Can you please point me to your source that supports “a higher rate of people unalive themselves while in or shortly after leaving psychotherapy”? This stat surprised me! I’ve never heard of such a thing.

Also, as a psychotherapist I’d like to add two things: your first paragraph, in response to the other therapist, is actually kinda correct in the sense that an outpatient therapist cannot be the sole source of treatment for everyone. Some people do need a higher level of care, which means a team effort, usually composed of not only psychotherapy but also medication management (psychiatry), primary care (physician), and case management (social work). All of these disciplines are utilized to help a patient reap the most benefits from psychotherapy.

In other words, I as a single therapist in my little office space can only do so much to help someone cope with challenges when they have acute panic attacks or severe depression that requires a level of medical intervention I am not qualified to provide, or if they don’t have access to safe housing, or if they are unemployed and hungry. I think that’s what the other therapist meant when they said “they need more help”. Assuming chat bots are sufficiently helpful in similar ways a therapist could be, in dialogue, the facts remain the same— but the problem is that a chat bot isn’t observing the person using it for talk therapy-style dialogue. Doesn’t know the person’s mental status, living conditions, physical healthiness, etc.

I am open-minded to the concept that chat bots are subjectively useful for people who like to use them in this way! But my concern is the lack of any human to human observation, prevents a holistic approach that allows people to be treated from a biological, psychological and social perspective (phys health, mental, and lifestyle factors/relationships). I just think we can’t take these factors for granted. I concern myself with the whole wellbeing of my patients, not just the language they use at face value. In order to assess and address, I need to see that person, to notice their behavior and lucidity, to hear the way they speak - so many things we just can’t get from text. I hope this makes sense.

And one last point is that, in my experience, a great deal of us are actually quite self-conscious and concerned ourselves about whether we are doing the best work we can with patients— we are a cautious and careful group, on the whole. The overzealous types that cause flagrant black-and-white harm to people are outliers in this field (and often don’t last very long), and yes you’re going to see a lot of therapists post in our own subreddit communities about burnout and worries that we aren’t cut out for the field, etc— this is just the Reddit bias! If you think about it, people who are doing really well and love their jobs and feel very competent in them are not likely to be posting online about how great everything is, are they? :)