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It seems like people here have already made up their mind about how bad llms are. So just my anecdote here, it helped me out of some really dark places. Talking to humans (non psychologists) had the opposite effect. Between a non professional and an llm, i'd pick llm for myself. Others should definitely seek help.


It's a matter of trust and incentives. How can you trust a program curated by an entity with no accountability? A therapist has a personal stake in helping patients. An LLM provider does not.

Seeking help should not be so taboo as people are resorting to doing it alone at night while no one is looking. That is society loudly saying "if you slip off the golden path even a little your life is over". So many people resorting to LLMs for therapy is a symptom of a cultural problem, it's not a solution to a root issue.


How can I trust a therapist that has a financial incentive to keep me seeing them?


I'll start with a direct response, because otherwise I suspect my answer may come across as too ... complex.

> How can I trust a therapist that has a financial incentive to keep me seeing them?

The direct response: I hope the commenter isn't fixated on this framing of the question, because I don't think it is a useful framing. [1] What is a better framing, then? I'm not going to give a simple answer. My answer is more like a process.

I suggest refining one's notion of trust to be "I trust Person A to do {X, Y, Z} because of what I know about them (their incentives, professional training, culture, etc)."

Shift one's focus and instead ask: "What aspects of my therapist are positives and/or lead me to trust their advice? What aspects are negative and/or lead me to not trust their advice?" Put this in writing and put some time into it.

One might also want to journal on "How will I know if therapy is helping? What are my goals?" By focusing on this, I think answers relating to "How much is my therapist helping?" will become easier to figure out.

[1] I think it is not useful because both because it is loaded and because it is overly specific. Instead, focus on figuring out what actions one should take. From here, the various factors can slot in naturally.


Over the last five years I've been in and out of therapy and 2/3 of my therapists have "graduated me" at some point in time, stating that their practice didn't see permanent therapy as a good solution. I don't think all therapists view it this way.


chat gpt has a financial incentive to keep you as a weekly active user. Not really any different.


$20 a month vs a few hundred per session


On the other hand, if someone really wants to leave, they should be allowed to.

"Seeking help" goes both ways.


Perhaps then the solution is that LLMs need to be aware when the chat crosses a threshold and becomes talk of suicide.

When I was getting my Education degree, we were told that, as teachers, to take talk of suicide by students extremely seriously. If a student talks about suicide, a professional supposedly asks, "Do you know how you're going to do it?" If there is an affirmative response, the danger is real.

I suspect that comes from examining case studies?


LLMs are quite good at psychological questions. I've compared AI with tharapy professional responses and they matched 80%. It is is easier to open to it, be frank (so fear of regection or ridicule is no more). And most importantly some people don't have access to proper pool of therapists (as yet you need to "match" with the one who resonates with you) making LLMs a bliss. There is place for both human and LLM psyhelp.

I'm glad you carried through that period.


I've heard this a lot, and personally I've had a lot of good success with a prompt that explains some of my personality traits and asking it to work through a stressful situation for me. The good thing with this rather than a therapist/coach is that it understands a lot of the subject matter and can help with the detail.

I wonder if really what we need is some sort of supervised mode, where users chat with it but a trained professional reviews the transcripts and does a weekly/monthly/urgent checkin with them. This is how (some? most?) therapists work themselves, they take their notes to another therapist and go through them.


Given how ideologically captured the therapist industry is now I think it’s very hard to say that an LLM do such things is objectively worse.




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