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In the absence of stronger federal regulation, some states have begun regulating apps that offer AI therapy as more people turn to artificial intelligence for mental health advice. But the laws, all passed this year, don’t fully address the fast-changing landscape of AI software development. And app developers, policymakers and mental health advocates say the resulting patchwork of state laws isn’t enough to protect users or hold the creators of harmful technology accountable. The reality is millions of people are using these tools and theyre not going back, said Karin Andrea Stephan, CEO and co-founder of the mental health chatbot app Earkick. ___ EDITORS NOTE This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988. There is also an online chat at 988lifeline.org. ___ The state laws take different approaches. Illinois and Nevada have banned the use of AI to treat mental health. Utah placed certain limits on therapy chatbots, including requiring them to protect users health information and to clearly disclose that the chatbot isnt human. Pennsylvania, New Jersey, and California are also considering ways to regulate AI therapy. The impact on users varies. Some apps have blocked access in states with bans. Others say they’re making no changes as they wait for more legal clarity. And many of the laws don’t cover generic chatbots like ChatGPT, which are not explicitly marketed for therapy but are used by an untold number of people for it. Those bots have attracted lawsuits in horrific instances where users lost their grip on reality or took their own lives after interacting with them. Vaile Wright, who oversees health care innovation at the American Psychological Association, agreed that the apps could fill a need, noting a nationwide shortage of mental health providers, high costs for care, and uneven access for insured patients. Mental health chatbots that are rooted in science, created with expert input, and monitored by humans could change the landscape, Wright said. This could be something that helps people before they get to crisis, she said. Thats not whats on the commercial market currently. That’s why federal regulation and oversight are needed, she said. Earlier this month, the Federal Trade Commission announced it was opening inquiries into seven AI chatbot companies including the parent companies of Instagram and Facebook, Google, ChatGPT, Grok (the chatbot on X), Character.AI and Snapchat on how they “measure, test and monitor potentially negative impacts of this technology on children and teens. And the Food and Drug Administration is convening an advisory committee Nov. 6 to review generative AI-enabled mental health devices. Federal agencies could consider restrictions on how chatbots are marketed, limit addictive practices, require disclosures to users that they are not medical providers, require companies to track and report suicidal thoughts, and offer legal protections for people who report bad practices by companies, Wright said. Not all apps have blocked access From “companion apps to AI therapists to mental wellness apps, AIs use in mental health care is varied and hard to define, let alone write laws around. That has led to different regulatory approaches. Some states, for example, take aim at companion apps that are designed just for friendship, but don’t wade into mental health care. The laws in Illinois and Nevada ban products that claim to provide mental health treatment outright, threatening fines up to $10,000 in Illinois and $15,000 in Nevada. But even a single app can be tough to categorize. Earkick’s Stephan said there is still a lot that is very muddy about Illinois’ law, for example, and the company has not limited access there. Stephan and her team initially held off calling their chatbot, which looks like a cartoon panda, a therapist. But when users began using the word in reviews, they embraced the terminology so the app would show up in searches. Last week, they backed off using therapy and medical terms again. Earkicks website described its chatbot as Your empathetic AI counselor, equipped to support your mental health journey, but now its a chatbot for self care. Still, were not diagnosing, Stephan maintained. Users can set up a panic button to call a trusted loved one if they are in crisis and the chatbot will “nudge users to seek out a therapist if their mental health worsens. But it was never designed to be a suicide prevention app, Stephan said, and police would not be called if someone told the bot about thoughts of self-harm. Stephan said she’s happy that people are looking at AI with a critical eye, but worried about states’ ability to keep up with innovation. “The speed at which everything is evolving is massive, she said. Other apps blocked access immediately. When Illinois users download the AI therapy app Ash, a message urges them to email their legislators, arguing misguided legislation has banned apps like Ash “while leaving unregulated chatbots it intended to regulate free to cause harm. A spokesperson for Ash did not respond to multiple requests for an interview. Mario Treto Jr., secretary of the Illinois Department of Financial and Professional Regulation, said the goal was ultimately to make sure licensed therapists were the only ones doing therapy. Therapy is more than just word exchanges, Treto said. “It requires empathy, it requires clinical judgment, it requires ethical responsibility, none of which AI can truly replicate right now. One chatbot company is trying to fully replicate therapy In March, a Dartmouth University-based team published the first known randomized clinical trial of a generative AI chatbot for mental health treatment. The goal was to have the chatbot, called Therabot, treat people diagnosed with anxiety, depression or eating disorders. It was trained on vignettes and transcripts written by the team to illustrate an evidence-based response. The study found users rated Therabot similar to a therapist and had meaningfully lower symptoms after eight weeks compared with people who didn’t use it. Every interaction was monitored by a human who intervened if the chatbots response was harmful or not evidence-based. Nicholas Jacobson, a clinical psychologist whose lab is leading the research, said the results showed early promise but that larger studies are needed to demonstrate whether Therabot works for large numbers of people. The space is so dramatically new that I think the field needs to proceed with much greater caution that is happening right now, he said. Many AI apps are optimized for engagement and are built to support everything users say, rather than challenging peoples thoughts the way therapists do. Many walk the line of companionship and therapy, blurring intimacy boundaries therapists ethically would not. Therabots team sought to avoid those issues. The app is still in testing and not widely available. But Jacobson worries about what strict bans will mean for developers taking a careful approach. He noted Illinois had no clear pathway to provide evidence that an app is safe and effective. They want to protect folks, but the traditional system right now is really failing folks, he said. So, trying to stick with the status quo is really not the thing to do. Regulators and advocates of the laws say they are open to changes. But today’s chatbots are not a solution to the mental health provider shortage, said Kyle Hillman, who lobbied for the bills in Illinois and Nevada through his affiliation with the National Association of Social Workers. Not everybody who’s feeling sad needs a therapist, he said. But for people with real mental health issues or suicidal thoughts, “telling them, I know that theres a workforce shortage but here’s a bot’ that is such a privileged position. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content. Devi Shastri, Associated Press health writer
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Do you suffer from time anxiety? Before you answer, consider if any of the following scenarios sound familiar: You get a late start, and the whole day you’re running behind. You always feel rushed, to the point that you start to get panicky. You look at your task list at the end of the day, and you’ve only finished half of what you planned. You constantly feel that time is slipping away. In other words, you’re constantly battling the feeling that theres simply not enough time. But what if you could reframe the way you think about time? Well, you can. It involves learning a little ancient Greek, and getting to know that societys approach to time. As you do, youll have an emotionally intelligent tool that allows you to see time through a different lens. I like to call this tool the Kairos Rule. What is the Kairos Rule? And how can it help you manage your emotions, reduce anxiety, and make the most of your time? To answer those questions, lets take a lesson in ancient Greek. (Sign up here for my free email emotional intelligence course.) Chronos, Kairos, and the ancient Greek view of time In her book Tiny Experiments, neuroscientist Anne-Laure Le Cunff explains how the ancient Greeks had not one, but two words to speak of time: Chronos refers to quantity. This is the time of clocks and calendars, productivity tools, and linear goals. Then, there’s kairos. Kairos expresses the quality of time, as opposed to the quantity. It recognizes each moment as unique, rather than a fixed, mechanical unit. Le Cunff describes moments of kairos as those instances “suspended in time,” where you are caught up in a moment with loved ones, or when youre deeply engaged in self-reflection. “Kairos,” she says, “is when you feel like this moment, right now, is perfect.” (Interestingly, the Japanese have a similar expression: Ichi-go ichi-e, or “once in a lifetime.”) The Kairos Rule, then, basically says this: Not all moments are created equal, and the value of time depends on the situation. The Kairos Rule is helpful because of the world we live ina world that idolizes productivity, but the wrong kind of productivity. Toxic productivity Nobody really wants to live a productive life, writes Le Cunff in Tiny Experiments. We want to express ourselves, connect with others, and explore the world. Productivity is just a means to those ends; it should certainly not come at the expense of actually living life.” Le Cunff argues somewhere along the way society’s ideas of productivity went bad, to the point where we downplay the meaning of rest, reflection, and meaningful engagement. “Each project needs a clear outcome,” writes Anne-Laure. “Conversations become transactional. So-called unproductive moments of playful curiosity and quiet contemplation where our most profound insights can arise are eliminated.” Its this broken view that causes many today to measure productivity in the short term, versus looking at the big picturewhich is why we see so much stress-related sickness and burnout, and so many mental health issues. In contrast, the Rule of Kairos encourages you to make the most of those moments of playful curiosity and quiet contemplation. It empowers you to prioritize and maximize the minutes, hours, and days with friends and loved ones. So, how can you use the Rule of Kairos to reframe the way you think about time? I recommend using the following questions: How much time am I taking for the things that really matterlike spending time with loved ones? Or taking time to reflect, recover, and recharge? Do I really need to get everything on my task list done? If I do, will it come at the expense of more important things? What changes can I make to use my time more wisely, with the big picture in mind? Remember: Not everything you do will feel productive. And that’s OK. Instead of focusing on productivity, strive to see the unseen. See the kairos moments. If you do, you’ll start to realize something important: You’re not running behind at all. In fact, you’re right on time. By Justin Bariso This article originally appeared on Fast Company‘s sister publication, Inc. Inc. is the voice of the American entrepreneur. We inspire, inform, and document the most fascinating people in business: the risk-takers, the innovators, and the ultra-driven go-getters that represent the most dynamic force in the American economy.
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I vividly remember the first time that I buckled my 8-year-old son into a 4,000 pound, AI powered robot, pressed a button, and sent us careening through the streets of San Francisco with no one behind the steering wheel. We were riding a Waymo, one of the first self-driving cars to offer public rides in selected U.S. cities, our own city of San Francisco included. After a few minutes of riding, I asked my son what he thought. I feel . . . he said, taking a long pause before responding, . . . uncomfortable. But, its really cool! I suspect hes not alone in feeling that way. According to data from AAA, 61% of Americans consider themselves afraid to ride in a self-driving car, with only 13% saying that they fully trust the technology. Yet people are immensely fascinated by these AI-powered machinesand surprisingly inclined to use them. A study in the journal Science and Public Policy explored early public dialogue around self-driving vehicles, finding that The investment and excitement surrounding self-driving vehicles are huge. Thats borne out by real-world data. In cities like San Francisco that adopted self-driving tech, autonomous rides now account for over 25% of all rideshare trips, surpassing the market share of companies like Lyft. Waymo has nearly 1,000 self-driving cars cruising the citys streets on any given day. I ride self-driving Waymo vehicles 23 times per week, and heres what I can tell you: They’re surprisingly boring. And thats their superpower. Summon the robots When I tell friends and colleagues from other cities about my Waymo habit, they usually assume that summoning a self-driving car requires some kind of high-tech, sci-fi-like process. Perhaps theres a glowing pendant you hold up in the sky, or some kind of supercomputing device that the company secretly issues to its cabal of riders. Maybe there are incantations. In reality, the process of calling up a Waymo is almost exactly like booking an Uber or Lyft. Waymo has an app with a user interface that looks entirely cribbed from the apps of its human-driven competition. You specify your destination, enter a credit card, and watch as a little animated car slowly approaches you on a map. Except instead of meeting John in a Kia Optima with a 4.93 rating, your vehicle is an anonymous robot with a rapidly spinning laser scanner on top. When your Waymo arrives, it pulls to the side of the road, trying its best not to block traffic. As annoyed human drivers curse under their breath and assertively careen around you (just like with a real Uber!), you climb inside, buckle your seatbelt, and press a button on the dashboard. Its steering wheel spinning as if controlled by some benign, rideshare-giving poltergeist, your Waymo turns into traffic, and youre off. During my first Waymo trip, I felt much like my sonnervous, excited, in awe of the tech. By my second Waymo ride, it was already starting to feel old-hat. Today, after more than a year of riding the cars all over San Francisco, it feels entirely normal. The fact that Im being chauffeured around town by an AI-powered, laser-studded robot barely registers. What does register is the surprisingly delightful sensory experience of riding in one of these super high-tech carsand the immense, almost subversive pleasure of being totally alone. No person, please Sartre famously said Hell is other people. He was talking about the existential angst of the human condition. But he could just as easily have been describing a bad Uber ride. As a professional news and travel photographer, Ive taken a lot of Ubers. And while most drivers are great, Ive had some truly bad experiences. Ive had drivers who appear to be on substances, who ask me probing questions about my life (one demanded to know, point-blank, How much do you make per year? and was unwilling to accept a noncommittal answer without a dollar figure attached), and drivers who seem to believe my airport ride across the Bay Bridge is secretly a time trial on the Nuremberg ring. And Im luckymany experiences are far worse. Data from the Government Accountability Office shows that over 4,600 people were sexually assaulted in rideshare vehicles in 2019. At least 19 people were killed in rideshare-related assaults. Both drivers and riders are at risk. To be clear, the vast majority of traditional rideshare trips end well, and rideshare companies are doing more and more to keep people safe. Still, even if a trip isnt outright dangerous, there are times where you simply dont feel like sharing space with another personsmelling their cologne, breathing their air, and answering their questions about your life. Without a human driver, Waymos offer something that no rideshare vehicle can providesolitude. As you cruise through your city in one of the companys cars, youre present in the world around you. Yet simultaneously, youre totally alone. Relaxing spa music plays over the cars speakers. The leather-wrapped seats are clean and cool to the touch (Waymo uses Jaguar I-Pace vehicles, a luxury electric SUV that retails for over $75,000). A map shows your surroundings and ride time, complete with cheerful icons representing cyclists, pedestrians, and fellow drivers. Its pleasant, almost meditative. And people appear to love it. Again, when given the choice between Waymo and traditional rideshare vehicles, San Franciscans are increasingly choosing Waymoeven though a study by the rideshare data company Obi shows Waymo rides cost up to $11 more. Why? As Obis chief revnue officer told TechCrunch, they like being alone. Back to the future Self-driving car skeptics usually criticize the tech on safety grounds, or claim that its an overhyped, faddish technology that riders will try once and abandon. Most critics compare the tech to traditional rideshares. What theyre missing is the fact that riding in a self-driving car isnt like a traditional rideshare at all. Indeed, the whiz-bang sci-fi coolness of the tech quickly becomes boring. Its the unique solitude and independence of the experiencenot the fancy AI techthat makes it an entirely new way of traveling. As with public transit, youre moving through your city without needing to directly move yourself. Yet on public transit, youre always surrounded by other people. Here, youre not. In a private car, youre alone. But you can never direct your attention away from the road for long enough to truly notice and experience your surroundings. During a recent Waymo ride, I realized that the technology reminded me most of a far older piece of transportation techthe horse. If youve ever ridden on horseback, you know that you can never truly control your horseyou can merely suggest to it where youd like it to go, and trust that the horsean autonomous entity capable of acting on its ownwill decide to act on your suggestions. You also cant crash a horse. If you direct your attention away from the task of ridingor even drop the reins entirelyyour horse will keep right on following its path. It can sense the space around it, and wants to walk into a tree even less than you do. As a kid, I even remember riding on old rental horses that knew their trails and routines so well, theyd turn around and head back to the stable of their own accord when your 60 minutes of riding time was up. Riding a Waymo feels similar. Youre in charge to a degree, but ultimately youre ceding the task of moving your body to an independent, nonhuman intelligence. You give up control, yes. But you gain something elsethe ability to move through the world while fully experiencing it. Alone and freed from the task of directing your own movement, you can open the window and watch city life unfold around you in an almost cinematic wayor just close your eyes and truly tune out for a moment. The AI is the boring part If the AI powering your Waymo constantly made its presence known, it would distract from this experience. Instead, the fact that the AI tech quickly becomes mundaneunnoticable, evenfacilitates this entirely new way of moving. Last month, I took another first-time rider on a Waymo trip; my boomer-age mom. Seated behind the nonexistent driver, my mom told me she quickly forgot we were riding in an AI robot. We could chat and catch up without another person eavesdropping onor perhaps joining inour conversation. It was a pleasant ride. Waymos AI facilitated the experience, but nothing about it felt especially high-tech or futuristic. Ultimatelybeyond the economics, or the novelty, or the safetythats why self-driving cars will succeed. Theyre a uniquely pleasant way to get around. Their technology is boring, fading into the background. And thats what makes them great.
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