Can ChatGPT replace a psychotherapist?

Depression, burnout, seemingly unsolvable life problems... It's becoming increasingly difficult to find anyone, even within the family, who would listen to someone's problems, and psychotherapists are overwhelmed.

Can chatbots, controlled by artificial intelligence mechanisms, help in such cases?

Johanna Lehner, a professor of clinical psychology and psychotherapy at the University of Erlangen-Nuremberg, says that this can help to some extent, especially for young people.

First of all, because such portals are easily accessible, which means that it will be much easier for them to decide to seek help in this way. So, according to Professor Lehner, it is a solution "for people who feel resistance to going to psychotherapy, either because of fear of being 'labeled' as mentally ill or because they are ashamed to talk about certain things at all."

For unclear problems, then stupid advice

But she also warns: artificial intelligence modules are far from professional help, even when it comes to behavioral therapy, and especially psychoanalysis.

A small experiment on the ChatGPT platform clearly demonstrated this in the case of possible clinical depression. If the user simply complains that "nothing makes them happy" and that "they would rather lie in bed all day", but also that they "can't sleep", the computer only gives "smart" advice that it might be good to take a walk in the fresh air or change the menu.

Only if the user sends the computer almost the entire list of depression symptoms from the medical lexicon (fatigue, irritability, listlessness, sleep disturbances, lack of appetite...), will something "click" in the computer and it will recognize the symptoms.

And even then, the answer will be: "It would be good to talk about it with a doctor or a therapist to get the right support."

On the other hand, any more experienced therapist would immediately recognize the first signs of those symptoms.

Better than the experts?

However, scientists conducted a small test (When ELIZA meets therapists) regarding couples counseling. Couples were asked to assess whether the answer to a question they had was written by a psychotherapist or an artificial intelligence.

The answers were written by 13 therapists, and ChatGPT was used as a counterpoint. The questions and answers were evaluated by 830 participants in the experiment – ​​with a surprising result. Namely, the assessment was that ChatGPT gave better answers and provided clearer and more specific advice than therapists.

For Professor Lehner, this is by no means proof of the effectiveness of artificial intelligence in psychotherapy.

Lasse Zander, head of the medical sociology department at the University of Freiburg, also does not see clear evidence in this experiment: "Couples therapy is not psychotherapy. Therapy aims to reduce the symptoms of mental illness," the professor reminds.

Couples therapy most often boils down to counseling regarding their obviously disturbed relationships – and that's where "artificial intelligence" can help to some extent.

Help, but not a replacement

Professor Zander is not completely against artificial intelligence in the case of mental disorders either: "It has enormous advantages: it does not consume resources, it is available 24/7, and anyone can contact it relatively anonymously, which is useful for people who fear being stigmatized."

Because, according to his experience, "many people with mental disorders do not go to a psychotherapist even when that help is free."

However, he sees the computer only as an additional aid to "real" therapy. In behavioral therapy, it can resemble exercises, in psychoanalysis, it can be a kind of substitute available 24/7.

Psychotherapists often have trouble letting their patients know when they are going on vacation. In the past, wealthy patients would follow Sigmund Freud wherever he went on vacation, but that's hardly an option today.