Using AI to Be Better Therapists
The AI in the Room: Embracing Technology to Enhance Therapy
As Livia Kent, editor-in-chief of Psychotherapy Networker, sat down to interview Dr. Heather Hessel, she couldn't help but feel a mix of excitement and trepidation. Kent had had countless conversations with mental health professionals about the emerging role of artificial intelligence in their field. More often than not, these discussions were tinged with anxiety, skepticism, and sometimes outright fear.
But Dr. Hessel was different. With 20 years of experience in the tech industry before transitioning to become a therapist, she brought a unique perspective to the table. Her eyes lit up as she talked about the potential benefits of AI in therapy, painting a picture of a future where technology could help therapists become better, more insightful clinicians. It was a stark contrast to the doom-and-gloom narratives Kent had grown accustomed to hearing.
As they delved into their conversation, Kent found herself on a journey of discovery, challenging her own preconceptions about AI's place in the therapy room. Could this technology, often viewed as a threat to the deeply human work therapists do, actually enhance their ability to connect and heal? Dr. Hessel's insights promised to illuminate a path forward that many in the field have been hesitant to explore.
"Why not look at what we can use it for?" Dr. Hessel posed, her voice filled with enthusiasm. "When have we ever seen it beneficial for an industry to keep their head in the sand when there's new disruptive technology coming into play?"
Her words struck a chord with Kent. As mental health professionals, therapists pride themselves on their ability to help others navigate change and uncertainty. Yet here they were, an entire field collectively burying their heads in the sand, hoping that if they ignored AI long enough, it might just go away.
But Dr. Hessel was proposing something radical: what if, instead of fearing AI, therapists embraced it as a tool for growth and self-reflection? What if they could use this technology not to replace the irreplaceable human element of therapy, but to enhance their skills, challenge their blind spots, and ultimately provide better care for their clients?
As they continued their discussion, Kent found herself being drawn into Dr. Hessel's vision of a future where AI serves as a silent partner in the therapy room, offering insights and perspectives that might otherwise go unnoticed. It was a future that, just an hour ago, Kent might have dismissed as science fiction. But now, she was beginning to see its potential.
Their conversation unfolded like a journey through uncharted territory, each revelation bringing with it new questions and possibilities. As they explored the landscape of AI in therapy, three main themes emerged: AI as a learning tool for therapists, the ethical considerations of implementing this technology, and the potential for AI to address gaps in current therapeutic practices.
AI as a Learning Tool: The Consultant in Your Pocket
"I began to think of it like a consultant giving me feedback on my session," Dr. Hessel explained, her eyes alight with possibility. "It's not going to replace me, it's not even maybe going to suggest dialogue for me. But maybe it can do some of the evaluation to identify some of the blind spots that I might have."
Kent found herself leaning in, intrigued by the concept. As therapists, they're trained to be lifelong learners, constantly honing their skills and expanding their knowledge. But the reality is, once they leave the structured environment of supervision, opportunities for in-depth feedback on their work become scarce.
Dr. Hessel painted a picture of AI as a "consultant in your pocket," capable of analyzing session transcripts or recordings to provide insights that might escape a therapist's conscious awareness. "I might want to know how I am across sessions," she mused. "Where am I doing similar kinds of things? Where am I doing different types of things? Am I doing more pauses with some clients than others?"
As she spoke, Kent could almost see it: a therapist reviewing their day's sessions, aided by an AI that could spot patterns, highlight areas for improvement, and even suggest new approaches based on the specific dynamics of each client interaction. It was a far cry from the fear of being replaced by chatbots that Kent had heard expressed so often.
"But how can a robot help therapists connect better human-to-human, heart-to-heart?" Kent asked, voicing the skepticism she knew many of their readers would share.
Dr. Hessel's response was measured and thoughtful. "I don't think of it as replacing that human connection," she clarified. "It's more about giving us tools to reflect on and improve that connection. Think about how we learn now - we go to consult groups, we do our CEUs, we attend conferences. But it's all very consumer-oriented. We sit back passively and get this information. With AI, we have an opportunity to be more interactive in our learning."
As she spoke, Kent found herself imagining a world where every session could be a learning opportunity, where therapists could gain insights not just from occasional workshops or supervision, but from each and every client interaction. It was a tantalizing prospect.
But it also raised questions. How would this technology actually work in practice? Dr. Hessel shared an experiment she had conducted, using ChatGPT to analyze mock therapy dialogues from different theoretical perspectives.
"I fed that dialogue back in and said, 'Okay, analyze this dialogue from a structural family therapy perspective or a Bowenian family therapy perspective. What are you seeing?' And it didn't actually do a terrible job of that."
Kent could feel her skepticism beginning to waver. If AI could already provide meaningful analysis of therapy sessions, even in this rudimentary form, what might be possible as the technology continues to advance?
Ethical Considerations: Navigating the AI Minefield
As exciting as the possibilities were, Kent couldn't ignore the ethical elephants in the room. Privacy, confidentiality, informed consent - these are cornerstones of the profession, and introducing AI into the equation seemed to complicate them all.
"Obviously, there are privacy and confidentiality issues," Dr. Hessel acknowledged, her tone growing more serious. "To some extent, you could argue we're already sending data to insurance companies, and we get their rules about that. We get consent from clients, et cetera, to be able to do that. But I'm not excited about sending raw data to insurance companies because that feels like it gives lots of power, and there are privacy issues with that."
Her concerns mirrored Kent's own. As therapists, they are entrusted with their clients' most vulnerable moments. The idea of feeding that information into an AI system, no matter how secure, felt like a violation of that trust.
But Dr. Hessel wasn't content to simply acknowledge the problem. She was already thinking of solutions. "I just wonder what the possibilities might be for keeping that data secure and being able to use the technology where it's not really housed somewhere else," she mused. "Can I bring the tool to me rather than having to go to the tool?"
It was a compelling idea - a version of AI that could analyze therapists' work without ever storing or transmitting sensitive client information. But was it technically feasible? And even if it was, would clients be comfortable with any form of AI being involved in their therapy, even indirectly?
As they delved deeper into the ethical quagmire, Dr. Hessel raised another concern that Kent hadn't even considered: the potential for AI to be too persuasive.
"I was interested in Matias's article, where he talked about technology being too persuasive, getting so sophisticated that it can actually figure out how to persuade people to do things that might not be in their best interest," she explained.
It was a chilling thought. As therapists, they wield significant influence over their clients' lives. The idea of an AI system potentially manipulating that influence, even unintentionally, was deeply troubling.
But perhaps the most insidious ethical concern Dr. Hessel raised was the potential for AI to perpetuate and amplify existing biases.
"So many of us are trying to work towards a more social justice-oriented practice," she noted. "Are we just perpetuating some of the biases that live in our dominant cultural narrative by using data that's just going to perpetuate that?"
To illustrate her point, Dr. Hessel shared a story from a recent professional development event she had attended. The presenter had used an AI system to create illustrations for a parable about AI. "Guess what the pictures were?" she asked, a note of frustration in her voice. "They were all young white women. That's really the best you can do?"
It was a stark reminder of the limitations and potential dangers of AI. These systems, after all, are only as good as the data they're trained on. And if that data reflects societal biases and inequalities, won't the AI inevitably perpetuate those same issues?
As they grappled with these ethical dilemmas, Kent found herself torn. The potential benefits of AI in therapy seemed immense, but so too did the risks. How could therapists possibly navigate this minefield safely?
Addressing Gaps in Current Practices
As their conversation continued, Dr. Hessel began to touch on an aspect of AI in therapy that Kent hadn't previously considered: its potential to address gaps in current therapeutic practices.
"I'm really focused on the people who I feel don't get any kind of feedback," she explained. "These are maybe newly licensed therapists. We know more experience doesn't necessarily mean better therapy, so what are the tools that we're using as therapists to be able to continue to improve over time?"
It was a poignant observation. In their field, there's often a stark divide between the level of support and feedback available to students and trainees, and what's available to licensed professionals. Once therapists are out of supervision, opportunities for in-depth feedback on their work can be few and far between.
"I would love to integrate technology in an ethical way with training students," Dr. Hessel continued, her passion evident. "We do a lot of live supervision where I'm at, so I'm seeing students work directly with clients in our clinic. We have the infrastructure for that, but lots of places, lots of programs don't have the infrastructure."
As she spoke, Kent found herself imagining a world where every therapist, regardless of their level of experience or the resources of their training program, had access to detailed, personalized feedback on their work. Could AI be the key to democratizing high-quality supervision and ongoing professional development?
But it wasn't just about training and professional development. Dr. Hessel also saw potential for AI to enhance the therapeutic process itself.
"There are companies that are definitely pushing the limits on this," she noted. "Being able to detect empathy, I think, is fascinating."
The idea of an AI system capable of quantifying something as nuanced and human as empathy initially struck Kent as absurd. But as Dr. Hessel explained further, she began to see the potential value.
"Imagine being able to track your empathy levels across different clients or different types of sessions," she suggested. "It could help us identify patterns in our own behavior that we might not be aware of. Maybe we're consistently less empathetic with certain types of clients or when discussing certain topics. That kind of insight could be invaluable for our own growth as therapists."
It was a compelling vision, but one that also raised new questions. How accurate could such empathy detection really be? And even if it was accurate, how would therapists respond to having such a core aspect of their practice quantified and analyzed?
As they explored these possibilities, Kent found herself oscillating between excitement and apprehension. The potential for AI to enhance therapists' work and their own growth was undeniable. But so too were the risks and ethical challenges.
Looking to the Future
As their conversation drew to a close, Kent asked Dr. Hessel to pull out her crystal ball and imagine what the landscape of therapy might look like in ten years if they embrace AI technology.
Her response was measured but optimistic. "I would love to see technology as part of that ongoing improvement process for therapists," she mused. "I've got this 'consultant in my pocket' idea. We'll see."
It was a future that, just hours ago, Kent might have dismissed as far-fetched. But now, having journeyed through the possibilities and pitfalls with Dr. Hessel, she found herself intrigued and even cautiously excited.
As they wrapped up their interview, Dr. Hessel left Kent with a final thought that encapsulated the complex terrain they had traversed: "I'd like to see us balance caution with exploration. I feel like there's a place for both of those things as we kind of move down this road."
It was a sentiment that resonated deeply with Kent. As she reflected on their conversation, she realized that her own perspective had shifted. The fear and skepticism she had harbored towards AI in therapy hadn't disappeared entirely, but it had been tempered by a new sense of possibility.
The journey ahead is undoubtedly fraught with challenges. The ethical considerations alone are enough to give any conscientious therapist pause. But as Dr. Hessel had so compellingly argued, burying their heads in the sand is not an option. AI is here, and its influence on their field is only going to grow.
The question now is not whether AI will play a role in the future of therapy, but how the profession will shape that role. Will therapists approach it with fear and resistance, or with cautious optimism and a commitment to ethical implementation?
As Kent bid farewell to Dr. Hessel, she found herself energized by the possibilities the interview had illuminated. The road ahead may be uncertain, but it's also ripe with potential. By embracing technology thoughtfully and ethically, therapists have the opportunity to not just adapt to the future of therapy, but to actively shape it.
The AI is in the room, whether therapists acknowledge it or not. The challenge now is to engage with it critically, creatively, and always with the best interests of their clients at heart. It's a daunting task, but also an exciting one. And who knows? In facing this challenge, therapists might just become better at their craft in the process.
As Kent turned off her recorder and gathered her notes, she couldn't help but smile. The conversation had left her with more questions than answers, but they were questions worth asking. Questions that could shape the future of their field. And isn't that, after all, what good therapy is all about? Not providing all the answers, but helping us ask better questions and imagine new possibilities.
The AI revolution in therapy is just beginning. It's up to the profession to decide how the story unfolds.
- 0:00 Intro
- 2:23 Switching from Tech to Therapy
- 3:11 Not scared
- 4:16 Benefits
- 6:08 AI: Better Therapists
- 9:29 An adjunct to Supervision
- 10:01 Feedback
- 11:39 Does the technology exist now
- 13:41 Client Change over time
- 14:05 Tracking empathy with clients
- 18:35 Example of how that bias might be perpetuated
- 20:13 10 years from now
- 22:03 Outro
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