Simulated patients can improve psychotherapists’ skills, and fast

Mental health professionals training to provide talk therapy can sharpen their clinical listening skills by practicing in chatbot sessions with neural conversational agents.

In fact, the study behind the finding shows that even entirely inexperienced trainees can improve some such skills in as little as 20 minutes using the agents, which are computer programs set up to naturalistically interact with people using everyday language.

The study was conducted at the University of Utah and published July 15 in the Journal of Medical Internet Research.

In introducing their work, Michael Tanana, PhD, and colleagues point out that training talk therapists with conventional methods, such as roleplaying exercises and standardized-patient sessions, is both time-consuming and expensive.

“Performance-based feedback is critical for skill development and expertise, but trainee therapists often receive minimal and subjective feedback, which is distal to their skill practice,” they wrote.

Seeking a technological alternative, the researchers trained a text-based conversational agent on an archive of 2,354 psychotherapy transcripts.

They recruited 151 volunteers from a variety of work backgrounds outside of mental healthcare to serve as experimental trainee therapists, educating all on basic talk-therapy principles and techniques.

The team then randomized the participants into two cohorts. One group received immediate feedback from the chatbot on their performance, while the other group only received education and encouragement from the researchers.

Tanana and colleagues found the chatbot group had higher rates of reflections, which are targeted “active listening” prompts to help patients express themselves, even after the feedback and prompts were removed.

The control group effectively used active-listening “open questions” even without feedback, but this usage steadily dropped off over time.

Additionally, after feedback was removed from the process, the chatbot group used 31% more listening skills overall.

“These initial results indicate that an untrained population can improve specific types of listening skills very quickly,” the authors comment in their discussion. “[A]t least for the population that participated in this study … this methodology can improve performance of specific listening skills. This type of system presents a promising avenue to improve the scale on which feedback, adherence and training can be delivered in the field of psychotherapy.”

The study is available in full for free.