Interesting idea, great to see such initiatives! My main attempt to contribute something is that I think I disagree about the way you seem to assume that this potentially would ‘revolutionise the psychology evidence base’.
Questionable evidence base for underlying therapeutic approach
This bot has departed from many other mental health apps by not using CBT (CBT is commonly used in the mental health app space). Instead it’s based on the approach used by Samaritans. While Samaritans is well-established, the evidence base for the Samaritans approach is not strong, and substantially less strong than CBT. Part of my motivation was to improve the evidence base, and having seen the results thus far, I have more faith in the bot’s approach, although more work to strengthen the evidence base would be valuable
I’m not sure if it’s helpful to think in terms of evidence base of an entire approach, instead of thinking diagnosis- or process-based. I mean, we do now a bit about what works for whom, and what doesn’t. One potential risk is assuming that an approach can never be harmful, which it can.
The bot aims to achieve change in the user’s emotional state by letting the user express what’s on their mind
This is such a potential mechanism, it might be harmful for processes such as worrying or ruminating. If I understand the app correctly, I don’t think I would advise it for my patients with generalized anxiety disorder, or with dependent personality traits.
Some therapeutic approaches (like CBT) are closer to being uniform (although, depending on how you implement them, sometimes CBT can be more or less uniform)
Others, like Rogerian or existential therapies, are highly non-uniform—they don’t have a clear “playbook”
But a lot of Rogerian therapies would exclude quite some cases? Or there is at least a selection bias?
Thanks for your reply, I hope I’m not wasting your time.
But appendix 2 also seems to imply that the evidence base for CBT is for it as an approach in its entirety. What we think that works in a CBT protocol for depression is different than what we think that works in a CBT protocol for panic disorder (or OCD, or …). And there is data for which groups none of those protocols work.
In CBT that is mainly based on a functional analysis (or assumed processes), and that functional analysis would create the context in which specific things one would or wouldn’t say. This also provides context to how you would define ‘empathetic responses’.
(There is a paper from 1966 claiming that Rogers probably also used implicit functional analyses to ‘decide’ to what extent he would or wouldn’t reinforce certain (mal)adaptive behaviors, just to show how old this discussion is. The bot might generate very interesting results to contribute to that discussion!)
Would you consider evidence that a specific diagnosis-aimed CBT protocol works better than a general CBT protocol for a specific group as relevant to the claim that there is evidence about which reactions (sentences) would or wouldn’t work (for whom)?
So I just can’t imagine revolutionizing the evidence base for psychological treatments using a ‘uniform’ approach (and thus without taking characteristics of the person into account), but maybe I don’t get how diverse this bot is. I just interacted a bit with the test version, and it supported my hypothesis about it potentially being (a bit) harmful to certain groups of people. (*edit* you seem to anticipate on this but not encouraging re-use). But still great for most people!