Revolutionizing AI Therapy: The Impact on Mental Health Care

Artificial intelligence (AI) is ushering in a new era in mental health care, transforming everything from diagnostic accuracy to the delivery of therapeutic interventions (D’Alfonso, 2020).

With the increasing demand for mental health care, AI offers cost-effective support to practitioners and clients, and, in some cases, a replacement for human-led treatments (Minerva & Giubilini, 2023).

In this article, we highlight existing uses of AI in therapy and mental health treatment, along with their potential benefits, challenges, and risks. We also imagine a possible future for AI therapy in promoting mental wellbeing.

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The Revolution of AI in Mental Health Care

While for many of us, AI has only recently come to our attention, as far back as the 1950s, Alan Turing wrote the seminal paper Computing Machinery and Intelligence. It opens with the sentence, “I propose to consider the question, ‘Can machines think?’” (Turing, 1950, p. 433).

By 1966, we saw the beginning of artificial intelligence in psychology, with the early chatbot Eliza convincing patients they were conversing with a real therapist (Weizenbaum, 1976; Mullins, 2005).

In recent years, with algorithms able to draw powerful statistical inferences from large amounts of data, AI has revolutionized the potential of mental health care to meet patient needs (Holohan & Fiske, 2021; D’Alfonso, 2020).

When OpenAI unleashed the conversational AI software ChatGPT upon the world in 2022, the wider population began to see the potential of AI for mental health, even ChatGPT therapy, and the creation of AI tools for therapists (Minerva & Giubilini, 2023; Nelson, 2024).

The impact of AI is proving impressive. A 2023 paper published in Information Systems Frontiers describes an AI assessment tool that is 89% accurate at identifying and classifying patients’ mental health disorders from only 28 questions — without human input (Tutun et al., 2023).

In a recent meta-review of research into mental health conversational agents, researchers noted that chatbots have the potential to “effectively alleviate psychological distress” and even result in therapeutic relationships being formed with the AI (Li et al., 2023, p. 9).

How is AI being used in mental health care?

Evolving digital technology and AI are transforming the field of mental health in multiple areas, including (D’Alfonso, 2020; Koutsouleris et al., 2022):

• Prediction and detection
  AI, particularly machine learning (a subset of AI focused on learning and decision-making systems), is increasingly used for prediction, detection, and treatment in mental health care.
• Digital intervention
  Web- and smartphone-based digital interventions (apps) enhance and personalize mental health care user experiences.
• Digital phenotyping
  Using sensor data from smartphones and other digital devices offers behavioral and mental health insights and supports the prediction of mental health conditions.
• Natural language processing
  Analyzing clinical texts and social media content provides a means to spot mental health states and supports the development of conversational agents for therapeutic intervention.
• Chatbots and virtual agents
  These offer accessible therapy options for various mental health conditions, with approaches such as Cognitive-Behavioral Therapy and other therapeutic techniques.
• Ecological momentary interventions
  Mobile devices can support real-time psychological interventions and behavioral prompts. They frequently use user feedback and behavior to inform their highly personalized therapy recommendations.
• Precision medicine in mental health
  Treatment issues like delayed, inaccurate, and inefficient care delivery can be alleviated with precise diagnoses, prognoses, and therapeutic choices.

Ultimately, “AI is quickly becoming effective at performing several tasks in healthcare settings that we used to consider a human prerogative” (Minerva & Giubilini, 2023, p. 809).

What Are the Tools of AI Therapy?

Mental health treatment depends on the patient’s ability to report their cognitive and emotional states, the course of their symptoms, and input from friends, relatives, and peers (Koutsouleris et al., 2022).

In turn, the mental health practitioner’s skills, knowledge, and experience are vital for diagnosis and therapeutic decision-making.

AI, machine learning, and other advanced technologies offer tools that support therapists in identifying and treating mental health conditions and performing tasks that are otherwise time consuming (Koutsouleris et al., 2022; Li et al., 2023).

While there are many AI tools for therapy, the following are particularly valuable.

Chatbots and virtual agents

AI therapy chatbots, such as Tess, Wysa, and Woebot, offer “virtual psychotherapeutic services and have demonstrated promising results in reducing symptoms of depression and anxiety” and helping address mental health issues in various populations, including the elderly (Holohan & Fiske, 2021, p. 1).

Such tools are increasingly integrated into practice, offering virtual psychotherapeutic services, assisting in diagnosis, facilitating consultations, providing psychoeducation, and delivering treatment options. AI enables more personalized and adaptive responses using multiple modes of interaction, such as text and voice (Li et al., 2023).

Mobile and instant messaging integration

Conversation agents (chatbots) can be integrated with mobile or instant messaging apps to “assist with diagnosis, facilitate consultations, provide psychoeducation, and deliver treatment” (Li et al., 2023, p. 1).

Such AI use has proven effective in reducing mental health issues, including depression and distress, and is shaped by the quality of the human–AI therapeutic relationships (Li et al., 2023).

Natural language processing

Natural language processing helps analyze patient language in conversations, chats, emails, and social media posts. It can detect patterns that correlate with mental health issues, such as depression or anxiety, and is a vital element of chatbots (Li et al., 2023; Holohan & Fiske, 2021).

Machine learning models for diagnosis

Machine learning models can be used in research and practice to predict the existence and type of mental disorders. Models are trained using participants’ answers to assessment questions and other historical data (Tutun et al., 2023).

These decision support systems (DSS) can assist mental health professionals in making evidence-based treatment decisions, analyzing data, and providing recommendations for mental health diagnoses and treatments.

In one study, researchers concluded that “accurate diagnosis for mental disorders through this proposed DSS can reduce the overall healthcare cost due to misdiagnosis, overdiagnosis, and unnecessary treatment” (Tutun et al., 2023, p. 1271).

What Are the Benefits of AI Therapy?

AI offers significant organizational and time-saving boosts to mental health practitioners, including (Bibhudatta, 2023):

• Automatically taking notes during video meetings
• Reviewing and summarizing client notes
• Creating tailored exercises, activities, and interventions
• Streamlining billing
• Arranging meetings and managing calendars

Yet the potential of AI goes much deeper. Researchers are currently assessing the benefits of AI to transform each of the following areas and ultimately support more positive client outcomes.

The benefits of using AI in therapy include (Li et al., 2023; Tutun et al., 2023; Holohan & Fiske, 2021; Koutsouleris et al., 2022):

• Being more accessible and convenient
  24/7 availability, providing immediate support when and where needed; removing geographical, financial, and time constraints
• Analyzing vast datasets
  Identifying behavioral patterns in what specific groups and populations do and say across many aspects of life – far beyond human capacities
• Being more cost effective
  Reducing costs, such as the need for physical spaces (offices) and equipment, and limiting expenditure to software and licensing
• Reducing stigma
  Clients may prefer talking to an AI therapist rather than a human one; they may feel more psychologically safe and less judged.
• Being more efficient in diagnosing and monitoring
  With the capacity to handle large amounts of data, AI can assist in diagnosing mental health conditions and monitoring treatment.

Perhaps above all else, the most substantial advantage AI has in therapy and supporting mental health is its ability to tailor communications, activities, feedback, and counseling to the specific needs of the client at that particular point in time (Tutun et al., 2023; Holohan & Fiske, 2021).

Can the Challenges and Criticisms Be Overcome?

While there are considerable benefits to embracing AI in therapy, there are still challenges and risks to using tools such as ChatGPT for therapy and AI tools for therapists (Minerva & Giubilini, 2023).

Concerns and questions have been raised regarding how much we should trust the advice and guidance of such systems and their potential for improving mental health outcomes (Koutsouleris et al., 2022).

Challenges and criticisms include the following (Minerva & Giubilini, 2023):

Lack of empathy

AI does not have the capacity to empathize and form genuine connections with clients, which are vital in therapy.

“It seems unlikely that AI will ever be able to empathize with a patient, relate to their emotional state, or provide the patient with the kind of connection that a human doctor can provide” (Minerva & Giubilini, 2023, p. 809).

Complexity of human psychology

Algorithms and data patterns cannot address the nuanced needs of each individual because human psychology is too complex.

Loss of patient autonomy

Overreliance on AI for mental health care could lead to clients becoming overly dependent on such tools for emotional support and decision-making, potentially reducing their ability to manage their mental health independently.

Unknown long-term effects

It is unclear how prolonged reliance on AI for mental health support could impact clients or the nature of human relationships.

Ethical and privacy concerns

There are significant ethical and privacy concerns related to the use of AI in therapy, including (Minerva & Giubilini, 2023):

• Data privacy and security: AI models collect vast amounts of personal data that could be exposed or misused.
• Bias and fairness: As with humans, AI can learn bias, potentially impacting the treatment provided or leading to misdiagnosis or inappropriate therapy.

Loss of personal touch

“One of the obvious costs associated with replacing a significant number of human doctors with AI is the dehumanization of healthcare” (Minerva & Giubilini, 2023, p. 809).

Overcoming the limitations of AI

So, how do we get around some of the limitations of AI identified above?

Good training

AI models must be trained with high-quality, unbiased data. “The development of robust predictive models starts with high-quality, reliable, and sufficiently representative data that capture both the variability, complexity, and specificity of the targeted phenomena” (Koutsouleris et al., 2022, p. 831).

Adequate data privacy and security measures

Privacy is paramount. Data must be secure against breaches and unauthorized access.

Consent and transparency

Users must be made aware of how and by whom their data will be stored, used, and accessed. Therefore, users must be helped to fully understand the implications of AI data processing.

Ensuring AI is fair and unbiased

Procedures and controls must be put in place to ensure that AI tools do not learn bias by adopting discriminatory practices or providing unequal treatment.

Accountability and liability

Clear guidelines are required for who is held accountable for negative outcomes. Is it the AI developer, therapists using the tools, or the practice owner?

Informed decision-making

AI recommendations are just that. We should use them to support rather than replace human judgment and decision-making.

Maintaining oversight

If therapists and mental health practitioners use AI tools, they must monitor how they are working and the advice and guidance they offer.

Can AI Therapists Replace Real Therapists?

Based on the benefits and challenges we’ve seen for AI in mental health care, artificially intelligent therapists seem unlikely to replace human therapists — at least for now (Minerva & Giubilini, 2023).

And yet, AI therapist tools and software can be valuable for supporting and augmenting care provided to clients, potentially improving the quality of and access to mental health services (Minerva & Giubilini, 2023).

For the moment at least, the role of AI in therapy is best seen as complementary, providing additional resources and support while leaving the core therapeutic relationship and decision-making to human professionals (Koutsouleris et al., 2022).

What Does the Future Hold for AI Therapy?

In their article “Is AI the Future of Mental Healthcare?” researchers Francesca Minerva and Alberto Giubilini (2023) identify several key points about the future of AI in mental health care.

1. Hybrid approach
   The future of mental health care will likely involve a hybrid approach, combining the strengths of AI and human therapists.
2. Cost-effectiveness and accessibility
   Mental health care will, as a result of AI, become more cost effective and reduce skilled staff shortages, making it more accessible globally and potentially improving care for a greater number of people.
3. Dehumanization concerns
   Empathy and trust, core aspects of health care provision, might be at risk of being lost with the use of AI.
4. Potential benefits in psychiatry
   Advances in AI in psychiatry might yield positive results, potentially challenging the traditional view of psychiatry as grounded in human connection.
5. AI in diagnosing mental illness
   We will likely see further improvements in diagnosing mental illnesses by analyzing large amounts of diverse data from various sources like medical records, social media, and wearable devices.
6. AI for specific patient groups
   AI will continue to be particularly useful for individuals who find human interaction challenging or are concerned about stigma, such as those with depression or autism.

Beyond that, the direction and capacity of AI to support mental health remain challenging to predict and easy to underestimate.

AI Apps for Supporting Mental Wellbeing

While AI is not a replacement for therapists, several AI apps and tools provide a reasonable degree of therapeutic support.

Here are several of our favorites:

Wysa: Mental Health Support

This AI-supported chatbot helps those struggling with anxiety, depression, and stress.

This clinically validated tool provides immediate support and longer-term coaching to provide a safe place to talk through worries and stressors.

Find the app in the Apple App Store.
Find the app in the Google Play Store.

Happify: For Stress and Worry

This popular app uses AI to support the user and offers science-based games and activities to help reduce stress and maintain overall wellbeing.

The app uses proven techniques taken from positive psychology, Cognitive-Behavioral Therapy, and mindfulness.

Find the app in the Apple App Store.
Find the app in the Google Play Store.

Rootd: Panic Attack Relief

This is a valuable tool for learning where panic comes from and helping manage and overcome panic attacks.

At the press of a button, the app helps the user struggling with a panic attack, either by facing panic head on or finding a place of comfort.

Find the app in the Apple App Store.
Find the app in the Google Play Store.

Sanvello: Anxiety & Depression

This app provides support for users’ mental health, including self-care, peer support, coaching, and therapy.

The app is based on techniques taken from Cognitive-Behavioral Therapy and mindfulness and is tailored to the needs of the individual user.

Find the app in the Apple App Store.
Find the app in the Google Play Store.

A Take-Home Message

We are all seeing AI’s potential to transform our world experience, including digital art, journalism, online shopping, driving, and how we interact with our technology.

Therefore, it is no surprise that AI is increasingly used in health care, supporting mental and physical health practitioners in diagnosing patients and finding the best treatments (Minerva & Giubilini, 2023).

Advanced technologies like large language models, made popular by ChatGPT’s release in 2022, are being explored for their potential in mental health care to generate sophisticated responses and interactions, supporting the mental health of those in need.

AI provides cost-effective support for clients in an overwhelmed mental health system, bridging the gap where traditional services struggle to meet the rising demand for treatment.

Although current advances in tools and technology aren’t yet ready to replace human mental health professionals, they can play a crucial role in enhancing and supplementing the care given to clients, potentially improving the standard and accessibility of mental health services (Minerva & Giubilini, 2023).

As we witness AI’s growing role in mental health care, it’s an ideal time for counselors and coaches to explore AI tools. Such innovations can enrich their practice, offering fresh approaches to support clients more effectively in today’s digital world.

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