Psychotherapy as Heuristic Search

Currently, there is no coherent framework for psychological therapy. From psychoanalysis to behaviour therapy, humanistic and third wave approaches, there are significant differences in terms of aetiology, methods and expected outcomes (Diederich, 2021). Heuristic search, an important method in artificial intelligence, can serve as a gen-eral frame of reference for psychotherapy. This approach is based on a clear def-inition of the starting and end points of psychological therapy and how to achieve identified outcomes; it allows the utilisation of particularly effective psychological interventions and a ranking of different forms of psychotherapy with regard to efficacy, time and effort.

A heuristic is a “rule of thumb”, a method that might not always find the best solution but is guaranteed to find a good solution in reasonable time. Heuristic search is a form of problem solving that aims at finding the best and most cost-effective path from a starting point to a well-defined goal. A cornerstone of this framework is the notion of "deep heuristic", that is, particularly useful psychologi-cal interventions based on clinical experience that move the client closer to recovery.

Let's look at a very simple example of a deep heuristic in the context of psychological service delivery. A client presents with some stress and anxiety as a result of changes in the workplace. The person is young, well-educated with no history of mental health problems and is in a stable relationship. In addition, there is no family history of mental health problems. This is the first time the client ap-proaches a clinical psychologist and the current distress is clearly related to work-place related issues. Based on experience, the practitioner decides not to launch a full-scale psychotherapy but to explain the psychological and biological founda-tions of stress and anxiety. The explanation is supported by reading material and a discussion of various relaxation techniques that may be useful. With this information, the client is on the way and no further sessions are booked unless specifically requested by the client.

What is the deep heuristic in this case? Based on experience, the decision is made not to launch a full course of psychotherapy including ten or more sessions. Rather, the focus is on psychoeducation as this may be sufficient to relieve the client’s stress.

Importantly, the framework introduced here applies to all forms of psycho-logical service delivery, from the everyday clinical work of trained psychologists to computational applications in mental health. Heuristic search can serve as a general frame of reference for psychotherapy and the usefulness is illustrated by case studies. It is likely that the heuristic search framework can be applied to interventions in psychiatry as well as health disciplines in general. The approach includes various forms of knowledge acquisition to obtain exper-tise. It allows the utilisation of particularly effective psychological interventions and a ranking of different forms of psychotherapy with regard to time and effort.

More generally, heuristic search is a form of problem solving. There is a clearly identified start state (e.g. a client with a set of symptoms) and a goal state (e.g. the client is free of symptoms). Often there are multiple or complex goals (e.g. client is free of symp-toms and well supported by a social network). There are also means of transforming one state to another: psychological interventions. These interventions are in-formed by evidence-based research but clinical practice is important as well. In-deed, a significant part of the training of clinical psychologists is based on clinical practice. As such, an experienced clinician develops heuristic knowledge: facts, skills and methods that are particularly useful. Sometimes this knowledge is explicit, for instance, when the therapists knows that s/he can initiate a certain ac-tion; sometimes the knowledge is implicit, that is, there is no conscious awareness of it. Here, deep heuristics refer to psychological interventions that are deemed particularly useful based on clinical experience in a given context.

Psychological interventions are the means of transforming one state (set of symptoms, level of well-being) to another in order to achieve a clearly defined goal. Psychological interventions can be ranked at any point in time with regard to a number of criteria: (1) Legal requirements and the management of risks, (2) empirical support for the intervention, (3) probability of success and (4) confi-dence of the practitioner to conduct the intervention based on training and clinical experience. Clearly, the ranking can include other criteria as well. In this approach, intermediate states in problem solving (heuristic search) that increase the risk to a particular client are avoided while those steps that increase well being are preferred.

In summary, artificial intelligence developed the idea that problem solving is search, in particular heuristic search. From this viewpoint, psychotherapy is the search for means to achieve goal states; a freedom of symptoms frequently among them. The solution to a problem is a viable path from a starting point (the client presents with symptoms) to one or several goals states (absence of symp-toms, general well-being, social support etc).

Diederich J, The Psychology of Artificial Superintelligence. Springer Nature Switzerland AG 2021, ISBN 978-3-030-71841-1, DOI https://doi.org/10.1007/978-3-030-71842-8