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Psychotherapy after the fourth industrial revolution

mental health.
Psychotherapy after the fourth industrial revolution

According to WHO, mental, neurological and narcological disorders account for 10% of the total burden of disease. In the search for strategies to work with depression, bipolar disorder, psychosis and other disorders, scientists and practitioners turn to artificial intelligence, big data, robotics and other technologies of the fourth industrial revolution. Can a chat bot replace a psychotherapist, a neural network can play the role of a psychiatrist, and VR glasses can become a safe training ground for injuries?



AI diagnostician

There are several approaches to the use of artificial intelligence in diagnostics - for example, when a recording device records a conversation between a psychotherapist and a patient, and special software isolates clinically important information from the conversation. A group of scientists from Southern California showed that digital assistants can analyze not only patient responses, but also gestures, body language, and voice changes. The psychotherapist later uses this information as an additional diagnostic tool. In addition, artificial intelligence gives the therapist feedback on his work: he evaluates the effectiveness of the treatment and helps the specialist adjust the approach to the patient.

Bipolar disorder manifests itself as an alternation of manic or hypomanic and depressive phases in the patient's condition. During hypomania, a person feels an unprecedented increase in strength and motor excitement, and during depression - a depressed state and lethargy.

In psychiatry, the main field of application of artificial intelligence is diagnostics based on neuroimaging, reconstruction of the structure, functions and biochemical characteristics of the brain. The neural network is able to detect structural and functional abnormalities of the brain associated with certain mental disorders.

Deep learning neural networks show significant results in classifying psychiatric disorders. For example, diagnosing dementia and attention deficit hyperactivity disorder neural networks cope in 90% of cases.

Such neural networks can also work with personal data from a smartphone. GPS routes, the number of messages and calls, activity indicators provide them with the data necessary to identify symptoms of mental disorders. In one study, scientists were able to identify with more than 90% success what phase the bipolar patients were in, depending on the speed and duration of how they typed on their phones.

In the future, neural networks will not only be able to diagnose diseases, but also predict their formation. As part of a series of studies, scientists study the pathways of disease development - for example, calculate the likelihood with which mild cognitive impairment can develop into Alzheimer's syndrome. These data are critical in order to learn how to diagnose a disease at an early stage and prevent its progression.

Supervision is an element of psychotherapy. During the supervision, the therapist discusses clinical material with a more experienced specialist. They analyze the course of treatment, highlight the strengths and weaknesses of the psychotherapist, correct mistakes.


Bot therapist

Traditionally, psychotherapy was built solely on the interaction of the attending physician and patient. Now between them often there is an intermediary - a digital assistant, a chat bot. The person who seeks help talks with a digital assistant who conducts not only diagnostics, but also therapy, and the doctor controls their interaction, acting as a supervisor. One of the successful examples of the use of digital assistants was presented by a group of scientists from Stanford University. As part of their study, boys and girls from 18 to 24 years old with symptoms of depressive disorder underwent therapy using an automated conversational interface. By comparing the results of automated therapy with the results of the control group that received standard treatment, scientists found that the conversational digital assistant was more effective in dealing with the symptoms of depression.

Among the projects for creating psychotherapeutic digital assistants, there are already successful examples, say the Help4Mood system, created at the initiative of the European Commission to the EU. This system consists of a computer program and sensors and is intended for people with depressive disorders. In addition to monitoring the level of activity, sleep quality and other health indicators, it has a chat bot that helps the user analyze their feelings and emotions, develop skills to overcome anxiety and make decisions.

Digital assistants will not replace a therapist. It is assumed that a combination of human efforts with the capabilities of computing technology will solve some problems. One of them is the lack of specialists and their burnout. Psychotherapists are faced with a flood of clients, each of whom has a request for deep and lengthy therapeutic conversations. If part of the responsibilities can be delegated to digital assistants, doctors will have time to recover. But most importantly, if chat bots can be improved and they can become an independent means of therapy, psychological assistance will be more accessible. Residents of remote territories or people who avoid seeking help due to stigmatization of mental disorders will be able to apply for it.

The term "robotherapy" arose in 2004 - it was proposed by scientists from the United States Elena and Alexander Libins.


Robot simulator

Robotherapy involves the interaction between a person and a robot, in which the robot acts as a tool for working out strategies for psychological adaptation. Like chatbots, robots can be delegated interaction with patients and therapy under the supervision of a specialist. But they show particular effectiveness in specific cases in which it is difficult to apply classical psychotherapeutic techniques.

This problem is often faced by doctors working with patients with autism spectrum disorders (ASD). Patients with ASD have difficulty entering into interpersonal communications and control their own emotions. They have difficulties with socialization: it is difficult for them to recognize and realize both their own feelings and the feelings of other people. Because of this, they often resort to maladaptive strategies of behavior: fall into anger or slide into longing. In advanced cases, this leads to depression and anxiety disorders.

To facilitate the social life of patients and provide them with stable psychological comfort, specialists develop their social skills and teach them adequate strategies for psychological response to negative events. The use of robots increases the effectiveness of such therapy. Interaction with the robot is more predictable and can take on a game form. The robot acts as a mediator between the psychotherapist and the patient, a catalyst for their communication, which provides the patient with a comfortable environment for practicing social skills.

 

Psychotherapy after the fourth industrial revolution


Ksenia Rykova for PostScience //

 

Do not confuse virtual reality with augmented reality: augmented reality introduces individual artificial objects into the real world, while virtual creates an artificial world.


Virtual reality

Virtual reality is used to treat phobias, anxiety and post-traumatic disorders. The main way to deal with such violations is exposure. The memory associated with fear is seen as a structure in which the stimulus of fear, the meanings that the patient gives it, and the anxious reaction are intertwined. The goal of exposure therapy is to start the process of rethinking this structure.

This can be achieved by simulating a situation for a patient that causes him fear or anxiety. The patient will be able to relive it again and discover traits in it that do not fit into his oppressive memory. Traditionally, in exposure therapy, the doctor asked the patient to imagine a disturbing memory, which was not immediately - and not always - successful. Virtual reality allows you to simulate an alarm situation in its entirety of its audiovisual and sensory characteristics and place the patient inside it.

In this case, the technological solution is also only one of the therapist’s tools: the doctor uses virtual reality only for some aspects of exposure therapy, relying on traditional practices in the rest. Therapy begins with several introductory conversations in which the doctor discusses with the patient the specifics of his experiences and prepares him for immersion in them. Immersion in an alarming situation occurs gradually. For example, in case of fear of flights - aerophobia - the patient will first be shown how he enters the plane. As the therapy advances, it will move toward more disturbing situations, such as flying in a turbulent zone. The pace of progression from one stage to another is always individualized; if necessary, the same situation is modeled several times.

The results of studies based on this method show its effectiveness. In one of them, a group of scientists from Spain compared how satisfied patients with phobias were with traditional therapy and virtual reality therapy. If the proportion of refusals from traditional therapy was 27% patients, then only 3% of patients refused therapy using virtual reality. Another study proves the effectiveness of VR therapy for the treatment of post-traumatic disorders: patients who have completed six sessions of virtual reality have shown lasting improvements comparable to the effect of taking antidepressants.

27 май 2020 /
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