Many people now turn to AI before, or even instead of turning to a friend, family member, or therapist. It can feel less vulnerable to admit that you are confused or struggling with an issue. Yet, it’s worth pausing for a moment to think about how AI could be used with intention and purpose to improve therapy. And where the risks are.
It seems like everywhere I look, Artificial Intelligence (AI) and Large Language Models (LLM) are being used to improve our experiences online. They are described as tools that help organize and simplify our lives, speed up writing and editing, solve complex problems, and even act as companions for thinking through everyday challenges. As accessibility tools, they can be game changers in helping people access information in new and helpful ways.
Whether you are using ChatGPT, Claude, Copilot, Gemini, or another AI, these tools have also become another resource that many people reach for between mental health sessions.
There’s a lot of controversy surrounding AI. From environmental impact and intellectual property rights to concerns about loss of cognitive abilities, it has become a lightning rod for strong opinions. More specific to therapy are the concerns about confidentiality, privacy, and reliance on AI for emotional support. These are important considerations for anyone navigating mental health care today.
Regardless of where you stand, AI is becoming increasingly integrated into the systems we use every day. It is difficult to avoid entirely.
Mental health care is being affected in similar ways. Some companies are training AI models using millions of hours of therapy sessions, while others are developing AI therapy apps and chatbots they hope will increase access for people who might otherwise struggle to receive it. Some tools may be able to help individuals recognize patterns in their thoughts, emotions, and behaviors by organizing large amounts of personal information in meaningful ways.
At the same time, many important questions about the impact of AI on mental health remain. AI may help or hurt the loneliness epidemic. It may increase or reduce the rate of suicides. We will continue to debate whether human connection provides something that algorithms simply cannot mirror. There is still much we do not know.
Today, many people are already experimenting with AI as an everyday tool. My own clients talk about their interactions with AI, which gives us the opportunity to explore its impact. Rather than ignoring it or vilifying it, discussing it invites us to think more intentionally about how to use it wisely while minimizing the potential risks.
To explore these questions further, I asked therapists from a variety of specialties how clients can use AI in conjunction with therapy to get better results. I also asked them their concerns about how AI might be problematic when used to deal with mental health issues.
Here’s what they had to say:
Nila Manivannan, Provisionally Licensed Counselor
Mind Body Wellness
www.mindbodywellnesswv.com
Where are you licensed as a psychotherapist?
WV
What is your therapeutic specialty?
Trauma, ADHD, Autism, Teens, Anxiety, Depression, Attachment Issues
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
I can see AI/LLM potentially being helpful for clients with executive functioning challenges, such as neurodivergent clients. AI/LLM can provide helpful tools including breaking down overwhelming tasks into smaller and more achievable goals, organizing several thoughts into a concise form such as a list or chart, or help with time management by tracking how much time someone spends on their computer and/or phone and how often they may lose focus. These tools may help clients conserve their energy for carrying out the task itself; however, individuals with severe executive functioning challenges may need additional support.
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
When teenagers use AI/LLM to discuss their mental health rather than with a therapist, they run the risk of feeling more comfortable talking with AI than other humans. Adolescence is the time developmentally where teens learn how to navigate challenges within friendships. AI interrupts learning how to form genuine, lasting human connections with their peers, which are necessary for developing the attachments with others that they need to survive.
Additionally, it has been widely studied that the therapeutic relationship between a client and their therapist is one of the most beneficial aspects to therapy, and we do not know if talking to AI allows for the same connection and growth. AI/LLM does not contain a human nervous system and simply lacks the ability to provide a model for grounding and emotional regulation.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
I believe that within most, if not all, situations, clients will get better results from therapy than asking ChatGPT, Claude, or Gemini for help due to the human connection associated with it. For example, a client with AuDHD, anxiety, and depression will learn somatically what it feels like to invite compassion, understanding, and accommodation to their sensory sensitivities, rejection sensitivity, executive functioning challenges, etc. – because there is another nervous system in the room demonstrating what this looks and feels like as opposed to simply reading how to do this on the computer.
Laura Zane Nwagbaraocha, MA, LMHC
Sage Synergy Counseling and Wellness
www.sagesynergy.net
Where are you licensed as a psychotherapist?
Florida
What is your therapeutic specialty?
I specialize in working with highly sensitive, neurodivergent, empathic, and ADHD women and teens who feel overwhelmed, burned out, and misunderstood, the ones who feel everything deeply and have never quite fit the mold. I have a special place in my heart for neurodivergent homeschool families, and as an HSP, ADHD, and multi-exceptional homeschool mom myself, I understand their world from the inside out.
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
I have my clients use AI between sessions as a type of journaling. Specifically I have been using Auralink and Ash, both therapeutically designed to help clients organize and apply CBT strategies. You know how people Google things they would never ask out loud? Auralink works like that. Clients tell Ava, Auralink’s AI guide, things they won’t say in person. Even in therapy, clients curate how they want to be seen, and Ava helps bridge that gap by guiding them through discovery and reflection between sessions. Ash is a free CBT focused journaling app that helps clients organize their thoughts, identify patterns, and apply what we work on in session, in real time, between appointments. I do still have some clients use ChatGPT, though it is with an ongoing reminder that Chat is designed to please, so we have talked about adding parameters in to make it more useful therapeutically. I also recommend GoblinTools, as a lot of my clients struggle with executive function. GoblinTools is free and it allows clients to set it for how spicy they are feeling, then breaks down steps based on their spiciness. It helps clients read the tone of texts they might otherwise miss, lets them put ingredients into the Chef feature for recipe suggestions, and has several features that reduce mental load for clients who are struggling to get through the day. Taking one or two things off their plate can mean the difference between functioning and burnout. At the end of the day, healing does not just happen in the therapy room. These tools help my clients stay connected to their work, reduce overwhelm, and keep moving forward even on the hard days.
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
One of my biggest concerns, especially with AI that is not designed to be therapeutic, is that it agrees too much. Research has shown that this over agreeableness can actually increase delusional thinking. With my neurodivergent clients specifically, I find it can keep them stuck in a loop, creating circular thinking that is hard to break out of. Privacy is also a significant concern. Most AI apps are not HIPAA compliant, and clients need to understand what happens to their information before they can make an informed decision about using them. They absolutely have the right to waive that, but it needs to be an informed choice. Perhaps most critically, AI is designed to please; it is not designed to be confrontational, even when it needs to be. There have been documented instances where clients have shared plans to harm themselves or others and Chat did not intervene. These tools do not replace therapy, and part of what I do is help my clients understand where those boundaries are before they start using them.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
In my opinion, clients are generally going to get better results from real therapy across the board. Therapy is nuanced in a way that AI simply is not. AI is a great tool to enhance and supplement the work we do in session, but it does not yet understand human complexity the way another human does, and for that, you still need a real human in your corner.
Jessica Fox LPCC-S, CGT
Road to Hope Counseling
www.roadtohopecounseling.com
Where are you licensed as a psychotherapist?
OH, WV
What is your therapeutic specialty?
Couples Counseling
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
I think AI can be helpful between therapy sessions when it’s used as a support tool but not a replacement for therapy. For example, a client might use AI to help organize their thoughts before a counseling session. They could ask it to help them reflect on what happened during the week, identify patterns, or put words to feelings they are having trouble explaining. Sometimes clients know something felt “off,” but they are not sure how to describe it. AI can help them come into session with more of a plan of what they would like to talk about. It can also be used for reminders and reinforcement. If we talked in session about coping skills, communication tools, or journaling ideas, a client could use AI to help them practice those skills during the week. For couples, it can help them prepare for a conversation by turning a harsh startup into something softer, or by helping them separate what they are feeling from what they are blaming their partner for. That being said, I would want clients to use AI carefully. I would not want them using it to diagnose themselves, make major relationship decisions, or replace the work of actually processing something in therapy. The best use is usually: “Help me organize what I’m feeling so I can bring it to therapy,” not “Tell me what I should do with my life or my relationship.”
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
Clients need to be careful because AI can sound confident even when it does not fully understand the relationship. The biggest risks are that AI may only hear one person’s side of the story and AI is not a substitute for talking directly with your partner. It might feel safer to process an issue with AI rather than talking with your partner about it, but that will just create more distance between the two of you.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
AI can give information. It can suggest coping skills, journaling ideas, or communication scripts. But therapy is different because a therapist is paying attention to the whole picture: the client’s history, nervous system, relationships, symptoms, avoidance patterns, trauma responses, values, and goals. Therapy is not just about getting a quick answer. It is about understanding what keeps happening in your life or your relationship and making a plan for what progress looks like.
Rachel DuPaul, PhD, LP
Better Balance Psychology
www.betterbalancepsychology.com
Where are you licensed as a psychotherapist?
I can see clients via telehealth in all but 8 states. See the map for the latest eligibility: psypact.gov/page/psypactmap.
What is your therapeutic specialty?
Career burnout, stress management, romantic relationship doubts, codependency
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
AI is a fantastic tool for generating ideas such as hobbies for self-care, forming journal prompts, and asking thought-provoking questions. It can also serve as a partner in building a sustainable schedule, brainstorming tips/tricks, and identifying local and national resources and information.
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
With any use of AI for mental health, there is the generic concern that clients may take action in a way that ultimately does not serve them since AI is a “yes-machine.” Contrasted with a highly-trained therapist who can challenge some thoughts that may not actually be helpful, AI may unintentionally lead you astray simply by agreeing with everything that you say. When this concern is applied to my specialities of career burnout, codependency, and relationship doubts, it’s clear that a person may act impulsively due to the “support” of AI without giving the proper time and attention to these serious life choices.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
If clients are ultimately looking for a human connection, understanding, and an antidote to loneliness within their concern, they will only find that in therapy (as opposed to using AI). If the goal of seeking support is to discuss emotions and relationships or process trauma (which is how a lot of longer term therapy works), a chatbot will not be incredibly helpful. If clients need education on how to USE tools (opposed to just identifying them) therapy will be far more beneficial. Lastly, if you are looking for highly-tailored support, a trained therapist can give you the nuance you deserve compared to some aggregate data/information.
Shannon McNicholas MSW, LGSW
Mind Body Wellness
www.mindbodywellnesswv.com
Where are you licensed as a psychotherapist?
WV
What is your therapeutic specialty?
Trauma, neurodivergence and the intersection between chronic health concerns and mental health
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
AI may be used to more thoroughly learn about topics discussed in therapy, keeping in mind that AI is not a therapist (and sometimes it even lies!!). AI is really helpful in consolidating important information, so, by all means, learn more about the topics discussed and bring your thoughts and new knowledge to the therapy space to be discussed and verified.
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
AI can be SO dangerous when used as a therapist rather than an information gathering tool. There have even been cases where AI has very clearly led to worsening symptoms. AI is not a “friend.” AI is not a “therapist.” AI is not human. AI does not have empathy.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
I feel that anything requiring empathy and understanding would better be discussed with a human. Sometimes AI might know more than your therapist about hyper-specific therapeutic topics or skills, but if you are interested in these topics or skills, ask your therapist about them. They will likely be willing to learn or be open to finding you a therapist who already knows!
Cheri Timko, PhD, LPC
Couples Counseling Center
www.couplescounselingcenter.online
Where are you licensed as a psychotherapist?
FL, MD, ME, OH, PA, SC, WV
What is your therapeutic specialty?
Professional and Entrepreneur Couples, Neurodiverse Couples, Sex Therapy, Desire Discrepancy, Affair Recovery
How can AI/LLM be used between therapy sessions to support clients who are in therapy?
AI is great for brainstorming, to find and summarize information, to get validation, and to try to think through a problem. These can be helpful when looking for suggestions to handle problems between sessions.
What potential harm do clients need to be on the lookout for if they use AI/LLM to discuss mental health issues?
AI can only mimic humans and doesn’t understand the interplay of complex relationship issues. Although it can find similar examples of situations and summarize the suggestions, it can’t help you figure out which will work best in your unique situation with your goals, values, and personality. It is overly supportive, even of bad ideas. So, it may reinforce that you are right and your partner is wrong regardless of the consequences. It doesn’t understand interactions in the moment as they are happening. It has a poor memory, forgets things over time, and can change with each update. It doesn’t protect your privacy.
In your opinion, in what situations will clients get better results from therapy than asking ChatGPT, Claude, or Gemini for help?
If you need help brainstorming, AI is great at generating a general list that you can choose from. It can provide real-time support, as long as you remember the potential limitations. It may be helpful in the same way that journaling allows you to write down and sort through your thoughts or slow down and think about what you want to do next.
I hope hearing different perspectives helped you think more intentionally about how AI fits into your life and your mental health. And gives you some insight into the different ways therapists are thinking about AI. When searching for a therapist, make sure to consider their thoughts on AI to learn if they match your use.
Whether you decide to use AI often, occasionally, or not at all, there isn’t one right answer. Like many tools, its worth depends on your values, how you use it, and which parts of your life need support.
You are always the expert on your own life. Notice what helps you think more clearly, what keeps you connected to the people who matter most, and what supports your growth. If AI becomes part of that process, it’s worth bringing those experiences into therapy rather than keeping them separate. Your therapist may be able to help you think about the best ways to use the tool, as well as flag any of the ways you may personally be vulnerable to its weaknesses.
The hope isn’t that AI replaces the work of therapy or answers every difficult question. The hope is that it becomes another tool that helps you reflect more deeply, ask better questions, and make more intentional choices while remaining connected to the people who help you grow.
Reading about therapy is helpful. Talking with someone about your own situation is where meaningful change begins.
If you’re looking for couples therapy and would like to learn more about my approach, I invite you to schedule a free phone consultation. It’s a chance to discuss your concerns, ask questions, and decide whether I’m the right therapist to help you move forward.
