Need to talk through some problems? You can try talking to a robot—or a WoeBot
Lesson summary
Coming up today: “Woe”—w-o-e—is a word that means difficulty, sorrow, distress, sadness, trouble, things like that. We don’t use that word very much, but most English-speakers know what it means. Today, we’ll be talking about a chat app called “WoeBot,” in other words, a robot for talking about your woes, for talking about your difficulties. WoeBot is a mental health chat app. And today we’ll be talking about how it works and whether it’s worth it.
In the second half of the lesson, we’ll explore the English expression “cracks in the system.” And we have a quote of the week. Let’s dive in.
WoeBot to the rescue: chat apps and mental health
The pandemic exposed a few cracks in the mental-health system worldwide: first, more people need mental health care than are currently in treatment. And second, treatment is not always accessible or convenient. Especially in rural areas, the nearest specialist may be miles and miles away.
Then there are the age-old issues: the long stigma of seeking help for mental health issues, and the high price of treatment for those without insurance or government benefits.
A new generation of chatbots aims to fill some of these cracks. It’s important to say “some.” The chatbots we’ll talk about today do not pretend to replace the relationship between a patient and a therapist. Instead, they aim to provide service to people who might not otherwise be able to see a therapist or who might be new to therapy. They’re for people who need some general coaching or guidance.
Let’s start with what they are. Chatbots are app-based tools that provide advice, exercises, and general counseling. The apps aren’t appropriate for serious issues like schizophrenia or suicidal thoughts—and the apps don’t claim to be. But for everyday issues like anxiety, stress, difficulty in relationships, they can be helpful.
From a user’s perspective, it feels like having a conversation. There are no long articles to read—just quick messages that feel like what you might get from a friend. And after you receive and read a message, it either gives you a few potential responses or it prompts you to write an answer in your own words.
There is a small element of artificial intelligence involved—but not a whole lot.
For example, if you tell Woebot a problem, it analyzes your speech and suggests the topics that might relate to your problem. I said, “I feel like I’m having the same argument with someone over and over in my head.” Woebot asked if my problems were related to stress and anxiety. That wasn’t exactly right. I tried a few other prompts and it got closer.
That was the extent of the “artificial intelligence” used in the experience—at least as far as I can tell. There might be more behind the scenes. The real strength, though, was in the branching logic of the chatbot. For example, it would ask you questions and give a few suggested responses. The next messages you get would depend on the response you had chosen earlier.
WoeBot remembers the exercises you’ve done in the past, so when you revisit a topic, it gives you more advanced exercises or messaging, so you never feel like you’re getting repetitive content.
By asking questions and noting your answers, and remembering what you’ve said before, it can get a sense of your thoughts and feelings and then guide you through a process to adjust your thoughts and feel better. I did a module designed to help with trouble in a relationship—either a friend, family member, or romantic partner.
Through a series of questions, Woebot determined that I was unhappy with something, but that I was not comfortable asking for what I wanted. So first, it educated me on different communication styles. Then, it guided me through planning a conversation designed to get the best outcome. It helped me identify the problem, determine what I wanted, and plan a constructive and respectful conversation.
The interactions were all about five minutes long; after an interaction, it pauses to ask if you’d like to continue or resume the next day. I found that one or two interactions—fifteen minutes max—was about all I really wanted. But I could return to it every day.
So you can see how this might be a complement to—and not a replacement for—traditional therapy. Clearly there’s no human relationship involved. And the bot will only provide the resources that it has been programmed to provide.
But traditional therapy is often a 50-minute appointment once a week. A chatbot interaction can be five minutes, once a day—or however often the user wants. The frequency and method of delivery are different; this can help keep a user on track in between traditional appointments.
And the chatbot is programmed with a lot of commonly-accepted techniques that therapists use. So these can be helpful by reminding a patient of what’s already been discussed in therapy. Or it can raise ideas or conversation topics for a future appointment.
Woebot has about a hundred people on staff, but it has counselled over one and a half million users. Whatever the app’s shortcomings, you can’t beat the leverage model.
A lot of its users are in places where traditional therapy isn’t available. There are other people who just don’t have anyone to talk to and they need an outlet for their thoughts.
And don’t discount this: a lot of people are afraid or ashamed to seek mental health care; or they think seeing a therapist is for people who are weak. But some of those people might be willing to start using an app—and they might be surprised that mental health care doesn’t fit the stereotype they may have previously believed in.
Thinking of both/and
I can also imagine in the future that a chatbot app can be used more directly in a therapy environment. So for example, a therapist in an in-person session might identify a path for a user to go down during the rest of the week—and activate a certain path for a patient.
I definitely would have wanted this. So imagine you have a 50-minute session with a therapist on a Monday. You cover some ground. And the therapist wishes she could talk to you for another hour about what she knows on a certain topic. Instead of waiting until the next week, she could activate a module or something on my app, and I can practice relevant techniques, watch informative videos, track my mood, whatever, during the week.
As my favorite therapist podcasters say , you don’t have to think of either/or; you can think of both/and. So we don’t have to think of either in-person counseling or a chatbot. Both can work well, especially if, someday, they work together.
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