However, users may overestimate the therapeutic benefits and underestimate the limitations of using such technologies, further deteriorating their mental health. Such a phenomenon can be classified as a therapeutic misconception where users may infer the chatbot’s purpose is to provide them with real therapeutic care.
With AI chatbots, therapeutic misconceptions can occur in four ways, through two main streams: the company’s practices and the design of the AI technology itself.
Company practices: Meet your AI self-help expert
First, inaccurate marketing of mental health chatbots by companies that label them as “mental health support” tools that incorporate “cognitive behavioural therapy” can be very misleading as it implies that such chatbots can perform psychotherapy.
The second type of therapeutic misconception is when a user forms a digital therapeutic alliance with a chatbot. With a human therapist, it’s beneficial to form a strong therapeutic alliance where both the patient and therapist collaborate and agree on desired goals that can be achieved through tasks, and form a bond built on trust and empathy.
Since a chatbot cannot develop the same therapeutic relationship as users can with a human therapist, a digital therapeutic alliance can form, where a user perceives an alliance with the chatbot, even though the chatbot can’t actually form one.
A great deal of effort has been made to gain user trust and fortify digital therapeutic alliance with chatbots, including giving chatbots humanistic qualities to resemble and mimic conversations with actual therapists and advertising them as “anonymous” 24/7 companions that can replicate aspects of therapy.
Technological design: Is your chatbot trained to help you?
The third therapeutic misconception occurs when users have limited knowledge about possible biases in the AI’s algorithm. Often marginalized people are left out of the design and development stages of such technologies which may lead to them receiving biased and inappropriate responses.
Lastly, a therapeutic misconception can occur when mental health chatbots are unable to advocate for and foster relational autonomy, a concept that emphasizes that an individual’s autonomy is shaped by their relationships and social context. It is then the responsibility of the therapist to help recover a patient’s autonomy by supporting and motivating them to actively engage in therapy.
AI-chatbots provide a paradox in which they are available 24/7 and promise to improve self-sufficiency in managing one’s mental health. This can not only make help-seeking behaviours extremely isolating and individualized but also creates a therapeutic misconception where individuals believe they are autonomously taking a positive step towards amending their mental health.
Through honest marketing and regular reminders, users can be kept aware of the chatbot’s limited therapeutic capabilities and be encouraged to seek more traditional forms of therapy. In fact, a therapist should be made available for those who’d like to opt-out of using such chatbots. Users would also benefit from transparency on how their information is collected, stored and used.
Active involvement of patients during the design and development stages of such chatbots should also be considered, as well as engagement with multiple experts on ethical guidelines that can govern and regulate such technologies to ensure better safeguards for users.
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