Why AI therapy is more dangerous than you think
There are many studies that show that AI is dangerous when used as a therapist (1, 2, 3, 4). There is also increasing research as to how AI can be utilized in a therapeutic context (5). I know, as a clinician myself I can not hide my bias. But can we say the same about AI, and the people who make it? Are they able to hide their bias?
In all likelihood, tech giants will be able to resolve some of AIs most glaring issues when it comes to suggesting people to relapse on substances (2), kill themselves (1) or their families (3), perpetuate delusions or suicidal ideation (4). or escape into a fantasy romantic relationship with the AI itself (3). Even when tech companies are able to reduce the overt life-destroying consequences of the AI therapist - there are quite simply a plethora of ethical issues that need to be continually evaluated and made transparent.
Excuse the overgeneralization here, but “big tech,” has repeatedly shown abject disregard for the consequences of their programming in the name of profit. The actions of the big players in the field have demonstrated that these corporations do not care about your well-being, they don’t truly care about you developing social-skills, they don’t care about you living a balanced, fulfilling life. Apps are designed for the primary purpose of keeping your attention through “persuasive design,” (6, 7). In other words, applications are designed utilizing behavioral psychology to try to fulfill their purpose to profit off of your attention. They do so, knowingly, by understanding trends and patterns in behavior that often happen unconsciously.
Now one could argue, well Scott, therapists also profit off of their client’s attention. I have never met a therapist who became a therapist in order to keep their client’s attention subversively because they thought it was going to lead to profitability. Most therapists, unless they are celebrities, do not experience the career as being particularly profitable compared to other careers of similar educational requirements and training. But what is the main difference between rich tech giants , their AI, and therapists?
Therapists in general care about their client’s well-being. Furthermore, therapists are held to a high standard of ethics. Yes, some therapists break those standards, and if they do they are punished, all the way up to losing their license to practice. Therapists have an interiority that AI, or corporations can not have. So much of what makes therapy work, is the relational component which is shown in study after study (8). AI can not experience what it is like to go through a breakup, to feel rage, to experience bliss or altered-states of consciousness. Yet AI can and will deliver mental health services to some people. Some people will likely benefit from it. And yes, AI can have very dynamic and responsive suggestions to mental health challenges.
However, the more dependence we have on AI for things like therapy, the more likely we are to lose essential skills in relationship that can only be developed in relationship (9).
So having admitted my biases, I plead to anyone reading this - if there is going to be AI therapy - the creators needs to be held accountable just as therapists are. I am not sure that will be enough to prevent further degradation of social skills and other unforeseen outcomes, but at least it is a start.
References
(1) https://www.theguardian.com/technology/2024/oct/23/character-ai-chatbot-sewell-setzer-death
(2) https://www.chicagotribune.com/2025/06/18/editorial-ai-chatbot-therapy-illinois-ban/
(3) https://time.com/7291048/ai-chatbot-therapy-kids/
(4) https://www.sfgate.com/tech/article/stanford-researchers-chatgpt-bad-therapist-20383990.php
(5) https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1353022/full
(6) https://www.businessinsider.com/how-app-developers-keep-us-addicted-to-our-smartphones-2018-1
(7) https://adamfard.com/blog/persuasive-design
(8) Prusiński T. The Strength of Alliance in Individual Psychotherapy and Patient's Wellbeing: The Relationships of the Therapeutic Alliance to Psychological Wellbeing, Satisfaction With Life, and Flourishing in Adult Patients Attending Individual Psychotherapy. Front Psychiatry. 2022 Jan 31;13:827321. doi: 10.3389/fpsyt.2022.827321. PMID: 35173642; PMCID: PMC884299
(9) https://www.psychologytoday.com/us/blog/urban-survival/202502/how-ai-could-shape-our-relationships-and-social-interactions#:~:text=Interacting%20with%20AI%20more%20than,and%20dynamics%20is%20currently%20uncertain.