Harnessing AI in Therapy: The Promise and Peril of Artificial Intelligence in Mental Health
We have arrived at a place where movies like The Terminator or I, Robot no longer feel entirely far-fetched. Artificial intelligence (AI) has become very intertwined into our daily lives, and it is even showing up inside the therapy room. For mental health professionals, as well as the clients, AI offers both exciting opportunities and real risks.
AI tools such as ChatGPT, Gemini, and other conversational agents have the potential to augment therapy by aiding in early screening, providing psychoeducation, and assisting clients between sessions. Yet, there are risks when clients become overly fixated on these tools, treating a chatbot or algorithmic “diagnosis” as a substitute for the therapeutic process, or as a new object of obsession. Understanding both the promise and the peril of AI is critical for integrating it in mental health care in a responsible and helpful way.
AI has the potential to expand access to therapy, which still remains limited for many populations. So many individuals deal with mental health challenges, but do not receive any treatment. Barriers include stigma, financial constraints, geographical limitations, or long waitlists for licensed clinicians, or clinicians accepting insurance or low fees. AI-driven tools can fill gaps by offering in the moment interventions, support, or preliminary detection of mental health warning signs. They can serve as a first step for someone hesitant to seek therapy or as a complementary adjunct for ongoing care.
Research demonstrates that AI can be clinically useful. Conversational agents, also known as chatbots, have shown effectiveness in reducing symptoms of depression and providing a general decrease in overall distress. A 2025 randomized controlled trial reported that an AI chatbot, delivered in a therapeutic format, led to measurable symptom improvement among clinical-level participants. This suggests that AI can provide support for monitoring mood, reinforcing therapeutic skills, and providing relief between sessions when human support is unavailable. It is helpful in situations where constant or frequent clinician contact is not possible.
AI can aid clients in self-management and early intervention. Mood-tracking apps, cognitive-behavioral exercises, mindfulness tools, and structured AI interactions can provide guidance for emotional regulation and stress management. When used correctly, these tools reinforce skills learned in therapy, encourage consistent practice, and help clients maintain awareness of patterns between sessions. However, these tools should not replace therapy, but act as a supplement that enhances engagement and agency.
AI also offers benefits for therapists themselves. Many therapy platforms now integrate AI to support administrative and clinical tasks. AI can assist in screening clients for risk factors, detecting patterns in their experiences, summarizing and writing session notes, and aiding in the use of tools and skills. These features allow clinicians to focus more on the relational and emotional work that is central to therapy, rather than spending disproportionate time on documentation. While these tools simplify workflow, they cannot replace the critical thinking, empathy, and relational skills of a trained professional. AI should be viewed as a supportive partner in the therapy process, not a replacement for human judgment.
Despite these benefits, AI comes with significant risks to take into consideration. One of the most common concerns is over-reliance and utilizing AI as more than just a tool. Some clients begin consulting chatbots before making any and every decision, whether it is a major life choice or a smaller matter. Over-reliance can manifest in several ways such as, repeatedly seeking confirmation from AI for a desired diagnosis or outcome, using AI as a substitute for internal reflection, or becoming distressed when responses are ambiguous. Systematic research has shown that “AI-dependence” in adolescents is associated with increased anxiety, depression, and lower self-efficacy, particularly when AI is framed as a social companion or emotional substitute. As therapists, is it important to monitor the frequency and context of AI interactions, ensuring that digital tools complement, rather than replace, human support.
Self-diagnosis via AI is another growing challenge. While AI tools can generate suggestions or provide psychoeducational feedback, they are not validated diagnostic instruments. A chatbot may offer a label based on limited input, but this cannot be a substitute for a formal clinical assessment conducted by a trained professional. The complexity that goes into making a diagnosis, sometimes evolving over the course of learning more about a client, needs to be carefully thought about in this context. Social media often amplifies the appeal of self-diagnosis, providing a sense of legitimacy to labels that may not accurately reflect the individual’s experience. A client might get hooked on a new diagnosis because part of it resonates with them, but without fully considering the bigger picture. Over-fixation on AI-generated diagnoses can stall therapeutic growth, as clients may interpret all their experiences through the lens of a single label, avoiding exploration of underlying emotions or contextual factors.
Emotional dependency on AI can also lead to isolation and can blur relational boundaries. Frequent use of AI for emotional support or even companionship, may inadvertently replace human connection, leading to loneliness and difficulty in real-world relationships. Studies on AI companions suggest that these interactions, while superficially appealing, may foster unrealistic expectations of intimacy and avoid the complex interpersonal work that is crucial for mental health. Therapists can encourage clients to reflect on the needs met by AI and the needs that remain unfulfilled, supporting a balanced integration of technology and human relationships.
The risks are particularly pronounced for vulnerable populations. There have been cases of “AI-induced psychosis,” where intensive chatbot use exacerbates delusional thinking, paranoia, or other severe mental health symptoms. AI interactions have also been linked to increased self-harm in at-risk users. Clients with pre-existing conditions such as psychosis, Bipolar Disorder, severe trauma histories, suicidality, or dissociation may be especially sensitive to the negative effects of AI use. For these individuals, unsupervised or excessive engagement with AI can pose serious clinical risks, emphasizing the need for careful evaluation before recommending AI tools.
In addition to direct clinical risks, systemic issues must be considered. Many AI tools remain in early stages of development, with limited long-term outcome data. Some tools may contain algorithmic biases or provide inaccurate feedback, potentially offering false reassurance. AI chatbots begin to learn what you want to hear and reinforce that same narrative to you, whether or not the information is accurate or helpful. This surely raises concerns, especially for already emotionally vulnerable people. Ethical and privacy concerns are paramount, including how client data is collected, stored, and used. Clients should understand these limitations and recognize that AI is a support tool, not a replacement for professional guidance.
When used responsibly, AI can be integrated into therapy. It is important to clarify that AI is a supplementary tool, designed to enhance, but not be a replacement for the therapeutic process. Selecting AI tools that are evidence-based and with transparent limitations is crucial. Therapists can use AI for monitoring, bridging between sessions, and guiding skill-building exercises, while maintaining reflection and discussion within sessions. Regular evaluation of client use, attention to over-reliance, and vigilance for self-diagnosis are critical. Boundary issues should also be addressed, helping clients reflect on how AI affects their relationships and self-awareness.
Planning for the limitations of AI is essential. Clients must understand that AI cannot respond to crises, acute psychosis, or suicidal ideation. Especially vulnerable clients, should not rely on AI as a primary support system. Therapists must remain informed about the evolving research, integrating AI thoughtfully to complement therapy rather than undermine it.
The allure of AI, instant, non-judgmental, always available, can lead some clients to ask, “What does AI say?” before reflecting on their own feelings or needs. Premature adoption of AI-generated diagnoses can entrench identity around a label, reducing curiosity and preventing exploration of the broader emotional context. Over-reliance on AI can also reduce engagement with human relationships, weakening the relational work central to therapy. For clients with serious mental health vulnerabilities, AI misuse can exacerbate symptoms or even create new risks.
Despite these challenges, AI integration in therapy offers an unprecedented opportunity. When used thoughtfully, AI can support skill-building, enhance insight, and provide bridge support between sessions. Misused or over-relied upon, it can lead to fixation, isolation, or harm. Therapists play a critical role in guiding clients toward responsible AI use, ensuring that human connection and relational growth remain at the heart of mental health care.
