Computer-mediated training and psychotherapy — that is, a computer program (whether an app, a website, or a piece of software) helping you learn something new, especially with regards to your thoughts, behaviors, and habits — has been with us a long time. One of the pioneers in this space has been Australia’s MoodGYM, first launched in 2001. It now has over 1 million users around the world and has been the subject of more than two dozen randomized clinical research trials showing that this inexpensive (or free!) intervention can work wonders on depression, for those who can stick with it. And online therapy has been available since 1996.
I like technology backed by science, because scientific data should drive developing new tools to help us change our thoughts, behaviors, and habits. It shouldn’t just come from some random developer’s pop psychology understanding of human behavior. Research data demonstrating a new intervention’s efficacy is the best answer to countering the placebo effect, which we know is very strong for novel techniques and treatments.
That’s why I also like what TAO Connect is doing, because it’s based upon research and work pioneered at the University of Florida.
TAO Connect — the TAO stands for “therapist assisted online” — is something a little different than MoodGYM. Instead of simply walking a user through a serious of psychoeducational modules (which vary in their interactivity and information presentation), it uses multiple modalities and machine learning (a form of artificial intelligence) to try and help more effectively teach the techniques that can keep anxiety at bay for the rest of your life. TAO Connect can be used for anxiety, depression, stress, and pain management, and can help a person with relationship problems and learning greater resiliency in dealing with stress.
TAO Connect is the result of years of work in devising machine learning intelligence, and then using natural language processing and sentiment analysis to make it work well with humans. The project was developed by University of Florida researcher Dr. Parisa Rashidi and her team, in collaboration with Dr. Matin Heesacker, UF psychology professor, and Dr. Sherry Benton.
TAO Connect is backed by a quality research study (Benton et al., 2016) that compared 72 university students who used the TAO intervention to 1,129 students who did treatment as usual (one-on-one psychotherapy at university counseling centers). Throughout the seven weeks of the study, subjects in the TAO Connect group experienced a greater reduction in their anxiety symptoms than students in the treatment-as-usual group. (Both groups could take anti-anxiety medications, but had to be on them for at least two months before the study began.)
Interestingly, both treatment groups participated in a similar number of sessions — five — before ending treatment. One of the challenges of technology-enhanced psychotherapy (whether done online or through a computer-mediated format) is drop-out rates, which tend to be higher than those in face-to-face encounters. So it was positive to see that people who undertook TAO didn’t drop out more quickly than those in regular psychotherapy.
More research needs to be conducted on the program to confirm these results. But this initial study shows the technology is very promising.
TAO is Being Used in Many Different Ways
We asked Dr. Sherry Benton, Ph.D., ABPP, head of TAO Connect, how the program is being used today. Her answer shows a surprising diversity in its use:
Some clients use it as strictly self-help, others receive minimal support and encouragement from a case manager, [and] others receive 16-20 minute sessions. It is also being used as an adjunct to face-to-face therapy, and to provide continuity of care for people transitioning from hospitals to after-care (the last option will be starting in a few months). Some centers are using it as homework for group therapy.
TAO Connect is based on the Stepped Care model of treatment delivery, offering more intensive and a greater variety of treatment options depending upon the severity of mental illness a person presents with. It is a model used elsewhere in the world, but has traditionally not been used as often in the U.S. (except in resource-constrained clinics, such as university counseling centers).
And TAO takes care of a lot of the management of that homework stuff therapists typically assign clients:
Think of TAO as the equivalent of the flipped classroom. Traditionally part of each therapy hour has been spent teaching clients mindfulness meditation, or how to modify cognitive distortions, or making an activation plan. TAO moves a lot of the routine patient education and practice functions to the platform, so the sessions can focus on things such as reducing barriers, individualizing, providing a supportive relationship, and so forth. Most effective therapists assign some kind of homework between sessions. TAO organizes that homework, makes it more entertaining, and provides accountability. Therapists have a dashboard that allows the therapist to see what a client did during the week, and when they did it. The weekly progress measure allows therapists to review the effectiveness of treatment.
The Mind Elevator & the Future of TAO Connect
The Mind Elevator is a component of TAO Connect. After you type out a thought or feeling, the Mind Elevator offers you feedback to help you practice more positive ways of thinking. According to the developers, “As users continue to submit content, the program responds to the sequence of sentences through its machine learning technology, tracking the thoughts on a positive vs. negative scale and providing constant positive reinforcement. In turn, this helps users start developing new neural pathways to override previously involuntary negative thought processes.” Sounds like a pretty innovative way to learn a new habit or thought, to replace old, unhealthy ones.
Today, TAO Connect is only available through a therapist whose practice subscribes to the service. However, the founder assures me that they are working on building a self-help version that a person could sign up to use with the therapist of their choice, which TAO Connect hopes to launch within a couple of months. Clinicians can also sign up to use TAO Connect right now for only $50 (75% off of the usual sign-up fee).
Learn more about TAO Connect here.
Benton S., Heesacker M., Snowden S., & Lee G. (2016). Therapist-Assisted, Online (TAO) Intervention for Anxiety in College Students: TAO Outperformed Treatment as Usual. Professional Psychology: Research and Practice. http://dx.doi.org/10.1037/pro0000097