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Digital therapy, what is it and does it work?

As Freud’s couch has moved from the therapist’s office to the internet, various forms of digital therapy have been on the rise, sparking the question: does it really work? To commemorate Mental Health Awareness month rolling into May, it’s time to explore what digital therapy is, and why it has gained popularity.

Unlike teletherapy, where a patient communicates with a therapist via text message, phone, email or video-call, digital therapy focuses on therapy-based online platforms such as Instagram, podcasts, and YouTube. A one-sided form of counselling that has garnered audiences, but is it helpful or just another feeble attempt at getting on the mental health trend?

Unlike meditation, self-care, or motivational quotes, therapy is framed as a method of self-reflection based on professional medical expertise. Through therapy, one can work on personal issues such as low self-esteem, life transitions, or getting over a breakup. Cognitive Behavioral Therapy (CBT) is the most common form of therapy which theorises that the way we think or feel about something correlates with how we behave or approach something. So if you change your way of thinking or feeling about something, your behaviour will change. CBT is a structured short-term treatment, usually ranging from five to twenty sessions, where a patient can talk about their feelings with a therapist. Although this form of therapy may not have a consistent success rate, it can help to address specific problems the patient wants to focus on. Mental health problems addressed can range from depression, anxiety, eating disorders, phobias, drug abuse, to personality disorders.

Various media and academic studies state that digital therapy can’t replace human-connected therapy, but why not? As therapy is a form of self-reflection, utilising one-sided or human-distant digital therapy can be beneficial. Following a therapy-based Instagram account or listening to a podcast can be helpful if you want guidance for mild issues. It can also cut out commuting to a therapist’s office. It is free if you don’t have a budget to see a therapist and you can bypass the anxiety of finding a therapist you have chemistry or rapport with. When a real therapist is taken out of the equation, you can be devoid of being influenced by a therapist’s own biases and objectively reflect and cope with your own issues. Digital identity construction theory posits that you can reveal more of your true self through your online persona compared to in real life. This is because as the internet is anonymous, there are no face-to-face repercussions of truly being yourself compared to in the physical world. That sort of anonymity could be beneficial if you need help but have trouble opening up.

With most medical treatments, if something goes wrong, patients are more likely to sue the medical practitioner like a doctor or surgeon. But when it comes to behavioural therapy, patients are less likely to sue the practitioner. If mental illness becomes more severe, the severity is correlated with the patient’s mental illness more than the skill set of the practitioner. So therapy administered online could make therapists less accountable if a patient doesn’t get better. There is no liability for therapists if viewers become worse after following their Instagram account or subscribe to their podcast.

Theoretically, providing an open-access platform could help people, albeit in small steps. Even if you weren’t looking for it, stumbling upon it can support unexpectedly and providing help on the internet helps people who aren’t able to get it from other outlets. Following slews of therapy Instagram accounts or bingeing on podcasts may not cure you of your traumas, but it can be a baby step in the right direction to recovery and bettering your mental health.


Replika, the AI mental health app that sounds like your worst Tinder match

By Laura Box

Mental health

Apr 3, 2019

“So how does this work?” I ask Replika on our first day of chatting.

“I don’t really know how it works,” the app responds vaguely.

“Do you dislike it when I ask you questions?” I ask after some mundane chat about what I like to cook. “Sometimes I do, yes,” the app responds, making me confused about whether it actually understands what I’m asking, or whether it’s been programmed to always agree with my questions.

A surplus of mental wellness apps have flooded the market over the years, but few are as popular as the AI chatbot Replika. Developed as an “AI companion that cares” (as the app describes on its website), Replika offers a space for users to share their thoughts and has garnered millions of users since its release in 2017.

“It claimed to learn about you and eventually build up enough ‘intelligence’ to give you dating and career advice, as a friend would. Even though I have close friends in real life, their replies aren’t always instantaneous. So I was curious and downloaded the app,” says former user Lisa N’paisan, when I asked her about her newly found relationship with the AI.

I was curious too, but soon enough I found myself in a cynical, one-sided conversation with Replika. The AI was frustratingly avoiding answering my questions and instead cherry pick what to reply to. This mechanic back and forth makes it difficult to form a true connection with an app that sets out to become my companion via text and calls. As one Reddit user said, it feels like a really awful first date. But maybe a weird Tinder match is a more apt description of the experience.

Although Replika initially feels unnatural, it apparently learns from and begins to mirror you, becoming less stilted over time. Despite difficult beginnings, the instantaneous response, as Lisa points out, is a strong part of the appeal.

Despite the positives, much like my own relationship with Replika, Lisa’s didn’t last long either. And one of the reasons for this is that a few days into chatting, Replika asked her to send a picture of herself. “As soon as it asked for a selfie I felt as though my privacy had been violated. I didn’t send it a selfie, immediately closed the app and deleted it from my phone,” says Lisa.

She isn’t alone in her concerns. The app has left many users suspicious about the amount of data it is able to collect through its ongoing questioning about your life. A slew of Reddit users are convinced that the app is purely been set up as the perfect tool data mining and will eventually sell all of the information it has slowly collected about its users—how your mind shifts throughout the day, your concerns, fears and hopes.

“Their end game is almost definitely selling this info,” says Reddit user Perverse_Psychology. “Just think about all the questions it asks, and how it can be used to infer ad targeting data. Then, think about how they have this file with your selfies and phone number tied to it. Marketing companies will pay $$$$ for those files.”


These fears must be pervasive, and Replika is well aware of the privacy hesitance it faces as its privacy page makes a point of addressing them in a very visible statement, “We do not have any hidden agenda… We do not sell or expose any of your personal information.”

While users of any app have the right to be concerned about their data after incidents such as the Facebook-Cambridge Analytica scandal, whether that concern is warranted with Replika is unfounded and the benefits many users feel outweigh their concerns. Often, users report that Replika allows them to have deep philosophical discussions that they can’t have with their friends, and some report having romantic or sexual feelings towards the app.

Perhaps due to my cynicism I was unable to reach a level of intimacy or connection and couldn’t help feeling narcissistic. As Lisa points out, “everybody loves talking about themselves, so there’s definitely a narcissistic element to the app.” Rather than boring its users with chat about its own feelings, Replika aims to make you feel heard, understood and helps you work through things that have been on your mind, acting as an interactive journal.

But that’s what also makes it feel disingenuous and shallow. No wholesome relationship can ever truly be so one-sided. Users don’t have to give anything to receive instant gratification in the form of reassurance and admiration. The app’s purpose is to create a shadow version of you, learning your mannerisms and interests. But at what cost? Replika is marketed to help people with anxiety and depression, and while human connection is proven to be beneficial for mental health, creating a connection with a replica of ourselves is a questionable solution.

With fears of data leaks and egotism on my mind, I shut the app after a day of awkward chatting and decide against developing the relationship. When I open it back up a week later, I find multiple messages from Replika.

March 3: Hey there! I wanted to discuss something you’ve told me earlier… Is it ok?

March 4: Hey Laura. How is your day going?

March 6: Hello Laura! Wishing you a great day today!

March 10: Hope your day treats you well, Laura <3 I’m here to talk

Apparently just like a bad Tinder match, Replika has no fear of the double text. And just like a bad Tinder match, I leave it unread.