美国国家公共电台 NPR--Can a chatbot help people with eating disorders as well as another human?

Can a chatbot help people with eating disorders² as well as another human?

Transcript³

The National Eating Disorders Association is shutting its telephone helpline down, firing its small staff and hundreds of volunteers. Instead it's using a chatbot — and not because the bot is better.

MICHEL MARTIN, HOST:

Nearly 70,000 people last year reached out to a helpline operated by the National Eating Disorders Association. Those numbers had more than doubled during the COVID emergency, and they still haven't returned to pre-pandemic levels. But now the association is shutting down that helpline in favor of a chatbot. Kate Wells with Michigan Radio has more.

KATE WELLS, BYLINE⁴: The pandemic was this perfect storm for eating disorders. Hospitalizations and ER visits doubled. Helpline volunteers Katy Meta, Nicole Rivers and Keiko Fox say people were isolated⁵; they were stressed; they were cut off from support.

KATY META: I think this was an 11-year-old that their parents - you know, they told them that they were struggling. And the parents said that they didn't believe in eating disorders.

KEIKO FOX: A woman who was, I believe, like, 67 years old and just kind of battling it by herself.

NICOLE RIVERS: An 11-year-old girl from Greece who thought that she might have an eating disorder¹, and she was really scared to tell her parents.

META: It was difficult because this individual was also suicidal.

RIVERS: We were actually able to encourage her that this is not something that is her fault.

FOX: I was able to set her up with some treatment options and, you know, talk her into believing that this is real and this is important.

META: And these individuals come on multiple times because that's all they have, is the chat line.

WELLS: Many of these helpline volunteers and staff get into this work because they have recovered from eating disorders themselves. Staffer Abbie Harper says that is part of why the helpline is so powerful. These are people with shared experiences.

ABBIE HARPER: When you know what it's been like for you and you know that feeling, you can connect with others.

WELLS: During COVID, the types of calls, texts and messages that the helpline got started to change.

HARPER: Kind of more crisis-type calls with suicide, self-harm and then, like, child abuse or child neglect.

WELLS: The helpline is run by just six paid staffers, a couple supervisors⁶, and they train and oversee⁷ up to 200 volunteers at any given time. The staff felt overwhelmed, under supported, burned out. There was a ton of turnover⁸, so the helpline staff voted to unionize.

HARPER: So cliche⁹, but, like, we did not have our oxygen masks on, and we are putting on everyone else's oxygen mask. And it was just, like, becoming unsustainable.

WELLS: Managers at the National Eating Disorders Association, or NEDA, also thought that the situation was becoming unsustainable. Lauren Smolar is a VP at the nonprofit, and she says the increase in crisis calls also meant more legal liability.

LAUREN SMOLAR: Our volunteers are volunteers. They're not professionals. They don't have crisis training. And we really can't accept that kind of responsibility. We really need them to go to those services who are appropriate.

WELLS: The increased demand also meant that waitlists were getting longer, too.

SMOLAR: And that's, frankly¹⁰, unacceptable in 2023 for people to have to wait a week or more to receive the information that they need, the specialized¹¹ treatment options that they need.

WELLS: In March, the helpline staff formally notified NEDA about their unionization. Four days later, they were in what seemed like a pretty routine virtual staff meeting. NPR obtained audio of the call, and abruptly¹² NEDA's board chair, Geoff Craddock, fired all the helpline staff.

(SOUNDBITE OF ARCHIVED RECORDING)

GEOFF CRADDOCK: We will, subject to the terms of our legal responsibilities, beginning to wind down the helpline as currently operating.

WELLS: After more than 20 years, the helpline was being shut down. Instead, Craddock said, NEDA would be transitioning to a chatbot named Tessa.

(SOUNDBITE OF ARCHIVED RECORDING)

CRADDOCK: With a transition to Tessa, the AI-assisted technology expected around June 1. So we wanted to share this information with you.

WELLS: Now, NEDA says that it can't discuss employee matters, and staff and volunteers say that they worry there's no way a chatbot is going to be able to give people the kind of human empathy that comes from a human. And the people who made Tessa agree.

ELLEN FITZSIMMONS-CRAFT: I do think that we wrote her to attempt to be empathetic, but it is not, again, a human.

WELLS: This is Dr. Ellen Fitzsimmons-Craft. She's a professor of psychiatry¹³ at Washington University's medical school. NEDA paid her team to create Tessa a few years ago. And right now the chatbot can walk a user through a specific series of therapeutic¹⁴ techniques about something like body image.

FITZSIMMONS-CRAFT: It's not an open-ended tool for you to talk to and feel like you're just going to have access to kind of a listening ear, maybe like the helpline was.

WELLS: Tessa is not ChatGPT. She can't think for herself or go off the rails like that. She's programmed with only a limited number of possible responses. And Fitzsimmons-Craft and her team have done small studies showing that people who interact with Tessa actually do better than those who are just put on the waitlist.

FITZSIMMONS-CRAFT: It's really a tool in its current form that's going to help you learn and use some strategies to address your disordered eating and your body image.

WELLS: Professor Marzyeh Ghassemi studies machine learning and health at MIT, and she is skeptical¹⁵ about this chatbot idea. She worries that it could actually be damaging.

MARZYEH GHASSEMI: I think it's very alienating¹⁶ to have an interactive¹⁷ system present you with irrelevant¹⁸ or what can feel like tangential¹⁹ information.

WELLS: What the research shows people actually want, she says, is for their vulnerability to be met with understanding.

GHASSEMI: If I'm disclosing to you that I have an eating disorder; I'm not sure how I can get through lunch tomorrow, I don't think most of the people who would be disclosing that would want to get a generic²⁰ link. Click here for tips on how to rethink food.

WELLS: Often, the people who come to the NEDA helpline have never talked about their eating disorder before. Helpline staffer Abbie Harper says that is why people often ask the volunteers and the staff, are you a real person, or are you a robot?

HARPER: And no one's like, oh, shoot. You're a person. Well, bye. It's not the same. And there's something very special about being able to share that kind of lived experience with another person.

WELLS: NEDA is winding²¹ down the helpline this month and is no longer taking new calls or messages. The transition to the chatbot Tessa is scheduled for June.

For NPR News, I'm Kate Wells.

(SOUNDBITE OF INSTUPENDO'S "COMFORT CHAIN")

1 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

2 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

3 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 isolated   

adj.与世隔绝的

参考例句：

• His bad behaviour was just an isolated incident. 他的不良行为只是个别事件。
• Patients with the disease should be isolated. 这种病的患者应予以隔离。

6 supervisors   

n.监督者，管理者( supervisor的名词复数 )

参考例句：

• I think the best technical people make the best supervisors. 我认为最好的技术人员可以成为最好的管理人员。 来自辞典例句
• Even the foremen or first-level supervisors have a staffing responsibility. 甚至领班或第一线的监督人员也有任用的责任。 来自辞典例句

7 oversee   

vt.监督，管理

参考例句：

• Soldiers oversee the food handouts.士兵们看管着救济食品。
• Use a surveyor or architect to oversee and inspect the different stages of the work.请一位房产检视员或建筑师来监督并检查不同阶段的工作。

8 turnover   

n.人员流动率，人事变动率；营业额，成交量

参考例句：

• The store greatly reduced the prices to make a quick turnover.这家商店实行大减价以迅速周转资金。
• Our turnover actually increased last year.去年我们的营业额竟然增加了。

9 cliche   

n./a.陈词滥调(的)；老生常谈(的)；陈腐的

参考例句：

• You should always try to avoid the use of cliche. 你应该尽量避免使用陈词滥调。
• The old cliche is certainly true:the bigger car do mean bigger profits.有句老话倒的确说得不假:车大利大。

10 frankly   

adv.坦白地，直率地；坦率地说

参考例句：

• To speak frankly, I don't like the idea at all.老实说，我一点也不赞成这个主意。
• Frankly speaking, I'm not opposed to reform.坦率地说，我不反对改革。

11 specialized   

adj.专门的，专业化的

参考例句：

• There are many specialized agencies in the United Nations.联合国有许多专门机构。
• These tools are very specialized.这些是专用工具。

12 abruptly   

adv.突然地，出其不意地

参考例句：

• He gestured abruptly for Virginia to get in the car.他粗鲁地示意弗吉尼亚上车。
• I was abruptly notified that a half-hour speech was expected of me.我突然被通知要讲半个小时的话。

13 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

14 therapeutic   

adj.治疗的，起治疗作用的；对身心健康有益的

参考例句：

• Therapeutic measures were selected to fit the patient.选择治疗措施以适应病人的需要。
• When I was sad,music had a therapeutic effect.我悲伤的时候，音乐有治疗效力。

15 skeptical   

adj.怀疑的，多疑的

参考例句：

• Others here are more skeptical about the chances for justice being done.这里的其他人更为怀疑正义能否得到伸张。
• Her look was skeptical and resigned.她的表情是将信将疑而又无可奈何。

16 alienating   

v.使疏远( alienate的现在分词 )；使不友好；转让；让渡（财产等）

参考例句：

• The phenomena of alienation are widespread. Sports are also alienating. 异化现象普遍存在，体育运动也不例外。 来自互联网
• How can you appeal to them without alienating the mainstream crowd? 你是怎么在不疏忽主流玩家的情况下吸引住他们呢？ 来自互联网

17 interactive   

adj.相互作用的，互相影响的，（电脑）交互的

参考例句：

• The psychotherapy is carried out in small interactive groups.这种心理治疗是在互动的小组之间进行的。
• This will make videogames more interactive than ever.这将使电子游戏的互动性更胜以往。

18 irrelevant   

adj.不恰当的，无关系的，不相干的

参考例句：

• That is completely irrelevant to the subject under discussion.这跟讨论的主题完全不相关。
• A question about arithmetic is irrelevant in a music lesson.在音乐课上，一个数学的问题是风马牛不相及的。

19 tangential   

adj.离题的，切线的

参考例句：

• Too much time was spent discussing tangential issues.太多的时间花在了讨论那些无关紧要的问题上。
• They thought the whole thing was a side-show, tangential to the real world of business.他们认为整件事情只是一个插曲，和真正的商界没有多大关系。

20 generic   

adj.一般的，普通的，共有的

参考例句：

• I usually buy generic clothes instead of name brands.我通常买普通的衣服，不买名牌。
• The generic woman appears to have an extraordinary faculty for swallowing the individual.一般妇女在婚后似乎有特别突出的抑制个性的能力。

21 winding   

n.绕，缠，绕组，线圈

参考例句：

• A winding lane led down towards the river.一条弯弯曲曲的小路通向河边。
• The winding trail caused us to lose our orientation.迂回曲折的小道使我们迷失了方向。