Can chatbots replace human therapists? Some startups and patients claim that it can, but the science hasn't fully proven it.
One study found that 80% of people who used OpenAI's ChatGPT for mental health advice considered it a good alternative to regular therapy, while another report found that chatbots are effective in reducing certain symptoms related to depression and anxiety. Meanwhile, it's well-known that the therapist-client relationship — that human connection — is one of the best predictors of success in mental health treatment.
Three entrepreneurs, Dustin Klebe, Lukas Wolf, and Chris Aeberli, are proponents of chatbot therapy: Their startup, Sonia, offers an “AI therapist” that users can talk to and text about a variety of topics through an iOS app.
“Developing an AI therapist is, in some ways, similar to developing a drug, in that we're developing a new technology rather than repackaging an existing one,” Sonia CEO Klebe told TechCrunch in an interview.
The three met while studying Computer Science at ETH Zurich in 2018 and moved to the US together to continue their graduate studies at MIT. Shortly after graduating, they reunited and launched a startup that encapsulated their shared passion for scalable technology.
That startup became Sonia.
Sonia leverages a range of generative AI models to analyse and respond to what users say during in-app ‘therapy sessions.’ Inspired by cognitive behavioural therapy techniques, the app, available for $20 per month or $200 per year, provides users with ‘homework’ aimed at gaining insight from their conversations, as well as visualizations designed to help identify their biggest stressors.
Image credit: Sonia
Klebe claims Sonia, which is not FDA-approved, can address a range of issues, from depression, stress and anxiety to relationship problems and poor sleep. For more serious situations, such as someone having thoughts of violence or suicide, Klebe says Sonia has “additional algorithms and models” that can detect a “crisis” and direct the user to a national hotline.
Somewhat surprisingly, none of Sonia's founders have a background in psychology, but Klebe says the startup is consulting psychologists, has recently hired a cognitive psychology graduate, and is actively recruiting a full-time clinical psychologist.
“It's important to emphasize that we don't consider human therapists or companies that provide human-delivered physical or virtual mental health care as competitors,” Klebe said. “For each response Sonia generates, approximately seven additional language model calls are made in the background to analyze the situation from different therapeutic perspectives and tailor, optimize and personalize the treatment approach Sonia selects.”
What about privacy? Can users rest assured that their data won't be stored in a vulnerable cloud or used to train Sonia's models without their knowledge?
Klebe said Sonia is committed to storing the “absolute minimum” of personal information for treatment purposes — just users' ages and names — but did not say where, how or for how long Sonia stores the conversation data.
Image credit: Sonia
Sonia has about 8,000 users, is backed by $3.35 million from investors including Y Combinator, Moonfire, Rebel Fund and SBXi, and is in talks with unnamed mental health organizations to offer Sonia as a resource through their online portals. Reviews for Sonia on the App Store have been pretty positive so far, with several users saying it's easier to talk to the chatbot about their problems than to a human therapist.
But is that a good thing?
Today's chatbot technology is limited in the quality of advice it can offer and may miss subtle signs of a problem, like someone with anorexia asking how to lose weight (Sonia doesn't even know how much the person weighs).
Chatbot responses also reflect bias. Often, Western bias is reflected in the training data. As a result, they are likely to miss cultural and linguistic differences in how people express mental illness, especially if English is a second language. (Sonia only supports English.)
In a worst-case scenario, a chatbot goes haywire: Last year, the National Eating Disorder Association came under fire for introducing “Tessa,” a chatbot that replaced humans to offer inspirational weight-loss tips to people with eating disorders.
Klebe stressed that Sonia isn't trying to replace human therapists.
Image credit: Sonia
“We're building a solution for the millions of people struggling with mental health issues who can't (or don't want to) see a human therapist,” Klebe said. “We're looking to fill a huge gap between demand and supply.”
To be sure, there are gaps, both in terms of the professional-to-patient ratio and the cost of care and what most patients can afford. A recent government report found that more than half of the U.S. is geographically underserved in mental health care, and a recent survey found that 42% of U.S. adults with mental health conditions don't receive treatment because they can't afford it.
The Scientific America article states that therapy apps are aimed at “anxious people” — people who can afford therapy and app subscriptions — not isolated individuals who may be most at risk but don't know how to seek help. At $20 a month, Sonia isn't cheap, but Klebe argues that it's still cheaper than a typical therapy appointment.
“Getting started with Sonia is much easier than seeing a human therapist, which requires finding one, waiting four months, showing up at a set time and paying $200,” he said. “Sonia has already seen more patients than a human therapist will in their entire career.”
I can only hope that the founders of Sonia continue to be transparent as they develop the app about the issues it can and can't address.