The use of AI to provide unsupervised therapy to those in crisis is clearly incredibly risky but many still argue that, with better safeguards programmed in, AI can still be a powerful therapeutic tool.'
That's certainly the view of the founders of HelloSelf, a UK-based online therapy platform that last week launched Companion -- the first AI in the world that has been developed by therapists for their clients.
Dr Rumina Taylor, co-founder of HelloSelf and a clinical psychologist who previously worked in the NHS, says Companion has huge potential to improve access to therapy and boost outcomes by supporting users between sessions. ''If you look at the evidence basis for talking therapies, lots of research papers show that if clients do their homework -- the work outside the sessions -- they'll realise benefits sooner. This is where Companion can help. It uses the work my client and I have completed in therapy to support them by reminding them of what to do between sessions, allowing them the space to reflect on what they're learning and identify what's not working.''
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Users interact with Companion through the HelloSelf app whenever they feel like it. It knows what they are struggling with and provides responses that are deemed therapeutically safe. Their therapist can also set reminders that appear on certain days. Companion also provides session summaries and measures outcomes.
Taylor points to a client of hers who can only afford therapy once a month but is now using Companion between sessions. "It reminds her of what we talked about and the strategies she came up with herself in the sessions.
"It also asks her what she's learnt. It helps her prepare for when she next sees me and reflect on the things that perhaps haven't gone so well. It means that in our precious hour together, she's ready to say what's happened and what she's tried.
"As a therapist, one key component of therapy is building an alliance with your client -- it's the connection that can really make the difference. The Companion is not trying to replace that -- it's boosting the alliance between therapist and client, like a co-pilot.''
Taylor acknowledges, however, that even an AI agent developed by therapists such as Companion isn't for the most vulnerable. "If I had a client presenting with risk needs then seeing them online might not be the safest or best care for them," she says. "If I am working with someone whose risk changes and we have a safety plan in place, then I might suggest they don't use Companion. It all depends on the client and a collaborative conversation with them as to what's best. However, if a conversation about risk is raised by anyone, Companion will let me know."
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Companion presents as a green pebble -- the company deliberately didn't want to put a face to AI. "We believe that AI should not pretend to be human,'' says Charles Wells, the co-founder of HelloSelf, "but we want to build trust. We don't want Companion to be a scary tech thing.''
Jim Kelley (not his real name) has been using Companion since its launch and says, "Companion feels like a genuinely supportive addition to therapy. It acts as a bridge between sessions, helping to keep the therapy experience alive outside the formal hour.
"The tone is warm and encouraging -- and the experience is more personal than I expected. It can provide guidance, help set or revisit goals and serve as a reminder of key methods to manage my mental health. For example, in managing anxiety the Companion reminded me of the catch, check, change framework that I had forgotten about. Having that prompt allowed me to course-correct my thoughts earlier.''
Jim, 39, who has two young children, says he was "surprised'' at how "empathetic'' Companion seems. "I expected something more mechanical, but instead it felt closer to an extension of the therapy process.
"It asks a lot of questions and builds on what information I'm providing, so the advice feels personal to me and my needs. I was also surprised it helped me recall insights from sessions that I might otherwise have let slip away, which shows it can feel more human than people might assume of an AI.''
He sees the main value as being continuity -- and the knowledge that he can access Companion in the small hours of the night when he occasionally feels like he needs support. "You can lean on it when you need to. It also creates a useful record of thoughts and feelings that you can feed back into the next session.''
Wells and Taylor first came up with the idea for Companion six years ago. It has been a slow and complicated process to develop using thousands of transcripts of sessions donated by HelloSelf members and donated therapist notes. "Therapists led the design,'' Wells says. "They led research into what to clinically teach it and then taught it through role play.'
Companion's AI consists of seven main components. The majority of these were built by the developers at HelloSelf -- including the risk model, an algorithm that provides an appropriate tone, a component that understands clinical pathways and outcomes, and a personalised aspect that tailors responses to each user's goals for therapy. Others are third-party-led, including an algorithm to deliver the "conversation experience'' and a transcription service.
The company hopes that Companion will help users recover faster -- and that it will also continue to support users after they stop having therapy. Taylor says, "One of the hardest things about my career is witnessing the revolving door of relapse where people who seemed better ended up in therapy again. That's not what you want as a therapist -- my job is not to keep you in therapy for life, it's to teach you how to look after yourself.''
After finishing sessions, HelloSelf users can now continue to interact with Companion. "This will help to keep people well by reminding them of how to take care of themselves. But it's therapist overseen so that if things start to wobble then it can prompt them to check in again,'' she adds.
The company is also hoping to reach those who haven't even had therapy yet through Companion. "We've launched a pathway for subclinical people who are struggling with sleep, worry or stress,'' Wells says.
"Each of those members will be matched with a named therapist who will oversee their plan but the coaching will be delivered by Companion. There will always be therapist oversight but not necessarily therapist sessions.
"Imagine if we gave that experience to everyone on a waiting list or even used it as early intervention prevention. That's how we can get on top of the need and help the overwhelmed mental health service in this country.''