NPCE Event 2024: Digitalization and Artificial Intelligence in Psychotherapy

How do digitalization of healthcare and artificial intelligence tools affect psychotherapeutic care in Europe? This question has been discussed with experts at the annual event of the Network for Psychotherapeutic Care (NPCE) on 29 May 2024.

Dr. Nikolaus Melcop, Vice President of the German Federal Chamber of Psychotherapists (BPtK), opened the event and explained that recently adopted EU Health Data Space Regulation has created a set of rules that enables the exchange of digital health data across Europe. It also facilitates the use of data for research purposes. This is particularly important for the development of AI-based applications in healthcare. Digitalisation in healthcare is necessary. However, digital applications must be proven to be effective and safe. First and foremost, digitalisation in healthcare must benefit patients - and not only commercial interests, Dr. Melcop said. Moreover, digital applications can only improve mental healthcare if they are embedded in local psychotherapeutic care. Regarding the use of artificial intelligence in psychotherapy, it needs to be scrutinized in how far and to which extent such tools can be used, and which ethical aspects need to be considered.

AI in psychotherapy? Not today, but in the future.

Prof. Dr. Harald Baumeister, University of Ulm, respond to this question. The psychological psychotherapist undertakes various research on digital applications in mental healthcare, especially in psychotherapeutic care. He pointed out that the development of AI-based applications has been taking place since the 1950s. However, when we talk about AI-based applications in psychotherapeutic care today, these are usually not actual AI applications, but merely algorithms. AI has therefore not yet played a role in psychotherapeutic care. In the future, AI-based chatbots and digital health applications could supplement psychotherapeutic care. But so far, there is no or not sufficient evidence of their effectiveness and safety. Prospectively, in the field of diagnostics AI tools could also assist psychotherapists. Baumeister underlined that ethical aspects must be considered while developing AI tools and their implementation. It must be assured that AI applications are transparent, that they do not reproduce discrimination and do not lead to misinterpretations. However, legal standards on data protection and privacy also influence how AI applications are developed. In view of the large investments being made by the USA and Asian countries, AI applications will primarily be developed out of commercial interests. Still, AI offers the opportunity to gain new insights into mental illnesses and can facilitate the development of individualized treatments, i.e. even more precise psychotherapeutic treatment. In the discussion of the participants of the event, the question arose which risks need to be taken into account when using AI in psychotherapy. The participants agreed that it is important for the profession to be continuously involved in AI development from the outset, in testing AI applications, and to be able to assess which AI applications are potentially indicated and safe for patients.

Digitalisation can support psychotherapeutic treatment

In her presentation, Maria Karekla, University of Cyprus, pointed out that study results always describe an average patient. This means that individual aspects that could be important for treatment get lost. However, the individual perspective must also be stronger considered in treatment. Patients perceive differentiated symptoms in everyday life but are not always able to address them in the psychotherapy session. As a result, psychotherapists cannot include these important insights in the treatment of a patient. A solution is digitally supported monitoring and documentation. By using a digital application patients can note down at any time how they feel and which symptoms arise. This can be analysed and thus, incorporated into treatment by psychotherapists. There are already many digital applications that can be used for this purpose. One example is smoking cessation. Digital applications could help to classify the patient's experiences and problems when quitting smoking and keep up the patient’s motivation. In Karekla’s view, virtual realities could also be a means of simulating certain challenging situations in psychotherapy in the future. It could be used to directly instruct patients on how to overcome or deal with specific situations. The range of digital applications, from apps to virtual reality, is wide and could offer opportunities for mental healthcare. However, if these tools are beneficial for patient treatment will depend on their further development.

Identification of safe and beneficial digital applications by guidelines

The participants then exchanged views on current developments in European countries. The use of digital applications and the development of new products are progressing continuously. The market is primarily determined by the industry, which develops and launches products very quickly. At this pace, it seems impossible for public research and development to keep up. It is therefore essential for psychotherapists to have knowledge and guidelines that enable them to identify evidence-based digital applications that are safe and useful for patients. Then, they can decide whether digital tools can be used in psychotherapeutic care.