A therapy chatbot for depression
businessinsider.fr
businessinsider.fr
I wish it outlined, in plain language, how private (or not) the transcripts of my chat data are and the retention policies associated with said data.
- The name woebot - is this a joke?
- The company is made up of 5 cs engeneers, only 1 clinical psycologist, and 1 ceo/doctor (of what?)
- It's a for-profit paid business, not a make-the-world-better university project
Chats with woebot == user suffering from depression
Combined with Facebook's previous psychological experimentation on users, your entire business model should be seen as harmful.
Have you thought through the ethical implications of what you're doing, at all?
Are you complying with current UK / EU laws about how you handle that data? Will you be compliant with GDPR when it comes in?
https://en.wikipedia.org/wiki/General_Data_Protection_Regula...
FB is a no-go!
Using so much tracking on your website that it's broken with ad-blocker and FF tracking protection on is a no-go!
In the current state the only sane thing to do is to warn people to not use your service.
Facebook routinely experiments on people in a way that's dangerous to people with mental health issues (and likely even healthy adults).
Opening up their treatment to Facebook is incredibly negligent.
is this responsible guys?
It's probably the basis of their business model, in order to monetize conversations people have with the chatbot.
It's even more absurd given the fact that conversations between patient and therapist should be guaranteed to be private, otherwise the necessary trust will never be established.
Thinking that a chatbot can do a therapist's job is, for me, either a clear display of massive ignorance, or a deliberate attempt to make a buck off people that can't afford proper therapy.
Psychological therapy focuses (not only, but mostly) on basic aspects of humanity: feelings and reasoning, and the actions that transpire from these.
Everything is important in such an engagement: the language used, the topics discussed, the best approach to a specific topic. And all of these depend on who the patient is (his feelings, outlook over life, language used to express these), but also on how the therapist reads/understands the patient and acts/dialogues over this.
I can't see how someone can honestly think this is something a chatbot can do, how could a piece of software reason over what the person is saying and feeling. But I think it's a well established fact that therapy can actually be nefarious or even dangerous if done improperly.
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.
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.
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
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...
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.
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.
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).
Everyone talks to social contacts. CBT therapy is something entirely different.
Parts of CBT and DBT are skill training in emotional and cognitive behavioural regulation, that people have not mastered sufficiently on their own. You can teach these skills, and I'd argue they should be mandatory classes on them through middle school. IMHO, they are the most valuable skills that you can learn, bar none.
>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.
There's hubris in your assumption of how therapy works, or in the tools it incorporates today. This application was released, along with a study demonstrating it's efficacy. It's not the first of it's type - it's just the chatbot format of a self help book. There will be much better versions, I'm sure, over time.
Or, you might talk with friends about what's bugging you, but they're not going to necessarily explore how your feelings relate to external factors, or ask questions to help you understand yourself. A therapist's job is very different from the role of a friend.
Just because you're not talking with a human about the data you're generating _today_ doesn't mean it won't bring interesting discussions to bear in the future.
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.
Edit: Maybe it _is_ all a scheme by Big Insurance to give the masses minimal treatment and doesn't actually solve their problems but provides the illusion of a solution while sucking them into a vile dependence on closed-source AI personalities to feel any sense of therapy. Technology enables so many insidious business practices I don't know what to believe anymore.
Here in the UK, most people with moderately severe depression or anxiety have to wait several months to get access to CBT. That will usually comprise of six one-hour sessions, often with a mental health care practitioner rather than a clinical psychologist. Patients with less severe symptoms will be triaged to a telephone-based service, an online service or self-help books.
That's a perfectly typical story for a high-income country with an excellent healthcare system. Access to psychotherapy is routinely and severely rationed because of cost. In lower-income countries, the picture is far worse. For most people, the choice is not between nuanced treatment and convenient treatment, but between cheap treatment and no treatment.
In all honesty, I'm struggling to contain my anger at your comment - it's quite clear that you're from an extremely privileged background. $150 for a weekly session with a psychotherapist is an unimaginable luxury for the vast majority of people in the world.
I'd love for everyone to be able to access a clinical psychotherapist on demand, but it simply isn't going to happen. There isn't the money or the political will to make it happen. I welcome innovative approaches to psychotherapy, provided they're evidence-based and rigorously evaluated. We have a real opportunity to improve the wellbeing of hundreds of millions of people. I think that rejecting these possibilities because of a hypothetical risk is utterly churlish.
Now then, you're right about access to care. If you felt like I was being dismissive of the idea that someone might lack the available funds to get proper treatment for a mental disorder then I apologize. My statement about the long term wasn't to suggest that the access problem is solved now or that it will be solved within the next few decades which in my mind represent the near term as far as timescales go. I simply meant to imply that, assuming the app continues to show promise and is eventually completed as a functional product, and that similar derivative programs aimed at helping treat different mental illnesses can be developed, the concern after those accomplishments becomes ensuring that they don't dissuade patients from pursuing other more appropriate treatment paths once/if their situations improve to that point. I did not mean this as being the only concern or the primary concern afterwards. It was simply the concern I voiced because it was interesting to me when I thought about it and so I shared it.
I'm making assumptions so I may of course be wrong, but my guess is that the latter part of what I just talked about was what upset you. I didn't mean to imply that patients could simply change their situation and go after a different treatment paths. I simply meant that, in a world where the only consideration is treatment appropriateness, I thought it was worth considering the secondary effects app based treatment could have on patient treatment seeking. I didn't mean this to discredit app based treatments as a viable tool and I see no reason they couldn't work in isolation, synergistically with other treatments, or any other variation of "I'm sure they can work" that might be appropriate to this discussion. That seems to be the other interpretation you made from my post, that I was being dismissive of the app compared to other treatments, and this was not something I realized I was communicating. However, since, as far as I can tell, this was the reason you accused me of being churlish I thought it worth clarifying.
Psychiatric hospitals across the developed world are discharging actively suicidal patients on a daily basis, because they're marginally less suicidal than the dozens of people who are waiting for a bed. Beyond suicide, there are vast increases in drug and alcohol related deaths in impoverished communities. We're in the midst of a mental health emergency and need all the help we can get.
You're speculating about whether an app might hypothetically dissuade people from seeking better treatment at some point in the distant future. I think my response is downright charitable.
Consider another hypothetical scenario. A great famine has struck. Someone is dying every 40 seconds. The UN start helicoptering in bulk quantities of freeze-dried rations. I remark that there is a great danger in providing food aid, because it might dissuade people from eating a balanced diet of fresh fruit and vegetables. What response would I expect?
Qu'ils mangent de la brioche.
However:
> Here in the UK, most people with moderately severe depression or anxiety have to wait several months to get access to CBT
Here's the data for Jan 2017: http://www.content.digital.nhs.uk/catalogue/PUB23831
> 90.2 per cent waited less than 6 weeks and 98.7 per cent waited less than 18 weeks to enter treatment
Most people wait less than 6 weeks to start treatment.
I agree about the rest of your comment: the CBT model should be 12 to 14 weeks of one hour sessions face to face with a therapist (we're not sure if the experience level of the therapist makes much difference), and many people are getting a much reduced version of this: 6 to 8 weeks, of 45 minute sessions, sometimes in groups or over the phone.
For example, here is an article about Ellie, a South-Carolina University virtual therapist used in the treatment of PTSD. It notes some explicit advantages which at least complement humans:
“One advantage of using Ellie to gather behaviour evidences is that people seem to open up quite easily to Ellie, given that she is a computer and is not designed to judge the person”, Morency explains to news.com.au
...
Morency stresses she is not a substitute for a human therapist. Rather, she is used in tandem with a doctor as a data-gatherer, able to break down walls which may exist due to a patient’s unwillingness to disclose sensitive information to a human.
As Morency explains, “The behavioural indicators that Ellie identifies will be summarised to the doctor, who will integrate it as part of the treatment or therapy. Our vision is that Ellie will be a decision support tool that will help human doctors and clinicians during treatment and therapy.”
- http://www.news.com.au/technology/innovation/meet-ellie-the-...
It makes me think of the roosevelt speech...
It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.
does anyone here have anything constructive to add?
This is a field where you're literally playing with peoples' lives. Your "daring failure" could result in suffering and/or death for those people. If you think you should be free to do that without criticism, maybe it's time to learn a thing or two about "ethics".
Depressed from your 2 part time jobs and driving Uber? There's an app for that! Oh, don't use it now - 4chan managed to learn the AI and now it's giving junk advice.
What about working for a better society that accomendates people instead of building crutches to maintain the problematic status quo while trying to make some money for yourself and your friends?
Given that research, wouldn't that make Facebook be the best platform for an anti-depression chat-bot? That's where the users will be.
Regardless of those, we definitely plan to develop non-FB options in the near future. There's a mailing list here if you'd like to find out when those are offered: https://www.woebot.io/#besides-facebook
On a personal note, I oft recommend the "Kill News Feed" Chrome extension for Facebook users. (Woebot doesn't recommend it as he doesn't know about it yet, he lives in a happy world free of news feeds :).
On the other hand although the creators of the bot have good intentions I wonder about the fact that you are using the internet to relay personal medical information. Also, I don't know if your woebot information is stored anywhere so if Woebot gets hacked a bunch of PII relating any medical data you send. I wish that this was a standalone app that would prompt me to upload my data if and when I see fit.
[1] https://en.wikipedia.org/wiki/Kenneth_Colby
[2] http://rdrosen.com/psychobabble-fast-talk-and-quick-cure-in-...
https://www.disruptingjapan.com/can-this-startup-solve-japan...
It's a great idea. I hope we see more of it.
Simpler question: with a sufficiently-smart story generator, could you enjoy it if you knew it was procedurally generated? I feel that I couldn't. But I'd love to be wrong about that.
I feel like this might commit you to having some amount of conflict with "death of the author"?
If one cares that the writing was written by a person, and not just transcribed by a person, but composed by a person, it seems to me like one probably cares that the writing was done with an intent.
I don't see a reason that one would care about whether the writing was made with an intent, in a way that plays a role in whether one enjoys it, but not care at all about what that intent was.
So, I would expect that anyone who couldn't, or at least most people who couldn't, enjoy a work of fiction if they knew it was procedurally generated, probably would care about the intent of the author in writing what they are reading.
I also generally care about that, but I think I sometimes enjoy procedurally generated works, though this might be largely due to my knowing about the intent behind the writing of the code that produced the procedurally generated content, which includes substantial bits of literal text to include in the output, so..
Citation needed. After 5 minutes of chatting with a robot, you conclude it's either an insane clown or a robot.
It's harder to fool someone in an actual, focused 1:1 conversation, but it's easy to do in brief interactions when people don't suspect the other party may be a bot.
See also: automated news stories, autogeneration of e-mails, etc.
Reminds me of the story about robots in old folks homes. Why not just have people to keep people company.
This has actually been tried in the Netherlands, apparently with great success. University students can live rent-free in a retirement community on the condition that they spend time with the residents.
http://www.pbs.org/newshour/rundown/dutch-retirement-home-of...