Designing a Chatbot as a Mediator for Promoting Deep Self-Disclosure to a Real Mental Health Professional

Abstract

Chatbots are becoming increasingly popular. One promising application for chatbots is to elicit people's self-disclosure of their personal experiences, thoughts, and feelings. As receiving one's deep self-disclosure is critical for mental health professionals to understand people's mental status, chatbots show great potential in the mental health domain. However, there is a lack of research addressing if and how people self-disclose sensitive topics to a real mental health professional (MHP) through a chatbot. In this work, we designed, implemented and evaluated a chatbot that offered three chatting styles; we also conducted a study with 47 participants who were randomly assigned into three groups where each group experienced the chatbot's self-disclosure at varying levels respectively. After using the chatbot for a few weeks, participants were introduced to a MHP and were asked if they would like to share their self-disclosed content with the MHP. If they chose to share, the participants had the option of changing (adding, deleting, and editing) the content they self-disclosed to the chatbot. Comparing participants' self-disclosure data the week before and the week after sharing with the MHP, our results showed that, within each group, the depth of participants' self-disclosure to the chatbot remained after sharing with the MHP; participants exhibited deeper self-disclosure to the MHP through a more self-disclosing chatbot; further, through conversation log analysis, we found that some participants made different edits on their self-disclosed content before sharing it with the MHP. Participants' interview and survey feedback suggested an interaction between participants' trust in the chatbot and their trust in the MHP, which further explained participants' self-disclosure behavior.

Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges

“…They are more inclined to accept the use of digital tools for the assessment, treatment or support of mental health issues ( 27 ). Further young people use the digital space (e.g., the Internet) as a trusted source of information ( 19 , 22 , 37 ) or see it as an easier way to start to talk about mental health, their problems or to seek help ( 27 , 32 , 34 , 38 ). In addition, our analysis suggests that the acceptability of using digital mental health technologies may also be positively influenced by their potential for enabling more anonymous interactions compared to face-to-face meetings with health professionals ( 24 , 25 , 38 ).…”

“…Further the type of data that can be collected through mental health apps, chatbots, or social media may well lead to an increased understanding of mental illnesses, as more data is available for analysis ( 19 , 20 , 23 , 24 , 37 , 38 ). The increased amount of data and positive attitude of people toward the usage, could ultimately help to eradicate or at least decrease the stigma that is attached to mental illness ( 24 , 26 ).…”

“…Further young people use the digital space (e.g., the Internet) as a trusted source of information (19,22,37) or see it as an easier way to start to talk about mental health, their problems or to seek help (27,32,34,38). In addition, our analysis suggests that the acceptability of using digital mental health technologies may also be positively influenced by their potential for enabling more anonymous interactions compared to face-to-face meetings with health professionals (24,25,38). The flexibility and anonymity of the digital space allows young adults to avoid social stigma or exclusion and increases their feeling of comfort to share personal data as you can quickly access the therapy tool through your smartphone (22,(24)(25)(26)(27)38).…”

Effects of Support-Seekers’ Community Knowledge on Their Expressed Satisfaction with the Received Comments in Mental Health Communities

“…If they are satisfied with it, the bot can further invite seekers to show their contentment in response by explaining the potential benefits (e.g., build a connection [39]) of doing so. If they are not, the bot could act as a friend to comfort the seekers and encourage them to disclosure their feeling to the bot [35][36][37]. However, designers should be aware that such technological interventions could potentially bring additional labor to the support-seekers [26] and frustrate support-seekers who are sensitive of being judged in OMHCs [25,77], and members should have the option to enable / disable such interventions.…”

Mediating Mental Illness: Digital Lifeworlds, Platforms and Algorithms

“…This is in fact to its advantage. Studies (Lucas et al 2017;Lee et al 2020) have shown that humans are more likely to disclose personal information and reveal deeper emotions that they may otherwise be ashamed of to a non-human entity, especially when there is a belief that the conversation would remain anonymous. Notwithstanding Woebot's privacy policy, this positioning of the chatbot increases the likelihood of continued usage and the willingness to engage.…”