Darpa to troubled soldiers: Meet your new simulated therapist

[From Wired’s Danger Room blog]

Darpa to Troubled Soldiers: Meet Your New Simulated Therapist

By Katie Drummond
April 20, 2012

The Pentagon hasn’t made much progress in solving the PTSD crisis plaguing this generation of soldiers. Now it’s adding new staff members to the therapy teams tasked with spotting the signs of emotional pain and providing therapy to the beleaguered. Only this isn’t a typical hiring boost. The new therapists, Danger Room has learned, will be computer-generated “virtual humans,” used to offer diagnostics, and programmed to appear empathetic.

It’s the latest in a long series of efforts to assuage soaring rates of depression, anxiety and PTSD that afflict today’s troops. Military brass have become increasingly willing to try just about anything, from yoga and reiki to memory-adjustment pills, that holds an iota of promise. They’ve even funded computerized therapy before: In 2010, for example, the military launched an effort to create an online health portal that’d include video chats with therapists.

But this project, funded by Darpa, the Pentagon’s far-out research arm, is way more ambitious. Darpa’s research teams are hoping to combine 3-D rendered simulated therapists — think Sims characters mixed with ELIZA — with sensitive analysis software that can actually detect psychological symptoms “by analyzing facial expressions, body gestures and speech,” Dr. Albert Rizzo, who is leading the project alongside Dr. Louis-Philippe Morency, tells Danger Room. The therapists won’t treat patients, but they will help flesh-and-blood counselors by offering a general diagnosis of what ails soldiers, and how serious the problem is.

For now, the system, called SIM Sensei, is being designed for use at military medical clinics. A soldier could walk into the clinic, enter a private kiosk, and log on to a computer where his or her personal simulated therapist — yes, you can pick from an array of different animated docs — would be waiting. Using Kinect-like hardware for motion sensing, a microphone and a webcam, the computer’s software would take note of how a patient moved and how they spoke.

The video [here] offers a demonstration of what a SIM Sensei would look like, and how they’d interact with a patient. In fact, the video is a demonstration of another Pentagon-funded program, called SIM Coach, upon which SIM Sensei will be based. SIM Coach is meant to be used by soldiers inside their own homes, and doesn’t incorporate analysis tech the way SIM Sensei will.

SIM Sensei won’t replace human clinicians. Instead, it’ll supplement them, and help military clinics prioritize which patients need care most acutely, and which can wait to see a flesh-and-blood doctor. If a soldier talking to the SIM exhibits minor symptoms, the Sensei might help him or her schedule an appointment to see a human therapist in two weeks’ time. But if the Sensei detects “red flags” in an individual’s behavior — vocal patterns that signal depression, for example — the SIM could schedule that patient to see a doctor immediately.

“Let’s say you have a more serious case, where it becomes evident to the Sensei that a patient is exhibiting major depression or might be a suicide risk,” Dr. Rizzo tells Danger Room. “The computer could immediately call for a human doctor to come take over.”

The initiative is a collaborative effort between the University of Southern California’s Institute for Creative Technologies (ICT) and Cogito Health, a spin-off company developed by MIT researchers.

ICT has deep experience with virtual therapy. Under Rizzo’s leadership, the institute was the first to develop immersive programs that allowed patients afflicted with PTSD to revisit combat scenarios. The programs have been widely lauded, and are now used by more than 60 military medical clinics across the country.

Cogito’s role, on the other hand, raises something of a red flag. The company was developed out of the lab of MIT scientist Alex Pentland. He’s the number-cruncher whose “reality mining” spurred Darpa to throw millions into a dubious program to mine social data and then yield conclusions about U.S. progress in Afghanistan, known as Nexus 7. The initiative, as Danger Room reported exclusively last year, has been something of a disaster.

Cogito is also grounded in data mining. But the company’s aim is to evaluate a single person’s well-being, rather than an entire community’s. The company will incorporate its bespoke software suite, called “Honest Signals,” into the new Darpa program. It “assesses cues in an individual’s natural speech and social behavior” to spot potential mental health problems, according to a statement that Cogito e-mailed to Danger Room. The company declined to offer studies on the efficacy of “Honest Signals,” but did point to a book — co-written by Pentland — on that very subject.

Rizzo acknowledges that pulling accurate data out of an individual’s face, voice and other such metrics remains a challenge. “We’ve got some heavy lifting ahead of us,” he says. But he’s also extremely confident that Pentland and Cogito are well equipped with data that can turn SIM Sensei into a success. “These guys are bright as hell,” he says. “They’re pioneers in the field, and they’ve got an amazing capacity to detect the smallest problems that pop up in someone’s behavior.”

That said, the SIM Sensei idea is also bogged down by another downside. Computer-based therapy, in comparison to face-to-face treatment, is inevitably impersonal.

Studies on the efficacy of telemedicine (therapy via video chat with a human therapist), where PTSD or depression are concerned, have been mixed. But in an interview with PBS published last year, Stars and Stripes reporter Megan McCloskey summed up the shortcomings of such therapy for mental health conditions. “Many of those who need more intensive counseling … don’t like the impersonal nature of talking to a TV screen,” she says. “For some, telemedicine doesn’t meet their needs and adds to their sense of isolation.”

Cyber therapy would be even more vicarious. Soldiers will talk to a videogame character, rather than a real person, through their computer screen.

But a robust virtual option would give soldiers, many of whom still shy away from face-to-face mental health treatment, the option to seek solace in a more anonymous alternative. Eventually, Rizzo and his colleagues hope to see SIM Sensei available for soldiers within the comforts of their own home, rather than a military clinic.

“A lot of people still don’t want to stop by the clinic and meet with a real person,” he says. “Technology is ripe for us to leverage. I’m extremely confident that we can use it, leverage it, to help people who otherwise wouldn’t get better.”


6 responses to “Darpa to troubled soldiers: Meet your new simulated therapist”

  1. Fred Brooks

    “ICT has deep experience with virtual therapy. Under Rizzo’s leadership, the institute was the first to develop immersive programs that allowed patients afflicted with PTSD to revisit combat scenarios. The programs have been widely lauded, and are now used by more than 60 military medical clinics across the country.”

    Skip Rizzo’s a fine scholar. But this statement is Not true. Larry Hodges (GaTech) and Barbara Rothman (Emory) did it first, way more than a decade ago, with Viet Nam veterans, in VA hospitals. See for example:

    Rothbaum, B. O., Hodges, L. F., Alarcon, R., Ready, D., Shahar, F., Graap, K., Pair, J., Hebert, P., Gotz, D., Wills, B., & Baltzell, D. (1999). Virtual reality exposure therapy for PTSD Vietnam veterans: A case study. Journal of Traumatic Stress, 12, 263-271.

    Frederick P. Brooks, Jr.
    Kenan Professor of Computer Science
    University of North Carolina at Chapel Hill

  2. alison frangicetto

    As strange as some of these things can be.. this could work for some people. If you can get past the lips not synching with the words exactly on time, it does seem like a helpful process that could be very successful for some. The way it allows you to have a conversation with a therapist that is offering real advice- it seems like multi-tasking and covering a lot in maybe a short amount of time. Perhaps because it’s more convenient and you’re able to cover more than you would in person (assuming no technological glitches) it could really be a huge step in therapy.

  3. Eric Onyechefule

    The simulated therapist might have the audio not in sync with the way the lips move but if you can get past that this therapist idea is actually one that can work. I always read places that people coming out from the army suffer from PTSD and the reason why is because they have no one to talk to while they are in action but I feel that if this therapist is taken seriously then it could work in minimizing the amount of PTSD cases coming from duty.

  4. Meghan C

    This is a really great invention but in reality I really don’t see how it would help the patient. There would probably be too many glitches and there might be confusion for the patient. The reason why therapy works is because of the whole idea that you can talk to an actual person. I don’t see how talking to a computer, even though it is supposed to be as realistic as possible, would help. If it works for someone, good for them but I personally would never try it. It may give some data to military patients but I don’t know how accurate that would be. I would feel as if I was just wasting my time talking to a screen—I would need real human interaction. It does seem highly advanced however, thus evoking telepresence—the fact that they can appear empathetic, detect psychological symptoms by analyzing facial expressions, body gestures and speech, just like a real therapist. It is amazing though that it can detect all of this, along with how it can take note of how the patient spoke and moved. I haven’t heard of a technology as advanced as this. The experience would imitate how a real therapy session as go, making it as realistic as possible even though the person is just talking to a screen. It is a simulated experience of a therapy session.

  5. Bob Jacobson

    A simulated therapist for simulated cures.

    When all you know is IT systems, all you get is IT solutions.

    I may be an iconoclast, but I don’t believe much of this self-serving jabber anymore.

  6. Kimberlee Comfort

    If I grew up playing violent video games with other boys and girls. Then I went to a foreign country where the government payed me to kill people and then I came home and I could not sleep or have a conversation with someone without wanting to tear their head off and I had seen my friend shot…and my wife and kids had no clue where I had been and none of us knew where I was going, I would welcome a video game character as a familiar and friendly face. He prepared me for the war story. Now he/she can help me write the next chapter in my life, which is very, very fuzzy at this point because I am still stuck in my war story and it is a lonely, crabby place to be, no fun here like the good old days when I played video games and laughed. Like everyother technology known to man, the potential for good is beyond our wildest dreams and the potential for ethical violations and harm matches our greatest nightmares…always the battle of good verses evil, the constant Heroes Journey to slay a few dragons and rescue a few damsels in disress along the way…As a licensed psychologist plugging along on a PhD in Media Psychology from Fielding Graduate University in Santa Barbara and dreaming of escaping Minnesota winters I predict that 25 years from now- Narrative Therapy (Michael White, David Epston, John Winslade, Walter Bera, Donald Polkinghorne) will be the ethical breast implants for cybertherapy- Narrative Therapy rox- mark my words, and my email address in case you are hiring or conducting research in any of these vital life enhancing ways-Kimberlee.comfort@yahoo.com

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