Do We Dare Use Generative AI for Mental Health?

Abstract

The mental-health app Woebot launched in 2017, back when “chatbot” wasn't a familiar term and someone seeking a therapist could only imagine talking to a human being. Woebot was something exciting and new: a way for people to get on-demand mental-health support in the form of a responsive, empathic, AI-powered chatbot. Users found that the friendly robot avatar checked in on them every day, kept track of their progress, and was always available to talk something through. ¶ Today, the situation is vastly different. Demand for mental-health services has surged while the supply of clinicians has stagnated. There are thousands of apps that offer automated support for mental health and wellness. And ChatGPT has helped millions of people experiment with conversational AI. ¶ But even as the world has become fascinated with generative AI, people have also seen its downsides. As a company that relies on conversation, Woebot Health had to decide whether generative AI could make Woebot a better tool, or whether the technology was too dangerous to incorporate into our product. ¶ Woebot is designed to have structured conversations through which it delivers evidence-based tools inspired by cognitive behavioral therapy (CBT), a technique that aims to change behaviors and feelings. Throughout its history, Woebot Health has used technology from a subdiscipline of AI known as natural-language processing (NLP). The company has used AI artfully and by design—Woebot uses NLP only in the service of better understanding a user's written texts so it can respond in the most appropriate way, thus encouraging users to engage more deeply with the process.