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September 12, 2018
by Tina Arnoldi

The Possibilities of Chatbots as Therapists: A Replacement or Addition?

September 12, 2018 11:02 by Tina Arnoldi  [About the Author]

The World Health Organization believes that by the year 2030, mental health will be the most significant disease worldwide. With an increase in the number who need treatment, advances in technology are one way to extend the reach to patients that need help. But is that a replacement for face-to-face connection? Recent research found that chatbots, or conversational agents, cannot express empathy to the extent a human can and people appreciate the nuances from their peers.  However, there is some benefit in the act of disclosing personal information - even to a computer.

Earlier this year, Woebot, a mental health chatbot, received $8 million in funding. Another startup, Wysa, was recently accepted to Launchpad Accelerator India. With a significant number of people not getting help for their mental illness and the increase of options available through AI (artificial intelligence), perhaps a chatbot can help as a replacement or supplement to traditional mental health therapy.

Roselyn G. Smith, Ph.D., has concerns about the use of an AI for mental health treatment. “One of the most important elements of effective therapy is the bond and rapport between the client/patient and therapist.” Something a computer cannot replicate. She notes that therapy is a “very complex, multi-faceted evaluation and approach, not one that can be programmed in a linear fashion.” When asked if there was ever a case for using a chatbot, such as when therapy is not accessible in rural areas or those with a limited income, she still said ‘no’.

In those cases, Smith would encourage tele-therapy through a secure connection or turning to a nearby college or university to seek assistance at a clinic. Emily Mendez, M.S. EdS, also a therapist, is open to chatbots as a supplement to counseling. “These applications are helpful — but only when used with the guidance of a trained therapist or mental health professional. Mental health disorders are quite complicated and require the skill of a person trained with them.” But what about when the therapist is not available? Or, if someone is struggling in the middle of the night, yet not in a crisis situation.

Nenad Cuk, with CroatiaTech , who works in software development, VR/AR, machine learning and AI, sees application for mental health treatment. “Having someone to talk to about how you're feeling or what some of your thoughts are, at any time of day or night, would go a long way to prevent suicides and to encourage individuals to seek further help. Bots don't sleep, and they can stay as emotional or distant as we program them to be, so this has some good opportunities from the get go. “

Others have a less favorable view of therapy as a profession.. Dary Merckens with Gunner Technology expressed his perspective. “Whether it's supposedly scientific fields like Freudian analysis or new-age religious experiments like so much of the self-help movement, therapy is largely a sham - an incredibly lucrative sham, but a sham nonetheless. What most people need is basic, age-old advice.” Merckens see therapy as primarily a motivation tool which can be be done through AI, such as a chatbot. When asked if there is ever a case where seeing a therapist is the right thing for a person, he concedes it is something for those who are seriously mentally ill compared to those who function day-to-day, but are “emotionally discontent”. He makes a case that this group needs “guidance, motivation, and a sounding board for their problems, all of which could be supplied by a sufficiently robust application.”

Merckens is currently working on a product “to replace the positive aspects of therapy with an app that is always available and doesn't charge you a couple hundred bucks for standard advice.”  He believes most people can benefit from basic assistance. “Eat better. Exercise. Accomplish things on a daily basis. Devote yourself to something. Educate yourself. Etc. You don't need a therapist to tell you that. You just need someone to keep you motivated.” As stigma continues to be an issue when it comes to receiving a mental health diagnosis and seeking treatment, technology solutions are a potential resource for people who may not receive help otherwise.  Whether that is in the form of apps, avatars or chatbots remains to be seen.

About the Author

Tina Arnoldi

Tina Arnoldi, MA is a marketing consultant and freelance writer in Charleston SC. Learn more about her and connect at

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