This article was originally published by AI Frontier.
Ng’s first product, Woebot, is out now. How hard was the AI technology used?
Planning Editor | Natalie
By Erin Brodwin
Compile | Sambodhi
Review | Vincent
“Mental illnesses, such as depression and anxiety, have long been difficult to treat in the medical field. As the pace of people’s life accelerates, their daily routine becomes more and more fragmented and irregular. If artificial intelligence can be used to effectively advance prevention and monitoring, necessary adjustments may be made before the development of the disease. Stanford University’s Woebot was born with that goal in mind. Woebot, launched last year, was built on Facebook, but that feature — talking to people only through Facebook Messenger — made it difficult for non-Facebook users to use. So, woebot’s website says: “If you don’t want to use Facebook to talk to Woebot, leave your email and we will notify you when Woebot becomes available on its messaging platform.” Now they have their own messaging platform, woebot for iOS. Andrew Ng joined woebot’s board as chairman. Today, we’re looking at Erin Brodwin’s latest investigation into Woebot.”
- Woebot is a free therapy chatbot available on Thursday
(AI Frontier: January 25)Released as a standalone iOS app. - Invented by Alison Darcy, a clinical psychologist at Stanford University.
- Woebot uses one of the most effective ways to treat depression: cognitive behavioral therapy, which provides users with scripted responses.
- It’s part of a trend to include smartphone apps in therapy.
I was on the bus around 6pm when a piece of news arrived that I couldn’t ignore. Instinctively, I held up my phone and took a furtive look at the blue bubble on the screen.
“Hi Erin, are you ready to check in?” “One message asked.
The news comes from Woebot, an ai chatbot designed to help people deal with depression and anxiety that launched Thursday as a standalone iOS app. This article is my latest investigation into the new, uncharted territory of digital mental health care.
Alison Darcy, a clinical psychologist at Stanford University, created Woebot based on a treatment called cognitive-behavioral therapy (CBT)[1], The treatment is a clinical research approach to depression designed to encourage people to study how to deal with challenging situations.
Darcy says Woebot isn’t a replacement for existing clinicians, nor will it help you find a doctor. Instead, this tool is part of a growing list of mental health approaches. But it is fundamentally different from any other form of therapy.
Darcy tells Business Insider that “the Woebot experience doesn’t map to human-computer relationships as we know them, it doesn’t map to human relationships as we know them, it seems to be something in the middle.”
AI the front: Founded in 2007 as Silicon Alley Insider, Business Insider was renamed Business Insider in 2009. Headquartered in New York, Business Insider has become the most influential Business news website in the United States in recent years. It offers popular news stories and “edgy” commentary.
Woebot’s uniqueness may be its greatest strength, but it may also be its downfall. But with about one in five Americans suffering from a mental illness or mental illness [2], experts say it’s time for a new approach.
The APP tells you when you’re being too hard on yourself
Depression is the leading cause of disability worldwide [3] and it can take lives. But scientists know very little about this, and treatments haven’t changed much in more than six decades.
Alison Darcy, founder of Woebot. Alison Darcy/Woebot LABS
We know that talking can help with depression, especially with a licensed therapist or psychologist. But treatment is often prohibitively expensive, inconvenient or difficult to obtain. In the United States, about 20% are mental patients, and it is estimated that nearly two-thirds of them have not received any treatment for at least one year [4].
Darcy says: “We have this idea that if you’re feeling miserable you need to talk to someone, and many of us stick to that. But to insist that this is the only way would actually alienate a lot of people, and that’s not possible.”
Unlike traditional treatments, Woebot can be accessed anytime, anywhere — as long as users use a smartphone. And it’s free.
Once you log in with your name, everything is set up. Woebot, a cute, animated-form robot that asks you questions about yourself, like how you’re feeling, or how energetic you are at that moment.
The AI program behind the APP provides users with scripted responses based on CBT principles.
At times, chatting with Woebot can feel like a conversation, but most of the time it feels like a fun game, with each interaction flashing a gem of intelligence.
During my week with the APP, Woebot’s reactions became somewhat predictable, but I still enjoyed using it. I can see why this APP might be helpful for people with anxiety or depression, especially those who are just starting treatment.
Woebot’s lessons for the text
Several psychologists unaffiliated with Woebot told Business Insider that CBT is a good fit for chatbots.
A recent review of research published in the journal World Psychology [5] compared people who had been treated online with those who had been treated in person and found that both treatments were equally effective.
One reason, Darcy says, is that CBT focuses on the present rather than the past. Instead of talking to your parents, talk about a recent conflict at work, or an argument you had with a friend.
“The premise of CBT is not to focus on what’s happening to us, but to focus on how we react to it,” Darcy says.
Woebot uses this method to determine when someone is engaging in “negative self-talk,” which may involve feelings of guilt, shame or low self-esteem. Darcy says the idea stems from patients’ distorted view of their environment.
For example, if a friend forgets your birthday, you might tell Woebot: “No one will remember me” or “I have no real friends.” Woebot may respond that you are trapped in an extreme form of negative self-talk called black and white thinking that distorts the real world. You have friends and people will remember you — only one of them forgot your birthday.
“CBT skills are skills that anyone can use.” Nancy Liu, an assistant professor of clinical psychology at the University of California, Berkeley, told Business Insider.
“The data blew us away”
Before launching Woebot, Darcy and her team recruited 70 college students with symptoms of depression for an early version of the test.
The results of the study, published in the April issue of Medical Internet Research [6], divided the students into two groups: one group was asked to chat with Woebot for two weeks, and the other group was asked to read an e-book about depression.
Unlike the ebook group, those who used Woebot reported a significant reduction in their depressive symptoms. They also reported talking to it almost every day.
“The numbers blew us away,” Darcy told Business Insider last October, after Woebot launched exclusively on Facebook. “We were like, yeah, that’s it!”
But Darcy is quick to point out that Woebot isn’t meant to replace traditional therapies.
“We don’t do a better job than traditional treatments,” Darcy says. “It’s about giving people alternatives — we don’t give people enough of them. What about people who don’t want to talk to others?”
Digital therapy is booming
In reality, meeting people today means “meeting” them on the phone.
“Something like Woebot is great,” Liu says. “It’s on your phone and you’re out there living your life.”
Continuous access is one of the biggest benefits of this tool. It can be accessed at any time of the day with a click of an icon, unlike a 9-to-5 therapist with a time limit.
I used to talk to Woebot late at night, and I panicked — that’s when I was afraid to call and text my regular therapist for fear of disturbing her. It was woebot that provided me with some ideas and space.
The scheme is not the only way. Other Silicon Valley-style approaches to depression [7] include replacing traditional psychiatric offices with text messages, chat rooms where problems can be discussed anonymously, and enabling employers to give workers online access to therapists and counselors.
One such digital mental health service, X2AI, is powered by ARTIFICIAL intelligence and can be used around the clock, similar to Woebot. But X2AI’s tool, called Tess, is not a scripted response, but a connection between therapist and patient.
Michiel Rauws, co-founder and CEO of X2AI, told Business Insider: “Typically, therapists see five patients a day and spend the rest of their time doing administrative work. We allowed them to look after 50 patients a day because while they were talking to patients, Tess was talking to other patients.”
If a person is prone to panic attacks on Sunday night, Says Rauws, Tess might reach out via text message to see how they’re doing and report the results to their treating physician.
Like Woebot, the service isn’t meant to replace traditional therapy, but complement it. The more new tools Darcy sees, the better.
Unknown situation
It’s unclear whether Woebot will have a significant long-term impact on users’ mental health.
In academia, researchers have spent years researching potential ways to help people with mental illness and then provide safe and proven treatments. Silicon Valley tends to quickly bring the technology to a large group of people and see if it helps.
“There’s a real divergence from the deep analysis in academia, which is very slow, and it’s hard to imagine scaling up, relative to the entrepreneurial world, where these companies are producing — fast iteration, that’s their business model,” Matthew Hirschtritt, a resident psychiatrist atthe University of California, San Francisco, told Business Insider.
“It makes sense: take it out, see if it works, and if it doesn’t, try something new,” he says. But it’s hard to do that in an academic setting, where you can rigorously analyze groups and grow them.”
But the untested nature of mental health apps isn’t the only risk facing users.
‘We want total anonymity’
As the field of digital therapy grows, users may be increasingly concerned about privacy.
When Woebot launched on Facebook Messenger last June, it attracted thousands of users from around the world. But many people reported to the company that they were reluctant to share private data on the Facebook platform because it had previously faced privacy issues [8].
So Woebot has left Facebook and launched a separate APP that requires only one name to sign up for. Darcy says the app is anonymous.
She says that giving feedback to the application is anonymous even through email, because the email address is not associated with the user profile. Users can also ask Woebot to delete their account history and delete all conversations.
woebot
“From our company’s perspective, we show very little data to anyone.” Darcy said. “We kind of cut ourselves off,” even when people E-mail us, we say, “We don’t know who you are!” From the beginning, it was a very clear decision: we wanted complete anonymity.
But in the world of mental health, total anonymity is a double-edged sword.
In the fall of 2016, a therapist hired by Talkspace, an app that connects people with licensed therapists via text message, accused the company of endangering public safety by keeping contact information for potentially at-risk patients anonymous [9].
Talkspace has since rewritten its confidentiality policy to state that therapists should ask patients for their contact details if they believe they are a danger to themselves or others.
If woebot users’ comments indicate they may be suicidal or have potentially harmful thoughts, the app will flag them and enter what Darcy calls crisis mode.
In that case, Darcy says, Woebot will send a message explaining what triggered the crisis mode and why it was beyond the APP’s capabilities. Woebot will then send a list of resources, such as emergency calls and a link to tec-Tec, which is one of the only apps found to help reduce suicidal thoughts and self-harm.
This approach to emergency situations is fairly standard for emerging mental health applications. But it’s not nearly as comprehensive as a face-to-face session with a therapist. If a patient has violent behaviour that threatens himself or others, then the provider is obliged to break confidentiality and intervene, which may include reporting them to the authorities or, in extreme cases, institutionalising them.
“In a situation like child abuse, you can’t just say, ‘Make a phone call,'” Liu said. “Clinically, this is not acceptable.”
Because Woebot is not a replacement for traditional therapies, it will inevitably be a disappointment for many. But the APP could also help some other people — perhaps those familiar with technology who are new to the treatment, or those in remote areas who can’t get traditional treatment, or those who are already in treatment but need extra help.
“If anything, it could be a precaution for some people,” Liu said. “I don’t see anyone having any obvious negative effects in the process of exploring and learning.”
[1] : Cognitive behavioral therapywww.mayoclinic.org/tests-proce…
[2] : the Prevalence of Any getting Illness (AMI) www.nimh.nih.gov/health/stat…
[3] : ‘Fact sheetwww. Who. Int/mediacentre…
[4] : getting the Health Facts IN AMERICAwww.nami.org/NAMI/media/…
[5]:Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: A systematic review and meta – analysiswww. Ncbi. While NLM. Nih. Gov/PMC/article…
[6]:Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (woebot): A Randomized Controlled Trialmental.jmir.org/2017/2/e19/
[7]:We’re on the cusp of an explosive change in how we treat one of America’s most ignored health Problemswww.businessinsider.com/how-text-ba…
[8] : Facebook Messenger is adding self – destructing messages and better encryptionwww.recode.net/2016/7/8/12…
[9] : Inside the messy world of anonymous therapy Talkspacewww.theverge.com/2016/12/19/ app…
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