Treatment 2.0: The Science of Language Intervention Powered by Artificial Intelligence

Our mental model of a typical psychotherapy session hasn't changed much in the past 100 years: You might imagine a distraught but comfortable client lying supine on the couch while a curious therapist takes notes and thinks about what to do. We predict that with the rapid rise of artificial intelligence based on large language models (LLM), this image will soon be just a funny meme with a less precise and efficient history, since helping other humans is more of an art form than a science.

It is certainly wrong to say that psychotherapy lacks scientific rigor. Since its inception, clinical scientists have published thousands of studies examining the efficacy of various psychotherapies and their respective techniques, which are said to be effective in reducing mental distress. Despite this wealth of scientific knowledge, psychotherapy has also been described as an art because the incredible variability of human behavior requires therapists to rely on frameworks rather than precise rules to manage countless unpredictable situations. Unfortunately, however, overreliance on the “art form” of psychotherapy has led to a proliferation of ineffective treatments that do not rely on scientific evidence, and as a result psychotherapy has fallen scientifically behind other treatment areas, such as immunology and oncology, where data-driven decision-making is the norm. Additionally, many mental health clinicians rely on intuition or life experience rather than the flexible application of known treatment modalities.

So, what steps do good therapists take to bring about positive change in those struggling with mental illness? Until now, the answer to this question has been largely a mystery. While there is substantial evidence that psychotherapy is better than no treatment, and that treatment is often as effective as medication, the specific words and their optimal configuration to produce change are largely unknown. Fortunately, our understanding of the science of language intervention has improved significantly over the past 10 years, thanks to the rapid growth of text-based psychotherapy as well as telemedicine—especially during Covid-19. During this time, several large companies began to rely on text-based care as a novel treatment modality to provide care to more people, and to deliver treatments via telemedicine. Although there were initial questions about the appropriateness of face-to-face interaction, it was quickly discovered that text-based care and telemedicine produced the same treatment outcomes as face-to-face care in most aspects. This shift has also given rise to something surprising: vast amounts of communication data between patients and providers—a veritable treasure trove of data for the scientific community that can unlock the secrets of how to choose words wisely to produce the right outcome for a given patient at a given time. For example, we now know that as people get better, they begin to use language with future verb tenses instead of using present or past tense; this knowledge can now be used to encourage a different direction, leading to faster recovery from depression.

With these advances, we are more keenly aware than ever of the importance of language. The right words are important. Saying the right thing at the right time is important.

A subtle “You can do this!” from a parent helping a child acquire a new skill, or a well-timed “I love you,” are just two examples of how words can create transformative moments in our lives. This fact is truly mind-boggling—words can be both destructive (“I hate you” or “you’re fired”) and healing if used correctly and precisely. In the context of psychotherapy, words are extremely powerful tools that can be used to unlock potential and alleviate mental illness. Their application is nuanced and needs to be personalized for each patient (for example, the same message must be tailored to suit different races, ages, or life experiences), and requires a deep understanding of a patient's medical history to know when a patient is most willing to hear the right words. It is a unique challenge for therapists to use language to assess problems and produce outcomes. In fact, psychotherapy is unique in that it is the only medical field in which the spoken word is both the primary diagnosis and the primary therapeutic tool.

While psychotherapy is arguably in the midst of a true renaissance thanks to the advancements noted above, we have now begun a new wave of acceleration in the science of language intervention: driven by LLM-based artificial intelligence (AI). Artificial intelligence and machine learning have accelerated the knowledge and discovery process for language intervention to previously unimaginable levels of precision and personalization. We believe this will be more impactful than the advances we have experienced so far. Given that the LLM is effectively controlled through English (as their programming language), this provides us with an important opportunity to further develop our understanding of how to help. By safely and discreetly integrating the LLM into the clinician environment, we have the potential to achieve the ultimate level of personalization: delivering the perfect words to the right person at the right time.

In the future, it is entirely possible that traditional psychotherapy as we know it will transform into a new form of treatment, often combined with artificial intelligence technology. However, therapists may also remain critical to the optimal recovery of those with mental health issues. While AI may be able to harness the ability to choose the right words with the right person at the right time, humans are still best suited to collaborate with patients to develop and execute a “meta” plan that takes into account the individual’s overall experience and ultimate desires—often in ways that patients themselves cannot consciously achieve. Therefore, in the near future, clinicians may be augmented by artificial intelligence, resulting in “super clinicians” like we have never encountered before. For example, clinicians will gain new insights into diagnosis, improved awareness of risk factors, a more real-time understanding of clients, and more effective and timely interventions that can be prescribed electronically. AI also has the potential to be used to help clients make progress during treatment and deliver high-quality, meaningful interventions guided by mental health clinicians 24/7.

We are all acutely aware that no one can accurately predict the future. However, we think it is almost certain that, whether we like it or not, psychotherapy has been and will be forever changed with the LL.M. Our hope and belief is that it will get better, and it is our responsibility to build and contribute to this future, not avoid it.

Photo: Vertigo3d, Getty Images

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