The Pros and Cons of AI in Mental Health

A Therapist's Journey Through AI Anxiety and Discovery (Part III)

Will AI make counsellors and therapists obsolete? Is AI a safe alternative to therapy? These lively debates among mental health care providers provoke anxiety, not just around job security but primarily around concerns for clients' welfare. I, like many others, am beginning to explore and question the role of AI in our lives. In this post, I will explore the pros and cons of AI in mental health services, its potential, and its limitations.

Where AI Enhances Therapy

AI offers several benefits that can improve therapy for both clients and therapists. Some key advantages include:

Increased Access to Care

AI-powered chatbots and apps provide mental health support anytime, anywhere. For those who cannot visit a therapist regularly due to location, cost, or stigma, AI tools offer a way to get help quickly. For example, apps like Woebot and Wysa use AI to guide users through cognitive behavioural techniques. This access to care may help someone feel heard. Because AI is available 24/7, it can offer psychoeducation, grounding exercises, or prompts to practise coping skills when it’s late at night or when you're between appointments.

Offer Skills and Structure Between Sessions

AI can tailor exercises and reminders based on individual needs. This helps clients stay engaged between sessions. For instance, an AI app might suggest mindfulness exercises when it detects rising stress levels from user input or challenge unhelpful thoughts. Some research has shown short-term symptom improvements for anxiety or depression. One randomised study of an AI “therabot” reported greater reductions in depression and anxiety over 4–8 weeks compared to a waitlist, with users rating the relationship with the bot as surprisingly collaborative. NEJM.

Efficiency in Routine Tasks

Therapists spend time on paperwork, scheduling, and note-taking. AI tools can manage appointments and send reminders, reducing missed sessions. They can also prompt clients to complete homework or self-care tasks between visits. Some platforms use AI to transcribe sessions and highlight important points. This can free up more time for direct client interaction.

Data-Driven Insights into Client Mental State

AI can analyse patterns in speech, writing, or behaviour to help therapists understand clients better and possibly predict where mental health issues are escalating. This can reveal hidden emotions or risks that might be missed in conversation. For instance, AI can detect changes in tone or word choice that suggest worsening depression.

Virtual Reality Therapy

AI combined with virtual reality creates immersive environments for exposure therapy. This helps clients face fears like phobias or PTSD triggers or deal with addiction and cravings in a controlled way.

Therapist taking notes with AI analysis on tablet

Where AI Falls Short in Therapy

Despite its benefits, AI also raises concerns that therapists and clients should consider:

AI and Lack of Human Connection

Therapy relies heavily on empathy, trust, and understanding—qualities that AI cannot genuinely feel. Some clients may feel isolated or misunderstood when interacting only with AI.

Creating Unrealistic Expectations in Human Relationships

Though AI might be available 24/7 and may seemingly give us what we want to hear in a tone we prefer, that's not how real life works. Humans must navigate difficult emotions in relationships with others, as well as enjoy the positive ones. This isn't just in intimate partnerships but also with friends, co-workers, family, and professionals like therapists. We don't always get it right, and the ability to tolerate discomfort and step into difficult conversations is what makes real connection possible. If we stop doing so, do we stunt our interpersonal skills? Do we risk disappointment if others can't behave like or be our compliant AI partner?

Risk of Over-Reliance & Loss of Personal Resourcefulness

We might rely too much on AI tools and delay seeking professional help when needed. We may develop an unhealthy and time-consuming habit of turning to AI instead of engaging with the human world.

Bias (Including AI Sycophancy)

AI systems learn from the data we provide. If most of the information AI uses to learn comes from particular cultures, genders, religions, or political viewpoints, it can approach you with that lens. This perspective may not be appropriate or culturally sensitive for you. Moreover, AI collects our beliefs, biases, and concerns in the words we provide. It may reflect back the same biases, reinforcing our thoughts. For example, the tool we rely upon could become sycophantic in agreeing with us instead of gently challenging our way of thinking.

Limited Understanding of Complex Issues

AI works best with clear patterns and rules. It struggles with complex, nuanced human emotions and situations. For example, AI might not handle trauma or crisis situations as effectively as a trained therapist.

Lack of Ethical Parameters

AI operates with data, not with a sense of ethical boundaries and professional responsibility. It can make mistakes and may not reliably recognise risk. An unstructured, informal AI system without boundaries may operate in ways that hurt rather than support clients. Professional bodies are being called upon to provide parameters for ethical use of AI. Ethical reviews emphasise strict testing and human oversight/governance for this reason. Societies (MDPI).

Privacy and Data Security

When you use AI tools, you may share sensitive personal information that cannot be withdrawn later. There is a risk of data breaches or misuse. Even though therapists could use AI for session notes, is this information protected? Clients must be informed about how their data is stored, and therapists must think carefully about how to protect that data.

Looking Ahead: The Future of AI and Therapy

AI will continue to evolve and become more integrated into mental health care. My hope is that it will make the processes of providing support easier. For clients, this means more options to engage with mental health tools.

The key is balance: using AI to improve access and efficiency while preserving the human connection that makes therapy effective. AI should complement, not replace, therapy with another person.

I recently heard a conference speaker state that AI therapy doesn't actually exist. At the heart of therapy and counselling is a relationship, one in which individuals have experiences of the relationship, of themselves, and of each other. Though AI gives the illusion of interacting with us, it isn't capable of care, empathy, or authentic human connection.

I wonder if AI technology might cause us to reflect on the profound impact we feel when another, even a chatbot, 'hears' us. How might the technology help us improve our listening skills? At the same time, I hope we can hold onto the desire to engage with other humans, to be challenged by, and rewarded by, the opportunity for interpersonal relationships.

Conclusion: Embracing the Future of Therapy

As we navigate the complexities of AI in therapy, it's essential to remain open-minded yet cautious. The landscape of mental health care is changing, and while AI can offer valuable support, it is not a replacement for the human touch.

In the end, the most effective therapy combines the best of both worlds: the efficiency of AI and the empathy of human connection. By embracing this balance, we can foster healthier, more integrated relationships with our sexuality and emotional well-being.

So, what does the future hold for therapy? Only time will tell, but one thing is certain: the journey is just beginning.