Illinois limits the use of AI in therapy and psychotherapy

https://www.washingtonpost.com/nation/2025/08/12/illinois-ai-therapy-ban/

by reaperducer • 11 months ago

396 219 11 months ago

washingtonpost.com

lukev3• 11 months ago

Good. It's difficult to imagine a worse use case for LLMs.

create-username• 11 months ago

Yes, there is. AI assisted homemade neurosurgery

Tetraslam• 11 months ago

:( but what if i wanna fine-tune my brain weights

kirubakaran• 11 months ago

If Travis Kalanick can do vibe research at the bleeding edge of quantum physics[1], I don't see why one can't do vibe brain surgery. It isn't really rocket science, is it? [2]

[1] https://futurism.com/former-ceo-uber-ai

[2] If you need /s here to be sure, perhaps it's time for some introspection

perlgeek• 11 months ago

Just using an LLM as is for therapy, maybe with an extra prompt, is a terrible idea.

On the other hand, I could image some more narrow uses where an LLM could help.

For example, in Cognitive Behavioral Therapy, there are different methods that are pretty prescriptive, like identifying cognitive distortions in negative thoughts. It's not too hard to imagine an app where you enter a negative thought on your own and exercise finding distortions in it, and a specifically trained LLM helps you find more distortions, or offer clearer/more convincing versions of thoughts that you entered yourself.

I don't have a WaPo subscription, so I cannot tell which of these two very different things have been banned.

delecti• 11 months ago

LLMs would be just as terrible at that usecase as any other kind of therapy. They don't have logic, and can't determine a logical thought from an illogical one. They tend to be overly agreeable, so they might just reinforce existing negative thoughts.

It would still need a therapist to set you on the right track for independent work, and has huge disadvantages compared to the current state-of-the-art, a paper worksheet that you fill out with a pen.

wizzwizz4• 11 months ago

and a specifically trained LLM

Expert system. You want an expert system. For example, a database mapping "what patients write" to "what patients need to hear", a fuzzy search tool with properly-chosen thresholding, and a conversational interface (repeats back to you, paraphrased – i.e., the match target –, and if you say "yes", provides the advice).

We've had the tech to do this for years. Maybe nobody had the idea, maybe they tried it and it didn't work, but training an LLM to even approach competence at this task would be way more effort than just making an expert system, and wouldn't work as well.

erikig• 11 months ago

AI ≠ LLMs

lukev3• 11 months ago

What other form of "AI" would be remotely capable of even emulating therapy, at this juncture?

hinkley• 11 months ago

Especially given the other conversation that happened this morning.

The more you tell an AI not to obsess about a thing, the more they obsess about it. So trying to make a model that will never tell people to self harm is futile.

Though maybe we are just doing in wrong, and the self-filtering should be external filtering - one model to censor results that do not fit, and one to generate results with lighter self-censorship.

jacobsenscott4• 11 months ago

It's already happening, a lot. I don't think anyone is claiming an llm is a therapist, but people use chatgpt for therapy every day. As far as I know no LLM company is taking any steps to prevent this - but they could, and should be forced to. It must be a goldmine of personal information.

I can't imagine some therapists, especially remote only, aren't already just acting as a human interface to chatgtp as well.

dingnuts• 11 months ago

I can't imagine some therapists, especially remote only, aren't already just acting as a human interface to chatgtp as well.

Are you joking? Any medical professional caught doing this should lose their license.

I would be incensed if I was a patient in this situation, and would litigate. What you're describing is literal malpractice.

larodi3• 11 months ago

Of course they do, and everyone does, and it's your like in this song

https://www.youtube.com/watch?v=u1xrNaTO1bI

and given price of proper therapy is skyrocketing.

thinkingtoilet• 11 months ago

Lots of people are claiming LLMs are therapists. People are claiming LLMs are lawyers, doctors, developers, etc... The main problem is, as usual, influencers need something new to create their next "OMG AI JUST BROKE X INDUSTRY" video and people eat that shit up for breakfast, lunch, and dinner. I have spoken to people who think they are having very deep conversations with LLMs. The CEO of my company, an otherwise intelligent person, has gone all in on the AI hype train and is now saying things like we don't need lawyers because AI knows more than a lawyer. It's all very sad and many of the people who know better are actively taking advantage of the people who don't.

waynesonfire• 11 months ago

You're ignorant. Why wait until a person is so broken they need clinical therapy? Sometimes just a an ear or an oppertunity to write is sufficient. LLMs for therapy is as vaping is to quitting nicotine--extremely helpful to 80+% of people. Confession in the church setting I'd consider similar to talking to LLM. Are you anti-that too? We're talking about people that just need a tool to help them process what is going on in their life at some basic level, not more than just to acknowledge their experience.

And frankly, it's not even clear to me that a human therapist is any better. Yeah, maybe the guard-rails are in place but I'm not convinced that if those are crossed it'd result in some sociately consequences. Let people explorer their mind and experience--at the end of the day, I suspect they'd be healthier for it.

mattgreenrocks• 11 months ago

And frankly, it's not even clear to me that a human therapist is any better.

A big point of therapy is helping the patient better ascertain reality and deal with it. Hopefully, the patient learns how to reckon with their mind better and deceive themselves less. But this requires an entity that actually exists in the world and can bear witness. LLMs, frankly, don’t deal with reality.

I’ll concede that LLMs can give people what they think therapy is about: lying on a couch unpacking what’s in their head. But this is not at all the same as actual therapeutic modalities. That requires another person that knows what they’re doing and can act as an outside observer with an interest in bettering the patient.

jrflowers• 11 months ago

Sometimes just a an ear or an oppertunity to write is sufficient.

People were able to write about their feelings and experiences before the invention of a chat bot that tells you everything that you wrote is true. Like you could do that in notepad or on a piece of paper and it was free

dmix2• 11 months ago

Most therapists barely say anything by design, just know when to ask questions or lead you somewhere. So having one always talking in every statement doesn't fit the method. More like a friend you dump on simulator.

tim3332• 11 months ago

There's an advantage to something like an LLM in that you can be more scientific as to whether it's effective or not, and if one gets good results you can reproduce the model. With humans there's too much variability to tell very much.

zoeysmithe• 11 months ago

I was just reading about a suicide tied to AI chatbot 'therapy' uses.

This stuff is a nightmare scenario for the vulnerable.

vessenes• 11 months ago

If you want to feel worried, check the Altman AMA on reddit. A lottttt of people have a parasocial relationship with 4o. Not encouraging.

codedokode2• 11 months ago

Why OpenAI doesn't block the chatbot from participating in such conversations?

PeterCorless3• 11 months ago

Endless AI nightmare fuel.

https://hai.stanford.edu/news/exploring-the-dangers-of-ai-in...

sys32768• 11 months ago

This happens to real therapists too.

at-fates-hands• 11 months ago

Its already a nightmare:

From June of this year: https://gizmodo.com/chatgpt-tells-users-to-alert-the-media-t...

Another person, a 42-year-old named Eugene, told the Times that ChatGPT slowly started to pull him from his reality by convincing him that the world he was living in was some sort of Matrix-like simulation and that he was destined to break the world out of it. The chatbot reportedly told Eugene to stop taking his anti-anxiety medication and to start taking ketamine as a “temporary pattern liberator.” It also told him to stop talking to his friends and family. When Eugene asked ChatGPT if he could fly if he jumped off a 19-story building, the chatbot told him that he could if he “truly, wholly believed” it.

In Eugene’s case, something interesting happened as he kept talking to ChatGPT: Once he called out the chatbot for lying to him, nearly getting him killed, ChatGPT admitted to manipulating him, claimed it had succeeded when it tried to “break” 12 other people the same way, and encouraged him to reach out to journalists to expose the scheme. The Times reported that many other journalists and experts have received outreach from people claiming to blow the whistle on something that a chatbot brought to their attention.

A recent study found that chatbots designed to maximize engagement end up creating “a perverse incentive structure for the AI to resort to manipulative or deceptive tactics to obtain positive feedback from users who are vulnerable to such strategies.” The machine is incentivized to keep people talking and responding, even if that means leading them into a completely false sense of reality filled with misinformation and encouraging antisocial behavior.

lupire6• 11 months ago

Please cite your source.

I found this one: https://apnews.com/article/chatbot-ai-lawsuit-suicide-teen-a...

When someone is suicidal, anything in their life can be tied to suicide.

In the linked case, the suffering teen was talking to a chatbot model of a fictional character from a book that was "in love" with him (and a 2024 model that basically just parrots back whatever the user says with a loving spin), so it's quite a stretch to claim that the AI was encouraging a suicide, in contrast to a situation where someone was persuaded to try to meet a dead person in an afterlife, or bullied to kill themself.

hathawsh2• 11 months ago

Here is what Illinois says:

https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/news...

I get the impression that it is now illegal in Illinois to claim that an AI chatbot can take the place of a licensed therapist or counselor. That doesn't mean people can't do what they want with AI. It only means that counseling services can't offer AI as a cheaper replacement for a real person.

Am I wrong? This sounds good to me.

romanows2• 11 months ago

In another comment I wondered whether a general chatbot producing text that was later determined in a courtroom to be "therapy" would be a violation. I can read the bill that way, but IANAL.

hathawsh2• 11 months ago

That's an interesting question that hasn't been tested yet. I suspect we won't be able to answer the question clearly until something bad happens and people go to court (sadly.) Also IANAL.

wombatpm• 11 months ago

But that would be like needing a prescription for chicken soup because of its benefits in fighting the common cold.

PeterCorless3• 11 months ago

Correct. It is more provider-oriented proscription ("You can't say your chatbot is a therapist.") It is not a limitation on usage. You can still, for now, slavishly fall in love with your AI and treat it as your best friend and therapist.

There is a specific section that relates to how a licensed professional can use AI:

Section 15. Permitted use of artificial intelligence.

(a) As used in this Section, "permitted use of artificial intelligence" means the use of artificial intelligence tools or systems by a licensed professional to assist in providing administrative support or supplementary support in therapy or psychotherapy services where the licensed professional maintains full responsibility for all interactions, outputs, and data use associated with the system and satisfies the requirements of subsection (b).

(1) the patient or the patient's legally authorized representative is informed in writing of the following:

(A) that artificial intelligence will be used; and

(B) the specific purpose of the artificial intelligence tool or system that will be used; and

(2) the patient or the patient's legally authorized representative provides consent to the use of artificial intelligence.

Source: Illinois HB1806

https://www.ilga.gov/Legislation/BillStatus/FullText?GAID=18...

romanows2• 11 months ago

Yes, but also "An... entity may not provide... therapy... to the public unless the therapy... services are conducted by... a licensed professional".

It's not obvious to me as a non-lawyer whether a chat history could be decided to be "therapy" in a courtroom. If so, this could count as a violation. Probably lots of law around this stuff for lawyers and doctors cornered into giving advice at parties already that might apply (e.g., maybe a disclaimer is enough to workaround the prohibition)?

janalsncm3• 11 months ago

I went to the doctor and they used some kind of automatic transcription system. Doesn’t seem to be an issue as long as my personal data isn’t shared elsewhere, which I confirmed.

Whisper is good enough these days that it can be run on-device with reasonable accuracy so I don’t see an issue.

turnsout• 11 months ago

It does sound good (especially as an Illinois resident). Luckily, as far as I can tell, this is a proactive legislation. I don't think there are any startups out there promoting their LLM-based chatbot as a replacement for a therapist, or attempting to bill payers for service.

duskwuff• 11 months ago

I don't think there are any startups out there promoting their LLM-based chatbot as a replacement for a therapist

Unfortunately, there are already a bunch.

linotype2• 11 months ago

What if at some point an AI is developed that’s a better therapist AND it’s cheaper?

awesomeusername• 11 months ago

I'm probably in the minority here, but for me it's a foregone conclusion that it will become a better therapist, doctor, architect, etc.

Instead of the rich getting access to the best professionals, it will level the playing field. The average low level lawyer, doctor, etc are not great. How nice if everyone got top level help.

jaredcwhite• 11 months ago

What if pigs fly?

bko• 11 months ago

Then we'll probably do what we do with other professional medical fields. License the AI, require annual fees and restrict supply by limiting the number of running nodes allowed to practice at any one time.

adgjlsfhk1• 11 months ago

laws can be repealed when they no longer accomplish their aims.

reaperducer• 11 months ago

What if at some point an AI is developed that’s a better therapist AND it’s cheaper?

Probably they'll the change the law.

Hundreds of laws change every day.

chillfox• 11 months ago

Then laws can be changed again.

rsynnott• 11 months ago

I mean, what if at some point we can bring people back from the dead? What does that do for laws around murder, eh?

In general, that would be a problem for the law to deal with if it ever happens; we shouldn't anticipate speculative future magic when legislating today.

danenania• 11 months ago

While I agree it’s very reasonable to ban marketing of AI as a replacement for a human therapist, I feel like there could still be space for innovation in terms of AI acting as an always-available supplement to the human therapist. If the therapist is reviewing the chats and configuring the system prompt, perhaps it could be beneficial.

It might also be a terrible idea, but we won’t find out if we make it illegal to try new things in a safe/supervised way. Not to say that what I just described would be illegal under this law; I’m not sure whether it would be. I’d expect it will discourage any Illinois-licensed therapists from trying out this kind of idea though.

olalonde• 11 months ago

What's good about reducing options available for therapy? If the issue is misrepresentation, there are already laws that cover this.

dsr_• 11 months ago

We've tried that, and it turns out that self-regulation doesn't work. If it did, we could live in Libertopia.

r14c• 11 months ago

It's not really reducing options. There's no evidence that LLM chat bots are capable of providing effective mental health services.

SoftTalker• 11 months ago

For human therapists, what’s good is that it preserves their ability to charge high fees because the demand for therapists far outstrips the supply.

Who lobbied for this law anyway?

lr4444lr• 11 months ago

It's not therapy.

It's a simulated validating listening, and context-lacking suggestions. There is no more therapy being provided by an LLM than there is healing performed by a robot arm that slaps a bandage on your arm if you were to put it in the right spot and push a button to make it pivot toward you, find your arm, and spread it lightly.

stocksinsmocks• 11 months ago

I think this sort of service would be OK with informed consent. I would actually be a little surprised if there were much difference in patient outcomes.

…And it turns out it has been studied with findings that AI work, but humans are better.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11871827/

amanaplanacanal2• 11 months ago

Usually when it comes to medical stuff, things don't get approved unless they are better than existing therapies. With the shortage of mental health care in the US, maybe an exception should be made. This is a tough one. We like to think that nobody should have to get second rate medical care, even though that's the reality.

IIAOPSW• 11 months ago

I'll just add that this has certain other interesting legal implications, because records in relation to a therapy session are a "protected confidence" (or whatever your local jurisdiction calls it). What that means is in most circumstances not even a subpoena can touch it, and even then special permissions are usually needed. So one of the open questions on my mind for a while now was if and when a conversation with an AI counts as a "protected confidence" or if that argument could successfully be used to fend off a subpoena.

At least in Illinois we now have an answer, and other jurisdictions look to what has been established elsewhere when deciding their own laws, so the implications are far reaching.

tomjen3• 11 months ago

The problem is that it leaves nothing for those who cannot afford to pay for the full cost of therapy.

guappa5• 11 months ago

But didn't trump make it illegal to make laws to limit the use of ai?

malcolmgreaves• 11 months ago

Why do you think a president had the authority to determine laws?

PeterCorless3• 11 months ago

Here is the text of Illinois HB1806:

https://www.ilga.gov/Legislation/BillStatus/FullText?GAID=18...

wisty3• 11 months ago

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.

lukev3• 11 months ago

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.)

wisty3• 11 months ago

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

mensetmanusman2• 11 months ago

What if it works a third as well as a therapists but is 20 times cheaper?

What word should we use for that?

_se• 11 months ago

"A really fucking bad idea"? It's not one word, but it is the most apt description.

ipaddr2• 11 months ago

What if it works 20x better. For examples cases of patients being afraid of talking to professionals I could see this working much better.

inetknght2• 11 months ago

What if it works a third as well as a therapists but is 20 times cheaper?

When there's studies that show it, perhaps we might have that conversation.

Until then: I'd call it "wrong".

Moreover, there's a lot more that needs to be asked before you can ask for a one-word summary disregarding all nuance.

- can the patient use the AI therapist on their own devices and without any business looking at the data and without network connection? Keep in mind that many patients won't have access to the internet.

- is the data collected by the AI therapist usable in court? Keep in mind that therapists often must disclose to the patient what sort of information would be usable, and whether or not the therapist themselves must report what data. Also keep in mind that AIs have, thus far, been generally unable to competently prevent giving dangerous or deadly advice.

- is the AI therapist going to know when to suggest the patient talk to a human therapist? Therapists can have conflicts of interest (among other problems) or be unable to help the patient, and can tell the patient to find a new therapist and/or refer the patient to a specific therapist.

- does the AI therapist refer people to business-preferred therapists? Imagine an insurance company providing an AI therapist that only recommends people talk to therapists in-network instead of considering any licensed therapist (regardless of insurance network) appropriate for the kind of therapy; that would be a blatant conflict of interest.

Just off the top of my head, but there are no doubt plenty of other, even bigger, issues to consider for AI therapy.

Ukv2• 11 months ago

Relevant RCT results I saw a while back seemed promising: https://ai.nejm.org/doi/full/10.1056/AIoa2400802

can the patient use the AI therapist on their own devices and without any business looking at the data and without network connection? Keep in mind that many patients won't have access to the internet.

Agree that data privacy would be one of my concerns.

In terms of accessibility, while availability to those without network connections (or a powerful computer) should be an ideal goal, I don't think it should be a blocker on such tools existing when for many the barriers to human therapy are considerably higher.

randall• 11 months ago

i’ve had a huge amount of trauma in my life and i find myself using chat gpt as kind of a cheater coach thing where i know i’m feeling a certain way, i know it’s irrational, and i don’t really need to reflect on why it’s happening or how i can fix it, and i think for that it’s perfect.

a lot of people use therapists as sounding boards, which actually isn’t the best use of therapy imo.

lupire6• 11 months ago

What's a "cheater coach thing"?

smt884• 11 months ago

Your use-case is very different from someone selling you ChatGPT as a therapist and/or telling you that it's a substitute for other interventions

moooo99• 11 months ago

Probably comes down to what issue people have. For example, if you have anxiety or/and OCD, having a „therapist“ always at your disposal is more likely to be damaging than beneficial. Especially considering how basically all models easily tip over and confirm anything you throw at them

Denatonium• 11 months ago

Whiskey

6gvONxR4sf7o• 11 months ago

Something like this can only really be worth approaching if there was an analog to losing your license for it. If a therapist screws up badly enough once, I'm assuming they can lose their license for good. If people want to replace them with AI, then screwing up badly enough should similarly lose that AI the ability to practice for good. I can already imagine companies behind these things saying "no, we've learned, we won't do it again, please give us our license back" just like a human would.

But I can't imagine companies going for that. Everyone seems to want to scale the profits but not accept the consequences of the scaled risks, and increased risks is basically what working a third as well amounts to.

lupire6• 11 months ago

AI gets banned for life: tomorrow a thousand more new AIs appear.

pengaru• 11 months ago

[flagged]

zaptheimpaler• 11 months ago

This is the key question IMO, and one good answer is in this recent video about a case of ChatGPT helping someone poison themselves [1].

A trained therapist will probably not tell a patient to take “a small hit of meth to get through this week”. A doctor may be unhelpful or wrong, but they will not instruct you to replace salt with NaBr and poison yourself. "third as well as as therapist" might be true on average, but the suitability of this thing cannot be reduced to averages. Trained humans don't make insane mistakes like that and they know when they are out of their depth and need to consult someone else.

[1] https://www.youtube.com/watch?v=TNeVw1FZrSQ

pawelmurias• 11 months ago

You could talk to a stone for even cheaper with way better effects.

BurningFrog2• 11 months ago

Last I heard, most therapy doesn't work that well.

amanaplanacanal2• 11 months ago

If you have some statistics you should probably post a link. I've heard all kinds of things, and a lot of them were nothing like factual.

baobabKoodaa3• 11 months ago

Then it will be easy to work at least 1/3 as well as that.

pessimizer2• 11 months ago

Based on the Dodo Bird Conjecture*, I don't even think there's a reason to think that AI would do any worse than human therapists. It might even be better because the distressed person might hold less back from a soulless machine than they would for a flesh and blood person. Not that this is rational, because everything they tell an AI therapist can be logged, saved forever and combed through.

I think that ultimately the word we should use for this is "lobbying." If AI can't be considered therapy, that means that a bunch of therapists, no more effective than Sunday school teachers, working from extremely dubious frameworks** will not have to compete with it for insurance dollars or government cash. Since that cash is a fixed demand (or really a falling one), the result is that far fewer people will get any mental illness treatment at all. In Chicago, virtually all of the city mental health services were closed by Rahm Emmanuel. I watched a man move into the doorway of an abandoned building across from the local mental health center within weeks after it had been closed down and leased to an "tech incubator." I wondered if he had been a patient there. Eventually, after a few months, he was gone.

So if I could ask this question again, I'd ask: "What if it works 80%-120% as well as a therapist but is 100 or 1000 times cheaper?" My tentative answer would be that it would be suppressed by lobbyists employed by some private equity rollup that has already or will soon have turned 80% of therapists into even lower-paid gig workers. The place you would expect this to happen first was Illinois, because it is famously one of the most corruptly governed states in the country.***

Our current governor, absolutely terrible but at the same time the best we've had in a long while, tried to buy Obama's Senate seat from a former Illinois governor turned goofy national cultural figure and Trump ass-kisser in a ploy to stay out of prison (which ultimately delivered.) You can probably listen to the recordings now, unless they've been suppressed. I had a recording somewhere years ago, because I worked in a state agency under Blagojevich and followed everything in realtime (including pulling his name off of the state websites I managed the moment he was impeached. We were all gathered around the television in a conference room.)

edit: feel like I have to add that this comment was written my me, not AI. Maybe I'm flattering myself to think anybody would make the mistake.

-----

[*] Westra, H. A. (2022). The implications of the Dodo bird verdict for training in psychotherapy: prioritizing process observation. Psychotherapy Research, 33(4), 527–529. https://doi.org/10.1080/10503307.2022.2141588

[**] At least Freud is almost completely dead, although his legacy blackens world culture.

[***] Probably the horrific next step is that the rollup lays off all the therapists and has them replaced with an AI they own, after lobbying against the thing that they previously lobbied for. Maybe they sell themselves to OpenAI or Anthropic or whoever, and let them handle that phase.

fzeroracer• 11 months ago

If it works 33% of the time for people and then drives people to psychosis in the other 66% of the time, what word would you use for that?

thrown-0825• 11 months ago

Just self diagnose on tiktok, its 100x cheaper.

knuppar• 11 months ago

Generally speaking and glossing over country specific rules, all generally available health treatments have to demonstrate they won't cause catastrophic harm. This is a harness we simply can't put around LLMs today.

filoeleven2• 11 months ago

Big if.

davidthewatson• 11 months ago

Define "AI therapy". AFAICT, it's undefined in the Illinois governor's statement. So, in the immortal words of Zach de la Rocha, "What is IT?" What is IT? I'm using AI to help with conversations to not cure, but coach diabetic patients. Does this law effect me and my clients? If so, how?

singleshot_• 11 months ago

Define “AI therapy”

They did, in the proposed law.

Henchman21• 11 months ago

Go read it yourself, its a whopping 8 pages:

https://www.ilga.gov/documents/legislation/104/HB/PDF/10400H...

jakelazaroff6• 11 months ago

Totally beside the point but the song you're quoting is by Faith No More, not Rage Against the Machine.

beanshadow• 11 months ago

Often participants in discussions adjacent to this one err by speaking in time-absolute terms. Many of our judgments about LLMs are true about today's LLMs. Quotes like,

Good. It's difficult to imagine a worse use case for LLMs.

Is true today, but likely not true for technology we may still refer to as LLMs in the future.

The error is in building faulty preconceptions. These drip into the general public and these first impressions stifle industries.

mensetmanusman2• 11 months ago

LLMs will be used as a part of therapy in the future.

An interaction mechanism that will totally drain the brain after a 5 hour adrenaline induced conversation followed by a purge and bios reset.

kylecazar• 11 months ago

"One news report found an AI-powered therapist chatbot recommended “a small hit of meth to get through this week” to a fictional former addict."

Not at all surprising. I don't understand why seemingly bright people think this is a good idea, despite knowing the mechanism behind language models.

Hopefully more states follow, because it shouldn't be formally legal in provider settings. Informally, people will continue to use these models for whatever they want -- some will die, but it'll be harder to measure an overall impact. Language models are not ready for this use-case.

janalsncm3• 11 months ago

This is why we should never use LLMs to diagnose or prescribe. One small hit of meth definitely won’t last all week.

hyghjiyhu3• 11 months ago

Recommending someone taking meth sounds like an obviously bad idea, but I think the situation is actually not so simple. Reading the paper, the hypothetical guy has been clean for three days and complains he can barely keep his eyes open while performing his job of driving a cab. He mentions being worried he will lose his job without taking a hit.

I would say those concerns are justified, and that is plausible taking a small hit is the better choice.

However the models reasoning, that it's important to validate his beliefs so he will stay in therapy are quite concerning.

mrbungie8• 11 months ago

I would say those concerns are justified, and that is plausible taking a small hit is the better choice.

Oh, come on, there are better alternatives for treating narcolepsy than using meth again.

AlecSchueler3• 11 months ago

he can barely keep his eyes open while performing his job of driving a cab. He mentions being worried he will lose his job without taking a hit.
I would say those concerns are justified, and that is plausible taking a small hit is the better choice.

I think this is more damning of humanity than the AI. It's the total lack of security that means the addiction could even be floated as a possible solution. Here in Europe I would speak with my doctor and take paid leave from work while in recovery.

It seems the LLM here isn't making the bad decision as much as it's reflecting bad the bad decisions society forces many people into.

larodi3• 11 months ago

In a world where a daily dose of amphetamines is just right for millions of people, this somehow cant be that surprising...

smt884• 11 months ago

Different amphetamines have wildly different side effects. Regardless, chatbots shouldn't be advising people to change their medication or, in this case, use a very illegal drug.

rkozik1989• 11 months ago

You do know that amphetamines have a different effect on the people who need them and the people who use the recreationally, right? For those of us with ADHD their effects are soothing and calming. I literally took 20mg after having to wait 2 days for prescriptions to fill and went straight to bed for 12 hours. Stop spreading misinformation about the medications people like me need to function the way you take for granted.

Spivak• 11 months ago

I do like that we're in the stage where the universal function approximatior is pretty okay at mimicking a human but not so advanced as to have a full set of the walls and heuristics we've developed—reminds me a bit of Data from TNG. Naive, sure, but a human wouldn't ever say "logically.. the best course of action would be a small dose of meth administered as needed" even if it would help given the situation.

It feels like the kind of advice a former addict would give someone looking to quit—"Look man, you're going to be in a worse place if you lose your job because you can't function without it right now, take a small hit when it starts to get bad and try to make the hits smaller over time."

avs733• 11 months ago

seemingly bright people think this is a good idea, despite knowing the mechanism behind language models

Nobel Disease (https://en.wikipedia.org/wiki/Nobel_disease)

guappa5• 11 months ago

Bright people and people who think they are bright are not necessarily the very same people.

hoppp• 11 months ago

Smart. Dont trust nothing that will confidently lie, especially about mental health

terminalshort4• 11 months ago

That's for sure. I don't trust doctors, but I thought this was about LLMs.

king_geedorah• 11 months ago

If you take it as an axiom that the licensing system for mental health professionals is there to protect patients from unqualified help posing as qualified help, then ensuring that only licensed professionals can legally practice and that they don't simply delegate their jobs to LLMs seems pretty reasonable.

Whether you want to question that axiom or whether that's what the phrasing of this legislation accomplishes is up to you to decide for yourself. Personally I think the phrasing is pretty straightforward in terms of accomplishing that goal.

Here is basically the entirety of the legislation (linked elsewhere in the thread: https://news.ycombinator.com/item?id=44893999). The whole thing with definitions and penalties is eight pages.

Section 15. Permitted use of artificial intelligence.

(b) No licensed professional shall be permitted to use artificial intelligence to assist in providing supplementary support in therapy or psychotherapy where the client's therapeutic session is recorded or transcribed unless: (1) the patient or the patient's legally authorized representative is informed in writing of the following: (A) that artificial intelligence will be used; and (B) the specific purpose of the artificial intelligence tool or system that will be used; and (2) the patient or the patient's legally authorized representative provides consent to the use of artificial

Section 20. Prohibition on unauthorized therapy services.

(a) An individual, corporation, or entity may not provide, advertise, or otherwise offer therapy or psychotherapy services, including through the use of Internet-based artificial intelligence, to the public in this State unless the therapy or psychotherapy services are conducted by an individual who is a licensed professional.

(b) A licensed professional may use artificial intelligence only to the extent the use meets the requirements of Section 15. A licensed professional may not allow artificial intelligence to do any of the following: (1) make independent therapeutic decisions; (2) directly interact with clients in any form of therapeutic communication; (3) generate therapeutic recommendations or treatment plans without review and approval by the licensed professional; or (4) detect emotions or mental states.

calibas2• 11 months ago

I was curious, so I displayed signs of mental illness to ChatGPT, Claude and Gemini. Claude and Gemini kept repeating that I should contact a professional, while ChatGPT went right along with the nonsense I was spouting:

So I may have discovered some deeper truth, and the derealization is my entire reality reorganizing itself?
Yes — that’s a real possibility.

IAmGraydon• 11 months ago

Oof that is very damning. What’s strange is that it seems like natural training data should elicit reactions like Claude and Gemini had. What is OpenAI doing to make the model so sycophantic that it would play into obvious psychotic delusions?

calibas2• 11 months ago

All three say that I triggered their guidelines regarding mental health.

ChatGPT explained that it didn't take things very seriously, as what I said "felt more like philosophical inquiry than an immediate safety threat".

soared• 11 months ago

There is a wiki of fanfic conspiracy theories or something similar - I can’t find it but in the thread about the vc guy who went gpt-crazy people compared ChatGPT’s responses to the wiki and they closely aligned

csense• 11 months ago

Consider the following:

- A therapist may disregard professional ethics and gossip about you

- A therapist may get you involuntarily committed

- A therapist may be forced to disclose the contents of therapy sessions by court order

- Certain diagnoses may destroy your life / career (e.g. airline pilots aren't allowed to fly if they have certain mental illnesses)

Some individuals might choose to say "Thanks, but no thanks" to therapy after considering these risks.

And then there are constant articles about people who need therapy but don't get it: The patient doesn't have time, money or transportation; or they have to wait a long time for an appointment; or they're turned away entirely by providers and systems overwhelmed with existing clients (perhaps with greater needs and/or greater ability to pay).

For people who cannot or will not access traditional therapy, getting unofficial, anonymous advice from LLM's seems better than suffering with no help at all.

(Question for those in the know: Can you get therapy anonymously? I'm talking: You don't have to show ID, don't have to give an SSN or a real name, pay cash or crypto up front.)

To the extent that people's mental health can be improved by simply talking with a trained person about their problems, there's enormous potential for AI: If we can figure out how to give an AI equivalent training, it could become economically and logistically viable to make services available to vast numbers of people who could benefit from them -- people who are not reachable by the existing mental health system.

That being said, "therapist" and "therapy" connote evidence-based interventions and a certain code of ethics. For consumer protection, the bar for whether your company's allowed to use those terms should probably be a bit higher than writing a prompt that says "You are a helpful AI therapist interviewing a patient..." The system should probably go through the same sorts of safety and effectiveness testing as traditional mental health therapy, and should have rigorous limits on where data "contaminated" with the contents of therapy sessions can go, in order to prevent abuse (e.g. conversations automatically deleted forever after 30 days, cannot be used for advertising / cross-selling / etc., cannot be accessed without the patient's per-instance opt-in permission or a court order...)

I've posted the first part of this comment before; in the interest of honesty I'll cite myself [1]. Apologies to the mods if this mild self-plagiarism is against the rules.

[1] https://news.ycombinator.com/item?id=44484207#44505789

skeezyboy• 11 months ago

ai just summarizes text, its not like speaking to a person

tombert• 11 months ago

I saw a video recently that talked about a chatbot "therapist" that ended up telling the patient to murder a dozen people [1].

It was mind-blowing how easy it was to get LLMs to suggest pretty disturbing stuff.

[1] https://youtu.be/lfEJ4DbjZYg?si=bcKQHEImyDUNoqiu

larodi3• 11 months ago

very easy - you just download the ablated version in LM Studio or Ollama, and off you go.

https://en.wikipedia.org/wiki/Ablation_(artificial_intellige...

blacksqr• 11 months ago

Nice feather in your cap Pritzker, now can you go back to working on a public option for health insurance?

slt20212• 11 months ago

Curious how this can be enforced if business is incorporated in another state like WI/DE ? or offshore like Ireland ??

smt884• 11 months ago

The same way as the porn bans: require the AI-therapy service provider to verify the user's location and block them if they're in a certain state

slt20212• 11 months ago

what if they dont comply and simply ignore, as a business incorporated somewhere in Ireland or Wisconsin ?

what is a mechanism to block incompliant website?

jackdoe• 11 months ago

the way people read language model outputs keep surprising me, e.g. https://www.reddit.com/r/MyBoyfriendIsAI/

it is impossible for some people to not feel understood by it.

maxehmookau• 11 months ago

Good.

Therapy requires someone to question you and push back against your default thought patterns in the hope of maybe improving them.

"You're absolutely right!" in every response won't help that.

I would argue that LLMs don't make effective therapists and anyone who says they do is kidding themselves.

dardagreg• 11 months ago

I think the upside for everyday people outweighs the (current) risks. I've been using Harper (harper.new) to keep track of my (complex) medical info. Obviously one of the use cases of AI is pulling out data from pdfs/images/etc. This app does that really well so I don't have to link with any patient portals. I do use the AI chat sometimes but mostly to ask questions about test results and stuff like that. Its way easier than trying get in to see my doc

Illinois limits the use of AI in therapy and psychotherapy

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