{"id":2894,"date":"2026-01-28T15:29:30","date_gmt":"2026-01-28T15:29:30","guid":{"rendered":"https:\/\/americanvoiceofhealth.com\/index.php\/2026\/01\/28\/is-a-chatbot-therapist-better-than-nothing\/"},"modified":"2026-01-28T15:29:30","modified_gmt":"2026-01-28T15:29:30","slug":"is-a-chatbot-therapist-better-than-nothing","status":"publish","type":"post","link":"https:\/\/americanvoiceofhealth.com\/index.php\/2026\/01\/28\/is-a-chatbot-therapist-better-than-nothing\/","title":{"rendered":"Is a chatbot therapist better than nothing?"},"content":{"rendered":"
\n
\n\t\t\t
\n\t\t\tHealth\t\t<\/a><\/p>\n

\n\t\tIs a chatbot therapist better than nothing?\t<\/h1>\n

\n\t\t\tExperts discuss role of AI and other technology in future of mental health care\t\t<\/p>\n

\n
\n
\n

\n\t\tAlvin Powell\t<\/p>\n

\n\t\t\tHarvard Staff Writer\t\t<\/p>\n<\/p><\/address>\n<\/p><\/div>\n

\t\t

\t\t
\n\t\t\tlong read\t\t<\/span>\n\t<\/div>\n<\/p><\/div>\n

<\/figure>\n<\/header>\n
\n

Recent reports suggest we are experiencing a loneliness epidemic and mental health crisis. Suicide<\/a> rates in the U.S. have risen over the past two decades; a recent surgeon general\u2019s report flagged troubling statistics on the well-being of American youth<\/a>; and more than a billion<\/a> people globally have a mental health condition, according to new World Health Organization data.<\/p>\n

Technologies such as smartphones, social media, and chatbots inevitably come up in any discussion about mental health \u2014 often as forces for harm. But could these same tools be used to help?<\/p>\n

In a recent symposium hosted by the Faculty of Arts and Sciences, four Harvard experts on depression, anxiety, and trauma \u2014 Karestan Koenen<\/a>, Elizabeth Lunbeck<\/a>, Matthew Nock<\/a>, and Jordan Smoller<\/a> \u2014 discuss the potential risks and rewards of using tools such as chatbots to narrow the gap between need and treatment access. Gazette senior science writer Alvin Powell moderated the following conversation, condensed for clarity and length. Watch the video for the full conversation.<\/p>\n

\n
\n<\/figure>\n<\/div>\n
\n

Whenever mental health comes up, inevitably technology becomes part of the conversation. AI-powered chatbots are powerful tools, clearly. Several cases have grabbed headlines, though, of potentially negative impacts \u2014 they\u2019ve even been accused of encouraging suicide. How closely do we need to monitor these chatbots for harmful interactions?<\/strong><\/p>\n

Nock: <\/strong>As I think about new technologies, I think about old technologies. A lot of the conversations that we\u2019re having now about chatbots we had a few years ago about social media, we\u2019ve had about TV and telephones, and so on. They are tools. For each of them, we\u2019ve got to figure out how do we use them in a way that maximizes the good and that minimizes the harm.<\/p>\n

Lunbeck: <\/strong>I appreciate the nod to history. I\u2019ll bring up another data point. The first chatbot for mental health was the ELIZA machine, which was set up by Joseph Weizenbaum, a computer scientist at MIT, and he found immediately that people reacted to the chatbot as if it were a person. And there\u2019s an apocryphal story of him \u2014 his secretary was using it in the interface and asked him to leave the room because she was having a private conversation with the chatbot. And even his colleagues who were computer scientists, he complained that they should have known better. There\u2019s something very alluring about this technology that we don\u2019t fully understand yet all these years later.<\/p>\n

Smoller: <\/strong>Chatbots are increasingly good at tapping into some of the machinery that we have ourselves in terms of identifying a connection with something and then anthropomorphizing it.<\/p>\n

Lunbeck: <\/strong>People talk about it \u2014 them hacking our attachment system.<\/p>\n

There\u2019s been a lot of focus on the sycophancy, the way that they are primed to agree with us, to mirror us. A recent study was just reported that the \u201cyes\u201d answers from ChatGPT outnumbered the \u201cno\u201d by 10 to 1.<\/p>\n

Nock: <\/strong>But what are we comparing them to? How I learned to do therapy in the room as human to human, I say \u201cyes\u201d a lot more than I say \u201cno.\u201d I do a lot more validating. We\u2019re trained, and the evidence suggests, there\u2019s benefit to validating a person\u2019s experience \u2014 \u201cyes and…\u201d I rarely, when I do therapy, say, \u201cNo, you\u2019re wrong, and don\u2019t do that.\u201d<\/p>\n

Lunbeck: <\/strong>Well, Freud said the analyst should be as a mirror to the patient. And now, we complain about chatbots mirroring, but that is part of what therapists do.<\/p>\n

Nock: <\/strong>I think we should acknowledge the positive here. There are a lot of people who have mental disorders and don\u2019t have the access to care. And here comes a technology that not everyone but a lot more people have access to. The possibility, the upside here is incredible.<\/p>\n

Alvin Powell (from left), Elizabeth Lunbeck, Karestan Koenen, Jordan Smoller, and Matthew Nock.<\/figcaption><\/figure>\n

It seems you are in agreement that there\u2019s great promise here, but are these tools ready for prime time when we hear about these troublesome cases?<\/strong><\/p>\n

Lunbeck:<\/strong> Well, you can talk about suicide. Obviously, we need better guardrails. For a long time we\u2019ve known that relationship is the key to effective psychotherapy. People have said, well, it\u2019s not a relationship with a human, but I\u2019m more focused on what\u2019s the nature of that relationship people are forming with the chatbot? In what ways does it matter, in what ways doesn\u2019t it matter that it\u2019s not human? If it\u2019s giving you something useful that you didn\u2019t have before, who are we to say\u2026?<\/p>\n

Koenen:<\/strong> Is that better than nothing?<\/p>\n

Lunbeck:<\/strong> If it\u2019s preventing you from seeking help, that\u2019s a problem. If it\u2019s responding to your suicidal ideation with, \u201cyay, go girl,\u201d that\u2019s terrible.<\/p>\n

Nock:<\/strong> I see this, as in many areas of health and medicine, there\u2019s an iteration that has to happen, and we think about: Are we ready? Is the treatment ready? There are people dying now. Let\u2019s get the best treatment we can in the hands of people, test it out through the scientific process, see what works, and see if we can make it more effective.<\/p>\n

The same approach is needed here. A lot of these platforms weren\u2019t designed to provide therapy, but people are using them for a pseudo-therapeutic kind of relationship. I\u2019d love to see more collaboration between industry and independent scientists to iteratively improve these technologies in ways that improve the health of society.<\/p>\n

Lunbeck:<\/strong> I don\u2019t want to lose sight of the dangers, though, because you did start with that. There has to be more attention to regulation and more pressure on the companies. It\u2019s kind of a semantic question. What\u2019s therapy, and what\u2019s emotional support? There are ways to build in some guardrails \u2014 if you\u2019ve been on it for five hours, for the bot to say, \u201cmaybe you should take a break\u201d or something like that \u2014 and we just have to keep pressure on the companies to do that.<\/p>\n

Would it be preferable if we boosted human connection?<\/strong><\/p>\n

Smoller: <\/strong>One of the things that we\u2019ve studied is looking for the factors that are likely to be causally protective against developing things like depression. And over and over, two things come up: physical activity and social connection. During the pandemic, we had a study in which people who had good social and emotional support early in the pandemic had half the rate of developing significant depression.<\/p>\n

So I think, absolutely. It\u2019s a difficult thing to do. Our society is being structured in the opposite direction too much.<\/p>\n

Koenen: <\/strong>And you\u2019ve had studies, I know, where you\u2019ve looked at people at high genetic risk of depression in the military, and found that those in units with high support, high conviction in their military units, even though they had high risk of depression genetically, had less new depression later. So even with high genetic risk, the social support and connection can buffer against that.<\/p>\n

\n
\n
\n

\u201cFreud said the analyst should be as a mirror to the patient. And now, we complain about chatbots mirroring, but that is part of what therapists do.\u201d<\/p>\n

Elizabeth Lunbeck<\/cite><\/p><\/blockquote>\n<\/div>\n<\/div>\n

We\u2019ve talked about large language models, but what about cellphones? Are there innovative things going on in that area?<\/strong><\/p>\n

Nock: <\/strong>We did a study at Harvard a few years back where we interviewed teens who were getting psychiatric treatment, and we asked them about their social media use and what is helpful, what is harmful. Everyone said there are aspects of it that I love: I connect with other people, I see what the new trends are, I learn skills that I can use for my mental health. And on the negative side, I do social comparison, and I feel lonely, and I feel like I don\u2019t have enough, and kids bully me, and so on.<\/p>\n

Kids are using social media. This is the world they\u2019re living in. How do we find out how to maximize health and minimize harm?<\/p>\n

Smoller: <\/strong>Social media is not going away. The numbers I\u2019ve seen are that 75 percent of young people get mental health information from social media, and there\u2019s room for raising the game there. I worry about that because there\u2019s so much misinformation and investment in psychiatric illness as being an important part of people\u2019s development, and a lot of expression of distress through the labels of psychiatric illness, often inappropriately. It\u2019s another thing we have to keep our eye on because that\u2019s where people are getting their information, and it\u2019s not always good.<\/p>\n

Lunbeck: <\/strong>I couldn\u2019t agree more. It\u2019s become a marker of identity. Through TikTok, there are whole communities around entities that aren\u2019t in the Diagnostic and Statistical Manual of Mental Disorders, but that have been named by users. We have to think about other ways for people to express their emotional vulnerabilities and concerns.<\/p>\n

Nock: <\/strong>We teamed up with an industry partner who developed an algorithm to find people on social media platforms who were in distress, and then we experimented with how do we get them to crisis services. And we found that through a little tweak, we could boost use of crisis services by about 25 percent.<\/p>\n

I worked with another platform to find blog posts that people found helpful and inspiring, and then randomized people to get those versus not. And found that people who got these blog posts had a significant decrease in their suicidal thinking, and they felt more hopeful, more optimistic, more connected with others. There are ways to use platforms and new technology in ways that boost people\u2019s mental health rather than decline it.<\/p>\n

Koenen: <\/strong>We have a study where we\u2019re doing an app-based treatment in Kenya for PTSD. I was a little skeptical but we\u2019re finding positive effects. People\u2019s PTSD symptoms are really going down with this mainly app-based treatment, and they meet occasionally with a facilitator.<\/p>\n

That\u2019s by people\u2019s smartphones, not something we could have done a decade ago. And it\u2019s reaching many more people than we could have reached if we were waiting for a therapist trained in the specific evidence-based treatment to see individual patients in their office.<\/p>\n

How do you see mental health care changing in 10 years?<\/strong><\/p>\n

Smoller:<\/strong> The problem with mental health care that dwarfs most others is access to care. We have to solve that problem. People with serious mental illness, psychotic illness actually have a shortened lifespan of 10 to 15 years.<\/p>\n

My hope also is that we\u2019re going to advance into this possibility of more precise, personalized treatment that\u2019s more effective. And, I hope, a much bigger focus on prevention and early detection because most of what we do now is reactive.<\/p>\n

Lunbeck:<\/strong> For years, it\u2019s been the case that about half of the people who seek psychotherapy do not meet the criteria for any diagnosable mental disease. They go for support, for advice, for companionship, for changing oneself, a whole range of reasons.<\/p>\n

From where I sit in therapy communities, there\u2019s a lot of worry, will therapists survive this, the new technology? Will there be a role for actual human-to-human interaction? And I\u2019m a big proponent of things happening when people actually talk to each other.<\/p>\n

Nock:<\/strong> Thinking about suicide, half of people who die by suicide saw a clinician in the four weeks before they died. So they\u2019re getting to care. One of my biggest questions is \u2014 and this is a focus of the center that Jordan and I lead at Harvard MGH \u2014 how can we use new technologies to provide better round-the-clock care, reach people when they need it, not in the absence of humans, but in addition to their human connections?<\/p>\n

Koenen:<\/strong> And I think the other piece that we need to think about is the brain doesn\u2019t exist separate from the rest of the body. As Jordan mentioned, there is good evidence that exercise can prevent depression.<\/p>\n

There\u2019s recently been large clinical trials where they\u2019ve compared a cognitive behavioral therapy \u2014 that\u2019s the gold standard for people with PTSD \u2014 against trauma-informed yoga. Randomized. They had the similar effects on PTSD symptoms, and there was less dropout from the yoga.<\/p>\n

I would have said you can\u2019t recover from PTSD without talking about your trauma. There was no talk about the trauma in the trauma-informed yoga. So what\u2019s going on there? I don\u2019t know, but there is this place for other things besides talking.<\/p>\n

Maybe it was the community of doing yoga in the group. I don\u2019t want to trivialize people with psychotic disorders or suffering from severe mental illness and say that yoga is going to cure them, but I think there are a lot of exciting developments in mind and body that we don\u2019t really understand that could also help address this.<\/p>\n

So it may be that a future Dr. Chatbot tells you to shut off the chatbot and go for a run, preferably with a whole group of people.<\/strong><\/p>\n

Koenen:<\/strong> Exactly.<\/p>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"

Health Is a chatbot therapist better than nothing? Experts discuss role of AI and other technology in future of mental health care Alvin Powell Harvard Staff Writer January 13, 2026 long read Recent reports suggest we are experiencing a loneliness epidemic and mental health crisis. Suicide rates in the U.S. have risen over the past …<\/p>\n","protected":false},"author":1,"featured_media":2895,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"loftocean_post_primary_category":0,"loftocean_post_format_gallery":"","loftocean_post_format_gallery_ids":"","loftocean_post_format_gallery_urls":"","loftocean_post_format_video_id":0,"loftocean_post_format_video_url":"","loftocean_post_format_video_type":"","loftocean_post_format_video":"","loftocean_post_format_audio_type":"","loftocean_post_format_audio_url":"","loftocean_post_format_audio_id":0,"loftocean_post_format_audio":"","loftocean-featured-post":"","loftocean-like-count":0,"loftocean-view-count":133,"tinysalt_single_post_intro_label":"","tinysalt_single_post_intro_description":"","tinysalt_hide_post_featured_image":"","tinysalt_post_featured_media_position":"","tinysalt_single_site_header_source":"","tinysalt_single_custom_site_header":"0","tinysalt_single_custom_sticky_site_header":"0","tinysalt_single_custom_sticky_site_header_style":"sticky-scroll-up","tinysalt_single_site_footer_source":"","tinysalt_single_custom_site_footer":"0","footnotes":""},"categories":[37],"tags":[],"class_list":["post-2894","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-staying-healthy"],"_links":{"self":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts\/2894","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/comments?post=2894"}],"version-history":[{"count":0,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts\/2894\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/media\/2895"}],"wp:attachment":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/media?parent=2894"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/categories?post=2894"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/tags?post=2894"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}