Is AI Therapy Effective?

What Is AI Therapy?

AI therapy uses artificial intelligence to provide therapeutic interventions through chat-based platforms or AI therapy apps. AI has exploded into the mainstream over the past decade and developers in the mental health space have created AI therapist chatbots.¹

Some AI therapy technologies include:

• Machine Learning (ML): AI learns from therapist input to improve therapeutic responses.
• Natural Language Processing (NLP): Enables chatbots to analyze and respond to user inputs empathetically.
• Deep Learning (DL) and Artificial Neural Networks (ANNs): Help improve AI’s decision-making.
• Reinforcement Learning (RL): Optimizes the chatbot’s behavior over time.

AI therapist chatbots are at the heart of AI therapy. These tools are part of the broader innovations in AI in mental health, which encompass not only therapy but also diagnostic tools monitoring, and personalized care. AI therapy chatbots, such as Wysa and Youper aim to offer accessible mental health support, especially for those who may not have access to traditional therapy.

How Does AI Therapy Work?.

AI therapy chatbots are often developed by entrepreneurs with significant input from AI engineers and mental health professionals. Therapists provide supervised machine learning (SML) data, enabling AI therapy chatbots to differentiate between conditions such as major depression and anxiety.¹

One area of concern is the use of generative AI – which uses unsupervised machine learning (UML) to analyze large datasets. In UML, AI is given a full range of information across our digital world for which it generates data, and might lack the precision needed to address complex mental health issues safely. Most available studies either discourage the use of generative AI in AI therapist chatbots or focus on other forms of AI, such as supervised machine learning, instead.^{1, 2}

Who Benefits From AI Therapy?

AI therapy can be an effective supplemental tool for individuals experiencing mild health concerns. For example, a person struggling with a break up, going through a life transition, or managing increased stress at work due to company cutbacks or promotion. AI therapy has the potential to increase mental health treatment when utilized in conjunction with a real-life therapist.³

When paired with traditional therapy, AI therapy chatbots and tools may reinforce coping strategies and provide insights into daily experiences. Real-life therapists could access their clients’ AI therapy chatbot for increased insight into the day-to-day experiences of their clients. If integrated soundly, AI may offer substantial benefits in the therapeutic space.

Tools Used in AI Therapy

There are a variety of AI therapy tools for consumers to utilize. The most utilized is AI therapy chatbots or virtual agents. Machine Learning for diagnostic purposes may offer a whole new way to bring together a person’s life data to discover what is really happening over time.

Some AI therapy tools include:

Chatbots & Virtual Agents

AI therapy chatbots and/or virtual agents are like having a therapist providing cognitive behavioral therapy techniques, meditations, and recommendations for self-care at your fingertips. Most of these chatbots rely on SML to deliver personalized, evidence-based responses.

Natural Language Processing (NLP)

Many AI therapy chatbots interpret emotional cues from user inputs, tailoring responses to each individual’s emotional state. NLP is a subsection of AI that analyzes written or spoken language. NLP technology can also help real-life therapists monitor their patients’ mental well-being in a whole new way.

Mobile & Instant Messaging Integration

AI therapy is available through certain online platforms as well. Abby.gg, according to its website, provides 24/7 access to a free PhD-level AI therapist via instant messaging.⁴ These instant messaging chatbots and virtual agents use ML to adapt recommendations over time, making them highly accessible for users with unique schedules or remote lifestyles.

Machine Learning for Diagnosis

AI’s diagnostic tools analyze historical and present data, offering therapists valuable insights into patterns of behavior or symptoms.This can both support therapists in the treatment planning phase and in their approach to monitoring certain historical symptoms.^{1, 5} For example, if ML identifies that a warning sign for increased symptoms is isolation, a real life therapist can work with a client on ensuring supportive social and familial connections.

Is AI Therapy Effective?

Yes and no. AI therapy is most effective when used as a supplemental tool alongside human therapists. Beg et al. (2024) found in their narrative review of data from 2009 to 2023 that AI therapy can be an additional supportive measure for persons engaged in real-life therapy.⁵ Additionally,  in a study of 63 mental health professionals, Mohammed et al. (2024) found that these professionals could only distinguish between an AI therapy chatbot and a real-life therapist responses to case studies 53% of the time.⁶

However, data is limited and its effectiveness for severe mental health issues, such as psychosis or suicidality, remains unproven. AI therapy may be most effective for mild psychological symptoms that can happen to most of us at some point in our lives. However, for more moderate to severe symptoms, especially when self-harm, suicidality, complex trauma and psychosis is present, the safest option is a real-life therapist.

Pros & Cons of AI Therapy

AI therapy can offer increased accessibility. Access often is the greatest concern for clients in need. It can also provide reinforcement of the therapy strategies learned with real life therapy. Of course, with any benefit also comes a cost. There is a large concern regarding AI and the high potential for bias, ethical conundrums, and confidentiality.

Benefits of AI Therapy

AI therapy can create more access for those that have limited resources. Many people across the world live in remote areas. They may also not have access to transportation. Some work odd hours, such as overnight shifts, when therapists are not available. Others may experience such severe social anxieties that starting communications with AI therapy may open them up to real-life therapy.

Some pros of AI therapy include:

• Increased Accessibility: AI tools are available 24/7 and often free or low-cost.
• Personalized Support: Chatbots adapt to users’ needs using NLP and ML.
• Convenience: Ideal for individuals in remote areas or with unconventional schedules.

Disadvantages of AI Therapy

As discussed, with benefits comes pitfalls. AI therapy lacks the most essential component of therapy: human connection. Additionally, there are concerns around bias. As humans hold bias’, and humans create technology, it means the technology is infused with bias.⁷ It is important to ensure AI therapy is held to the same standard of equity as real-life therapists.

Some cons of AI therapy include:

• Lack of Human Connection: AI cannot replicate the empathy and nuance of human interaction.
• Bias and Ethical Concerns: AI tools can inadvertently perpetuate biases present in their programming.
• Privacy Risks: Ensuring confidentiality in digital platforms is a significant challenge.

Can AI Therapists Replace Human Therapists?

No, AI therapy cannot replace human therapists. Humans are social beings, even though some people prefer to be alone or may isolate due to mental health struggles, overall, we thrive in connection with one another. While AI can simulate empathy and provide evidence-based techniques, it lacks the human connection and nuanced understanding that make therapy effective. The therapeutic relationship between client and therapist is irreplaceable for fostering trust and emotional healing. In many therapists training, it is often advised that what is most healing about therapy is the relationship between therapist and client.

What Are the Risks of AI Therapy?

AI therapy is likely inappropriate for complex mental health conditions. Some studies have shown that AI underestimates the risk of suicidality compared to trained professionals.⁸ Complex mental health concerns may include: psychosis, suicidality, self harm, personality disorders, and moderate to severe mood disorders. These disorders often benefit from intensive treatment, for which AI therapy could support. However, is likely not best for being the sole support.

Another potential risk is increasing isolation. There can be benefits in the beginning for introducing a person with social anxiety to therapy in this way. However, a goal in therapy, oftentimes, is to connect those in our care to real-life social support, to get them out into the world to reduce any fears. Avoidance does not offer the healing many persons need from anxieties and depressive states.

Real-Life Success Story: Jenny’s Anxiety Journey With AI Therapy

Jenny (not her real name) is a 20-year-old cis-gender, lesbian Latina female, using she/her pronouns. Jenny started treatment with me due to anxiety which was exacerbated by failing her recent college semester. Jenny reported negative thoughts such as “I’m a failure”, “I’m stupid”, and “I’ll never be anything”. Jenny noted a mild depressed mood. Jenny shared she has experienced mild depressive and anxious symptoms since adolescence, however, has never doubted herself so significantly. Previously, Jenny felt that she was always able to “bounce back”.

Coming into therapy services, Jenny had supportive coping skills, such as listening to music, exercising four times per week, and painting. Jenny has found that these skills have only slightly helped, while before they usually supported her in resolving any symptoms rapidly. In the beginning of our therapy, I began to take a cognitive behavioral approach.

After a few weeks, Jenny shared that she was able to utilize the skills immediately following the session. However, after another day or two, it became more difficult. Even with different handouts and writing out the skills, she did not feel “anything” would help her. So, we turned to the Youper app, which reinforced cognitive behavioral strategies and provided daily support.

Over time, the Youper app provided Jenny an additional, interactive space to express her negative thoughts and feelings. Jenny reported the AI therapy supported her in believing in herself as she was going through her current semester. Jenny found that the AI therapy chatbot provided reinforcement of the different cognitive skills we had reviewed repeatedly in session, she regained confidence, reduced her negative thoughts, and improved her academic performance.

Jenny ended her recent semester, following the one she had failed, with a 90 average.

I felt Jenny was a good candidate to utilize AI therapy as an additional source because of her history. Jenny has always been resilient, she has always had mild symptoms, if they do occur, and there has never been an instance of suicidal thoughts, self harm or psychosis.