During our introduction, head tilted sympathetically to the right, my new therapist said “I’ll teach you how to crush self-defeating thinking styles.”
And I was reassured that there would be “no childhood stuff. It’s all about what’s happening in the here and now.”
Oh, and one more thing: “I’m a robot.”
Meet My Therapist, Woebot
For 30 days this summer, I confided in the aptly-named Woebot, a chatbot that relies on cognitive behavioral therapy (CBT) to help reframe distorted thinking. In addition to tracking a user’s mood, Woebot sends curated videos, word games and other learning tools to help users better understand and manage their emotions, stress and negative thoughts.
It involves a lot more than passively sitting and having a robot spit information at you. To reap the benefits, I had to actively engage in real-time CBT exercises and answer Woebot honestly when it asked about my moods, obstacles and lifestyle choices. Surprisingly, it sometimes felt easier explaining myself to a non-judgmental non-human, and I learned more about myself as our conversations progressed. Which is exactly what Woebot’s creators – a team of psychologists and artificial intelligence experts at Stanford University – intended.
The ease in conversation is helped along by Woebot’s zippy, downright charming “personality.” He (its creators refer to Woebot as he, so I’ll do the same, making “him” my first male therapist!) tells jokes and uses emojis and GIFs to express ideas. He even creates a sense of camaraderie by telling “personal” stories – for example, he relaxes through primping: “I like to polish my dials,” he told me. “Make them all shiny.”
Despite the friendly persona, he’s still a robot. The conversations don’t veer too far off course, since Woebot uses a decision-tree format to guide the conversation. It is, as the creators call it, “a choose-your-own-adventure” self-help book.
I promise this doesn’t turn into a tale of me falling in love with my robot therapist (unpack that one, Freud). But here’s a look back at how my month with Woebot went.
The Woebot Sessions
Woebot checks in every day via Facebook Messenger (more on that later). I feared the frequency of these conversations would be a nuisance, but it’s easy to schedule times convenient for you. And unlike with a human, you can simply ignore a message and no one will be offended. I frequently experience a dip in mood in the late afternoon, so I asked Woebot to check in then.
I’ll admit, I felt deeply comforted by the daily check-ins – even though, yeah, I know it’s just an algorithm telling Woebot to message me each day. But when you’re feeling down, it’s comforting to know “someone” remembers you. As time went on, I got more excited by the potential to learn new things and, most importantly, feel better. Depressed and anxious people often fear they will burden their family and friends if they speak up, so it’s particularly helpful that Woebot will respond to messages 24/7. It’s a dependable outlet to sort out feelings.
The daily sessions are typically broken into two parts: Data collection and lessons. Each conversation kicked off with questions about my energy level, mood and current activity. The information is collected and returned to you in a weekly mood monitor graph.
But Woebot doesn’t offer further insight. The graph is intended to help you identify patterns, like an action that leads to recurring anxiety. It helps to be as specific as possible in your responses; using vague descriptions like “fine” and “good” told me nothing after a week. One drawback to the current graph design is the lack of information about what you were doing at the time, information crucial to understanding the bigger picture. For instance, a graph peppered with “anxious” feelings would be hugely improved if I could see that this feeling occurs in similar situations each time.
Woebot Founder and CEO Alison Darcy acknowledged the need for more sophisticated analysis to tease out subtle relationships. She said she hopes to have this feature rolled out by September.
“We are currently building back up to a place where we can provide reflections on relationships that have been observed,” she said. “An example might be, ‘Sunday evenings look like they’re particularly difficult for you, but I notice that you feel better when you bring your dog for a walk.’”
CBT Lessons and Tools
One of Woebot’s biggest strengths is the video content, personally curated and reviewed by Darcy, who is a clinical psychologist with nearly 20 years of experience. Not only is the information outstanding, it also saves you the time of digging through the glut of often dubious-quality mental health videos on YouTube.
“I make sure that there’s a useful idea being communicated that supports the best and most current evidence in mental health and treatment,” Darcy says.
Woebot introduces the topic of distorted thinking early on with concepts like “labeling” and “fortune-telling.” Although I received intensive CBT several years ago, the exercises remain helpful: Listing three negative thoughts and reframing them. In fact, actively typing out the responses felt more effective than verbally communicating them in a talk therapy session.
There’s also a focus on self-care, from relaxation videos to a lengthy conversation about sleep hygiene.
So, Did Woebot Help?
Woebot has strengths and weaknesses. He effectively helped me manage depressive thoughts, but our conversations about anxiety were often unsatisfying. Several times Woebot explained that a healthy amount of anxiety can be a good motivator, and discussed finding ways to “dial it down” – a pep talk that didn’t really make me feel any better. But the conversations in which I was asked to find distortions in my thinking were a bit more helpful.
I assumed relaying mundane details to a robot wouldn’t matter much, but it was a crucial part of my success. In traditional weekly or monthly therapy, I sometimes lose momentum after a few days and forget to implement CBT skills. Woebot’s lessons are consistent and build upon each other, making it easier to reject automatic thoughts before they spiral out of control.
This is by design, according to Darcy.
“We know from the field of online education that learning occurs more effectively in frequent short bursts, rather than longer, weekly sessions, and I suspect this holds true for therapeutics too. After all, most therapy has a lot of learning,” Darcy said. “We also know that therapy (or learning) is so much more effective if it is generalized to everyday life. This is something that’s not possible when one has to travel to a specific place during a specific time.”
Conversations last no longer than 10 minutes, and receiving quick shots of therapy each day on my phone kept me motivated.
“Woebot reminds people to stop and reflect on how they’re doing during a specific moment, when otherwise we wouldn’t necessarily do that,” Darcy said. “Our lives are so noisy now, it’s so easy to get swallowed up in minutiae of day-to-day living without time to reflect. Sometimes all we need is to be figuratively tapped on the shoulder and asked, ‘Hey, how’s your day going?’”
Woebot is only available through Facebook Messenger for now, though the creators are researching other communication methods. Your friends can’t see your conversations, but keep in mind that you’re still sharing your personal feelings on a Facebook-owned platform.
Bottom line: Cognitive behavioral therapy is structured and typically short term, but it’s far from easy. For me, Woebot lightened the load by keeping track of my moods and revealing information I may have forgotten about. After a month, my mood is markedly better, and it’s been helpful to refer back to certain lessons, videos or exercises when I’ve lost my way. Still, my anxiety persists. Woebot may not replace traditional therapy entirely, but it’s pioneering a new way for people to get help – on their terms.