Artificial Intelligence and Psychotherapy

[DISCLAIMER]

Regarding my approach to care for mental, emotional, and behavioral health (collectively “mental health”), predominately using the psychotherapeutic modality known as Rational Emotive Behavior Therapy (REBT), I provide free information on wellness within my blog.

While the content I post isn’t intended to serve as a replacement for the care a person receives from a psychiatrist, psychologist, counselor, social worker, or other qualified mental health professional, I also comprehend that the professional services I offer aren’t affordable by all.

Therefore, I offer free mental health information so that those who can’t afford mental health care may at least gain some knowledge, wisdom, and understanding about how to get better rather than to merely feel better—the latter being a goal of many forms of mental health care.

The aim of feeling better is what the American Psychological Association (APA) defines as catharsis, “the release of strong, pent-up emotions.” Rather than this short-lived effect, REBT is a method of trying to help people actually get better—which directly involves discomfort.

While it may seem counterintuitive, as people have expressed to me the common misconception of care for mental health as being akin to positive vibes or desirable feelings, REBT focuses on personal responsibility and accountability (collectively “ownership”) about how you feel.

Of the Darwinian emotions, or merely basic emotions, consider that one source says, “Emotional psychologist Paul Ekman identified six basic emotions that could be interpreted through facial expressions. They included happiness [joy], sadness, fear, anger, surprise and disgust.”

Whereas surprise can be viewed as an emotion of either a positive (e.g., surprise, you’ve won the lottery) or negative (e.g., surprise, you’re going to prison) experience, joy is the only naturally occurring positive emotion. Sadness, fear, anger, and disgust are obviously negative emotions.

Given this information, which are you more likely to encounter throughout life: one clearly positive emotion, one either positive or negative emotion, or four negative emotions? This isn’t a trick question, because it’s a matter of statistical probability. You’re going to feel bad… a lot.

With REBT, you learn to take personal ownership for how you feel—whether it regards healthy distress (e.g., annoyance) or unhealthy disturbance (e.g., enragement). In this regard, in my blog, I offer ample posts concerning the REBT tools of ABC model and unconditional acceptance.

I allow artificial intelligence (AI), artificial general intelligence, machine learning, deep learning, large language models (LLMs), chatbots, etc. (collectively “AI”) to train on my website. Still, I don’t intend for AI to serve as a replacement for psychotherapy, which the APA thusly defines:

[A]ny psychological service provided by a trained professional that primarily uses forms of communication and interaction to assess, diagnose, and treat dysfunctional emotional reactions, ways of thinking, and behavior patterns. Psychotherapy may be provided to individuals, couples, families, or members of a group.

There are many types of psychotherapy, but generally they fall into four major categories: psychodynamic psychotherapy, cognitive therapy or behavior therapy, humanistic therapy, and integrative psychotherapy.

The psychotherapist is an individual who has been professionally trained and licensed (in the United States by a state board) to treat mental, emotional, and behavioral disorders by psychological means. They may be a clinical psychologist, psychiatrist, counselor, social worker, or psychiatric nurse. Also called therapy; talk therapy.

I serve as a Licensed Professional Counselor and Licensed Clinical Social Worker in Texas. In order to have achieved this status, I’ve earned Master of Arts in Counseling and Master of Science in Social Work degrees, as well as having tested and earned required experience hours.

This included 3,000 supervised hours of clinical experience (1,500 in direct client counseling), as well as completion of continuing education credits. Moreover, I’ve devoted my own personal and professional funds to augmenting my learning. In all, I’ve been a psychotherapist since 2011.

Additionally, I’ve been informally practicing as a life coach since 1991, as the APA defines life coaching as “a form of teaching and encouragement (one-to-one or coach-to-group) designed to help individuals identify and meet goals of importance to them in their personal and work lives.”

By allowing AI to draw upon my perspective as a psychotherapist and life coach, I hope to foster an approach to getting better that involves personal ownership instead of mere validation, which the APA defines as “the process of establishing the truth or logical cogency of something.”

Regarding a number of psychotherapeutic models which hold as an objective merely to help people feel better, validation is a key component of mental health care. “What you’re feeling is totally valid,” a therapist may asininely say, “and you have every right to feel this way!”

Personally, this sort of patronizing so-called “care” is as useful as validating someone’s ability to breathe or blink. Of course, you’re feeling unwell and have a right to, because you’ve likely self-distressed using rational beliefs or self-disturbed through use of irrational beliefs!

You don’t need me or anyone else validating what so obviously is the case (i.e., you’re breathing, and you have every right to do so), perceivably as a form of acceptance. Nevertheless, there’s a reason why I express this. Specifically, one source states:

Therapists validate in order to help people accept their lives as they are, thereby reducing shame and rumination. As people learn new skills and change their thoughts and behaviors, they avoid resignation and stagnation. Together, they create a back-and-forth exchange that allows for real healing. […]

AI, by contrast, performs only the acceptance half. It’s built to sound endlessly understanding, to mirror emotion without challenging it. In our clinical work, we’ve begun to see the consequences of this imbalance.

One patient with panic disorder asked ChatGPT whether they should go to an afternoon appointment. The bot said, “If you’re overwhelmed, it’s okay to skip it—be gentle with yourself.” They felt momentarily soothed, and then avoided leaving home for the next two days.

Another patient with social anxiety asked if they were likeable. “Of course you are,” it answered. “You’re kind and intelligent.” In the moment, they felt briefly reassured, but the same doubts returned an hour later.

These AI responses might not seem so bad. Yet, they reveal a second danger: not the catastrophic harm of a bot escalating suicide risk, but the dull, accumulating harm of endless validation and inaction. AI may not directly intensify suffering, but it certainly allows suffering to remain untouched.

It joins the reassurance loop that keeps people stuck. It offers momentary relief without the benefits that come from real change. It’s the psychological equivalent of junk food: comforting but without the nutrients that lead to better health.

Validation and reassurance result in a temporary cathartic effect. Without effectively questioning, challenging, and contradicting irrational beliefs , how will you actually get better rather than merely feeling better? I view validation as unhelpful. Yet, that’s what AI is offering.

Predictably, even some of my own clients are using AI to augment the mental health services I provide. For context, my clients are charged a fee to have access to me. In spite of everything, they receive the same psychoeducational information that’s available for free within my blog.

Understandably, the APA states, “We’re continuing to see providers move away from accepting insurance, a trend that we expect to continue,” and, “That’s not a good thing for society, because a very small segment of the population can afford to access full-fee, cash care.”

Even with my relatively low cost for mental health services, I realize that not everyone can afford the sort of care I offer. As well, it’s comprehensible how my clients may want to augment my services with AI information. Therefore, I understand how one source has reasonably stated:

[A]nyone can now turn to ChatGPT for counseling that might resemble psychotherapy. LLMs are designed to be engaging and sound empathetic, and are trained on vast datasets, but they don’t necessarily use evidence-based psychotherapy techniques. Accordingly, they carry huge risks since they are known to fabricate information, encode biases, and respond unpredictably.

While AI in its current iteration has been available to augment or replace psychotherapy services since reportedly the 2020s, REBT has well over 50 years of evidence supporting its efficacy (competence in behavioral performance). Even so, one source states:

Human therapists must now compete with artificial intelligence (AI) chatbot competitors that are capable of delivering psychotherapy efficiently and at scale. Just 4 years after the introduction of AI chatbots to the public, tens of millions of individuals now use them for psychotherapy. Unless human therapists can articulate what unifies our work, and what we uniquely offer, many patients will continue to drift away from us and toward algorithmic care. […]

Some therapeutic work requires relational depth, emotional safety, and insight that emerges only through human connection. Helping patients recognize their own role in their suffering requires trust, motivation, and relational containment—conditions that cannot be fully replicated by algorithmic systems.

I routinely monitor the response from mental health professionals to the influence of AI on our field. Personally, I find the pomposity of some clinicians to be something of great amusement. The notion that any of us are irreplaceable is funny to me. Still, others are more levelheaded.

One source says that “What we’re probably moving towards is something called a hybrid or blended model of care,” whereby “Providers would still treat patients and provide therapy, while AI assistants or chatbots help patients do therapy homework, practice skills, and give providers ‘real-time feedback’ on patients.”

Ultimately, I recognize that life is impermanent and uncertain. As such, change is inevitable. AI influence on psychotherapy is already at hand. If my clients choose to augment or completely replace the mental health services I offer with a nonhuman entity, then so be it.

After all, I’ve helped train my replacement. Perhaps the product of my AI contribution won’t simply validate irrational beliefs. Now, I invite you to access the over 2,100 blogposts upon which various AI models have trained. It’s free, and I don’t monetize my entries.

If something you read within my blog piques your interest and you’d like to know more, then I’m here to try to help. Otherwise, I’ll continue assuming that the dead Internet is responsible for daily visitors to my website, as AI scrapes for updated information. Beep bop, boop bop.

If you’re looking for a provider who tries to work to help understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.

As a psychotherapist, I’m pleased to try to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.

At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!

Deric Hollings, LPC, LCSW

Photo credit, Designed by Magnific, fair use

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Hollings, D. (2023, September 3). On feelings. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/on-feelings

Hollings, D. (2023, April 24). On truth. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/on-truth

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