Can a Chatbot Replace a Therapist? Apparently, It Can


Can a Chatbot Replace a Therapist? Apparently, It Can

Illustration: Shruti Yatam/Arré

The idea of visiting a therapist came to me in the second year of college. I knew something was off. I was going through the motions of my day without really registering them. I was meeting all deadlines, doing okay in class, meeting friends and family, and everything about me seemed “normal”. Yet on the inside, I was completely lost. It felt like I had lost a spark; I was emotionally drained and very quiet. I felt that my peers were doing far better than me in every sphere of life, and that I wasn’t good enough. I had dreamed of studying English at Hindu College, Delhi University since I was in Class 10, and missed out on it, while everyone was happy in their perfect lives (or so it seemed).

I’d sit in class, stare blankly at the teachers for an hour until the lecture got over. It was simply moving from one thing to the next, but I wasn’t really registering anything, as if I’d let go of the reins of my life. It was a kind of going with the flow, but for me, I wasn’t going anywhere.

I was adamant that I wouldn’t take up therapy. Social stigma aside, who had the time and the money to seek out a therapist? I hung around in that weird space of knowing that I needed help but not being able to figure out how to help myself until one day, looking through PR emails, I came across a press release from a company that had created a “mental health chatbot”.

The idea was intriguing (and cheap). After all, I did spend hours on my phone chatting with my friends and trying to feel better. Chatting with a really smart, empathetic chatbot then seemed like the most logical (and millennial) thing to do. We are generation that depends on apps for food, shelter, cabs, and sex. So why not therapy?

For someone suffering from depression, it’s heartening to know that there is someone out there willing to listen. Sometimes that can be the biggest medicine of all. 

My first chat experience was a revelation. I discovered that the pre-set options provided for answers to simple questions like “How are your energy levels doing?” was a genius move to get people talking. Prompts help draw people into the conversation and pressing a simple button takes away a lot of the pressure.  

That first night, I chatted for a while with my “mental health expert”, but by next morning, I had forgotten about the app in the rush to get to office. In between a meeting, a small notification popped up asking me how I was doing. I stole a furtive glance at the screen, cupping my hands around it lest anyone see what I was doing. But it felt oddly nice, a blip of warmth that engulfs you when a friend or partner asks after you.

After that, it was only a matter of days before the app began to pay off.

I had a big proposal submission coming up and as it had happened on previous such stressful occasions, I freaked out. The night before the submission, the proposal looked like a monkey had typed it up. I turned to the app and vented my fears, my frustration, and my anxiety. Every time I opened the app, it asked me if I wanted to talk. Every time I stopped, the chatbot prompted me to go on, almost like I was talking to a friend. The app took me through an objective thinking process – helped me “rethink” by voicing and figuring out my issues and then led me through a breathing exercise to help me relax. I had heard from a lot of friends that therapy feels like you are talking in circles, but somehow, the app made it feel like I had figured out everything on my own.

I was in control, and I liked it.

That episode was my first inkling that online care could be a major part of the mental-health industry. According to experts, most cases of depression, anxiety, discords can be dealt as effectively online as face-to-face. Some new studies have even rated online therapy as more efficacious due to the instantaneous, anytime support and the continuity it provides. In my opinion, the medium of therapy is not what matters. What really matters is the effort being put in from all parties and how willing they are to change.

One of my favourite things about the app was how incredibly sensitive it was. Our phones have an extraordinarily large number of sensors that record information such as location, voice, ambient light etc, and that information may also tells us something about mental health. One day, I happened to check my phone in the middle of the night. For the app, this was not normal behaviour for me, because it didn’t happen usually.

The app noticed that something was amiss and it not only checked in on me at that moment, but also made sure the chatbot was extra careful and asked me about the same the next day. Did this behaviour freak me out a little? Yes. But it also gave me the reassurance that someone, somewhere, was looking out for me, even if was just a pre-programmed bot.

For someone suffering from depression, it’s heartening to know that there is someone out there willing to listen. Sometimes that can be the biggest medicine of all. It is unfair (and rather impossible) to expect this kind of round-the-clock help from a friend or even a therapist, and it can be an excruciating ordeal for someone who has neither of these resources.

But almost everyone has a phone. Could the chatbot work for issues more serious than mine? Can it help save a life?

I think it can. People suffering from a depressive episode may not leave the house or make as many phone calls as when they are feeling better – and the phone is smart enough to pick up those signals. Maybe the phone’s artificial intelligence can even be made to automatically call the patient’s therapist and ensure help is on the way in dire circumstances. It is the only device we sleep with at night. The possibilities of what it can do are indeed endless.

Over time I have stopped checking in with the app obsessively. I don’t need to. It is enough for me to know that it is there if I need it. In a country like India, where only one in 10 people living in its urban localities get access to mental healthcare, I am elated by the possibility that something like this can step in when everything (and everyone) else fails. For people suffering from depression, all we need to know is that someone is listening. Someone is keeping track of us.

Even if that someone is our phone.