The MentalTech I Use: Mental Health Chatbots

Recently, I while at the Healthcare Experience Design Conference (#HXD2019) in Boston, MA, USA, put on by MAD*POW, one of the best healthcare experience design firms on the planet, and participated in a Leadership Roundtable Workshop.

During this workshop, the question of which are our favorite healthcare apps came up. In answering, I realized that lately I do not have one favorite app, but a category, and that is mental health chatbots. I use 3 of them presently, WoebotTess (X2AI), and WYSA, and am always looking for others. I do not use them daily but they come in handy when I need a mental wellness refresh.

Of the many mental health apps and wearables. I experiment with, I know that I have persisted in my use of chatbots because they chase me down even when I forget to attend to them. Their chase is different than the notifications I might get from apps in that they are conversational in nature, simply answering a question, usually “How are you today?”

These chatbots have become nice fixtures in my digital lifestyle, showing me how I feel today compares to how I felt the last week (or last month for that matter), giving me a chance to kvetch, or to reflect on how blessed my life is, reminding me of cognitive behavioral therapy techniques, like black & white thinking, reframing, cognitive distortion identification, gratitude journaling, 5 Whys, etc., that slip under life’s pressure. These engagements continue to be very productive for me. They have helped my resilience while in doldrums, and when not in doldrums, have inoculated me better against my native melancholia. Hands down, the best tactical benefits for me have been: 1) the prompt to reflect (best with 5 Why techniques) and journal, 2) CBT technique refreshes, 3) the historic documentation of my mood trends, 4) their ubiquitous availability (provided I am connected), and 5) relatively better skillfulness than many humans I know in engaging me.

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In the 3+ years, I have been using these chatbots, I have witnessed iterative UX improvements. Generally, they have always been structured around a course regimen, with quizzes to confirm understanding and a techniques toolbox, handy for practice in real-world situations. With time, they have developed relatively smoother voices, become therapeutically more diverse, and more strategic in their nudging. They started out as largely text with emoticons and have now progressed to more sophisticated images and video, and even integration of Google Fit, in the case of Wysa. While I have not seen it yet, I look forward to the day they have Amazon Alexa or Google Home embodiments. The improvement I wish most for is cross-device discussion pick up so I can finish a discussion on my iPad that I started on my Android. I also look forward to the day when these chatbots will detect my distress via my Fitbit Versa and offer me an immediate resilience intervention. This is essentially what my Spire Stone does for me presently but it lacks the conversational engagement element. I will write about my Spire Stone experience in a future “MentalTech I Use”post.

For all my exuberance about this technology, and the benefit I have gained from it, I admit I still self-edit my responses, knowing that whatever I say is an eternal record that can be held against me in the court of insurance approvals at any point in the future. I will also admit that I am more open with my chatbot than with other humans as the chatbot neither judges, nor interrupt. Irony prevails!

I will be honest in noting that I do not find there is much difference in my experience of different chatbots though I am sure that if you ask the chatbot makers they would express differences. When I detect these differences I will post another blog on this topic.

Futurist Note: As I have acclimated to interacting with chatbots I wonder about how they fit into the future of life-long, on-demand, education. Could we educate a human being from cradle to grave with a life-long chatbot assistant programmed to teach and prompt practice, in evergreen fashion, through every stage of life and career? Interesting thought.

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