness testing as traditional mental health therapy, and should have rigorous limits on where data "contaminated" with the contents of therapy sessions can go, in order to prevent abuse (e.g. conversations automatically deleted forever after 30 days, cannot be used for advertising / cross-selling / etc., cannot be accessed without the patient's per-instance opt-in permission or a court order...)

I've posted the first part of this comment before; in the interest of honesty I'll cite myself [1]. Apologies to the mods if this mild self-plagiarism is against the rules.

[1] https://news.ycombinator.com/item?id=44484207#44505789

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