As far as I can tell, a lot of therapy is just good common-sense advice and a bunch of 'tricks' to get the patient to actually follow it. Basically CBT and "get the patient to think they figured out the solution themselves (develop insight)". Yes, there's some serious cases where more is required and a few (ADHD) where meds are effective; but a lot of the time the patient is just an expert at rejecting helpful advice, often because they insist they're a special case that needs special treatment.

Therapists are more valuable that advice from a random friend (for therapy at least) because they can act when triage is necessary (e.g. send in the men in white coats, or refer to something that's not just CBT) and mostly because they're really good at cutting through the bullshit without having the patient walk out.

AIs are notoriously bad at cutting through bullshit. You can always 'jailbreak' an AI, or convince it of bad ideas. It's entirely counterproductive to enable their crazy (sorry, 'maladaptive') behaviour but that's what a lot of AIs will do.

Even if someone makes a good AI, there's always a bad AI in the next tab, and people will just open up a new tab to find an AI gives them the bad advice they want, because if they wanted to listen to good advice they probably wouldn't need to see a therapist. If doctor shopping is as fast and free as opening a new tab, most mental health patients will find a bad doctor rather than listen to a good one.

▲

lukev 4 days ago | parent [-]

I agree with your conclusion, but what you characterize as therapy is quite a small part of what it is (or can be, there's lots of different kinds.)

▲

wisty 4 days ago | parent [-]

Yet the evidence is that almost everything can and is treated with CBT.

▲

mrbungie 4 days ago | parent [-]

Nope, that's not right. BPD can't be treated with CBT (comorbidities may be, with caveats if BPD is the root cause), you probably will also need at least DBT.

▲

wisty 2 days ago | parent | next [-]

Is "almost everything" a bit strong? Should I have specifically mentioned BPD and schizophrenia (which I though were the two exceptions I thought people would most likely mention, there's bound to be a few others).

I coild argue that DBT is kind of just a variant of CBT, and while it's generally got evidence of being more effective there's credible sources suggesting CBT is effective (even if it's not quite as good). But nah.

I know there's exceptions. I said there's exceptions.

▲

dmix 4 days ago | parent | prev [-]

Can BPD even be treated with talk therapy? That's all LLMs would be used for afaik, it's not ever going to have a long term plan for you and check in

	▲	mrbungie 4 days ago \| parent [-]
		Yes, afaik BPD is the only Cluster B diagnosis with documented remission rates, when using a mix of therapies that normally are based around DBT. Not sure what you refer about "talk therapy" in this case (psychoanalysis, maybe?), as even CBT needs homework and check-ins to be done.