the strongest head-to-head test to date found that users of ELIZA, a decades-old non-AI conversational bot, showed greater mental health improvements than users of a purpose-built AI chatbot, suggesting that structured engagement, not generative AI, may be driving observed gains.
ELIZA outperforming purpose-built AI mental health chatbots is a devastating finding that undermines the entire premise of the category. ELIZA (1966) has no understanding of language, no memory, and no clinical design — it uses simple pattern matching. If structured attention alone explains the observed benefits, then companies charging subscription fees for 'AI therapy' are monetizing a placebo effect while attributing it to technology.