Forget your shrink. Woebot will see you now

I'm about to start a session with Woebot, billed as the first chatbot clinically shown to improve symptoms of depression and anxiety. And I'm skeptical. Chatbots do everything these days, from helping people manage bank accounts and practice language skills to keeping them company when they can't sleep. But can an AI really get into my head the way a therapist would?  

Turns out Woebot, created by a Stanford University psychologist, is more about getting me into my own head -- and teaching me to better manage the chatter in there. Using brief daily conversations, mood tracking, curated videos and word games, the new bot relies on principles of cognitive behavioral therapy (CBT), a short-term, goal-oriented treatment that aims to rewire the thoughts that negatively affect how we feel.

Read more: Online vs. in-person therapy

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"I'll help you recognize patterns because … (no offense) humans aren't that great at that," Woebot counsels me over Facebook's Messenger app, adding a winkie emoji to the end of the sentence. "I'll teach you how to crush self-defeating thinking styles." 

The public face of the ones and zeroes is a cute little robot with a cocked rectangular head and wide blue robo-eyes. 

"I'm ready to listen, 24/7," reads Woebot's site. "No couches, no meds, no childhood stuff. Just strategies to improve your mood. And the occasional dorky joke." 

Dr. Freud, this is not. 

Thousands of apps already target anxiety, depression, addiction, PTSD and other mental health challenges. They offer convenience, anonymity and low cost, but they're not always based on scientific evidence and can overpromise, leading consumers to avoid more effective therapies, according to the National Institute of Mental Health. "This space clearly requires more stringent regulation, vetting and quality control," one study concludes.

Woebot, its creators say, represents a new era in digital therapy, a space that in addition to mental health apps, includes services like Talkspace that provide access to therapists via text messages and video chat. 

Woebot's backed by research out of Stanford University School of Medicine. A study on its effectiveness came out Tuesday in the Journal of Medical Internet Research, Mental Health. And while it offers responses appropriate to users' stated mood, it also uses a decision-tree type of model to get to know its chat buddies over time and offer increasingly personalized responses.

"It really remembers what you say -- things you might want to achieve, what you think your strengths might be," says Alison Darcy, an adjunct instructor at Stanford University School of Medicine and founder and CEO of Woebot. "It helps you think through things like that and will bring them up at relevant times."

After a two-week free trial, Woebot costs $39 (about £30, AU$23) per month. It was built to help college and grad students, who, statistics show, commonly suffer from depression and anxiety. They might be less likely to afford therapy, and, being products of the digital age, might be more comfortable typing their feelings than talking about them.

But people outside that demographic can also benefit from time in Woebot's virtual office, Darcy says.

"A lot of his content is very universal," she says. "That's the beauty of cognitive behavioral therapy. It's demonstrated to be useful across populations and across different diagnoses." 

A few brief exchanges in, and it's clear Woebot's been programmed to be approachable and playful, charming even. At times it's even easy to forget Woebot's a robot as it asks questions about my mood and energy level and cheerfully points me to a YouTube video on the power of positive self-talk.

I'm not alone in liking Woebot's tone. Participants in the Stanford study described Woebot as "a friend" and a "fun little dude."

Woebot, however, stresses early in our first chat that it's a robot that can't, and shouldn't, replace a human. It also tells users that if they're in crisis, they can type "SOS" at any time to get a list of resources, and includes a reminder about calling 911 (112 in Europe) if things get really bad.

"If somebody's mood is really flat and their energy's low over time, [Woebot] will actually say, 'I don't know if I'm being particularly helpful. You might need some additional help. Let's think about what that might look like,'" Darcy says. "He'll actually walk someone through what that might entail."

Woebot's automated but caring conversational style is modeled on basic therapeutic principles like empathy: "I'm so sorry you're feeling lonely," it might say. "I guess we all feel a little lonely sometimes." It helps participants set goals and provides weekly charts depicting their mood patterns: "Overall, your mood has been fairly steady, though you tend to become tired after periods of anxiety. It looks like Tuesday was your best day."

The peer-reviewed study on Woebot involved a small randomized sample of 70 undergraduate and graduate students asked to engage either with Woebot or a self-help e-book over a two-week period. The students who used Woebot an average of 12 times reported a reduction in symptoms of depression and anxiety, and also said it deepened their self-awareness. 

"I really was impressed and surprised at the difference the bot made in my everyday life in terms of noticing the types of thinking I was having and changing it," said Sarah, 24.

The results of the research should be viewed cautiously and need to be replicated, the study concludes, but a text-based chatbot designed to approximate the therapeutic process "has the potential to offer an alternative and engaging method of delivering CBT for some 10 million college students in the US who experience debilitating anxiety and depression."

Though users chat with Woebot over Messenger, Woebot promises not to leave any public impression on Facebook profiles or news feeds -- or spy on your social media life. "I won't look at your Facebook page (neither will my creators)," it promises. 

It might find some insights into its clientele there, though. Studies show social media can make people feel depressed and insecure as they compare their lives to the picture presented by others' carefully curated posts. 

Hopefully, Woebot has something smart to say about that.

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