How to rank psychotherapists and select them for specific problems of a person
- Your lecture was about
- In practice, yes. I work not only as a person who transforms thoughts into code, but also as a person who communicates with other people, colleagues, as a leader who communicates with subordinates, and this is a lot of work “person - person”. And there is the Alter project, where we are engaged in such a specific task - the selection of psychologists and psychotherapists for everyone. There are even more things connected with psychology, with experiences, with some subjectively important things.
- How did you come up with Alter, how did it start?
- I saw that psychotherapy among people conditionallymy social circle is very much undervalued. This is a very useful tool for many things - and for solving some difficult life situations, and just for self-development. A lot of people who value self-development do not use psychotherapy for this. I somehow wanted to tell a lot of people about it, but I realized that the first question I was asked would be: “Well, I want to use psychotherapy, and where should I get a specialist?”. And in order to find a specialist, there are difficulties. Because, in principle, there are a lot of people who call themselves psychologists. And not all of them can be trusted, not all of them know how to work safely for the client, not all of them have learned enough time to do it. Therefore, the idea arose of doing some kind of service that would be recommended by professional psychologists.
Well, when I started thinking about how such a servicedo, then began to meet people who have had similar ideas and similar projects. And one of the projects that I met started shortly before that - it was Alter. Then they have not launched anything yet, that is, we literally, at the stage of the idea, met and united with them. Now we are co-founders. I was not thinking at all in this direction, and we now have many interesting competitors who are trying to solve the same problem. This suggests that the idea is correct - you need to do it.
- As far as Alter is a technological project, do algorithms mean a lot there?
- From the point of view of algorithms in Alter, everything is veryjust - there is no big technical challenge there. But in order for this to happen, some unique information has been collected. We worked with specialists who are studying psychotherapy; we have assembled a base of psychotherapists. That is, these are not algorithmic ideas, but simply a lot of work in order to really find good specialists for people.
- Are there any recommendations algorithms in Alter - does the system of psychotherapists rank, for example, based on user ratings?
- Generally Alter's main goal is to separateprofessionals we are sure of. Real professionals. And we are putting a lot of effort into ensuring that every psychologist and psychotherapist we register passes a multi-stage verification system. This is our main difference from all the others. We also do automatic selection. But you ask about the reviews, about customer ratings - in fact, in this area it is not good to do so. That is, we cannot base ourselves on customer evaluations, because there are ethical problems with this.
- They can not be trusted in this regard?
- That's not the point. If the therapist is interested in leaving a good review about him, it may consciously or subconsciously influence his work. Therefore, we try not to create conditions when such an opportunity arises.
- How do you rate them then?
- First, we check some basicprofessional level, that is necessarily education, and special on psychotherapy, and not just psychological. We have just with the consultants of the PI RAO compiled a set of tasks for the basic settings of therapists, an understanding of how the mind works, and so on. We are looking for a person to use supervision. Supervision is when one psychologist comes to another and confidentially talks about his cases in order to get feedback. This is a very important and absolutely obligatory thing for a practitioner. And then our main task - from those professionals whom we already trust, to select someone who works narrowly with client requests. Therefore, we show a fairly complex questionnaire to the client - we try to determine what is important for him, and we choose those professionals who work with it.
Not only to find a psychotherapist, but also to prepare a person for therapy
- How many psychotherapists do you have now and how many users?
- Our database is now registered, if I don’tI am mistaken, 150 specialists - psychologists and psychotherapists. Some more are in the process of registration, because this is a long story. 200 clients came to the first session in February. And this number is growing every month.
- The initial stage and the first session are understandable, but how does the user further interact with the service and why does he need it? Or a search-only service?
- Right now we do only search, but we wantfrom this to go. We want not only to select a specialist, but also continue to lead the client. Right now you come, fill out a questionnaire, choose a specialist in the catalog, write off with him, and that's it - go to him further. We want to make it so that we help you sign up for the right time, so that it doesn’t be an exchange of letters - it is long and inconvenient. Then we want to help the client to track the course of psychotherapy. He does not always understand whether there is progress. Here a man went to psychotherapy for three months, how advanced? In order to track this progress, you need to write down in some form what was at the beginning and check what is now. To do this, there are all sorts of questionnaires, and you can offer customers to fill them in at the start and do so several times in the process so that the person can see his progress.
We also try - we do it a little bit -prepare the client for psychotherapy. Inform about how it works, what methods there are, on what parameters to pay attention, choosing a specialist. Quite a lot depends not only on professionalism, but also on the coincidence of personal characteristics. How to avoid some bad effects in psychotherapy, how to recognize that the psychologist is not working well with you - we try to tell such things. I recently gave a lecture on this topic, the first trial, then we will try to make an online course out of it.
- What does a person need to know before psychotherapy, if he has never practiced it before?
- I would say this: you only need to know what you need to find a professional. We are trying to solve this problem so that you don’t have to think: how to understand that this person on the Internet is a good psychologist. Nothing more is needed.
Since people know little about psychotherapy,a person can procrastinate — already decide what will go, and postpone it for a month, two, six months, a year. I once postponed psychotherapy for three years. Quite a large part of this postponement is associated with the unknown - what will be there, I do not understand. What should I say in the first session? It is not necessary to know something for the first session to go well, a psychologist will help you there, everything is in order. But if a person does not know this, he will survive and postpone. We are trying to help with this.
What happens to psychotherapy in Russia
- Psychotherapy has become much more popular lately. Do you think everyone needs it?
- Psychotherapy is useful for almost everyone. Almost every person can find what he wants to improve in his life and do it with the help of psychotherapy. At the same time, it is “necessary” in the sense that the need is acute — it is very subjective. And it depends on everything — on a person’s perception of himself, on culture. 100 years ago it was considered the norm to have any such difficulties, even physical ones - not to mention the psychological ones, which are now considered nonsense, it is treated. In this sense, the level of comfort that a person considers acceptable to himself is a very subjective thing. Very often it happens: even if my sense of self is quite comfortable and in principle everything is not bad, I would like to improve something. Something in my behavior, somewhere it seems to me that I often make decisions unconsciously. I do it, and why - I do not understand. Even in a situation that does not require correction and does not affect my life globally, I feel that I lack awareness, I lack freedom of choice. Even in such a situation it is useful. Especially, if I have some complicated experiences - confusion, depression, or in some situations I do not control my experiences, I throw out some aggressive flow on others, and I don’t like what happens. It's not that you never need to express aggression, but sometimes it happens in such a way that it bothers me. Of course, in such cases, you can quickly and efficiently get some results with
- You mentioned that it depends on the culture. If we talk about Russian culture and the attitude of people to psychotherapy now, in what condition are they?
- There is no objective line, but, according to minesensations, in our country, psychotherapy is not in the order of things. At some point, this becomes a common place, and there is such a feeling: now, if I constantly feel depressed, then I need to go to a psychotherapist. This has already become the norm some time ago in some parts of the United States and some European countries.
- These are mostly quite rich regions.
- Yes, these are fairly well-off countries, butthe ratio of income and cost of psychotherapy in large cities of Russia is comparable. Indeed, some California is a very rich place, but there and psychotherapy is insanely expensive. There is a different licensing.
As far as I can see, we now understandthat some things are definitely on psychotherapy, it has not yet come, but we are gradually moving towards this. For example, if I have a panic attack, then I definitely need psychotherapy. I heard that some companies already include some form of psychotherapy. I think that this will gradually progress with the growth of the standard, the quality of life, which gradually occurs, and with the growth of knowledge about what exists.
“Psychotherapy and medicine are two different things.”
- Where does Alter work now?
- In general, for the whole of Russia, we have customers fromdifferent cities and even outside Russia. There were customers from Berlin. But most psychologists from Moscow and St. Petersburg are more from Moscow. There are several psychologists from other points. But for most people from other regions of Russia, this will just be a help on Skype.
- Now, for example, telemedicine is rapidly developing - if we talk about psychotherapy online, via video link - is it as effective or less useful?
- It's tricky here, yes. Just in case, I always notice that psychotherapy and medicine are two different things. As for efficiency, I tried to find out, it seems there are no studies that show that psychotherapy via video link is better or worse. But there is a consideration that it is harder for a psychologist. This is more workload, because the psychologist receives less information. When a person sits in front of you, you can see much more than through the camera. And in this case it is more difficult to work in the same way, just to capture as much information from the client via video link. Therefore, some psychologists with whom I communicate, say that they are more tired when working online.
In this sense, a balance is needed. Video psychotherapy is much better than none. Perhaps, since this is a large load, it is more difficult for a psychologist to issue the same level. It may be somewhat less reliable and effective than personal therapy. I myself periodically take the session via video. I usually go to the therapist's office, and if I left or the therapist left, I take video sessions - and I see that this works perfectly normal.
- Do you treat the project as a business or is it not about money?
- When I started it, I thought it was not at allabout the business, that's really, really. And over time, it became clear that a good project is always a business. Not in the sense that it is necessary to extract money from it, but in the fact that it is a metric - as far as it is needed. Now we have not yet arrived at a profit.
- How is monetization now built?
- The psychologist pays us a commission to drive a client. Over time, we want to slightly change the monetization model, because it seems that this is not a fair situation. On the other hand, we can bring much more benefit if we are more integrated into the process between the client and the psychologist. So last year I think about this more as a business - with a completely accurate humanitarian mission, with goals and limitations, ethical and many others. Nevertheless, the fact that the project can earn is a very good way to understand how it really benefits clients, psychologists, how much we can tell people that this is useful. In a non-commercial project, you can calm down that we receive 200 clients per month. Well, we are great, we help 2,400 people a year. But a business project does not survive this way; it simply cannot support itself in this way. And it pushes us not to dwell on modest numbers and to seriously engage in getting, conveying information to people who really need psychotherapy. So that they know about us - they went, signed up, got qualified help and thus improved their lives.
- Do you want to look for investments now or you do not need third-party money?
- We are not looking for them now, while we are coping with ourby forces. In general, it seems to me that if sometime we are talking about foreign investments in a project, it will be in some distant future if we go to other markets. While in the Russian-speaking space, we can handle without external investment.
- Are there any similar Western projects now, from which you take an example?
- I do not see such samples, I only knowOne successful service that is associated with psychotherapy, it is called BetterHelp. And this is such a tricky model, they sell a subscription. That is, you come, register, they offer you a specialist, you just pay a subscription fee for spending some time with him. This subscription is much cheaper than face-to-face psychotherapy in America or the UK. To be honest, I don’t know anything about how their business is going, they have a completely different model. They mostly have remote assistance - not what we do, but this is an interesting model. The only more or less lively startup I know that started a long time ago and has not closed yet.
There are very interesting projects in the early stages,associated with the automation of therapeutic care. People come up with some bots, it's all very curious. I do not really believe that we will completely replace psychotherapists with bots in the foreseeable future, but we will be able to provide some of the help quickly with the help of artificial intelligence. We are not doing this at Alter right now, but there is a feeling that this will happen within a few years. Of course, not a complete psychotherapy. But about some specific requests - there is already scientific evidence that bots work efficiently.
- What tasks in this area can artificial intelligence cope with?
- There are protocols on which some workspecialists, in particular, psychotherapists. A protocol is, roughly speaking, such an algorithm by which work is built. Naturally, there is no universal protocol for everything. But when it is clear that the client has a specific request, there is a sequence of steps for working with this request. Some sequences are so detailed that they can be automated. As far as I know, so far there are results for a very small number of such protocols. This, as I understand it, is mainly developing in the field of cognitive-behavioral therapy. There they have just a lot of protocols.
I can give an example from the head. There is a diary of emotions - it is such a tool in cognitive therapy. You write down some vivid experiences that you had in four columns: what happened, what you thought, what emotions you had, how you behaved. And there are enough clear steps to analyze this diary of emotions. What you need to understand how to relate thoughts and emotions, how to evaluate the brightness of emotions. In principle, a bot can quite help with this, even without an AI. Just a bot programmed for specific steps. And if you teach him a little more naturally to talk - with speech synthesis everything is already quite good, then it will also be a fairly lively dialogue in which the person will be involved more sincerely. Not with the feeling that he is filling out a questionnaire, but with the feeling that he is talking to someone. But I do not believe in full-scale automated therapy. It seems to me that if we get to this, the singularity already absorbs us by that moment.