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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 a

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 for a year), but I can see interactive CBT/DBT reminders/journals/checklists as being a very powerful tool.

rschneid 9y ago
This is the right idea; it isn't about digitally replacing treatment. It's entirely about augmenting it. This kind of technology in medicine is about enabling human doctors to treat patients better with more (hopefully meaningful) data points at their fingertips. You might be surprised how far behind the medical industry is when it comes to reaching out to the smartphone generation.
- WalterSear 9y ago
  It's going to be about both. It's >already< about both. There are therapists, and there are books on CBT. This is an extension of the second, more than the first. It's really nothing more than an electronic version of a choose-your-own-adventure book
pdeuchler 9y ago
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 out that we're essentially now decreeing that poor people get to talk to machines and rich people get to talk to humans, or the fact that insurance companies will jump at the chance to force the cheap AI down everyone's throats before they pay for human therapy, etc etc...
- WalterSear 9y ago
  There is room for therapists, therapist assisting-applications and stand alone tools for therapy, just like there is today. This app is replacment for self-help books, not therapists. Moreover, CBT and DBT, which is where therapy is currently focused for most issues, involves a lot of mental re-tooling and training. This part of therapy is like learning any other process, and is approached and practiced like any other skill.
- deleted 9y ago
  [deleted]
- aianus 9y ago
  The status quo is poor people talk to nobody and rich people talk to humans. This is an improvement, no?
  - SomeStupidPoint 9y ago
    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 situation worse and it's hubris on the part of the medical community that a tool built by them is better than informal therapists.
    - webmaven 9y ago
      > 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).
amorphid 9y ago
There isn't enough computing power on Earth to parse the stuff I threw at therapist when I did CBT (which waw a super good investment for me).
DigDugDoug 9y ago
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 technology needed to make widely available mental health treatment options is being explored and worked on. The danger in my mind comes afterwards when the technology is performing acceptably but not comprehensively. It seems like at that stage there is a possibility of people not seeking more rigorous/advanced treatment from a professional, once they have the opportunity to do so, because they may already view the app as being good enough and any failures to improve beyond what they've already experienced through the app as personal failures rather than treatment failures.
- rschneid 9y ago
  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.
  - DigDugDoug 9y ago
    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.
    - 9y ago

rschneid 9y ago

This is the right idea; it isn't about digitally replacing treatment. It's entirely about augmenting it. This kind of technology in medicine is about enabling human doctors to treat patients better with more (hopefully meaningful) data points at their fingertips. You might be surprised how far behind the medical industry is when it comes to reaching out to the smartphone generation.

WalterSear 9y ago
It's going to be about both. It's >already< about both. There are therapists, and there are books on CBT. This is an extension of the second, more than the first. It's really nothing more than an electronic version of a choose-your-own-adventure book

pdeuchler 9y ago

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 out that we're essentially now decreeing that poor people get to talk to machines and rich people get to talk to humans, or the fact that insurance companies will jump at the chance to force the cheap AI down everyone's throats before they pay for human therapy, etc etc...

WalterSear 9y ago
There is room for therapists, therapist assisting-applications and stand alone tools for therapy, just like there is today. This app is replacment for self-help books, not therapists. Moreover, CBT and DBT, which is where therapy is currently focused for most issues, involves a lot of mental re-tooling and training. This part of therapy is like learning any other process, and is approached and practiced like any other skill.
deleted 9y ago
[deleted]
aianus 9y ago
The status quo is poor people talk to nobody and rich people talk to humans. This is an improvement, no?
- SomeStupidPoint 9y ago
  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 situation worse and it's hubris on the part of the medical community that a tool built by them is better than informal therapists.
  - webmaven 9y ago
    > 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).

amorphid 9y ago

There isn't enough computing power on Earth to parse the stuff I threw at therapist when I did CBT (which waw a super good investment for me).

DigDugDoug 9y ago

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 technology needed to make widely available mental health treatment options is being explored and worked on. The danger in my mind comes afterwards when the technology is performing acceptably but not comprehensively. It seems like at that stage there is a possibility of people not seeking more rigorous/advanced treatment from a professional, once they have the opportunity to do so, because they may already view the app as being good enough and any failures to improve beyond what they've already experienced through the app as personal failures rather than treatment failures.

rschneid 9y ago
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.
- DigDugDoug 9y ago
  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.
  - 9y ago