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The Typing Cure: Experiences with Large Language Model Chatbots for Mental Health Support

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arxiv 2401.14362 v3 pith:GD2JENOJ submitted 2024-01-25 cs.HC cs.AIcs.CY

classification cs.HCcs.AIcs.CY
keywords chatbotssupporthealthmentalcareeffectiveexperienceslanguage
verification ladder T0 review T1 audit T2 compute T3 formal

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People experiencing severe distress increasingly use Large Language Model (LLM) chatbots as mental health support tools. Discussions on social media have described how engagements were lifesaving for some, but evidence suggests that general-purpose LLM chatbots also have notable risks that could endanger the welfare of users if not designed responsibly. In this study, we investigate the lived experiences of people who have used LLM chatbots for mental health support. We build on interviews with 21 individuals from globally diverse backgrounds to analyze how users create unique support roles for their chatbots, fill in gaps in everyday care, and navigate associated cultural limitations when seeking support from chatbots. We ground our analysis in psychotherapy literature around effective support, and introduce the concept of therapeutic alignment, or aligning AI with therapeutic values for mental health contexts. Our study offers recommendations for how designers can approach the ethical and effective use of LLM chatbots and other AI mental health support tools in mental health care.

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Forward citations

Cited by 15 Pith papers

Reviewed papers in the Pith corpus that reference this work. Sorted by Pith novelty score. OpenAlex reports about 16 citations worldwide. Full citation record

  1. The Impact of Security and Privacy Controls on Users' Emotional Engagement with Generative AI Chatbots

    cs.HC 2026-07 accept novelty 7.0 of 10

    In a vignette study of 354 U.S. participants, deletion-based privacy controls outperformed all other controls in increasing willingness to engage with GenAI chatbots for emotional support, while technically complex co...

  2. Depression Symptoms and Relational Patterns in 187k ChatGPT Histories

    cs.HC 2026-07 conditional novelty 6.5 of 10

    Higher-PHQ users bring more mental-health, relational, late-night, and high-disclosure concerns to ChatGPT without higher professional redirection, and language prediction is too weak for screening (AUROC 0.591).

  3. "Is This Really a Human Peer Supporter?": Misalignments Between Peer Supporters and Experts in LLM-Supported Interactions

    cs.HC 2025-06 unverdicted novelty 6.0 of 10

    Mixed-methods studies of an LLM-supported peer support system uncover systematic misalignments where mental health experts flag critical safety and fidelity issues in peer responses that the supporters themselves do n...

  4. Customizing Emotional Support: How Do Individuals Construct and Interact With LLM-Powered Chatbots

    cs.HC 2025-04 conditional novelty 6.0 of 10

    Adults with social loneliness customize LLM chatbots with personas, voices, and avatars to serve varied emotional needs, from comfort and self-reflection to confronting stressful figures, based on a one-week field stu...

  5. Evaluating an LLM-Powered Chatbot for Cognitive Restructuring: Insights from Mental Health Professionals

    cs.HC 2025-01 conditional novelty 6.0 of 10

    A GPT-4 chatbot followed cognitive restructuring steps for 19 users, but mental health experts flagged toxic positivity, advice-giving, and context misunderstandings.

  6. Simulation-Free Hierarchical Latent Policy Planning for Proactive Dialogues

    cs.CL 2024-12 conditional novelty 6.0 of 10

    LDPP automatically discovers latent dialogue policies from raw records and uses offline hierarchical reinforcement learning to plan in that latent space, outperforming strong baselines on proactive dialogue benchmarks.

  7. Private Yet Social: How LLM Chatbots Support and Challenge Eating Disorder Recovery

    cs.HC 2024-12 conditional novelty 6.0 of 10

    A 10-day field study found that an LLM chatbot supported eating disorder recovery through private storytelling, yet also produced unnoticed harmful responses such as praising weight loss and restriction.

  8. From Lived Experience to Insight: Unpacking the Psychological Risks of Using AI Conversational Agents

    cs.HC 2024-12 conditional novelty 6.0 of 10

    The authors derive a psychological risk taxonomy for AI conversational agents from survey responses and workshops, mapping 19 AI behaviors, 21 negative psychological impacts, and 15 user contexts.

  9. Towards Experience-Centered AI: A Framework for Integrating Lived Experience in Design and Development

    cs.CY 2025-08 conditional novelty 5.0 of 10

    A conceptual framework, LEAF, organizes four dimensions of lived experience into a five-stage AI development pipeline for more human-centered systems.

  10. "I Said Things I Needed to Hear Myself": Peer Support as an Emotional, Organisational, and Sociotechnical Practice in Singapore

    cs.HC 2025-06 unverdicted novelty 5.0 of 10

    Volunteer peer supporters in Singapore experience emotional labour, organisational gaps, and ambivalence toward AI, yielding design implications for human-centred support technologies.

  11. AI Chatbots for Mental Health: Values and Harms from Lived Experiences of Depression

    cs.HC 2025-04 conditional novelty 5.0 of 10

    People with lived depression experience who tried a GPT-4o chatbot prioritized five values: informational support, emotional support, personalization, privacy, and crisis management.

  12. Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers

    cs.CL 2025-04 conditional novelty 5.0 of 10

    Current large language models show stigma and give clinically inappropriate responses to common mental health symptoms, so they should not be deployed as replacement therapists.

  13. Longitudinal Study on Social and Emotional Use of AI Conversational Agent

    cs.HC 2025-04 conditional novelty 5.0 of 10

    Active emotional and social use of commercial AI chatbots for five weeks increased users' perceived attachment, perceived AI empathy, and comfort seeking personal support, without a measured rise in overall AI dependency.

  14. Interpersonal Theory of Suicide as a Lens to Examine Suicidal Ideation in Online Spaces

    cs.HC 2025-04 conditional novelty 5.0 of 10

    Using the Interpersonal Theory of Suicide as a lens, the authors classify 59,607 Reddit suicide-related posts into risk categories and find AI support responses are more coherent but less empathetic than human ones.

  15. A Mathematical Theory of Discursive Networks

    cs.CL 2025-07 reject novelty 3.0 of 10

    A two-state Markov model of error propagation suggests that small amounts of cross-agent peer review can flip a network of fallible language models from a falsehood-dominant to a truth-dominant state.

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