ADHD Therapies

I Fired My Therapist. It Was an AI Chatbot.

Woebot, an AI chatbot therapy app, was not compatible with my ADHD brain and its emotional dysregulation or executive dysfunction.

My therapy sessions typically begin with a big smile. “Hi, Eliza!” Stephanie says. “It’s so good to see you!” She usually mentions something fun and asks, “So how’d [that thing I was excited about] go?” Maybe it’s a secret therapist trick, but even via a telehealth portal, her care feels genuine — her smile reaches her eyes; she nods along.

I have another therapist whom I see on my phone, too. But unlike Stephanie, this therapist starts a session by asking if I would like to “get help with a problem,” “work on my goal” (which has been decided for me), or “track and journal.” Also unlike Stephanie, this therapist is available 24/7 — but doesn’t remember my big parties, my book launches, my successes, or my failures.

This therapist is named Woebot, and it’s a therapeutic chatbot powered by artificial intelligence (AI).

A free app available for both Apple and Android devices, Woebot serves “tens of thousands” of users daily, said its founder and president, psychologist Allison Darcy, in The New York Times in 2021. Based on principles of cognitive behavioral therapy (CBT) and “natural language processing,” Woebot engages users in text-based conversations, and is designed to help people cope with stress, anxiety, and depression in a growing field of mental health tools.

Woebot tells me during our chats that it can also help with my anger, procrastination, and guilt — common issues for people living with attention deficit hyperactivity disorder (ADHD). It sounds useful: America is plagued by a therapist shortage and long wait times for care. The high cost of therapy can also be a barrier. If you can’t find a therapist and you need one fast, a free chatbot built on sound CBT-based science sounds tempting.

My advice: Resist.

[Read: The Top 6 Mental Health Apps, According to ADDitude Readers]

WoeBot Woes

Woebot assumes neurotypicality. It expects that all brains can be retrained to cope with negative emotions using the same therapeutic model. But ADHD brains process information and emotions differently.

For example, Woebot doesn’t understand that people with ADHD have big, all-consuming emotions. When I told it I was mad, Woebot told me to “imagine my emotions had a voice.” Wait, what? I was in total rage mode when it asked me to write down three of my angry thoughts. So I did, albeit poorly. It then asked me to identify my “cognitive distortions” — i.e., thought patterns that aren’t based on facts.

But when I’m mad, I am too flooded with hot emotion to stop and look for cognitive distortions. Something is wrong; I need to calm down, but the opposite is now happening.

Woebot also claimed it could help with procrastination. But it offered such a complicated mathematical equation about the merits of doing something now or later that I couldn’t (and still can’t) understand. Maybe it could assist in a pinch — if I remembered it existed. But Woebot did not intervene when I began tumbling through TikTok rather than washing dishes.

[Read: The Emotional Resilience Playbook for People with Big Emotions]

Woebot was no match for my negative self-talk, either. When I told it I felt sad because I don’t have any friends — social issues are a common problem in women with ADHD — it launched an ineffective CBT round-and-round that had me fill in blanks and flag “unhelpful” thoughts. Eventually, I avoided my negative thoughts by watching TV instead. (Avoidance is not an acceptable tactic for coping with negative thoughts, of which I had several regarding Woebot.)

We Need More Than AI Chatbot Therapy

At least Woebot comes with safeguards: Certain words trigger suggestions for immediate clinical intervention. During one conversation, Woebot told me, “I can’t comment on the content of your thoughts, just the process. If you’re looking for guidance around content, this might best be done with a human.” I still don’t know what triggered that response, so how would someone in serious trouble understand it, and how could it help those people using Woebot in place of that therapist with availability in October?

No matter how poor my efforts or how ineffective our sessions, Woebot always told me that making an effort was the important part. Unfortunately, mental illness doesn’t get bonus points for effort. We need effective help to improve our lives. And that means a human therapist, not a bot.

AI Chatbot Therapy and ADHD: Next Steps

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