A Chat with a Therapist

I decided to talk to someone in the mental health industry to gain more insight on the impact of stigma. Vanessa McGann, PhD is a therapist and Assistant Director at The New School’s Student Health and Support Services. She kindly allotted some time to chat with me over the phone.

I asked her what she felt was necessary in order to fight mental health stigma. She believed that more people needed to be able to talk about their struggles with a sense of hope and that things are manageable. She also said that fighting stigma was a multi-pronged approach — all aspects need to be considered, from family support, to public awareness, to managing struggles internally.

She gave me a lot of precedents to look at, like livethroughthis.org, a photograph collection of people who’ve attempted suicide, or Mood Gym, a website that helps people walk through exercises in order to improve their outlook.

I asked her what she thought about the role of chatbots or technology in the field of mental health; she replied saying that for people who don’t have access to therapists, technology can be a great way to help, as well as helping people feel accepted. She also said that she didn’t think technology would be able to replace therapists or human warmth.

I thought about our conversation for a while. My entire project revolves around diminishing mental health stigma in some way. In my last concept development, I had tried to shove in as many aspects of what I believed would be helpful; but in the end, the project seemed convoluted and muddled. I decided to take a step back and focus on one aspect of the problem.

I want to create a tool for people with mental illnesses to manage and reduce distorted thoughts in order to improve their outlook, reducing internalized stigma.

This is what should happen normally:

But stigma stands in the way of a lot of people’s path to treatment:

As a result, my project aims to intervene at the moments when people are filled with anxiety and doubt, hoping to help them improve their views on life so they may feel better about themselves and seek proper treatment.

Most people don’t realize when they’re feeling anxious or thinking negative thoughts, so they’re unable to apply the methods that therapists employ in day-to-day life. As soon as Moodbot detects tension or anxiety over long periods of time, it’ll ping you and ask to check-in and go over negative emotions.

Concept Development II

01. Problem

People struggling with mental illnesses are met with stigma. People who internalize this stigma are often unable to receive the treatment they need because they don’t want to be associated with the labels, stereotypes, and discrimination perpetuated by society. As a result, people with self-stigma have diminished self-esteem, self-efficacy, and confidence to achieve life goals. In order to overcome this, research shows that personal empowerment and conquering cognitive distortions can be a solution.

02. Context Analysis

People with mental health disorders fear labels such as “you’re violent/crazy/unstable/dangerous”, which can be applied just by being seen exiting from a psychologist’s office. These stigmas can also be attached to a person attending a peer support group, which is a valuable service that brings people together affected by a similar concern, and provides support, encouragement, and hope. So how do we treat internalized stigma if people don’t want to see a therapist (which provides the necessary CBTs in order to treat the stigma) or attend peer support groups (which provide empowerment) because of stigma itself?


03. Questions:

1. How can I take the therapist out of the office?

This can protect the user’s privacy so they are more willing to work on their cognitive distortions.

2. How can I bring people together and connect them?

This helps empower people — “you are not alone”.

04. Goals

Help people suffering from stigma to overcome the low self-esteem, self efficacy, confidence in one’s future as a result of self-stigma.

05. Solutions

Revisiting my concept statement, I listed out the solutions to each aspect I wanted to deliver in my service.

1. Chatbot – takes therapist out of the office, works through CBT methods and helps with overcoming internalized stigma

2. CBT journal – a thoughtful approach to processing distorted thoughts

3. Peer support groups – service and resource that brings together people affected by a similar concern so they can explore solutions to overcome shared challenges and feel supported by others who have had similar experiences and who may better understand each other’s situation

In my previous concept development, I had prioritized the chatbot as the centerpiece of the project. After some more research, I realized that peer support groups had a huge impact on people — not only do people come together based on similar hardships, adversities and challenges in life, they mutually support and give encouragement to one another as they move through similar life experiences. The opportunity to build new relationships and strengthen social support networks helps reduce isolation and feelings of loneliness.

As a result, I decided that an online peer support service would be an ideal starting point as a solution to the problems I want to tackle.

06. Making a peer support group

In WHO’s guide to making peer support groups, some steps to making a peer support group are as follows.

1. Identify a common purpose or need

2. Facilitators lead and facilitate discussions in a group and take responsibility for the development and functioning of the group

3. Code of ethics — includes keeping confidentiality, recognizing that thoughts and feelings are not right or wrong, showing acceptance, etc.

4. Sharing stories — members are not obligated to share their stories, but encouraged. As always, confidentiality is a high priority.

5. Identifying common experiences — identify the most common experiences of the group so that people feel connected on various levels with each other

There are barriers to attending peer support groups, which WHO addresses:

  • mental health stigma
  • lack of trust that it will be a safe space where they can talk freely
  • too burned out to venture out to another meeting
  • nervous about what might happen

In order to address these challenges, I decided that I would try building an online peer support group. This protects a user’s privacy because users can remain anonymous, and doesn’t require the same time and effort it takes to attend an in-person peer support group.

07. Addressing scope and limitations

Online peer support groups are not for everyone. Some people prefer in-person communication.


This project does not help solve mental illnesses. It does not replace a trained medical professional.

08. Criteria

  • easy to access
  • private/confidential/anonymous
  • provides a safe space to talk
  • connects people based on similar experiences and challenges with the goal of empowerment and reducing stigma
  • reduces sense of isolation
  • helps work through cognitive distortions associated with stigma

09. Role Prototypes

My project, currently called You Are Not Alone (YANA), is a service that combines a peer support group with CBT methods. The user signs up to be a member or a group facilitator. After signing up, the user is able to download the mobile app, which has these functions:

  • Moodbot the chatbot: helps you identify cognitive distortions in real-time.
  • Messages screen: Moodbot, group chat, or individual peer chat conversations.
  • Journal entries: Write a thoughtful journal entry about your thoughts. The process takes you through identifying cognitive distortions.
  • Plant friend: over time, you nurture a plant in the app through your mental health journey. Each time you accomplish a mood check-in with Moodbot, or write a journal entry, or participate in a peer support group chat, you gain items that help your plant flourish.
  • Insights and trends: Check and see what moods you feel most often and why.
  • Friends: Visit peers’ profiles to see their plants.
  • User profile: Displays your current plant and a summary timeline of your journey in the app.

The sign-up process is lengthy and requires the user to answer thoughtfully. The more detailed the answer, the better idea the service would have of the person, and how to better match them with others in a peer support group. The personality questions are currently taken from Greet, a precedent I looked at that matches people together for deep and meaningful conversations. I will have to consider how to make my own personality questions.


10. Look and Feel Prototypes






  • facts about mental health
  • mental health stigma and why it’s a problem
  • why I’m interested in mental health
  • goals of the project
    • how can the design of a process or tool help people with mental illnesses connect, feel empowered, and reduce distorted thinking?
    • focus on reducing self-stigma
  • scope and limitations
    • scope: not one size fits all
    • types of users
    • limited time and resources
  • significance of project for society

Explorative Research

  • background of mental health stigma
  • how stigma is arrived
  • types of stigma
  • research-backed solutions to stigma
  • precedents and comparisons
  • design themes
    • empowerment, connection

Design Concepts

  • how my design concepts fit into the design themes
  • concept explanations, prototypes – where it started, what influenced it, where it ended
    • criteria: safe, private
    • challenges and limitations: trolls, limited feedback
  • evaluative testing
  • personas and scenarios
    • impact


  • summary of project and themes


Concept Prototype I

My users are people with mental illnesses who feel isolated and need a safe space to talk to people about their problems and gain emotional support.

Some precedents I looked at are as follows:

I imagined a service that contained a chatbot, which took the therapist out of the office, and collected insights on a user’s distorted thoughts. It then matches the user to people based on these insights, allowing them to connect and have a safe space to speak freely about emotions and struggles. I wanted to combine the usefulness from technology with the warmth of human connection.

I first tried my hand at making an iOS chatbot app. I used Google’s Dialogflow and XCode. It was challenging trying to get the API to work, and have the app communicate with Dialogflow. In the end, I was able to make it work — you can now type things and communicate with the bot!

This prototype is an implementation prototype — I wanted to see how the chatbot could be implemented, and if it was feasible. It also shows how the user would interact with the chatbot.

I hope to be able to implement a chat user interface, which I mocked up in Sketch. This mockup is a look-and-feel prototype.


My next step is to see how users would be matched together, and how they would interact with one another. I would like to perform a user survey, but I’m not sure how to approach the sensitive topic, or what questions to ask, or where to find my specific user group.



Concept Development

Narrowing down my focus from the overarching topic of mental health stigma, I decided that I wanted to provide some form of support to people suffering from self-stigmatization. From my previous research, I found that when people disclose their illnesses, they often gain a sense of personal empowerment. I looked into how technology might benefit people who are seeking for someone to talk to, and want to unload the burden of hiding their illnesses. As it turns out, it has its benefits and limits.

Often times, people need regular reminders or check-ins from friends, family, or others in order to gain a sense of support. From what I gathered from a popular mood tracking app, Moodnotes, users really appreciated the app notifications that checked in with how they were feeling. I recalled a conversation I had with a friend with mental illnesses, who said that they really liked when I texted and asked how they were doing. It made them feel valued.

I feel like having a chatbot that walked the user through some cognitive behavioural practices would be useful on a day-to-day basis. It would regularly check in and see how the user is feeling, recording the data into a tracker that could show trends and insights into how the user felt normally/most often. This process would be more intuitive and natural than simply inputting text in a form as per normal mood tracking applications.

An algorithm could put together insights from the user’s moods and thoughts, matching them with other users for peer support. Users would be matched based on what illnesses they have, similarities, or CBT strategies they’ve overcome.

This is Woebot, a therapist bot on Facebook that uses cognitive behavioural therapy as a way to chat with the user.

While a therapist bot seems helpful on a daily basis, it cannot detect nuances in human speech. This is why I imagine using a bot in adjunct with real human connection could potentially be powerful. The process is illustrated below.


Then the users could interact through the following:





Perhaps people who are interested in thoughtful conversations would like a pen-pal system, where they could experience the joys of receiving mail from someone across the world. This would be like journal type of therapeutic support. I would want to make a package that would be sent to the users with letter notepads that show them how to not only write out their emotions, but how to cognitively process them.

Of course, there is also the excitement of being connected to people in an online chatroom — connected to people who can relate to you, and share their own experiences and how they worked through them. Chat groups provide a more immediate sense of support.

Thus, my concept statement would be:

I am creating an app for people with mental illnesses to connect with others and increase feelings of validation and empowerment, while reducing their sense of isolation and distorted thinking from a day-to-day basis.

Narrowing down my user group, I would describe them as:

  • people with mental illnesses and emotional distress and need someone to unload their stress to in a safe space without fear of stigma

My desired outcome would be to:

  • increase validation
  • reduce isolation
  • relieve people from their immediate emotional distress
  • help people walk through their thoughts in an objective way