Speaker A
Welcome back, friends. Michael McFarland with the Road Runner ZX. We have the second half of our interview with CJ Hamilton from Illinois State University, talking about AI and mental health and how it is affecting the workplace.
CJ Hamilton discusses AI's role in therapy, ethical concerns, and its impact on mental health and education in this interview.
Key Takeaways
- AI is a helpful tool but unlikely to replace human therapists completely.
- Ethical use of AI in therapy requires strict protection of client confidentiality and data privacy.
- AI can enhance therapy by automating creative tasks, allowing therapists more time for direct client work.
- Ongoing discussions about AI ethics and data governance are critical as the technology advances.
- There is a need to prepare future mental health professionals to use AI responsibly and effectively.
Summary
- CJ Hamilton explores AI's potential as a tool in mental health therapy but doubts it can replace human interaction.
- Large corporations view AI primarily as a cost-cutting measure, while social services and education focus on ethical integration.
- AI can assist in creating therapeutic tools, such as social-emotional skill-based escape rooms, saving time for therapists.
- Strict caution is advised against inputting any client-identifiable information into AI to avoid HIPAA violations.
- Ethical concerns include data storage, access, and the potential future use of AI as a therapist trained on real client data.
- The conversation highlights the importance of discussing AI ethics now before widespread adoption in therapy.
- There is skepticism about AI's ability to replicate the nuanced human brain response in therapy sessions.
- Concerns about bias and misuse of AI in therapy are raised, emphasizing the need for careful oversight.
- The interview draws parallels between AI backlash and historical resistance to calculators in education.
- CJ Hamilton encourages openness to learning and adapting as AI technology evolves in mental health fields.
Full Transcript — Download SRT & Markdown
Speaker A
Um, so let's get right into it. If you didn't see last week's episode, go back and watch that before you watch this. They're both so very interesting.
Speaker A
People, um, I see AI kind of circling back to the beginning of this as a tool that can be used not only in my field, but in any workforce.
Speaker A
I just don't really buy that it can be a replacement for interaction like you and I are having now. I'd be very surprised if it affected the brain in the exact same way.
Speaker A
But I mean, I've been wrong before. So can you think a person could have an inappropriate relationship with an AI?
Speaker A
Yeah. Oh, yeah. Okay. Well, we'll go on from there.
Speaker A
Okay. Um, so I said a little bit. What do you think business's viewpoint is on AI?
Speaker A
If we're talking about large corporations. Large corporations?
Speaker A
Um, yeah. I think they're hoping it is a cost-cutting measure.
Speaker A
Um, but I'm more on social services and higher education. I'm not really in the business world kind of as embedded as you are, but I do see it as that they're hoping it's a cost-cutting measure.
Speaker A
Yeah. Well, that's always comforting. So, um, let's talk now a little bit about AI and mental health.
Speaker A
Sure. And you're the, we'll say, authority more than I am because you've been dealing with it day-to-day. So you went from, we'll say, pre-AI in the elementary schools.
Speaker A
Yeah. Now you're at college. What are we teaching our kids now that you would say are probably those real high-level items about AI and therapy?
Speaker A
Yeah, it's interesting. Um, so I was reading to sort of like, I'm in the process of writing a manuscript about AI and how it affects, you know, my sort of subfield of mental health, which is like schools.
Speaker A
Um, and so there are a lot of people that are understandably in that environment. Um, there's this backlash to AI and I had one author who talked about the similarities between the world of English language arts and pushing back against AI is similar to how the field of mathematics had pushed back against the calculator.
Speaker A
Right. Um, and so as I'm reading through it, I'm like, "Oh, a lot of this makes sense." And they sort of had different responses from different schools.
Speaker A
Um, and they mapped that to that. So I'll go back towards the beginning when I said, "This technology is out of the box. It's here whether or not we want it to be."
Speaker A
And so what I tell my students is some of you are going to use it and I can't stop you from using it.
Speaker A
Um, so I'm here to have the conversation about how do we use it ethically.
Speaker A
Um, so it can do some really cool stuff. Like, for example, I have a graduate assistant who works with, like, he works at a practice with young children.
Speaker A
And he used AI to develop an escape room that was social emotional skill-based. So every time the kid demonstrated a social emotional skill, it unlocked another form of this escape room.
Speaker A
And so the AI is using it to set up the escape room. And what would have back in the day been like you're spending all afternoon to design this therapy game for a child took him, you know, 30 minutes, maybe an hour.
Speaker A
Um, and so as a result, you can free up your time to think creatively about these things and to actually do them and put them into practice.
Speaker A
Now, what he didn't do was he did not give the AI any client demographic information. He didn't talk to it about symptoms. He didn't say, "Hey, what question should I as the therapist ask him?"
Speaker A
He had an idea, which is this is my therapy modality. Then he said, "How do I make this fun for kids?" And then he said, "AI, help me do it."
Speaker A
Like to me, that's sort of the essence of it at this point, how we should be integrating it.
Speaker A
So not a question once again I had, but now you've helped lead to it, which is so we're leading to some possible HIPAA problems on this?
Speaker A
Yeah. Because is it one of those ones of if the AI, depending on where it's collecting the information, is like going on and it's like, "Oh, are you talking about Pete?" And you're like, "Not Pete. Somebody else."
Speaker A
And so that's why it's important that you don't put in any identifying client information because that absolutely is a HIPAA problem.
Speaker A
So I want to reiterate, you're not going to it saying, "This is the name of my client. This is his age. This is what I'm for. Design an activity."
Speaker A
You're just saying like, "Hey, I am doing cognitive behavioral therapy. These are some skills that are part of cognitive behavioral therapy that any client may need to master."
Speaker A
And those are things that are out in the ether of the internet because a lot has been written on CBT.
Speaker A
And then you're saying, "I'd really like to design an escape room for my client based on these skills. Do that for me."
Speaker A
Like, and I think there's a big difference between that and like just treat this person for me, right?
Speaker A
I don't know. Maybe I'm a skeptic. I just look at it from the standpoint of there are just a lot of less than smart people.
Speaker A
Yeah. I want to say something else. Less than smart people. And that they're just going to be like, "I'm doing my job da da da da da."
Speaker A
And because of their own biases and life just coming out, they'll lay it out and be like boom boom boom.
Speaker A
And like all of a sudden the confessional now becomes the priest in there. That's not the human being, but it's the chatbot that now has collected the information back on the other side.
Speaker A
It's just like it seems like it would be a lot of work to try and keep your brain that desensitized to the actual information.
Speaker A
So like I had a friend, Dr. Benning. So I believe you had him in college.
Speaker A
That is going back a while, but yeah, I know Dr. Benning.
Speaker A
And one of the things he would talk about people telling stories and he'd talk about people being like, "Well, and so there was this black guy."
Speaker A
Mhm. And all of a sudden he's like, "Why did you put that into the story?"
Speaker A
"What does it matter that the person's black, white, green, or whatever? It doesn't matter with the story to tell it."
Speaker A
Mhm. You told it to the emphasis because almost in a racist way of bringing up their black.
Speaker A
Yeah. It's like, "You suck." But I mean, your brain's prewired into that type of thinking because you're day-to-day and it's just constantly reinforced.
Speaker A
So that's where I think, man, that would just be hard if you're having to keep all of that information.
Speaker A
To me, that's almost like instead of you have Google or X or Grok or whatever or ChatGPT that's keeping the information.
Speaker A
That seems like it's almost like a health-based server for the country that is just that information is locked in there and that you should only have access if you're their doctor for whatever reason.
Speaker A
Correct. Yeah. So. And again, that's why the ethics of this needs to be discussed because like, you know, this is again, I don't have a crystal ball, but this is more than likely the future of industry.
Speaker A
And so these are conversations we need to be having now. Like if there is client data, where is it stored?
Speaker A
Who has access to it? The other thing is, so let's say we get to a point, and I love talking with my students about this when it gets to ethics.
Speaker A
Like let's say we get to a point where AI is becoming the therapist, right? And we need data on which to train it.
Speaker A
So all of a sudden, it has access to client profiles for training purposes that may be real people.
Speaker A
Well, it's in that database forever essentially. It's the blueprint for how it's going to treat people.
Speaker A
How do you navigate that? Like there's a lot of conversations we need to have before we go further, I think, with this.
Speaker A
I think I already know how to handle this.
Speaker A
And for those of us that are old enough, sorry, you're born in the...
Speaker A
optimistic about this, but I was wrong and we learn and we move forward." I guarantee it'll be one of your students will walk in and say, "Dr. Hamilton, um can we talk about a video that you made?" And you'll be
Speaker A
like, "That is not gone off the air yet." I I hope none of my students ever find this. But the reality is they probably won't because this is long-form content and anything besides like a 15-second Tik Tok is a little long.
Speaker A
Well, probably what they'll do is they'll have it like summarized and you'll be like, "That's completely wrong." So, uh next. Um I'll I'll be clipped and taken out of context or something and they'll be like, "Did you say this?" And I'm like, "That was part
Speaker A
of a 1-hour segment, but yeah." [sighs] So, are you seeing with your students, maybe uh people that have gone out, uh come back?
Speaker A
Are is the therapy world concerned about AI? Or are they just embracing it? Yeah.
Speaker A
I I think I think the I I think my field is very very concerned about AI. In fact, I'm I'm a little more on like the liberal to positive side of it compared to others in my field. And even then,
Speaker A
what has most of this conversation been? About how dangerous it is, right? Um so, I I think people are actively scared of it for a couple different reasons.
Speaker A
One, um I think they're scared it could harm clients and it absolutely could. So, we should be scared. Being scared just means we care.
Speaker A
The other reason, and I don't know that the average person working in the mental health industry would admit this to you, but I think they're just as scared of being replaced as everyone else because just because AI isn't coming for their
Speaker A
jobs yet doesn't mean that they're afraid of a world where one day it might. Um And I don't know that and this is long long term. This is a decade or two from now. Although with how fast technology
Speaker A
advances, who knows. Um But I don't even know that my field is quite as insulated as we'd like to think it is. Um But like, you know, another another positive vision for that. So, it's funny we're doing this today because I
Speaker A
actually ISU had a social work day event. Social work day 2026. We had a guest speaker who's a a clinical associate professor from UFI who who talked about kind of this same thing and who painted this vision for imagine
Speaker A
10 years from now like you are a social worker and you're working with a team of AI agents who are handling paperwork, who are assisting your clients with billing, who are doing the diagnostic stuff for you so that you can focus on
Speaker A
what you love most and why you got into this profession, which is the relationship you have with the client.
Speaker A
So. Yeah. Uh I have to back for just a second here. Because you said it and was this in a textbook or something that you guys write in a syllabus? We're scared because we care. Really? It's like a bumper sticker. Where'd that come
Speaker A
from? E- Even Even I have trouble like taking sort of my my mental health hat off and my professional hat off.
Speaker A
But I, you know, I I do genuinely mean that. I I think if I think if you're afraid and willing to have these conversations, it just means that you care about the outcome, you know?
Speaker A
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Speaker A
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Speaker A
So, thank you for watching and please help our sponsor. So, what is one boundary you think is it should never be passed within the AI area for therapy?
Speaker A
Yeah, that That's a hard one. That's That's a tough one. For me, I would say I would be very uncomfortable having AI do an assessment and an intervention like like ever. Like I don't know.
Speaker A
And maybe like again, watching this 10 years from now, it's like this old fogey was scared of this and and they do it all the time.
Speaker A
But a a client with active suicidal ideation who needs immediate intervention like I I'm sort of going to be like a a purist and say like AI should never like cross into that boundary. Um I I I feel very strongly about this. I
Speaker A
got my start in mental health actually working at the the PATH Crisis Center here in town. So, I was a like in college I was a volunteer for them. Um and then I I went on to be like
Speaker A
a phone room trainer and then I used to train volunteers and then I I was their intern phone room supervisor for a while. So, I'm I'm pretty intimately familiar with what that's like and for people who are at the lowest point in
Speaker A
their lives, I mean like it's a single conversation that might be the difference between life and death. Um To trust an AI to make the right call to de-escalate the situation and then to intervene if things go south. Um
Speaker A
I just like that that would scare me. Like that's a boundary that I'm not sure that I'm ready for the technology to cross.
Speaker A
As it hangs up on you in the process. Yes, I have this problem. I think I'm going to kill my thick What? Yeah? Press three for more help.
Speaker A
That That'd be That'd be a scary world. Now, now I guess the the argument against that, like I don't mean to play devil's advocate against myself, is like I I there are some clinicians who freeze up and are uncomfortable with
Speaker A
stuff like that, just aren't good under pressure and and could mess it up, too.
Speaker A
So, the more I I think about it, the more I'm like uh could be bad either way, but I I still stick with like it's I I'd be nervous if a chatbot was doing stuff like that.
Speaker A
So, do you think that there is a place where somebody could get themselves into just a bad situation with a chatbot for therapy?
Speaker A
Yeah. Um what would your steps be to try and get that person off? I mean, is it Do we go back to the intervention? You know, dad's sitting there, cousin's sitting there, best friend's sitting there.
Speaker A
They're like, "Hey, we need to talk about your relationship with your chatbot. It's We don't think it's healthy." Yeah. So, so what's I [sighs and gasps] I'm I'm glad you brought this up because I I really worry about um
Speaker A
young men and relationships with chatbots. Um, I don't know. Have Have you heard anything about like they they've sort of dubbed it like the male loneliness epidemic and you have people like um I think his name is is Scott Galloway that are talking a
Speaker A
lot about like a generation of young men that are just lost. Um So I I worry about a world where young men may turn to AI not only for like intimate companionship, but maybe even friendship. Um And and that's that that's that's a
Speaker A
bleak world. Like that's not a a world that I I'd really want to live in. Um But I also would kind of understand.
Speaker A
Like if you had no one else to talk to and suddenly you have someone who you can bounce ideas off of um or who may like even compliment or if you're gosh, there's um There's a Grok AI companion that is just
Speaker A
like overtly flirty and it's very weird. Um and like if if you want some nightmare fuel, just like do a little research on it when you go home, but like to a young susceptible lonely and developing brain that may be an attractive option. Um
Speaker A
and so I think if I were I I do think we will see in the next and this is the immediate future. Like I think this is the next three to five years. Like people who are in intensely addicted
Speaker A
relationships like that and clients or parents who may be seeking treatment for it and that's such uncharted water as far as like how you might treat someone like that. Um But for me I think as a clinician where
Speaker A
I start is just like what are small steps we can take to begin developing the social skills to have real human relationships and we'd start very small and we just kind of move towards that. Um But like that that's something I'm I'm
Speaker A
afraid of. So [snorts] I'm going to say this and throw the flag on the field, I guess, but the thing of um to me it's almost kind of like a thing of porn. I mean, from the standpoint of
Speaker A
you know, people that only watch hardcore porn that's out there have a unrealistic viewpoint of what sex is, okay?
Speaker A
100%. So if you are going to that for your mental entertainment stability or companion on and on or companionship Yeah. Um And that sets you up cuz you're thinking, oh, this is how I get to go deal with a female or male in the real
Speaker A
world. Mhm. Um now I have a felony. That's what I hear. So we'll we'll take it a step back from that.
Speaker A
But let's talk about the expectations related to pornography, right? So I am I have a a friend who his his graduate thesis is actually in um like porn addiction amongst young men. Um and and we've talked a lot about that as an
Speaker A
issue and porn essentially is artificial intimacy. Right? And so it's not out of the realm of possibility that some of these AI companions, like the Grok companion, may fill that for someone. And so talking about unrealistic expectations if your brain has developed with a
Speaker A
companion that um is always going to meet your needs 100% of the time, is never going to disagree with you, is always going to make you feel like you're the most attractive, best, most handsome man in the world all all of a sudden like um an
Speaker A
actual companion, maybe one doesn't sound as appealing and two when you get it it's what you said. You don't have a real foundational understanding of what an actual relationship is because in an actual relationship there is conflict.
Speaker A
Your needs are not always going to be met perfectly 100% of the time. You're not always going to agree on things.
Speaker A
Like those are fundamental part of the human experience and relationships. Our partners aren't perfect and that's okay.
Speaker A
But if you don't know that and if you don't grow up seeing that modeled or having that, yeah, you can run into some real problems when you're older. I [snorts] just so I go with the thing for porn, there really no guardrails.
Speaker A
No. Um so then on this there are no guardrails. And now you're setting up the emotional interaction that should be happening or they're saying, hey, this is how this person this is what I can do with them because this is what the AI
Speaker A
will let me do. Yeah, yeah. And we get trained. I mean, that's the whole thing. It's called this thing called civilization. Yeah. So I know we try and break out of that. I want to be an individual, but I mean, there reasons
Speaker A
why we want to have a civilization and not anarchy. So We we could we could come back and do a whole 'nother piece about my my thoughts on AI companions and how that's going to affect probably a generation of men and I we could we
Speaker A
could fill the hour. We could we could do two more. What I was going to say I my question was what's the worst case scenario and without even trying I think we got there. So I don't think we need
Speaker A
to go any deeper. I think yeah, I think we're good. So Um So as we hit the end of our our time today, I my best time is the lightning round. So this is not one of those ones
Speaker A
where CJ gets to sit there and just kind of think about things for a long period of time. I'm going to ask you a question and you have to give an answer, How much thinking do you think I've done
Speaker A
during this? More than I'm used to. So [laughter] um so based on that, okay? Yeah. What do you think would be better, an AI therapist or a good local bartender?
Speaker A
Oh, um better Okay, no, it's got to be lightning round. [clears throat] Let's go with a local bartender.
Speaker A
Okay. Uh what do you think is a bigger red flag in the mental health field? A chatbot that tells you it loves you or a boss that tells you AI is going to streamline your workflow?
Speaker A
Uh oh gosh. Um let's go with the first one. AI that tells you it loves you.
Speaker A
[laughter] This is good. This is fun. Um What is a human emotion that you think AI will never ever be able to fake?
Speaker A
Um bliss. Bliss. Okay. Not I was not expecting that one. I know you weren't.
Speaker A
Okay. So do you see the uh sorry world. My bro my brain didn't work right there.
Speaker A
I was trying to read the the words here with the bright light in my face. So do you see the AI world uh just handling our boring busy work that's going to make us relax more or do you see AI
Speaker A
actually ramping us up more and that we're going to be more stressed at the end of the day by having this stupid thing called AI? I'm hopeful for the first, but there is historically some precedent for the second.
Speaker A
Okay. So in three words sum up the future of mental health in the age of the algorithm.
Speaker A
Three words. Um so AI age of the algorithm um exciting uncharted scary. Okay. We'll go with that.
Speaker A
[snorts] So um our last little bit that we have for uh you here is this is. So this is your camera right here.
Speaker A
Yep. What is it that you either have coming up or things that you want people to know. It already sounds like you maybe have a boring paper or whatever, but you have things that people you want to know. This is your camera. So that's
Speaker A
this is your time to shine. Yeah. Um so I'm going to be doing my next big presentation is going to be to the Illinois Association of School Social Workers. We're going to talk about the use of AI in the world of school social
Speaker A
work as well as ethics. Um so I believe that's going to be the 24th of next month and if you're a clinician, registration should still be open. So go to the Illinois Association of School Social Workers website, which I will
Speaker A
give to Michael for him to either put somewhere or ignore. Um I hope to see you all there and I'd love to chat with any of you um about how you're experiencing this in your practice or your field.
Speaker A
So uh I'd like to say thank you for watching today. Uh we will be splitting this up into two parts so people can digest uh the two uh different times, but uh thank you for watching Roadrunner ZX. We look forward
Speaker A
to seeing you next time and thank you to my guest uh CJ Hamilton for coming in and speaking.
Speaker A
Friends, thank you for watching our second half of our video with CJ Hamilton. We look forward to seeing you next week with our next video and uh if you haven't done so already, please go out to our YouTube page and subscribe so
Speaker A
that we can get uh the latest episodes. If you liked it, please like the uh the video and then if you have any comments, we'd like to hear those.
Speaker A
Uh if you want uh quick uh hits on information going on with us, we have our Facebook page. You can go out and follow that. And for those of you that are out driving that just want to hear
Speaker A
uh the interviews that we have, we have our podcast, too. So thank you for watching the two parts and we look forward to seeing you next
Topics:AI in therapymental healthethical AIHIPAA compliancetherapy innovationAI and educationsocial emotional learningmental health technologyAI biasfuture of therapy
