Kokobot Review

With the possible impending demise of Twitter hanging on the horizon, I have been exploring other social media options for sharing my content and connecting with my communities.

I was on Tumblr for the first time in years and exploring some hashtags related to mental health when I got a new message. The last time a stranger messaged me on Tumblr turned out to be some kind of p*rn account, so I was wary. Instead, I was introduced to Kokobot, an AI that reaches out to people to offer them support with their mental health.

Screenshot: Kokobot. "Koko offers kind words of support from other Tumblr users just like you." Not following each other.
Tuesday
Kokobot: Hi! I'm Kokobot. I'm working with Tumblr to connect people who are interested in mental health topics. Type "hi" to get started...
Me: Hi
Kokobot: Hi (flower emojis) Koko connects you with real people who truly get you. Not therapists, not counselors, just people like you.

I am 100% in favor of making mental health support available and accessible, and I fully understand and appreciate the value of peer support. At the same time, this made me nervous. Who is it connecting? What is being shared? Is this supposed to be a substitute for mental health treatment?

Here is my experience chatting with Kokobot and my thoughts on it as a resource, from my perspective as a psychologist.

Kokobot: Great! Please note: we are a *nonprofit* and your data is anonymous. We will never sell it to anyone. (Links to privacy policy and terms of service) By selecting "Yes" below, you accept the terms of service and warrant that you are 13 years of age or older. Type the letter 'A' to continue... A. Yes

I want to point out, they say the information you share is anonymous. BUT there is a reason I tell clients not to use any social media platform to try and message me – they are not HIPAA compliant. Employees at Tumblr can view your direct messages, so it’s not fully confidential, and if any information connected to your account (such as your email address or IP) can be connected to your real identity, this is not fully secure.

That being said, I’m glad that Kokobot is transparent about a commitment to not selling your data. I hope this means they are also not giving it to anyone. My point is, just always be careful about claims of anonymity online. Computers always know.

Kokobot: Before we start, we just have one last question. How hopeful do you feel about your life right now? A. Extremely hopeful B. Somewhat hopeful C. Neutral D. Somewhat hopeless E. Extremely Hopeless

This is a pretty standard mood check in, similar to ones I have used with clients in the past. No red flags here.

Kokobot: Ok, let's get started! First - tell us what you're struggling with right now. Pick one category below. You can always change this later! A. Dating B. Friendships C. Work D. School E. Family F. Eating Disorders G. LGBTQ+ H. Discrimination I. Other...

Letting users choose from a list can make it less daunting to share what they are going through and makes it easier for the AI to determine how to proceed. I was concerned that there is a category for Eating Disorders, since this is clearly a peer support system and not a referral to clinical services. EDs are some of the most dangerous mental health issues with the highest mortality rates, and there is a huge online community around encouraging people with EDs to continue engaging in disordered and dangerous behavior. But when I said that was my issue, Kokobot did not connect me to a peer and instead offered educational information.

Kokobot: You are not alone. A lot of Koko users struggle with disordered eating. And, no matter your gender, about 10-40% of us experience body dissatisfaction. We have a short mini course that can help. It's free, anonymous, and it takes less than 10 minutes. Check it out here: (link). Note: This course is not currently designed for all disordered eating conditions. If you think it's missing something, it probably is. Please let us know. To see more resources, or to keep trying Koko, please continue:

If you select an issue that is appropriate for peer support, Kokobot asks for more details. I tried several different ones and got the same prompt in response.

Kokobot: OK, pplease tell us more about your situation. Write a few sentences below and we'll send it out anonymously. A. See examples

If you’re not sure what to say, Kokobot will provide you with responses that others have provided. Also, if you write something profane or graphic, the AI will indicate that it isn’t appropriate to send out. I did not screen shot that message, but it basically said it understood if I did not mean to be inappropriate but asked me to re-word my message. This showed me there are protections in place for people using the bot, though of course I cannot speak to how effective they are.

Kokobot: Ok, just one more thing... Let's tag your situation with your most negative thought. What's the darkest thought you have about this? What goes through your mind? Select an option below. Even if you think they all apply to you, just choose one. A. This sucks B. This won't get better C. I'm a loser D. No one cares E. People suck F. Other..

Identifying negative thoughts is a cognitive behavioral technique that I do in many sessions. It can be included in a thought record as a way for clients to explore their thought processes on their own as well. Pretty standard.

Kokobot: Ok, now do the opposite. Tag your situation with something positive (even if you don't really believe it): A. It's not so bad B. This could get better C. I'm actually ok D. People can be good E. Unicorns exist F. Other..

This is basically an overly simplified version of cognitive restructuring. Again, not a substitute for therapy, but it could have benefits for users.

Kokobot: OK, thanks for sharing all that. Sending this off to the Koko community... You should start getting replies in a few minutes. While you wait, let's try helping others. The vast majority of Koko users say that helping others helps them feel better. A. Let's do it

If you say that you want to help others, it walks you through a very brief and simplified training about how to express empathy for another person. It is incredibly basic though, so I’m not sure the quality of responses that users are getting.

If you choose to talk to other users, it gives you the option to skip any responses you don’t feel comfortable answering, or you can flag them as inappropriate. I do not know what Kokobot does with posts that are flagged, unfortunately.

Overall, my feeling towards Kokobot is cautious optimism. I can see this being a valuable resource that connects people to supportive peers when they are having a hard time, but I worry about its potential for abuse. I would like to know more about how it handles this and what steps it takes to prevent misuse. I would also like to see more resources being offered to connect users to professionals when appropriate – I didn’t see anything about that when I tried it.

We definitely need more resources that meet people where they are, and you can’t get more “meeting people where they are” than sliding into their DMs on social media.

Did you talk to Kokobot? Tell me about your experience!

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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