{"id":227383,"date":"2022-06-16T10:12:26","date_gmt":"2022-06-16T14:12:26","guid":{"rendered":"https:\/\/supchina.com\/?p=227383"},"modified":"2023-11-18T23:32:00","modified_gmt":"2023-11-19T04:32:00","slug":"the-next-frontier-for-mental-health-support-vr-and-ai-powered-chatbots","status":"publish","type":"post","link":"https:\/\/thechinaproject.com\/2022\/06\/16\/the-next-frontier-for-mental-health-support-vr-and-ai-powered-chatbots\/","title":{"rendered":"The next frontier for mental health support: VR and AI-powered chatbots"},"content":{"rendered":"

This article is brought to you by Xi’an Jiaotong-Liverpool University<\/a>, a leading international joint venture university based in Suzhou, Jiangsu, China.<\/em><\/p>\n

\n

\nWhat comes to mind when you hear the word psychotherapy<\/em>? Chances are that like most people, you would think of sitting on a couch across from a soft-spoken therapist with a notebook in hand. This stereotype of therapy being a conversation-driven, face-to-face interaction in a quiet room is so firmly embedded in our collective psyche that it can be hard to imagine new forms of the treatment being developed and popularized.\n<\/p>\n

\nBut people\u2019s mental health needs are changing, and that requires innovative solutions. As the conversation about psychological well-being has become more commonplace in society at large, mental health conditions are increasing worldwide. According to Gallup \u2014 a U.S.-based analytics firm \u2014 anger, stress, worry, and sadness have been on the rise worldwide for the past decade, and they all reached record highs in 2020, when the COVID\u201019 pandemic severed social connections for many and forced them to be surrounded by death and disease, poverty and anxiety, hardship and uncertainty.\n<\/p>\n

\nChina, which is still rolling out lockdowns to contain COVID-19 outbreak, is not immune to what the United Nations described as \u201ca looming global mental health crisis.\u201d In a country where mental illness was long misunderstood and talking about it is still viewed as taboo for many, the pandemic has led to a spike in mental health challenges. In 2020, when the outbreak was at its peak, a nationwide survey by a Shanghai university found<\/a> that nearly 35% of respondents across the country had experienced symptoms of depression, anxiety, insomnia, or acute stress.\n<\/p>\n

\nIt also has highlighted the supply-demand imbalance for mental health care in many parts of China, especially in the countryside, where awareness about psychological well-being is lacking and access to therapy is extremely limited. According to a 2019 paper<\/a>, for a country that has a massive population of 1.4 billion people, there were only 1,000 rehabilitation psychiatrists, 1,500 mental health social workers, and 3,000 psychotherapists working in professional institutions.\n<\/p>\n

\nThis is exactly where technology comes to the rescue, with the potential to expand access, reduce costs, and identify patients who can benefit from individualized emotional support. And among the technologies that could potentially open new frontiers in psychotherapy, nothing looms larger than virtual reality (VR) and artificial intelligence (AI).\n<\/p>\n

Individualized virtual reality to relieve depression<\/h2>\n<\/p>\n

\nPicture this: When you meet up with a therapist for your first session, you are told to create an avatar in a virtual world. With a VR headset strapped to your head, you are given the choice to put your character in a specific environment \u2014 be it a room, a beach, a forest, or a castle. On the screen, your avatar spots a crying girl in the world you selected. Hoping to make her feel better, the virtual version of yourself walks toward the girl, using words and actions to comfort her.\n<\/p>\n

\nThis might sound like a bizarre scenario for now, but it\u2019s part of a VR system designed to enable individual choices when virtual environments are applied in therapeutic treatment, especially for people dealing with depression and anxiety. Scientists say this novel design, named iVR, may not only enhance self-compassion for participants and improve their mental health in the long run, but it could also help therapists understand their clients better, particularly in situations where they don\u2019t seem forthcoming with information or struggle to explain how they feel.\n<\/p>\n

\n\u201cIt allows participants to make choices that would be difficult for a mental health professional to replicate in real life. Those choices might enable the therapist to dig deeper into the psychological makeup of the patients and get information by observing their interaction that they would not be able to extract otherwise,\u201d said Professor Hai-Ning Liang, a researcher in the work, from the Department of Computing at Xi\u2019an Jiaotong-Liverpool University (XJTLU).\n<\/p>\n

\nOver the last two years, in collaboration with a New Zealand-based team of researchers led by Dr. Nilufar Baghaei, Liang has developed three prototypes for iVR, with the latest one developed using the game development software Unity and operated on Meta\u2019s Oculus Quest 2 headsets.\n<\/p>\n

\nWriting in the 2021 IEEE International Symposium on Mixed and Augmented Reality Adjunct, Liang and his colleagues report that preliminary feedback from the seven clinical psychologists they interviewed was overwhelmingly positive. Some praised the patient-centered nature of the design and said the choices made in the virtual environment could increase their knowledge about clients, while others said they wanted proper training before incorporating the system in their daily practice and asked for more controls, such as \u201cincreasing or decreasing individuation for each patient depending on their individual situation,\u201d Liang noted. \u201cOur avatars look very realistic now, and our next step is to make them intelligent and responsive to the needs of each person,\u201d he added.\n<\/p>\n

\n\u201cOur work is also supported by two review papers that we recently published, one in JMIR Mental Health and the other in Games for Health Journal, and several other projects examining the use of VR to help people overcome mental health issues,\u201d Liang said.\n<\/p>\n

\n\u201cWe are currently working on the next prototype, which includes intelligent avatars with facial animations and the ability to have human-like conversations with the participants,\u201d he said. \u201cWe believe our work can pave the way for large-scale efficacy testing, clinical use, and potentially cost-effective delivery of VR technology for mental health therapy in the near future.\u201d\n<\/p>\n

The rise of chatbot therapy<\/h2>\n<\/p>\n

\nFor years, artificial intelligence has been heralded<\/a> as a potential game-changing technology in the mental health domain. COVID-19 accelerated that integration. During the pandemic, millions of people around the globe suffered from depression, and those in isolation or quarantine were forced to turn to AI-powered chatbots for mental support<\/a>.\n<\/p>\n

\nRiding this wave of interest were a string of mental health companies such as Woebot. Founded in 2017 by a team of Stanford psychologists and AI experts, the app offers a fully automated conversational agent that is able to monitor users\u2019 mood, talk to them about mental health, and provide useful tools based on their needs.\n<\/p>\n

\nThe rise of digital therapists like Woebot is one of the topics explored in Counseling and Psychotherapy: Theory and Beyond<\/em>. Featuring a collection of contributions from 37 experts from diverse cultural backgrounds, the book, edited by Dr. Russell Fulmer, a senior associate professor in the Academy of Future Education at XJTLU, is a \u201cfresh and contemporary look at what counselors and psychotherapists use to help people,\u201d he said.\n<\/p>\n

\nIn the chapter dedicated to the application of AI chatbots in psychotherapy, Fulmer argues that although therapeutic chatbots offer advantages like \u201cproviding mental health support 24\/7, and some individuals don\u2019t feel judged when they converse with these bots,\u201d they are not a substitute for long-term human-to-human therapy.\n<\/p>\n

\n\u201cThey seem to excel in things like cognitive behavioral therapy (CBT) and are good at delivering psychoeducation,\u201d Fulmer said. \u201cOn the other hand, we know from outcomes research that the therapeutic relationship accounts for a wide portion of the variants that are responsible for positive change. You can make a case that these bots don\u2019t provide that therapeutic relationship because, after all, they are not human. Most are just words on a screen right now.\u201d\n<\/p>\n

\nWith growing attention on this field, Fulmer believes that there\u2019s a lot of potential waiting to be unlocked when it comes to AI and psychotherapy. For example, text-based chatbots can take the form of a human, a possibility that has already been explored through SimSensei, an implemented virtual human interviewer developed by researchers by the University of Southern California.\n<\/p>\n

\nAI can also be tailored to help particular populations and be more culturally responsive. \u201cIf you are a counselor from wherever and you are working overseas or in a different country with a different population, you really have to get to know something about them, the culture, the people,\u201d he says. \u201cOne benefit of AI is that it\u2019s customizable. You can personalize it. So I think there’s potential there.\u201d\n<\/p>\n

\nHistorically, the introduction of new technologies in an established field has frequently been accompanied by new complaints and fears<\/a>. And the application of AI in psychotherapy is no exception. Fulmer suspects that as the use of AI continues to expand in mental health services, there will be some heavy pushback against it, specifically in regard to data security and the lack of rigorous studies about human-to-AI relationships. But Fulmer remains cautiously optimistic.\n<\/p>\n

\n\u201cIf we are being realistic, I don\u2019t think it’s going to be stopped. You can deny that reality or you can accept that it\u2019s here and help shape it. That\u2019s where I\u2019m at with psychological AI. I would add as well that it\u2019s not like the human being is perfect, either,\u201d he says. \u201cThere\u2019s every indication that AI will continue to advance across the board, including in mental health. Let\u2019s acknowledge that reality and help shape AI in an ethical manner.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Technology presents huge opportunities to change the face of mental health care. Virtual reality and artificial-intelligence-enabled chatbots are among the most promising innovations that many experts believe could potentially open new frontiers in psychotherapy. <\/p>\n","protected":false},"author":20030,"featured_media":227384,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"episode_type":"","audio_file":"","cover_image":"","cover_image_id":"","duration":"","filesize":"","date_recorded":"","explicit":"","block":"","filesize_raw":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[12908],"tags":[14995,16427,19136,14523,16052,16912],"column":[],"class":[16300,15723],"coauthors":[18963],"acf":[],"la_post_categories":{"society-and-culture":"Society & Culture"},"la_post_tags":{"artificial-intelligence":"artificial intelligence","mental-health":"Mental Health","therapy":"therapy","virtual-reality":"Virtual Reality","xian-jiaotong-liverpool-university":"Xi\u2019an Jiaotong-Liverpool University","xjtlu":"XJTLU"},"content_writeup":{"rendered":"

This article is brought to you by Xi’an Jiaotong-Liverpool University<\/a>, a leading international joint venture university based in Suzhou, Jiangsu, China.<\/em><\/p>\n

\n

\nWhat comes to mind when you hear the word psychotherapy<\/em>? Chances are that like most people, you would think of sitting on a couch across from a soft-spoken therapist with a notebook in hand. This stereotype of therapy being a conversation-driven, face-to-face interaction in a quiet room is so firmly embedded in our collective psyche that it can be hard to imagine new forms of the treatment being developed and popularized.\n<\/p>\n

\nBut people\u2019s mental health needs are changing, and that requires innovative solutions. As the conversation about psychological well-being has become more commonplace in society at large, mental health conditions are increasing worldwide. According to Gallup \u2014 a U.S.-based analytics firm \u2014 anger, stress, worry, and sadness have been on the rise worldwide for the past decade, and they all reached record highs in 2020, when the COVID\u201019 pandemic severed social connections for many and forced them to be surrounded by death and disease, poverty and anxiety, hardship and uncertainty.\n<\/p>\n

\nChina, which is still rolling out lockdowns to contain COVID-19 outbreak, is not immune to what the United Nations described as \u201ca looming global mental health crisis.\u201d In a country where mental illness was long misunderstood and talking about it is still viewed as taboo for many, the pandemic has led to a spike in mental health challenges. In 2020, when the outbreak was at its peak, a nationwide survey by a Shanghai university found<\/a> that nearly 35% of respondents across the country had experienced symptoms of depression, anxiety, insomnia, or acute stress.\n<\/p>\n

\nIt also has highlighted the supply-demand imbalance for mental health care in many parts of China, especially in the countryside, where awareness about psychological well-being is lacking and access to therapy is extremely limited. According to a 2019 paper<\/a>, for a country that has a massive population of 1.4 billion people, there were only 1,000 rehabilitation psychiatrists, 1,500 mental health social workers, and 3,000 psychotherapists working in professional institutions.\n<\/p>\n

\nThis is exactly where technology comes to the rescue, with the potential to expand access, reduce costs, and identify patients who can benefit from individualized emotional support. And among the technologies that could potentially open new frontiers in psychotherapy, nothing looms larger than virtual reality (VR) and artificial intelligence (AI).\n<\/p>\n

Individualized virtual reality to relieve depression<\/h2>\n<\/p>\n

\nPicture this: When you meet up with a therapist for your first session, you are told to create an avatar in a virtual world. With a VR headset strapped to your head, you are given the choice to put your character in a specific environment \u2014 be it a room, a beach, a forest, or a castle. On the screen, your avatar spots a crying girl in the world you selected. Hoping to make her feel better, the virtual version of yourself walks toward the girl, using words and actions to comfort her.\n<\/p>\n

\nThis might sound like a bizarre scenario for now, but it\u2019s part of a VR system designed to enable individual choices when virtual environments are applied in therapeutic treatment, especially for people dealing with depression and anxiety. Scientists say this novel design, named iVR, may not only enhance self-compassion for participants and improve their mental health in the long run, but it could also help therapists understand their clients better, particularly in situations where they don\u2019t seem forthcoming with information or struggle to explain how they feel.\n<\/p>\n

\n\u201cIt allows participants to make choices that would be difficult for a mental health professional to replicate in real life. Those choices might enable the therapist to dig deeper into the psychological makeup of the patients and get information by observing their interaction that they would not be able to extract otherwise,\u201d said Professor Hai-Ning Liang, a researcher in the work, from the Department of Computing at Xi\u2019an Jiaotong-Liverpool University (XJTLU).\n<\/p>\n

\nOver the last two years, in collaboration with a New Zealand-based team of researchers led by Dr. Nilufar Baghaei, Liang has developed three prototypes for iVR, with the latest one developed using the game development software Unity and operated on Meta\u2019s Oculus Quest 2 headsets.\n<\/p>\n

\nWriting in the 2021 IEEE International Symposium on Mixed and Augmented Reality Adjunct, Liang and his colleagues report that preliminary feedback from the seven clinical psychologists they interviewed was overwhelmingly positive. Some praised the patient-centered nature of the design and said the choices made in the virtual environment could increase their knowledge about clients, while others said they wanted proper training before incorporating the system in their daily practice and asked for more controls, such as \u201cincreasing or decreasing individuation for each patient depending on their individual situation,\u201d Liang noted. \u201cOur avatars look very realistic now, and our next step is to make them intelligent and responsive to the needs of each person,\u201d he added.\n<\/p>\n

\n\u201cOur work is also supported by two review papers that we recently published, one in JMIR Mental Health and the other in Games for Health Journal, and several other projects examining the use of VR to help people overcome mental health issues,\u201d Liang said.\n<\/p>\n

\n\u201cWe are currently working on the next prototype, which includes intelligent avatars with facial animations and the ability to have human-like conversations with the participants,\u201d he said. \u201cWe believe our work can pave the way for large-scale efficacy testing, clinical use, and potentially cost-effective delivery of VR technology for mental health therapy in the near future.\u201d\n<\/p>\n

The rise of chatbot therapy<\/h2>\n<\/p>\n

\nFor years, artificial intelligence has been heralded<\/a> as a potential game-changing technology in the mental health domain. COVID-19 accelerated that integration. During the pandemic, millions of people around the globe suffered from depression, and those in isolation or quarantine were forced to turn to AI-powered chatbots for mental support<\/a>.\n<\/p>\n

\nRiding this wave of interest were a string of mental health companies such as Woebot. Founded in 2017 by a team of Stanford psychologists and AI experts, the app offers a fully automated conversational agent that is able to monitor users\u2019 mood, talk to them about mental health, and provide useful tools based on their needs.\n<\/p>\n

\nThe rise of digital therapists like Woebot is one of the topics explored in Counseling and Psychotherapy: Theory and Beyond<\/em>. Featuring a collection of contributions from 37 experts from diverse cultural backgrounds, the book, edited by Dr. Russell Fulmer, a senior associate professor in the Academy of Future Education at XJTLU, is a \u201cfresh and contemporary look at what counselors and psychotherapists use to help people,\u201d he said.\n<\/p>\n

\nIn the chapter dedicated to the application of AI chatbots in psychotherapy, Fulmer argues that although therapeutic chatbots offer advantages like \u201cproviding mental health support 24\/7, and some individuals don\u2019t feel judged when they converse with these bots,\u201d they are not a substitute for long-term human-to-human therapy.\n<\/p>\n

\n\u201cThey seem to excel in things like cognitive behavioral therapy (CBT) and are good at delivering psychoeducation,\u201d Fulmer said. \u201cOn the other hand, we know from outcomes research that the therapeutic relationship accounts for a wide portion of the variants that are responsible for positive change. You can make a case that these bots don\u2019t provide that therapeutic relationship because, after all, they are not human. Most are just words on a screen right now.\u201d\n<\/p>\n

\nWith growing attention on this field, Fulmer believes that there\u2019s a lot of potential waiting to be unlocked when it comes to AI and psychotherapy. For example, text-based chatbots can take the form of a human, a possibility that has already been explored through SimSensei, an implemented virtual human interviewer developed by researchers by the University of Southern California.\n<\/p>\n

\nAI can also be tailored to help particular populations and be more culturally responsive. \u201cIf you are a counselor from wherever and you are working overseas or in a different country with a different population, you really have to get to know something about them, the culture, the people,\u201d he says. \u201cOne benefit of AI is that it\u2019s customizable. You can personalize it. So I think there’s potential there.\u201d\n<\/p>\n

\nHistorically, the introduction of new technologies in an established field has frequently been accompanied by new complaints and fears<\/a>. And the application of AI in psychotherapy is no exception. Fulmer suspects that as the use of AI continues to expand in mental health services, there will be some heavy pushback against it, specifically in regard to data security and the lack of rigorous studies about human-to-AI relationships. But Fulmer remains cautiously optimistic.\n<\/p>\n

\n\u201cIf we are being realistic, I don\u2019t think it’s going to be stopped. You can deny that reality or you can accept that it\u2019s here and help shape it. That\u2019s where I\u2019m at with psychological AI. I would add as well that it\u2019s not like the human being is perfect, either,\u201d he says. \u201cThere\u2019s every indication that AI will continue to advance across the board, including in mental health. Let\u2019s acknowledge that reality and help shape AI in an ethical manner.\u201d<\/p>\n"},"_links":{"self":[{"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/posts\/227383"}],"collection":[{"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/users\/20030"}],"replies":[{"embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/comments?post=227383"}],"version-history":[{"count":0,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/posts\/227383\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/media\/227384"}],"wp:attachment":[{"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/media?parent=227383"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/categories?post=227383"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/tags?post=227383"},{"taxonomy":"column","embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/column?post=227383"},{"taxonomy":"class","embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/class?post=227383"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/thechinaproject.com\/wp-json\/wp\/v2\/coauthors?post=227383"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}