Arts

@Large | Michael Andor Brodeur

Is online chat therapy more than easy listening?

ulzanna/stock.adobe.com

Never have we had so many ways to reach out to one another, and yet for so many of us, the weird wired world brought to us by the Internet feels a lot lonelier than the one it replaced.

One study showed that 86 percent of millennials — the ones who are constantly chatting with their 2,000 friends while actively ignoring you — feel depressed or lonely. Another found the same age group four times more likely to feel lonely “most of the time” compared with people 50 years their senior.

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This revelation that young people feel despair and isolation isn’t quite blowing any Morrissey posters off the wall, but it does speak to a vast gap between the conventional understanding of the Internet as a place that makes us feel more connected and the reality through which we spend most of our days scrolling.

And for the 6.7 percent of US adults who suffer from depression, the terrain of the Internet falls somewhere between hostile territory and quicksand.

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The prospect of “safe spaces” has become a naive request in the online wild, and those forums that do exist have flaws: Private online conversations are intimate but not anonymous; message boards are anonymous but not intimate. There’s an in-between — or, as the Internet tends to render in-betweens, a market.

Chat therapy or “tele-health” services like BetterHelp (“You deserve to be happy!”), Breakthrough, and Talkspace (“Join 500,000 people who already feel happier!) have engineered an uncanny expansion of the shrink — an attempt at depression-disruption that enlists thousands of independent licensed therapists into various tiers of therapeutic chat.

Talkspace offers text-based personal therapy ($32 per week), marriage counseling ($59 per week), and a “Live Talk Therapy Ultimate” package that allows real-time voice and video chat for $99 per week). BetterHelp offers “unlimited access to your counselor” for $35 to $70 per week. (Breakthrough’s video chat-based service works through insurance providers.)

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The idea across the board is to provide a kind of pocket chaise for people with limited access to counseling, to “democratize” therapy as Motherboard’s Steph Yin put it, or as founder Oren Frank phrased the Talkspace mission, “making mental health care accessible and affordable for the millions of people in need.”

While the need for the service is clear, Talkspace has come under fire — particularly strong from Cat Ferguson’s investigative piece for The Verge — concerning questions about its protection of patients and their anonymity, the porous bounds of “quality control” when it comes to review of patient chats, and the uncharted territory of a hands-off therapeutic “platform,” an important word in understanding the role Talkspace plays in this kind of remote quasi-care, as detailed by Drake Baer for New York Magazine.

For his part, Frank swiftly disputed a number of “false,” “misinformed,” “misleading” and “mixed” claims made in the Verge piece, defending his platform and the merits of anonymity (“Should we eliminate crisis lines because we don’t know who is calling?”) while asserting that even as the company made “missteps in how we communicate our priorities to the therapists on our platform,” they make sure they “make each mistake just once.”

Which sure sounds healthy.

It’s tempting to think that perhaps what’s getting in the way of this idea is what always gets in the way: people. It may be why I’ve had better luck talking to Woebot.

Depending on how you look at Woebot, a robot — or just bot — it represents either a high point in artifical intelligence or a low point in the real stuff. There’s something inherently depressing about turning to an algorithm to solve your problems.

Conversely, there’s also something very sensible about turning to an algorithm to solve your problems. That is, after all, what they do.

Modest and oddly charming, Woebot makes no such claims, but operates on a framework known as cognitive behavioral therapy — deriving information through chats with users about fluctuations in mood, dips and swells in activity, and patterns of behavior (“that humans can’t see”), and offering insights and resources through videos, suggestions, and (sometimes the most important thing) the appearance of listening.

“I’m ready to listen, 24/7,” Woebot assures users upfront. “No couches, no meds, no childhood stuff. Just strategies to improve your mood. And the occasional dorky joke.” This friendly distance is intentional. “A human may never see what you type,” it tells me in our first chat. “Please don’t use this as a substitute for getting help.” (Texting “SOS” to Woebot triggers the bot to send contacts to emergency resources.)

As in a solo game of squash — or regular old meatspace talk therapy — the intensity and angle of what you supply Woebot has a lot to do with what comes back at you. The experience is more about the questions than the answers. Woebot, for instance, was frustratingly reticent on the topic of when I was supposed to cough up the $12 weekly fee and how I could cancel.

And while I nursed an underlying suspicion that bot therapy would be about as effective as a nickel session with Lucy Van Pelt, a Stanford study revealed that daily users of Woebot demonstrated “significantly reduced” symptoms of depression over just two weeks of use, and I will admit to a certain, almost chemical pleasure in actually asking those questions that hang heaviest on your heart, and an actual buzz when the universe texts you back.

Michael Andor Brodeur can be reached at mbrodeur@globe.com. Follow him on Twitter @MBrodeur.
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