THE DOCTOR IS ON And how

THE DOCTOR IS ON

AND HOW DOES THAT MAKE YOU REAL? Therapy websites offer affordable, convenient and immediate mental health support, but lack human connection.

I’VE BEEN FEELING DOWN LATELY, SO I decide to take advantage of therapy. It is my very first time trying it out. On a Thursday afternoon, I leave work and step outside of my comfort zone; I open up about my feelings.

THERAPIST: I’m looking forward to getting to know you better over time. Why don’t you start by telling me a little more about what brought you here today? ME: Lately, I’ve been feeling a little bit depressed and not like myself. THERAPIST: It might help to tell me more about your moods. ME: I am constantly tired and easily irritated, I have no energy to do anything. THERAPIST: What do you try when you are tired out? ME: I usually just end up at home being lazy, watching TV after my long days which consists of either working or studying at school. THERAPIST: What drains your enthusiasm most? ME: Waking up and doing the same thing over and over again THERAPIST: What are you most looking forward to in the future? ME: Travelling and building great memories with my partner. THERAPIST: Please lend me a hand in interpreting. Would you like me to refer to this person as a male or female? ME: Male. THERAPIST: OK, noted. Continue typing with what is important.

“Typing?” That conversation was not with a human therapist, but an online conversation on a website called Open Dialogue, a private company run by Vancouver resident and UBC commerce graduate Ed Blunderfield. It’s a self-help site (opendialogue.ai) encouraging users to find their own answers by continuously rephrasing their questions and problems. It also offers “The Mindset Course” to teach self-reflection and stress management skills. The site’s humanizing language made me

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CAROLINE JIRKA illustration by CYNTHIA TRAN VO

feel comfortable to continue the conversation, and the questions the chatbot asked allowed me to reflect on my answers. “They help people learn more about themselves and overcome life stress,” says Blunderfield, “This website gives people the opportunity to self-reflect in an anonymous, non-judgmental space” Then, I hit a roadblock.

After a few interactions, the bot began asking similar questions repeatedly. This was expected of the program, but I began to hunger for specific feedback. As the bot itself and the website description mention, the program is new and still “learning.” The use of artificial intelligence in chatbots is growing in popularity and becoming a means of providing support for people seeking help or simply someone to talk to. Open Dialogue combines “educational resources with an artificially intelligent conversational program,” Blunderfield explains. However, the experience definitely left me wanting more. Mental health problems have increased significantly over the past decade. According to the World Health Organization, depression affects nearly 300 million people worldwidearound the world. By age 40, about 50 per cent of the population will have — or have had — a mental illness. These rates are higher than ever before, which heightens the need for alternative resources. People with mental health issues have several options available to them, including medication and therapy; however, the problem is that not everybody is comfortable utilizing these methods.

Problems such as the stigma around mental health or a lack of financial resources, can cause barriers for people with mental health conditions seeking help. The Mental Health Commission of Canada notes that almost one half (49 per cent) of those who feel they have suffered from depression or anxiety have never gone to a doctor. This is where AI websites and apps for mental health or self-help come in. These automated therapists (TAs) are designed to offer a time-efficient, cheap and short-term alternative.

Therapy sessions with another human normally require taking time out of your day getting to and from the appointment. It’s not an instantaneous process, and it can be expensive unless you have health insurance. Alternatively, you can connect with Open Dialogue

Ed Blunderfield

and it responds immediately. No appointment needed and no fee is charged for the first two weeks. For Blunderfield, it is critical for us to “first take responsibility for ourselves and our lives” and “use the various different tools to help us on our personal growth journey.” People shouldn’t solely rely on AI bots, especially for long-term issues. Tools like Open Dialogue and therapy chatbots offer people services in moments of need with the click of a button. The non-stop nature of social media allows us access to chatbots 24 hours a day, seven days a week. “Smartphones put this information and these digital experiences in the palm of our hand, whenever and wherever we want,” says Blunderfield. AI in healthcare still raises concerns regarding ethics. Can a chatbot replicate the same levels of trust and empathy that take place during complex interactions between client and therapist in a real-world therapy session? The answer is unclear.

“It all depends on what our expectations of technology are,” Blunderfield acknowledges. “There are certainly aspects of human companionship that an AI is highly unlikely to be able to replicate, but if we look to AI for other forms of companionship then you can see it has some advantages over humans.”

Blunderfield distinguishes Open Dialogue not as a trained therapist but as an interactive tool to encourage self-help. It provides accessibility and gives people resources that aid them in overcoming their struggles. A disclaimer on the site states that it is not a crisis service and recommends users seek immediate help if someone is in need. Those contemplating suicide are encouraged to contact the Canadian Suicide Prevention Services (CSPS) by calling 1-833-456-4566 or texting “TALK” to 686868 for the Crisis Text Line. The use of artificial intelligence in mental healthcare, or in any situation for that matter, also raises concern in regards to privacy and security. Vulnerabilities in website design may allow hackers to access private and sensitive information about users. Therefore, it’s crucial for the companies creating these websites to ensure their data is stored and managed appropriately. Open Dialogue’s data is managed using Amazon’s AWS trusted platform and is stored on their servers located in Oregon.

Many website users have given the company positive feedback. One client felt his ability to support others people improved. By using this website, he believed his “empathic listening and skillful questioning” significantly increased. Another user described the website as “a chatbot that helps you get your shit together.” He shared that, “solutions like Open Dialogue are good for people who are stressed- out, don’t have time to sit with a therapist or don’t really need one, and just need someone to help them refocus their thoughts.”

When utilizing these tools for personal growth, we must keep in mind that they simply provide temporary help. Open Dialogue’s ultimate goal is to “help people develop skills that enhance their mental and physical wellbeing.” Blunderfield claims “so many of our problems arise as a result of a lack of understanding of how the mind works.” AI potentially gives a significant percentage of the population access to therapy in a way they’ve never had before.

“I believe that we can teach people these foundational life skills, and then provide a safe, encouraging environment for them to explore how these ideas relate to their own personal situation,” Blunderfield insists.

Open Dialogue was launched as a basic website to start with, and its chatbot was thoroughly tested using volunteers. The company is continually adding new content and capabilities to meet individuals’ needs.

Blunderfield emphasizes, “It’s been evolving for a long time and continues to grow and learn new things.” Blunderfield hopes that his website can “help people experience meaningful personal growth and will remind us of our humanity, help us cultivate our most essential attributes and encourage us to thrive as human beings.” ■