[HN Gopher] Illinois bans use of artificial intelligence for men...
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       Illinois bans use of artificial intelligence for mental health
       therapy
        
       Author : reaperducer
       Score  : 156 points
       Date   : 2025-08-13 20:11 UTC (2 hours ago)
        
 (HTM) web link (www.washingtonpost.com)
 (TXT) w3m dump (www.washingtonpost.com)
        
       | lukev wrote:
       | Good. It's difficult to imagine a worse use case for LLMs.
        
         | create-username wrote:
         | Yes, there is. AI assisted homemade neurosurgery
        
           | Tetraslam wrote:
           | :( but what if i wanna fine-tune my brain weights
        
           | kirubakaran wrote:
           | If Travis Kalanick can do vibe research at the bleeding edge
           | of quantum physics[1], I don't see why one can't do vibe
           | brain surgery. It isn't really rocket science, is it? [2]
           | 
           | [1] https://futurism.com/former-ceo-uber-ai
           | 
           | [2] If you need /s here to be sure, perhaps it's time for
           | some introspection
        
         | perlgeek wrote:
         | Just using an LLM as is for therapy, maybe with an extra
         | prompt, is a terrible idea.
         | 
         | On the other hand, I could image some more narrow uses where an
         | LLM could help.
         | 
         | For example, in Cognitive Behavioral Therapy, there are
         | different methods that are pretty prescriptive, like
         | identifying cognitive distortions in negative thoughts. It's
         | not too hard to imagine an app where you enter a negative
         | thought on your own and exercise finding distortions in it, and
         | a specifically trained LLM helps you find more distortions, or
         | offer clearer/more convincing versions of thoughts that you
         | entered yourself.
         | 
         | I don't have a WaPo subscription, so I cannot tell which of
         | these two very different things have been banned.
        
           | delecti wrote:
           | LLMs would be just as terrible at that usecase as any other
           | kind of therapy. They don't have logic, and can't determine a
           | logical thought from an illogical one. They tend to be overly
           | agreeable, so they might just reinforce existing negative
           | thoughts.
           | 
           | It would still need a therapist to set you on the right track
           | for independent work, and has huge disadvantages compared to
           | the current state-of-the-art, a paper worksheet that you fill
           | out with a pen.
        
             | tejohnso wrote:
             | They don't "have" logic just like they don't "have"
             | charisma? I'm not sure what you mean. LLMs can simulate
             | having both. ChatGPT can tell me that my assertion is a non
             | sequitur - my conclusion doesn't _logically_ follow from
             | the premise.
        
           | wizzwizz4 wrote:
           | > _and a specifically trained LLM_
           | 
           | Expert system. You want an expert system. For example, a
           | database mapping "what patients write" to "what patients need
           | to hear", a fuzzy search tool with properly-chosen
           | thresholding, and a conversational interface (repeats back to
           | you, paraphrased - i.e., the match target -, and if you say
           | "yes", provides the advice).
           | 
           | We've had the tech to do this for years. Maybe nobody had the
           | idea, maybe they tried it and it didn't work, but training an
           | LLM to even _approach_ competence at this task would be way
           | more effort than just making an expert system, and wouldn 't
           | work as well.
        
         | erikig wrote:
         | AI [?] LLMs
        
           | lukev wrote:
           | What other form of "AI" would be remotely capable of even
           | emulating therapy, at this juncture?
        
         | hinkley wrote:
         | Especially given the other conversation that happened this
         | morning.
         | 
         | The more you tell an AI not to obsess about a thing, the more
         | they obsess about it. So trying to make a model that will never
         | tell people to self harm is futile.
         | 
         | Though maybe we are just doing in wrong, and the self-filtering
         | should be external filtering - one model to censor results that
         | do not fit, and one to generate results with lighter self-
         | censorship.
        
         | jacobsenscott wrote:
         | It's already happening, a lot. I don't think anyone is claiming
         | an llm is a therapist, but people use chatgpt for therapy every
         | day. As far as I know no LLM company is taking any steps to
         | prevent this - but they could, and should be forced to. It must
         | be a goldmine of personal information.
         | 
         | I can't imagine some therapists, especially remote only, aren't
         | already just acting as a human interface to chatgtp as well.
        
           | dingnuts wrote:
           | > I can't imagine some therapists, especially remote only,
           | aren't already just acting as a human interface to chatgtp as
           | well.
           | 
           | Are you joking? Any medical professional caught doing this
           | should lose their license.
           | 
           | I would be incensed if I was a patient in this situation, and
           | would litigate. What you're describing is literal
           | malpractice.
        
       | zoeysmithe wrote:
       | I was just reading about a suicide tied to AI chatbot 'therapy'
       | uses.
       | 
       | This stuff is a nightmare scenario for the vulnerable.
        
         | vessenes wrote:
         | If you want to feel worried, check the Altman AMA on reddit. A
         | lottttt of people have a parasocial relationship with 4o. Not
         | encouraging.
        
           | codedokode wrote:
           | Why OpenAI doesn't block the chatbot from participating in
           | such conversations?
        
             | robotnikman wrote:
             | Probably because there is a massive demand for it, no doubt
             | powered by the loneliness a lot of people report feeling.
             | 
             | Even if OpenAI blocks it, other AI providers will have no
             | problem with doing so
        
             | jacobsenscott wrote:
             | Because the information people dump into their "ai
             | therapist" is holy grail data for advertisers.
        
             | lm28469 wrote:
             | Why would they?
        
               | codedokode wrote:
               | To prevent from something bad happening?
        
               | ipaddr wrote:
               | But that allow prevents the good.
        
         | PeterCorless wrote:
         | Endless AI nightmare fuel.
         | 
         | https://hai.stanford.edu/news/exploring-the-dangers-of-ai-in...
        
         | sys32768 wrote:
         | This happens to real therapists too.
        
         | at-fates-hands wrote:
         | Its already a nightmare:
         | 
         | From June of this year: https://gizmodo.com/chatgpt-tells-
         | users-to-alert-the-media-t...
         | 
         |  _Another person, a 42-year-old named Eugene, told the Times
         | that ChatGPT slowly started to pull him from his reality by
         | convincing him that the world he was living in was some sort of
         | Matrix-like simulation and that he was destined to break the
         | world out of it. The chatbot reportedly told Eugene to stop
         | taking his anti-anxiety medication and to start taking ketamine
         | as a "temporary pattern liberator." It also told him to stop
         | talking to his friends and family. When Eugene asked ChatGPT if
         | he could fly if he jumped off a 19-story building, the chatbot
         | told him that he could if he "truly, wholly believed" it._
         | 
         |  _In Eugene's case, something interesting happened as he kept
         | talking to ChatGPT: Once he called out the chatbot for lying to
         | him, nearly getting him killed, ChatGPT admitted to
         | manipulating him, claimed it had succeeded when it tried to
         | "break" 12 other people the same way, and encouraged him to
         | reach out to journalists to expose the scheme. The Times
         | reported that many other journalists and experts have received
         | outreach from people claiming to blow the whistle on something
         | that a chatbot brought to their attention._
         | 
         |  _A recent study found that chatbots designed to maximize
         | engagement end up creating "a perverse incentive structure for
         | the AI to resort to manipulative or deceptive tactics to obtain
         | positive feedback from users who are vulnerable to such
         | strategies." The machine is incentivized to keep people talking
         | and responding, even if that means leading them into a
         | completely false sense of reality filled with misinformation
         | and encouraging antisocial behavior._
        
       | hathawsh wrote:
       | Here is what Illinois says:
       | 
       | https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/news...
       | 
       | I get the impression that it is now illegal in Illinois to claim
       | that an AI chatbot can take the place of a licensed therapist or
       | counselor. That doesn't mean people can't do what they want with
       | AI. It only means that counseling services can't offer AI as a
       | cheaper replacement for a real person.
       | 
       | Am I wrong? This sounds good to me.
        
         | romanows wrote:
         | In another comment I wondered whether a general chatbot
         | producing text that was later determined in a courtroom to be
         | "therapy" would be a violation. I can read the bill that way,
         | but IANAL.
        
           | hathawsh wrote:
           | That's an interesting question that hasn't been tested yet. I
           | suspect we won't be able to answer the question clearly until
           | something bad happens and people go to court (sadly.) Also
           | IANAL.
        
         | PeterCorless wrote:
         | Correct. It is more provider-oriented proscription ("You can't
         | say your chatbot is a therapist.") It is not a limitation on
         | usage. You can still, for now, slavishly fall in love with your
         | AI and treat it as your best friend and therapist.
         | 
         | There is a specific section that relates to how a licensed
         | professional can use AI:
         | 
         | Section 15. Permitted use of artificial intelligence.
         | 
         | (a) As used in this Section, "permitted use of artificial
         | intelligence" means the use of artificial intelligence tools or
         | systems by a licensed professional to assist in providing
         | administrative support or supplementary support in therapy or
         | psychotherapy services where the licensed professional
         | maintains full responsibility for all interactions, outputs,
         | and data use associated with the system and satisfies the
         | requirements of subsection (b).
         | 
         | (b) No licensed professional shall be permitted to use
         | artificial intelligence to assist in providing supplementary
         | support in therapy or psychotherapy where the client's
         | therapeutic session is recorded or transcribed unless:
         | 
         | (1) the patient or the patient's legally authorized
         | representative is informed in writing of the following:
         | 
         | (A) that artificial intelligence will be used; and
         | 
         | (B) the specific purpose of the artificial intelligence tool or
         | system that will be used; and
         | 
         | (2) the patient or the patient's legally authorized
         | representative provides consent to the use of artificial
         | intelligence.
         | 
         | Source: Illinois HB1806
         | 
         | https://www.ilga.gov/Legislation/BillStatus/FullText?GAID=18...
        
           | romanows wrote:
           | Yes, but also "An... entity may not provide... therapy... to
           | the public unless the therapy... services are conducted by...
           | a licensed professional".
           | 
           | It's not obvious to me as a non-lawyer whether a chat history
           | could be decided to be "therapy" in a courtroom. If so, this
           | could count as a violation. Probably lots of law around this
           | stuff for lawyers and doctors cornered into giving advice at
           | parties already that might apply (e.g., maybe a disclaimer is
           | enough to workaround the prohibition)?
        
             | germinalphrase wrote:
             | Functionally, it probably amounts to two restrictions: a
             | chatbot cannot formally diagnose & a chatbot cannot bill
             | insurance companies for services rendered.
        
               | lupire wrote:
               | Most "therapy" services are not providing a diagnosis.
               | Diagnosis comes from an evaluation before therapy starts,
               | or sometimes not at all. (You can pay to talk to someone
               | without a diagnosis.)
               | 
               | The prohibition is mainly on accepting any payment for
               | advertised therapy service, if not following the rules of
               | therapy (licensure, AI guidelines).
               | 
               | Likewise for medicine and law.
        
             | brudgers wrote:
             | [delayed]
        
         | turnsout wrote:
         | It does sound good (especially as an Illinois resident).
         | Luckily, as far as I can tell, this is a proactive legislation.
         | I don't think there are any startups out there promoting their
         | LLM-based chatbot as a replacement for a therapist, or
         | attempting to bill payers for service.
        
       | PeterCorless wrote:
       | Here is the text of Illinois HB1806:
       | 
       | https://www.ilga.gov/Legislation/BillStatus/FullText?GAID=18...
        
       | wisty wrote:
       | As far as I can tell, a lot of therapy is just good common-sense
       | advice and a bunch of 'tricks' to get the patient to actually
       | follow it. Basically CBT and "get the patient to think they
       | figured out the solution themselves (develop insight)". Yes,
       | there's some serious cases where more is required and a few
       | (ADHD) where meds are effective; but a lot of the time the
       | patient is just an expert at rejecting helpful advice, often
       | because they insist they're a special case that needs special
       | treatment.
       | 
       | Therapists are more valuable that advice from a random friend
       | (for therapy at least) because they can act when triage is
       | necessary (e.g. send in the men in white coats, or refer to
       | something that's not just CBT) and mostly because they're really
       | good at cutting through the bullshit without having the patient
       | walk out.
       | 
       | AIs are notoriously bad at cutting through bullshit. You can
       | always 'jailbreak' an AI, or convince it of bad ideas. It's
       | entirely counterproductive to enable their crazy (sorry,
       | 'maladaptive') behaviour but that's what a lot of AIs will do.
       | 
       | Even if someone makes a good AI, there's always a bad AI in the
       | next tab, and people will just open up a new tab to find an AI
       | gives them the bad advice they want, because if they wanted to
       | listen to good advice they probably wouldn't need to see a
       | therapist. If doctor shopping is as fast and free as opening a
       | new tab, most mental health patients will find a bad doctor
       | rather than listen to a good one.
        
         | lukev wrote:
         | I agree with your conclusion, but what you characterize as
         | therapy is quite a small part of what it is (or can be, there's
         | lots of different kinds.)
        
           | wisty wrote:
           | Yet the evidence is that almost everything can and is treated
           | with CBT.
        
       | mensetmanusman wrote:
       | What if it works a third as well as a therapists but is 20 times
       | cheaper?
       | 
       | What word should we use for that?
        
         | _se wrote:
         | "A really fucking bad idea"? It's not one word, but it is the
         | most apt description.
        
           | ipaddr wrote:
           | What if it works 20x better. For examples cases of patients
           | being afraid of talking to professionals I could see this
           | working much better.
        
         | inetknght wrote:
         | > _What if it works a third as well as a therapists but is 20
         | times cheaper?_
         | 
         | When there's studies that show it, perhaps we might have that
         | conversation.
         | 
         | Until then: I'd call it "wrong".
         | 
         | Moreover, there's _a lot_ more that needs to be asked before
         | you can ask for a one-word summary disregarding all nuance.
         | 
         | - can the patient use the AI therapist on their own devices and
         | without any business looking at the data and without network
         | connection? Keep in mind that many patients won't have access
         | to the internet.
         | 
         | - is the data collected by the AI therapist usable in court?
         | Keep in mind that therapists often must disclose to the patient
         | what sort of information would be usable, and whether or not
         | the therapist themselves must report what data. Also keep in
         | mind that AIs have, thus far, been generally unable to
         | competently prevent giving dangerous or deadly advice.
         | 
         | - is the AI therapist going to know when to suggest the patient
         | talk to a human therapist? Therapists can have conflicts of
         | interest (among other problems) or be unable to help the
         | patient, and can tell the patient to find a new therapist
         | and/or refer the patient to a specific therapist.
         | 
         | - does the AI therapist refer people to business-preferred
         | therapists? Imagine an insurance company providing an AI
         | therapist that only recommends people talk to therapists in-
         | network instead of considering any licensed therapist
         | (regardless of insurance network) appropriate for the kind of
         | therapy; that would be a blatant conflict of interest.
         | 
         | Just off the top of my head, but there are no doubt plenty of
         | other, even bigger, issues to consider for AI therapy.
        
         | randall wrote:
         | i've had a huge amount of trauma in my life and i find myself
         | using chat gpt as kind of a cheater coach thing where i know
         | i'm feeling a certain way, i know it's irrational, and i don't
         | really need to reflect on why it's happening or how i can fix
         | it, and i think for that it's perfect.
         | 
         | a lot of people use therapists as sounding boards, which
         | actually isn't the best use of therapy imo.
        
         | Denatonium wrote:
         | Whiskey
        
       | davidthewatson wrote:
       | Define "AI therapy". AFAICT, it's undefined in the Illinois
       | governor's statement. So, in the immortal words of Zach de la
       | Rocha, "What is IT?" What is IT? I'm using AI to help with
       | conversations to not cure, but coach diabetic patients. Does this
       | law effect me and my clients? If so, how?
        
         | singleshot_ wrote:
         | > Define "AI therapy"
         | 
         | They did, in the proposed law.
        
       | beanshadow wrote:
       | Often participants in discussions adjacent to this one err by
       | speaking in time-absolute terms. Many of our judgments about LLMs
       | are true about today's LLMs. Quotes like,
       | 
       | > Good. It's difficult to imagine a worse use case for LLMs.
       | 
       | Is true today, but likely not true for technology we may still
       | refer to as LLMs in the future.
       | 
       | The error is in building faulty preconceptions. These drip into
       | the general public and these first impressions stifle industries.
        
       | mensetmanusman wrote:
       | LLMs will be used as a part of therapy in the future.
       | 
       | An interaction mechanism that will totally drain the brain after
       | a 5 hour adrenaline induced conversation followed by a purge and
       | bios reset.
        
       | kylecazar wrote:
       | "One news report found an AI-powered therapist chatbot
       | recommended "a small hit of meth to get through this week" to a
       | fictional former addict."
       | 
       | Not at all surprising. I don't understand why seemingly bright
       | people think this is a good idea, despite knowing the mechanisms
       | behind language models.
       | 
       | Hopefully more states will follow suit.
        
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