4 ms·

You're holding up a perfect status quo that doesn't correspond to reality. Countries vary, but in the US and many places there's a shortage of quality therapis

by ethbr1 1y ago

You're holding up a perfect status quo that doesn't correspond to reality. Countries vary, but in the US and many places there's a shortage of quality therapists. Thus for many people the actual options are {no therapy} and {LLM therapy}. > This is why we have safety regulations, why we don't let people drive cars that haven't passed tests, build with materials that haven't passed tests, eat food that hasn't passed tests. And the reason all these regulations and tests are less than comprehensive is that we realize that people working, driving affordable cars, living in affordable homes, and eating affordable food is more important than avoiding every negative outcome. Thus most societies pursue the utilitarian greater good rather than an inflexible 'do no harm' standard.

deleted 1y ago
[deleted]
spookie 1y ago
Ok then, the LLMs must pass the same tests and be as regulated as therapists. After all, it should be easy peasy (:
- paulcole 1y ago
  If the choice is between no food and food then your standard for food goes way down.
- jodrellblank 1y ago
  [flagged]
  - baobun 1y ago
    > Are people not allowed to talk to their friends in the pub about suicide because the friends aren’t therapists? I don't see anyone in thread arguing that. The arguments I see are about regulating and restricting the business side, not its users. If your buddy started systematically charging people for recorded chat sessions at the pub, used those recordings for business development, and many of their customers were returning with therapy-like topics - yeah I think that should be scrutinized and put a lid on when recordings show the kind of pattern we see in OP after their patrons suicide.
- nelox 1y ago
  What tests? The term “therapist” is not protected in most jurisdictions. No regulation required. Almost anyone can call themselves a therapist.
  - criddell 1y ago
    In every state you have to have a license to practice. The advice to not leave the noose out is likely enough for ChatGPT to lose it's license to practice (if it had one).
- terminalshort 1y ago
  LLMs can pass the bar now, so I don't think they would have any problems here.
jack_tripper 1y ago
>Countries vary, but in the US and many places there's a shortage of quality therapists. Worse in my EU country. There's even a shortage of shitty therapists and doctors, let alone quality ones. It takes 6+ months to get an appointment for a 5 minute checkup at a poorly reviewed state funded therapist, while the good ones are either private or don't accept any new patients if they're on the public system. And ADHD diagnosticians/therapists are only in the private sector because I guess the government doesn't recognize ADHD as being a "real" mental issue worthy of your tax Euros. A friend of mine got a more accurate diagnosis for his breathing issue by putting his symptoms in ChatGPT than he got from his general practitioner, later confirmed by a good specialist. I also wasted a lot of money on bad private therapists that were basically just phoning in their job, so to me, the bar seems pretty low, since as long as they pass their med-school exams and don't kill too many people through malpractice, nobody checks up on how good or bad their are at their job (maybe some need more training, or maybe some don't belong in medicine at all but managed to slipped through the cracks). Not saying all doctors are bad (I've met few amazing ones), but it definitely seems like the healthcare systems are failing a lot of people everywhere if they resort to LLMs for diagnosis and therapy and getting better results from it.
- kakacik 1y ago
  Not sure where you are based, but in general GPs shouldn't be doing psychological evaluation, period. I am in Europe, and this is the default. If you live in utter shithole (even if only health-care wise), move elsewhere if its important for you - it has never been easier, Europe is facing many issues and massive improvement of healthcare is not in the work pipeline, more like the opposite. You also don't expect butcher to fix your car, those are as close as above (my wife is a GP so I have a good perspective from the other side, including tons of hypochondriac and low-intensity psychiatric persons who are an absolute nightmare to deal with and routinely overwhelm the system so that there isn't enough resources to deal with more serious cases). You get what you pay for at the end, 'free' healthcare typical for Europe is anyway still paid for one way or another. And if the market forces are so severely distorted (or bureaucracy so ridiculous/corrupt) that they push such specialists away or into another profession, you get healthcare wastelands you describe. Vote, and vote with your feet if you want to see change, not ideal state but thats reality.
alex-moon 1y ago
I don't accept the unregulated and uncontrolled use of LLMs for therapy for the same reason I don't accept arguments like "We should deregulate food safety because it means more food at lower cost to consumers" or "We should waive minimum space standards for permitted developments on existing buildings because it means more housing." We could "solve" the homeless problem tomorrow simply by building tenements (that is why they existed in the first place after all). The harm LLMs do in this case is attested both by that NYT article and the more rigorous study from Stanford. There are two problems with your argument as I see it: 1. You're assuming "LLM therapy" is less harmful than "no therapy", an assumption I don't believe has been demonstrated. 2. You're not taking into account the long term harm of putting in place a solution that's "not fit for human use" as in the housing and food examples: once these things become accepted, they form the baseline of the new accepted "minimum standard of living", bringing that standard down for everyone. You claim to be making a utilitarian as opposed to a nonmaleficent argument, but, for the reasons I've stated here, I don't believe it's a utilitarian argument at all.
- freedomben 1y ago
  I think the reason you don't believe the GP argument, is because you are misunderstanding it. The utilitarian argument is not calling for complete deregulation. I think you're taking your absolutist view of not allowing llms to do any therapy, and assuming the other side must have a similarly absolutist view of allowing it to do any therapy with no regulations. Certainly nothing in the GP comment suggests complete deregulation as you have said. In fact, I got explicitly the opposite out of it. They are comparing it to cars and food, which are pretty clearly not entirely deregulated.
- malka1986 1y ago
  > I don't accept the unregulated and uncontrolled use of LLMs for therapy for the same reason I don't accept arguments like "We should deregulate food safety because it means more food at lower cost to consumers" That is not the argument. The argument is not about 'lower cost', it is about availability. There are not enough shrinks for everyone who would need it. So it would be "We should deregulate food safety to avoid starving", which would be a valid argument.
- 1y ago

by ethbr1 1y ago

deleted 1y ago

[deleted]

spookie 1y ago

Ok then, the LLMs must pass the same tests and be as regulated as therapists. After all, it should be easy peasy (:

paulcole 1y ago
If the choice is between no food and food then your standard for food goes way down.
jodrellblank 1y ago
[flagged]
- baobun 1y ago
  > Are people not allowed to talk to their friends in the pub about suicide because the friends aren’t therapists? I don't see anyone in thread arguing that. The arguments I see are about regulating and restricting the business side, not its users. If your buddy started systematically charging people for recorded chat sessions at the pub, used those recordings for business development, and many of their customers were returning with therapy-like topics - yeah I think that should be scrutinized and put a lid on when recordings show the kind of pattern we see in OP after their patrons suicide.
nelox 1y ago
What tests? The term “therapist” is not protected in most jurisdictions. No regulation required. Almost anyone can call themselves a therapist.
- criddell 1y ago
  In every state you have to have a license to practice. The advice to not leave the noose out is likely enough for ChatGPT to lose it's license to practice (if it had one).
terminalshort 1y ago
LLMs can pass the bar now, so I don't think they would have any problems here.

jack_tripper 1y ago

>Countries vary, but in the US and many places there's a shortage of quality therapists. Worse in my EU country. There's even a shortage of shitty therapists and doctors, let alone quality ones. It takes 6+ months to get an appointment for a 5 minute checkup at a poorly reviewed state funded therapist, while the good ones are either private or don't accept any new patients if they're on the public system. And ADHD diagnosticians/therapists are only in the private sector because I guess the government doesn't recognize ADHD as being a "real" mental issue worthy of your tax Euros. A friend of mine got a more accurate diagnosis for his breathing issue by putting his symptoms in ChatGPT than he got from his general practitioner, later confirmed by a good specialist. I also wasted a lot of money on bad private therapists that were basically just phoning in their job, so to me, the bar seems pretty low, since as long as they pass their med-school exams and don't kill too many people through malpractice, nobody checks up on how good or bad their are at their job (maybe some need more training, or maybe some don't belong in medicine at all but managed to slipped through the cracks). Not saying all doctors are bad (I've met few amazing ones), but it definitely seems like the healthcare systems are failing a lot of people everywhere if they resort to LLMs for diagnosis and therapy and getting better results from it.

kakacik 1y ago
Not sure where you are based, but in general GPs shouldn't be doing psychological evaluation, period. I am in Europe, and this is the default. If you live in utter shithole (even if only health-care wise), move elsewhere if its important for you - it has never been easier, Europe is facing many issues and massive improvement of healthcare is not in the work pipeline, more like the opposite. You also don't expect butcher to fix your car, those are as close as above (my wife is a GP so I have a good perspective from the other side, including tons of hypochondriac and low-intensity psychiatric persons who are an absolute nightmare to deal with and routinely overwhelm the system so that there isn't enough resources to deal with more serious cases). You get what you pay for at the end, 'free' healthcare typical for Europe is anyway still paid for one way or another. And if the market forces are so severely distorted (or bureaucracy so ridiculous/corrupt) that they push such specialists away or into another profession, you get healthcare wastelands you describe. Vote, and vote with your feet if you want to see change, not ideal state but thats reality.

alex-moon 1y ago

I don't accept the unregulated and uncontrolled use of LLMs for therapy for the same reason I don't accept arguments like "We should deregulate food safety because it means more food at lower cost to consumers" or "We should waive minimum space standards for permitted developments on existing buildings because it means more housing." We could "solve" the homeless problem tomorrow simply by building tenements (that is why they existed in the first place after all). The harm LLMs do in this case is attested both by that NYT article and the more rigorous study from Stanford. There are two problems with your argument as I see it: 1. You're assuming "LLM therapy" is less harmful than "no therapy", an assumption I don't believe has been demonstrated. 2. You're not taking into account the long term harm of putting in place a solution that's "not fit for human use" as in the housing and food examples: once these things become accepted, they form the baseline of the new accepted "minimum standard of living", bringing that standard down for everyone. You claim to be making a utilitarian as opposed to a nonmaleficent argument, but, for the reasons I've stated here, I don't believe it's a utilitarian argument at all.

freedomben 1y ago
I think the reason you don't believe the GP argument, is because you are misunderstanding it. The utilitarian argument is not calling for complete deregulation. I think you're taking your absolutist view of not allowing llms to do any therapy, and assuming the other side must have a similarly absolutist view of allowing it to do any therapy with no regulations. Certainly nothing in the GP comment suggests complete deregulation as you have said. In fact, I got explicitly the opposite out of it. They are comparing it to cars and food, which are pretty clearly not entirely deregulated.
malka1986 1y ago
> I don't accept the unregulated and uncontrolled use of LLMs for therapy for the same reason I don't accept arguments like "We should deregulate food safety because it means more food at lower cost to consumers" That is not the argument. The argument is not about 'lower cost', it is about availability. There are not enough shrinks for everyone who would need it. So it would be "We should deregulate food safety to avoid starving", which would be a valid argument.
1y ago