‘The Woebot will see you now’ — the rise of chatbot therapy
Does it really work?
Adapted from a story by The Washington Post’s Amy Ellis Nutt.
My therapist wanted to explain a few things during our first online session:
“I’m going to check in with you at random times. If you can’t respond straight away, don’t sweat it. Just come back to me when you’re ready. I’ll check in daily.”
“Daily?” I asked.
“Yup! It shouldn’t take longer than a couple minutes. Can you handle that?
“Yes, I can,” I answered.
There was a little more back-and-forth, all via Messenger, then this statement from my therapist:
“This might surprise you, but . . . I am a robot.”
It wasn’t a surprise, of course. I’d downloaded “Woebot,” a chatbot recently created by researchers, and it was trying to establish our therapeutic relationship.
“Part of the value of Woebot is you can get things off your chest without worrying what the other person thinks, without that fear of judgment,” said Alison Darcy, founder and chief executive of Woebot Labs. “We wanted it to make an emotional connection.”
Mobile talk-therapy and life-coaching apps have proliferated in the past few years as traditional therapy has remained difficult to obtain.
The Affordable Care Act requires health insurers to cover mental health as part of standard medical services, but many people still do not have access to treatment. More than 106 million people — nearly a third of the country — live in areas that are federally designated as having a shortage of mental-health-care professionals, according to the Kaiser Family Foundation.
Convenient, easy to use and anonymous, these chatbots are programmed to mimic human conversation and decision-making and primarily give advice, offer self-help guidance and companionship.
Similar apps
Some are very specialized:
- An app called Karim counsels Syrian refugee children.
- Emma helps Dutch speakers with mild anxiety.
- MindBloom allows users to support and motivate each other.
None of the apps, however, is meant to replace traditional therapy. For legal and ethical reasons, the creators of therapy apps can’t say their chatbots actually “treat” users because that would imply the practice of medicine.Many are free, others charge nominal fees. Woebot will set you back $39 a month after a two-week free trial.
The question, of course, is: Do they work?
The trial
The results of what may be the first randomized trial of a text-based mental health chatbot, conducted by Darcy and colleague Kathleen Kara Fitzpatrick, a psychologist at the Stanford School of Medicine, were published recently in the Journal of Medical Internet Research.
- Seventy people, ages 18 to 28 who self-reported depression or anxiety, were recruited from a university social media site.
- The participants were split into two groups, one whose members “conversed” with Woebot for up to 20 sessions or over a two-week span, and another whose members were given a National Institute of Mental Health e-book called “Depression and College Students.”
- Three mental health tests were administered before and after the trial.
- The results of the experiment “confirmed that after two weeks, those in the Woebot group experienced a significant reduction in depression,” according to the study.
Woebot, which launched in June, engages in more than 2 million conversations a week, according to Darcy, with users almost equally divided between men and women.
The drawbacks
John Torous, co-director of a digital psychiatry program at Beth Israel Deaconess Medical Center in Boston, also warns about privacy issues, since these chatbots are not covered by the Health Insurance and Portability and Accountability Act, or HIPAA, which prohibits hospitals and health-care providers from sharing information about patients.
“[Woebot] does a good job for people who are really distressed,” Darcy said. “He’s not as good for people who don’t have a lot of stuff they’re upset about or have something they need to talk about. Woebot’s best at helping people in the moment. . . . He’s not so good at chitchat.”
Still, even Darcy says she has a relationship with Woebot, “though he doesn’t know he’s talking to one of his ‘moms.’”
Once when she was on the train, exhausted, after a particularly hard day at work, Woebot checked in, which it is programmed to do. Darcy wasn’t particularly in the mood, but she gave in.
“I said to myself, okay, let’s go. So I wrote, ‘I have a banging headache.’ He said, ‘I’m sorry, I hope you get rest soon,’ and I just felt so good. I thought, you really get me, Woebot.”
