Can AI Chatbots Replace Human Therapists? Exploring the Debate
The question of whether chatbots can replace human therapists is gaining traction. Some startups and patients believe they can, but the scientific community remains divided.
A study revealed that 80% of users who sought mental health advice from OpenAI’s ChatGPT found it a viable alternative to traditional therapy. Another report highlighted that chatbots could effectively alleviate symptoms of depression and anxiety. However, the human connection between therapist and client is a well-established predictor of successful mental health treatment.
Entrepreneurs Dustin Klebe, Lukas Wolf, and Chris Aeberli advocate for chatbot therapy. Their startup, Sonia, offers an “AI therapist” accessible via an iOS app for various topics.
“Developing an AI therapist is akin to creating a new drug; we’re building new technology rather than repackaging existing ones,” said Klebe, Sonia’s CEO, in an interview with TechCrunch.
The trio met in 2018 while studying computer science at ETH Zürich and later moved to the U.S. for graduate studies at MIT. After graduating, they launched Sonia to pursue their passion for scalable technology.
This startup, Sonia, is the result of their shared vision.
Sonia utilizes various generative AI models to interpret user input during “therapy sessions” and provide appropriate responses. Incorporating cognitive behavioral therapy techniques, the app, which costs $20 per month or $200 annually, assigns “homework” to reinforce insights from conversations and uses visualizations to help identify major stressors.
Klebe asserts that Sonia, which lacks FDA approval, can address issues such as depression, stress, anxiety, relationship problems, and poor sleep. For critical situations, like those involving thoughts of violence or suicide, Sonia employs “additional algorithms and models” to detect emergencies and direct users to national hotlines.
Despite none of Sonia’s founders having psychology backgrounds, Klebe mentions that the startup consults with psychologists, has recently hired a cognitive psychology graduate, and is actively seeking a full-time clinical psychologist.
Klebe emphasizes, “We don’t view human therapists or any companies offering physical or virtual mental health care by humans as our competition. For every response Sonia generates, about seven additional language model calls are made in the background to analyze the situation from multiple therapeutic perspectives, ensuring the approach is adjusted, optimized, and personalized.”
How does Sonia handle privacy concerns? Can users be confident that their data isn’t stored insecurely or used to train the AI without their consent?
Klebe assures that Sonia only retains the “absolute minimum” personal information necessary for therapy, specifically a user’s age and name. However, he did not specify the location, method, or duration of conversation data storage.
Sonia, which boasts around 8,000 users and has secured $3.35 million in funding from investors like Y Combinator, Moonfire, Rebel Fund, and SBXi, is currently negotiating with various mental health organizations to offer Sonia through their online platforms. App Store reviews for Sonia are generally positive, with many users finding it easier to discuss their issues with the chatbot than with a human therapist1.
However, is this necessarily a good thing?
Today’s chatbot technology has limitations in the quality of advice it can provide and may not detect subtle signs of issues, such as an anorexic person asking for weight loss tips. (Sonia wouldn’t even know the person’s weight.)
Additionally, chatbot responses often reflect Western biases from their training data, potentially overlooking cultural and linguistic nuances in how people express mental health issues, especially if English is their second language. (Sonia currently only supports English.)
In the worst-case scenario, chatbots can malfunction. For instance, the National Eating Disorders Association faced backlash last year for replacing human staff with a chatbot, Tessa, which gave triggering weight-loss advice to individuals with eating disorders2.
Klebe emphasizes that Sonia is not intended to replace human therapists1.
“We are developing a solution for the millions of people struggling with their mental health who either can’t or don’t want to access a human therapist,” Klebe stated. “Our goal is to bridge the significant gap between demand and supply.”
Indeed, there is a notable gap, both in the ratio of professionals to patients and the cost of treatments versus what most patients can afford. A recent government report highlighted that over half of the U.S. lacks adequate geographic access to mental health care. Additionally, a survey found that 42% of U.S. adults with a mental health condition couldn’t receive care due to financial constraints.
An article in Scientific American discusses therapy apps that cater to the “worried well,” or those who can afford therapy and app subscriptions, rather than isolated individuals who might be most at risk but don’t know how to seek help. At $20 per month, Sonia isn’t exactly cheap, but Klebe argues it’s more affordable than a typical therapy session.
“It’s much easier to start using Sonia than seeing a human therapist, which involves finding a therapist, being on a waitlist for four months, attending sessions at a set time, and paying $200,” he explained. “Sonia has already seen more patients than a human therapist would see over their entire career.”
I hope that Sonia’s founders remain transparent about the app’s capabilities and limitations as they continue to develop it.