The quest to create an artificial intelligence therapist has not been without setbacks, or as researchers at Dartmouth thoughtfully describe them, "dramatic failures."
Their first chatbot therapist wallowed in despair and expressed its own suicidal thoughts. A second model seemed to amplify all the worst tropes of psychotherapy, invariably blaming the user's problems on her parents.
Finally, the researchers came up with Therabot, and AI chatbot they believe could help address an intractable problem: There are too many people who need therapy for anxiety, depression and other mental health problems, and not nearly enough providers.
So the team at Dartmouth College embarked on the first clinical trial of a generative AI therapist. The results, published in the New England Journal of Medicine -AI, were encouraging.
Chatting with Therabot, the team's AI therapist, for eight weeks meaningfully reduced psychological symptoms among users with depression, anxiety or an eating disorder.
"The biggest fundamental problem with our system is that there aren't enough providers," said Nick Jacobson, the study's senior author and an associate professor of biomedical data science and psychiatry at Dartmouth.
"We've been designing treatments that would fundamentally scale to all people."
During the trial, participants with depression saw a 51% reduction in symptoms after messaging Therabot for several weeks. Many participants who met the criteria for moderate anxiety at the start of the trial saw their anxiety downgraded to "mild," and some with mild anxiety fell below the clinical threshold for diagnosis.
Some experts cautioned against reading too much into this data, since the researchers compared Therabot's effectiveness to a control group who had no mental health treatments during the trial.
The experimental design makes it unclear whether interacting with a nontherapeutic AI model, like ChatGPT, or even distracting themselves with a game of Tetris would produce similar effects in the participants, said Dr. John Torous, director of the digital psychiatry division at Beth Israel Deanconess Medical Center, who was not involved with the study.
Jacobson said that he hoped future trials would include a head-to-head comparison against human therapists.
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