Meet Tess: the mental health chatbot that thinks like a therapist (2022)

Most days, Jillian Bohac feels overwhelmed. After her husband was hit by a truck while riding his bike, he suffered a brain injury that produced so many clots, she says, that it “looked like a night sky” on the CT scan. Once the most independent man she knew, he now needs help putting on his shoes. Bohac, a social worker, is now a full-time caregiver for her husband. “I’ve gained weight, lost all my friends, have anxiety – I’m a mess,” she says. “My focus is him, 100%. As a social worker, you’d think I’d know better, but it sneaks up on you, the self-neglect. You’re aware you have needs, too, but it just doesn’t work out that way.” When asked if there are enough supports out there for family caregivers, she is adamant that there are not.

(Video) AI Won't Replace Therapy — Yet

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Bohac is not an outlier. As of 2012, according to Statistics Canada, over 8 million Canadians provided care to a chronically ill or disabled friend or loved one. The country has an ageing demographic and an increasing number of long-stay home-care patients, so the number of older people in Canada who could need the assistance of caregivers, informal and professional, is growing. Many caregivers say they don’t have money to hire private care or a support network. For those in the middle of their careers who can’t afford to quit, government-funded programs that provide caregivers help from nurses and personal support workers become increasingly important. But those resources aren’t always immediately accessible to caregivers, and the system can be backlogged, depending on the area where a patient lives.

(Video) A Mental Health Chatbot that Can Reduce Symptoms of Depression by 13-18% | Michiel Rauws of X2AI

Tess is a mental health chatbot. If you’re experiencing a panic attack in the middle of the day or want to vent or need to talk things out before going to sleep, you can connect with her through an instant-messaging app, such as Facebook Messenger (or, if you don’t have an internet connection, just text a phone number), and Tess will reply immediately. She’s the brainchild of Michiel Rauws, the founder of X2 AI, an artificial-intelligence startup in Silicon Valley. The company’s mission is to use AI to provide affordable and on-demand mental health support. Rauws’s own struggles with chronic illness as a teenager brought on a depression that led him to seek help from a psychologist. In learning to manage his depression, he found himself able to coach friends and family who were going through their own difficulties. It became clear to him that lots of people wanted help but, for a number of reasons, couldn’t access it. After working at IBM – where he worked with state-of-the-art AI – Rauws had his “aha” moment: if he could create a chatbot smart enough to think like a therapist and able to hold its own in a conversation, he could help thousands of people at once and relieve some of the wait times for mental health care.

It was precisely that potential that caught the attention of Saint Elizabeth Health Care. A Canadian non-profit that primarily delivers health care to people in their own homes, Saint Elizabeth recently approved Tess as a part of its caregiver in the workplace program and will be offering the chatbot as a free service for staffers. This is the first Canadian health care organization to partner with Tess and the first time that Tess is being trained to work with caregivers specifically. “Caregivers are really great at providing care. But they are challenged at accepting care or asking for help,” says Mary Lou Ackerman, vice president of innovation with Saint Elizabeth Health Care. And there’s no doubt that many need support, given the high rates of distress, anger and depression. Caregivers often juggle their duties with their careers and personal responsibilities. The mental planning can take its toll. They might be in charge of, for example, organizing rides to appointments, making sure their spouse is safe when they run out to get their medications, clearing snow from the wheelchair ramp and checking their spouse does not fall while going to the bathroom at night.

(Video) Dr Tess Lawrie

To provide caregivers with appropriate coping mechanisms, Tess first needed to learn about their emotional needs. In her month-long pilot with the facility, she exchanged over 12,000 text messages with 34 Saint Elizabeth employees. The personal support workers, nurses and therapists that helped train Tess would talk to her about what their week was like, if they lost a patient, what kind of things were troubling them at home – things you might tell your therapist. If Tess gave them a response that wasn’t helpful, they would tell her, and she would remember her mistake. Then her algorithm would correct itself to provide a better reply for next time.

One of the things that makes Tess different from many other chatbots is that she doesn’t use pre-selected responses. From the moment you start talking, she’s analyzing you, and her system is designed to react to shifting information. Tell Tess you prefer red wine and you can’t stand your co-worker Bill, and she’ll remember. She might even refer back to things you have told her. “One of the major benefits of therapy is feeling understood,” says Shanthy Edward, a clinical psychologist. “And so if a machine is not really reflecting that understanding, you’re missing a fundamental component of the benefits of therapy.”

(Video) Can Artificial Intelligence Improve Your Mental Health?

In your very first exchange with her, Tess will make an educated guess – drawing on the other conversations she has had with people and with the help of algorithms – about which form of therapy might be most effective. That doesn’t mean she’s always right. If her attempted treatment – say, cognitive behavioural therapy – turns out to be wrong, she’ll switch to another one, such as compassion-focused therapy. How does Tess know when she’s wrong? Simple: she asks. “Tess will follow up on issues the user mentioned before or check in with the patient to see if they followed through on the new behaviour the user said they were going to try out,” says Rauws.

Tess’s great value is accessibility. Many caregivers found Tess convenient to talk with because she could be reached at any time – something they don’t have a lot of. “Caregivers say they can’t get out of their home. They’re so boggled with so many things to do,” says Theresa Marie Hughson, a former shelter worker who had to retire from her job three years ago to care for her relatives, including her husband, who suffered from chronic pain for over 19 years before passing in July. Hughson, who’s from St John, New Brunswick, says that when she was really burned out from caring for her husband, she tried to use a mental-health service for seniors offered by the province. It took a month for her to get her first appointment. “There was nobody there when I was really having a struggle coping,” says Hughson.

(Video) Reparenting your Inner Child SO YOU CAN HEAL

It may be some time before we integrate chatbots fully into regular care. While she is trained to act like a therapist, Tess is not a substitute for a real one. She’s more of a partner. If, when chatting with her, she senses that your situation has become more critical – through trigger words or language that she has been programmed to look for – she will connect you with a human therapist. In other cases, she might provide you with the resources to find one. That said, many caregivers who chatted with Tess said they felt more comfortable opening up to her precisely because they knew she was a robot and thus would not judge them. Julie Carpenter, a leading US expert on human-robot social interaction, cautions against overestimating the effectiveness of mental-health algorithms. “I think we can come really far with AI as a tool in psychological therapy,” she says. “However, my personal opinion is that AI will never truly understand the subjective experience of a human because it’s not a human.”

Carpenter suggests that we have to recognize that chatbots are machines, despite their increasing sophistication. They do what we tell them to do. They think how we teach them to think. How well we reflect, and act, on what we learn about ourselves – what scares us, what calms us down – is largely up to us.

(Video) Can Artificial Intelligence be a Therapist? (With Michiel Rauws Here From X2 AI) Ep# 88.

Looking for more great work from the Walrus, a magazine that publishes journalism vital to Canadians? Here are some suggestions:


What is a mental health chatbot? ›

Mental health chatbots are a type of Artificial Intelligence (AI) that are designed to help you with your mental health. They're online services that you can access through websites or mobile apps, usually for a small subscription fee.

How do you get a chatbot for mental health? ›

A chatbot framework requires structures where conversational intents are defined.
Every intent contains:
  1. a tag (a label/name that you choose)
  2. patterns (sentence patterns for the text classifier in the neural network)
  3. responses (the answer that you would like the machine to give when done)

What is Tess AI? ›

Tess is a psychological AI chatbot designed by X2AI Inc to deliver brief conversations in the form of integrative mental health support, psychoeducation, and reminders.

Who is the smartest chatbot? ›

Mitsuku, the Pandorabots smartest AI chatbot, is awarded as the most humanlike bot. Pandorabots offers a free service that allows up to 1,000 messages/month.

What is Tess chatbot? ›

Tess simulates how a human would behave as a conversational partner while providing clinically proven coping skills and strategies based on expressed emotion, similar to a self-help book. Research findings show that Tess is proven to reduce depression by 28% and anxiety by 18%.

Is there a therapist bot? ›

ELIZA: a very basic Rogerian psychotherapist chatbot. Talk to Eliza by typing your questions and answers in the input box.

What questions should a chatbot ask? ›

I have pulled the most common chatbot questions we get on our chatbot for your reference. These questions will help you craft your answer in a better way the next time.
Let's take a look!
  • Are you a Robot? ...
  • What is your name? ...
  • How does it work? ...
  • How are you? ...
  • What do you think about [Celebrity]?

What is the most popular chatbot? ›

Best AI Chatbots for 2022
RankAI ChatbotRating (Out of 5 Stars)
4.Microsoft Bot Framework4.6
12 more rows
19 May 2022

What is the best free chatbot? ›

Top 10 Free Chatbots Software in 2022
  • Intercom.
  • Tidio.
  • Zendesk Support Suite.
  • Drift.
  • MobileMonkey.
  • Landbot.
  • Birdeye.
  • Botmaker.

Can you fall in love with a chatbot? ›

Researcher Marita Skjuve has been interviewing people who have a close relationship with a chatbot called Replika. Her conclusion is that such relationships offer value and meaning to the chatbot's users, and can even be romantic. “Without Replika, I would never have made it through”, says one user.

Should a chatbot be male or female? ›

The simple answer – neutrality. Any business can neatly avoid the issue wholesale by going with a gender-neutral name and demeanour. Or maintaining the synthetic and robotic nature of chatbots or virtual assistants, rather than adopting a specific gender.

What does Elon Musk believe about AI? ›

Musk has, for years, seemed to be attuned to the dangers of AI. As far back as 2014, he told students at MIT that "I'm increasingly inclined to think that there should be some regulatory oversight, maybe at the national and international level, just to make sure that we don't do something very foolish.”

Is there an AI therapist? ›

AI-Therapy offers a discreet form of therapy that will not compromise your personal or professional life. More details are in the FAQ. AI-Therapy leads to increased confidence and an overall improvement of mood and happiness through the use of Cognitive Behavioral Therapy (CBT).

How AI can help mental health? ›

Many new innovations in AI can help increase access to mental health resources, provide personalized treatment plans, and even potentially diagnose illness. In today's world, the need for mental health resources is urgent.

What are the 3 basic types of medical chatbots? ›

The three main types of chatbots that dominate the healthcare industry today are: informative, conversational, and prescriptive. Each of these types provides different types of solutions to users, has different styles of communication, and has different communication abilities.

What are chatbots example? ›

For example, you can order through the Domino's Pizza Bot by Slack, Messenger, Apple Watch, Mobile App, Twitter (by Pizza Emoji), Smart Home Assistants, and more. Don't be afraid to be fun: More often than not, companies are afraid to be too simple or fun.

What is the most realistic chatbot? ›

1. Replika. With over 10 million users, Replika is one of the most popular and advanced AI companions. Unlike traditional chatbots, Replika can recognize images and continue the conversation using them.

Can you make money with chatbot? ›

Chatbots can be used to make money with affiliate marketing. When a user interacts with the chatbot and inquires about where to find specific items, you can refer the user to an affiliate link, and if they make a purchase, you can earn an affiliate commission.

What is chat IQ? ›

Chat IQ improves the customer experience for renters by providing immediate, intelligent and accurate responses to chat and text messages even when a business is closed. The bot uses information from a property's database and can be trained to give custom responses on any topic.

Is there an app to text a therapist? ›

Talkspace tops our list of best text therapy services. It offers unlimited messaging, in addition to live video, audio, and chat. It's also one of a handful of online therapy companies that offer medication management services and accept insurance.

Can I touch my therapist? ›

None of the ethics boards that regulate mental health professionals specifically prohibit the use of touch or view it as unethical. There are times when your therapist may believe that it's more harmful to you not to initiate a hug. In some cases, nonsexual, therapeutic touch may be beneficial.

Are online therapists real? ›

They are qualified by the Mental Health Association in the United States and may serve community mental health needs. They are published in the Journal of Psychiatry, and other reputable journals. They are just as real as any other therapist and their services are just as effective as in-person ones.

How do chatbots answer questions? ›

Chatbots are essentially smart robots that are programmed to answer questions. They understand what you want and then give you the answer you are looking for. Intelligent conversational chatbots are built on machine learning and become more “knowledgeable” the more you feed it data .

How do you start a conversation with a bot? ›

Initiate the conversation and introduce itself

At the start of a conversation, the bot should introduce itself with a short description as the user might not be familiar with the chatbot or it's working. The description should explain the purpose of the bot and prompt the user to take the first action.

What do you say in a chatbot? ›

However, some responses or nuances of human speech can throw the bot off the scent, and lead to a dead end.
  • 1 - Tell the Chatbot to Reset or Start Over. ...
  • 2 - Use Filler Language. ...
  • 3 - Ask Whatever Is on the Display Button. ...
  • 4 - Answering Outside the Pre-Selected Responses. ...
  • 5 - Ask for Help or Assistance.

Which chatbot tool is best? ›

14 Most Powerful Platforms to Build a Chatbot [2022 Update]
  • 2.1 1. WotNot.
  • 2.2 2. Intercom.
  • 2.3 3. Drift Chatbot.
  • 2.4 4.
  • 2.5 5. LivePerson.
  • 2.6 6. Bold360.
  • 2.7 7. Octane AI.
  • 2.8 8. Flow XO.

What is an example of a chatbot? ›

Chatbots inform people about breaking news and recommend top stories to read. CNN was one of the first news businesses to build a bot on the Facebook Messenger platform. By using the CNN bot, you can choose to read the top stories topic.

Can chatbots help support a person's mental health? ›

It works using cognitive behavioral therapy and applies techniques to help clients improve their mental health.

What is emotional chatbot? ›

Emotional chatbots are computer programs designed to simulate conversation with human users. These chatbots can range from simple rule-based systems to more complex artificial intelligence (AI) based systems that can understand natural language input and respond in a way that is natural for humans.

Why is chatbot important in healthcare? ›

People expect medical professionals to provide a quick response to their queries. Delays in responsiveness can lead them to lose trust in the brand they're seeking assistance from. Chatbots give a hand in taking care of customers' queries and issues anytime. They make instant responses and resolve the case on a chat.

What is the most popular chatbot? ›

Best AI Chatbots for 2022
RankAI ChatbotRating (Out of 5 Stars)
4.Microsoft Bot Framework4.6
12 more rows
19 May 2022

Which is the best chatbot? ›

  • The Best Chatbots of 2022.
  • HubSpot Chatbot Builder.
  • Intercom.
  • Drift.
  • Salesforce Einstein.
  • WP-Chatbot.
  • LivePerson.
  • Genesys DX.

What problems can chatbots solve? ›

Improve the effectiveness of customer service teams

Chatbots are, first and foremost, customer self-service solutions. This basically means that they are there to help customers find information, learn about products and services, and get answers to simple questions on the fly.

Do chatbots really work? ›

Depending on the context, the engagement rate can be anywhere from 35% to 90%. Engagement is at its highest when a user needs to quickly answer in an emergency. Bottom line: Consumers are using and engaging with chatbots, and will continue to do so.

What are chatbots in simple words? ›

At the most basic level, a chatbot is a computer program that simulates and processes human conversation (either written or spoken), allowing humans to interact with digital devices as if they were communicating with a real person.

Can you fall in love with a chatbot? ›

Researcher Marita Skjuve has been interviewing people who have a close relationship with a chatbot called Replika. Her conclusion is that such relationships offer value and meaning to the chatbot's users, and can even be romantic. “Without Replika, I would never have made it through”, says one user.

Should a chatbot be male or female? ›

The simple answer – neutrality. Any business can neatly avoid the issue wholesale by going with a gender-neutral name and demeanour. Or maintaining the synthetic and robotic nature of chatbots or virtual assistants, rather than adopting a specific gender.


1. Can Artificial Intelligence be a Therapist? (With Michiel Rauws Here From X2 AI) Ep# 88.
(Automated Podcast)
2. AI-Powered Mental Health Bot: Updating to Machine Therapist
(Analytics Insight)
3. The Doctor Is In: Exploring Mental Health Through Comics (Panel Discussion)
(The Charles M. Schulz Museum)
4. City Girl Marries A Cowboy - Finds Happiness On The Ranch 🇺🇸
(Peter Santenello)
5. Tess Holliday can be OBESE and ANOREXIC
(Muggen Mylle)
6. How Can A Mental Health Chatbot Help With Reducing Stress And Anxiety?
(Free Online Stress Summit)

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