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>The notion that the impact of talk therapy comes purely from the intellectual discourse seems to me severely misguided.

The evidence suggests otherwise. Internet-based CBT does not seem to be markedly inferior to face-to-face CBT, which is the current gold-standard talk therapy. We really don't have any evidence that the human contact element of psychotherapy is integral or even significant to the effectiveness of the therapy.

We should also be careful to avoid letting the perfect be the enemy of the good. There are many barriers to psychological care, from cost to stigma to simple availability. For the overwhelming majority of people worldwide, it isn't a choice between internet-based CBT or face-to-face psychotherapy - it's a choice between internet-based CBT or no treatment at all. Even if internet-based CBT is significantly inferior, it still has the potential to prevent immense amounts of suffering and death.

https://www.ncbi.nlm.nih.gov/pubmed/25273302

https://www.ncbi.nlm.nih.gov/pubmed/25590119




The question here may not be face to face vs remotely, but a person vs a rudimentary AI. Can one feel acceptance and support from a chatbot that has no sense of self?


It seems possible that the external is the trigger to allow oneself to feel and acceptance and support internally. For me, that was the difference maker in talk-therapy; I learned how to treat myself better, tutored by an external resource.




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