Marianne Brandon Ph.D.
The Future of Intimacy
THERAPY
Twenty-four-hour access, always sympathetic, what’s not to love?
KEY POINTS
- Virtual therapists already offer an economical and convenient alternative to traditional talk therapists.
- Currently, hybrid models combining a human therapist with 24-hour AI therapy backup are being promoted.
- Today’s chatbot therapists are proficient in cognitive behavioral techniques and biofeedback.
Source: AI-generated content/Shutterstock
“My last therapist fell asleep during my session!”
“I was too embarrassed to tell my last therapist I was watching so much porn.”
“My last therapists never spoke – I just listened to myself talk for 50 minutes every week.”
“I can’t afford to be in both individual therapy and couples therapy at the same time.”
“My partner won’t see a therapist unless they have evening or Saturday hours.”
For all its powerful benefits, psychotherapy is sometimes challenging for clients. Yet most of my clients and colleagues respond negatively when I bring up the intriguing subject of chatbot therapy. After all, what is therapy about, if not genuine human contact? I remind them that one might have said that about sex at one time, though now sex with tech is quite popular. I wouldn’t be surprised if we see the same response to chatbot therapists. For at least a subset of the population, chatbot therapists will be preferred – or at least more easily accessible – than the human variety.
I’m suggesting this for several reasons. One, younger folks are more receptive to technology permeating the more personal aspects of their lives than older populations. This just makes sense – the more exposure you have to tech as a young person, the more ease you’ll have with advancing technologies as you mature. Similarly, young people don’t have the same knowledge base as older folks. It wouldn’t occur to a young person who never experienced a human therapist to compare the two. Thus, the simple act of time passing will ease the transition to chatbot therapy.
And then, of course, there are logistical issues. Chatbot therapists will be more affordable than human ones. It’s easily conceivable that you could see your chatbot therapist daily for less than it would cost to see a human therapist once a week. Similarly, chatbot therapists will be so much more accessible – gone will be the limitations of office hours, weather cancellations, vacation breaks, and sick days. Instead, your chatbot will be available the moment you need them, any time of day or night – no exceptions. What a benefit for people whose depression worsens at 3 AM or whose desire to over-eat happens just before bedtime.
And then there’s the issue of shame. Unfortunately, the most important things to share with a therapist are often the most embarrassing. As a sex therapist, it’s not uncommon for people to avoid discussing their concerns, even though they expressly come to sex therapy for this purpose. The fear of another’s judgment is deeply engrained in us all. In contrast, clients won’t worry as much that a chatbot therapist will judge or secretly criticize them.
Some clients may feel relief and freedom in truly saying anything to their chatbot therapist without worrying about whether it’s appropriate or how it’s being received. One study found that research participants reported equivalent benefits from talking about their feelings with a person and a chatbot (Ho et al., 2018). (Yes, you read that right but remember that these participants weren’t talking to therapists and probably weren’t sharing intimate information, so we can’t generalize this result).
Finally, much importance is placed today on “evidence-based treatment,” meaning proven treatments based on research. It seems likely that chatbot therapists’ responses will more easily standardize to at least some evidence-based treatments, such as cognitive-behavioral therapy, thus enabling more consistency in the therapeutic process. Today’s VR chatbots can even gather biometric data, such as biofeedback, to enhance their treatment. Further, chatbot therapists don’t have difficulty concentrating because they are hungry or tired and don’t feel personally triggered by a client’s differing viewpoint or lifestyle, further ensuring consistent, effective responses. As stress levels in the U.S. rise, human therapists might actually appreciate the support of chatbot therapists to meet the increasing demand for mental health treatment.
Of course, no technology is all good or bad, and chatbot therapists are no exception. They raise a whole host of security concerns. But perhaps most importantly, they lack critical components: humanity and genuine emotion. They can’t offer authentic warmth or compassion. They won’t provide personalized feedback based on their own life experiences or wisdom based on their knowledge of what it feels like to be human.
Having never felt grief over the loss of a beloved pet, the thrill of falling in love, the shame of being bullied, the pain of rejection, the fears of being vulnerable with a lover, or the profound love for a child, virtual therapists’ feedback will lack depth. And today, most therapists would agree that our depth and humanity provide the ultimate healing ingredient in the therapy we offer.
Interestingly, the virtual world agrees. I felt it only fair to ask Chat GPT about its opinion of chatbot therapists. After a lengthy discussion of pros and cons, it concluded, “Both chatbot and human therapists have unique strengths and limitations, and the choice between the two will depend on individual patient’s needs and preferences.” Precisely.
In closing, chatbot and human therapists will always differ significantly. One thing strikes me as certain, though. Just as human therapists will inform how chatbots practice therapy, the opposite will also be true. As chatbots become more mainstream, they will indelibly change the field of mental health and, thus, the ways that human therapists practice our trade.
To find a therapist, visit the Psychology Today Therapy Directory.
References
Ho, A., Hancock, J., & Miner, A.S. (2018). Psychological, relational, and emotional effects of self-disclosure after conversations with a chatbot. Journal of Communication, 68(4), 712-733. https://doi.org/10.1093/joc/jqy026
