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A therapy chatbot for depression

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Re: A therapy chatbot for depression

#41

Post by 659087 »

andrewtbham wrote: post #39
pdeuchler wrote: post #13

There seems to be a new push for technological problems to social illnesses, and it consistently boggles my mind how so many smart "experts" really think people engaging more with computers/phones/AI instead of, you know, engaging more with actual people will solve any kind of social ill.

Hacker news used to be a site with optimistic people, entrepreneurs, people that did stuff, people that built stuff... now it's all whining about people that are actually doing things. It makes me think of the roosevelt speech... It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually…

In this case, the "dust, sweat and blood" could end up on the face of someone suffering from depression who ends up in an even worse situation as a result of that "move fast and break things" entrepreneurial spirit.

This is a field where you're literally playing with peoples' lives. Your "daring failure" could result in suffering and/or death for those people. If you think you should be free to do that without criticism, maybe it's time to learn a thing or two about "ethics".

Re: A therapy chatbot for depression

#42

Post by rschneid »

DigDugDoug wrote: post #37
WalterSear wrote: post #14

Earlier quoted context omitted.

A decent CBT therapist can charge $150+ per hour, and personal change can take years of constant, ongoing effort. For most people right now, it's going to be an app or no treatment at all, particularly if for people who are only mildly impaired by their distress. Besides, it's not an either/or proposition. Personally, I don't think that chatbots are all that useful (I've been building them as a large part of my job f…

It seems like the real danger is the appeal of sacrificing nuanced treatment for convenient treatment. Your comment pointed out that for many people the choice might boil down to a supportive app or nothing. And as you noted, personal change can take years of dedicated person effort. To me, it seems like the biggest risk in the long term isn't in whether or not people get treated. The article demonstrates that the te…

Nearly any new method of treatment opens up new doors for human failings and there will inevitably be some nonzero number of people whose lives are made worse by an overwhelmingly positive experience for humanity and mental health. Let's first worry about making the apps "good enough" for people to feel like they're getting _any_ decent treatment, let alone comprehensive to the point of eliminating the desire for additional human components, before we worry about this strange, potentially irrelevant rabbit hole.

Re: A therapy chatbot for depression

#43

Post by rschneid »

pdeuchler wrote: post #20
WalterSear wrote: post #14

Earlier quoted context omitted.

A decent CBT therapist can charge $150+ per hour, and personal change can take years of constant, ongoing effort. For most people right now, it's going to be an app or no treatment at all, particularly if for people who are only mildly impaired by their distress. Besides, it's not an either/or proposition. Personally, I don't think that chatbots are all that useful (I've been building them as a large part of my job f…

Something isn't adding up here... if this is supposed to be supplemental therapy to talking with an actual human, but instead the actual human part is nixed and it is used as the entirety of therapy (i.e. outside of it's prescribed and tested usage) are we not worried about the negative externalities of replacing human contact with machines for curing social ills? That's not even touching where you've just pointed ou…

Imagine in the future, a really smart shrink AI is invented that can provide useful insight on how mental health of an individual might be improved. Then, everyone who has logs with this bot, or similar technologies, will be able to benefit retroactively simply by having more digital data points.

Just because you're not talking with a human about the data you're generating _today_ doesn't mean it won't bring interesting discussions to bear in the future.

Re: A therapy chatbot for depression

#44

Post by DigDugDoug »

rschneid wrote: post #42
DigDugDoug wrote: post #37

Earlier quoted context omitted.

It seems like the real danger is the appeal of sacrificing nuanced treatment for convenient treatment. Your comment pointed out that for many people the choice might boil down to a supportive app or nothing. And as you noted, personal change can take years of dedicated person effort. To me, it seems like the biggest risk in the long term isn't in whether or not people get treated. The article demonstrates that the te…

Nearly any new method of treatment opens up new doors for human failings and there will inevitably be some nonzero number of people whose lives are made worse by an overwhelmingly positive experience for humanity and mental health. Let's first worry about making the apps "good enough" for people to feel like they're getting _any_ decent treatment, let alone comprehensive to the point of eliminating the desire for add…

What makes you think it's potentially irrelevant? Go by any mental health clinic in your city and ask if there are any patients who have conditions that impair either their ability to come in for treatment or their ability to recognize that they need treatment. I agree with the majority of your rebuttal that, at the moment, it's more productive to focus on simply getting this new treatment to a point of reliable functionality. But that doesn't mean that its potential secondary effects on patient treatment outcomes shouldn't also be considered or explored during experimental trials.

Re: A therapy chatbot for depression

#45

Post by webmaven »

SomeStupidPoint wrote: post #33
aianus wrote: post #31

Earlier quoted context omitted.

The status quo is poor people talk to nobody and rich people talk to humans. This is an improvement, no?

No. The status quo is poor people talk to social contacts (eg, friends, family, church community, etc) while rich people talk to professionals (eg, therapists). This is a change in that poor people are being moved to a professionally manufactured tool, which isn't necessarily an improvement -- it's just replacing an established, ad hoc system with an unknown technical one. There's every possibility that it would make…

> The status quo is poor people talk to social contacts (eg, friends, family, church community, etc) while rich people talk to professionals (eg, therapists).

For some people (particularly those who have large extended families), that is indeed the status quo, but for others not so much.

If your home environment is not supportive (you can imagine responses ranging from "everybody gets depressed sometimes, just work harder and things will get better" to "grow a pair"), or even abusive, and you aren't in a position to get professional help, a tool like this (though given various other concerns, perhaps not this specific one) could very well be the only alternative to no treatment at all.

What comes to mind though, isn't an automated therapist per-se, but something closer to the "Young Lady's Illustrated Primer" (from the novel The Diamond Age).

Re: A therapy chatbot for depression

#46

Post by jonjacky »

Kenneth Colby, another Stanford professor, had something like this in the 1970's and 80's. According to the Wikipedia article [1] it was sold as a product. I remember reading a skeptical account of it in a popular book back then [2].

[1] https://en.wikipedia.org/wiki/Kenneth_Colby

[2] http://rdrosen.com/psychobabble-fast-talk-and-quick-cure-in-...

Re: A therapy chatbot for depression

#47

Post by motardo »

tpowell wrote: post #15

This is an excellent idea, but their loose stance on privacy doesn't seem to line up with the intended field. Even a cursory look over their privacy policy raises questions (third party marketing, data in the event of a sale/acquisition). As for Messenger, they merely provide a link to Facebook's privacy policy. I wish it outlined, in plain language, how private (or not) the transcripts of my chat data are and the re…

When I read the headline, my first impression was great! But digging deeper:

  - The name woebot - is this a joke?
  - The company is made up of 5 cs engeneers, only 1 clinical psycologist, and 1 ceo/doctor (of what?)
  - It's a for-profit paid business, not a make-the-world-better university project
Yuck. Just no.

Re: A therapy chatbot for depression

#48

Post by jdietrich »

jonjacky wrote: post #46

Kenneth Colby, another Stanford professor, had something like this in the 1970's and 80's. According to the Wikipedia article [1] it was sold as a product. I remember reading a skeptical account of it in a popular book back then [2]. [1] https://en.wikipedia.org/wiki/Kenneth_Colby [2] http://rdrosen.com/psychobabble-fast-talk-and-quick-cure-in-...

Going right back to the dawn of AI, ELIZA was designed to crudely emulate a Rogerian psychotherapist.

https://en.wikipedia.org/wiki/ELIZA

Re: A therapy chatbot for depression

#49

Post by rschneid »

DigDugDoug wrote: post #44
rschneid wrote: post #42

Earlier quoted context omitted.

Nearly any new method of treatment opens up new doors for human failings and there will inevitably be some nonzero number of people whose lives are made worse by an overwhelmingly positive experience for humanity and mental health. Let's first worry about making the apps "good enough" for people to feel like they're getting _any_ decent treatment, let alone comprehensive to the point of eliminating the desire for add…

What makes you think it's potentially irrelevant? Go by any mental health clinic in your city and ask if there are any patients who have conditions that impair either their ability to come in for treatment or their ability to recognize that they need treatment. I agree with the majority of your rebuttal that, at the moment, it's more productive to focus on simply getting this new treatment to a point of reliable func…

I agree that a wide range of potential effects and side-effects should be considered. I'm sure a key metric in this experiment involves collecting data on how it influences users' further treatment. I think this will either put your fears to rest (for now) or immediately draw the concerned attention of everyone conducting this experiment.

Edit: Maybe it _is_ all a scheme by Big Insurance to give the masses minimal treatment and doesn't actually solve their problems but provides the illusion of a solution while sucking them into a vile dependence on closed-source AI personalities to feel any sense of therapy. Technology enables so many insidious business practices I don't know what to believe anymore.

Re: A therapy chatbot for depression

#50

Post by jdietrich »

DigDugDoug wrote: post #37
WalterSear wrote: post #14

Earlier quoted context omitted.

A decent CBT therapist can charge $150+ per hour, and personal change can take years of constant, ongoing effort. For most people right now, it's going to be an app or no treatment at all, particularly if for people who are only mildly impaired by their distress. Besides, it's not an either/or proposition. Personally, I don't think that chatbots are all that useful (I've been building them as a large part of my job f…

It seems like the real danger is the appeal of sacrificing nuanced treatment for convenient treatment. Your comment pointed out that for many people the choice might boil down to a supportive app or nothing. And as you noted, personal change can take years of dedicated person effort. To me, it seems like the biggest risk in the long term isn't in whether or not people get treated. The article demonstrates that the te…

The overwhelming majority of people who need psychotherapy cannot get access to adequate treatment. Access totally dwarfs every other issue in psychotherapy.

Here in the UK, most people with moderately severe depression or anxiety have to wait several months to get access to CBT. That will usually comprise of six one-hour sessions, often with a mental health care practitioner rather than a clinical psychologist. Patients with less severe symptoms will be triaged to a telephone-based service, an online service or self-help books.

That's a perfectly typical story for a high-income country with an excellent healthcare system. Access to psychotherapy is routinely and severely rationed because of cost. In lower-income countries, the picture is far worse. For most people, the choice is not between nuanced treatment and convenient treatment, but between cheap treatment and no treatment.

In all honesty, I'm struggling to contain my anger at your comment - it's quite clear that you're from an extremely privileged background. $150 for a weekly session with a psychotherapist is an unimaginable luxury for the vast majority of people in the world.

I'd love for everyone to be able to access a clinical psychotherapist on demand, but it simply isn't going to happen. There isn't the money or the political will to make it happen. I welcome innovative approaches to psychotherapy, provided they're evidence-based and rigorously evaluated. We have a real opportunity to improve the wellbeing of hundreds of millions of people. I think that rejecting these possibilities because of a hypothetical risk is utterly churlish.

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