Is AI therapy safe, effective, and ethical?

Picture having a personal therapist who is always there for you, understands your needs, and gives helpful advice whenever you ask. There are no hourly fees, and you can start or stop sessions whenever you want. Thanks to new developments in AI, this idea is close to becoming a reality.

With advanced AI and large language models (LLMs), what once sounded impossible is closer to reality: AI is rapidly becoming a stand-in for therapists, offering users advice and mental health support. While society increasingly turns to AI for personal and professional assistance, a new debate arises: can AI truly replace human mental health expertise?

Therapy keeps secrets; AI keeps data

Registered therapists must maintain confidentiality except to avert serious harm, fostering a safe, non-judgemental environment for patients to speak openly. AI models, however, depend on large-scale data processing and lack an equivalent duty of confidentiality, creating ethical risks around privacy, secondary use and oversight.

The privacy and data security concerns are not hypothetical. In June 2025, users reported that sensitive Meta AI conversations appeared in the app’s public Discover feed, often because chats were unintentionally shared, prompting scrutiny from security researchers and the press. Separately, a vulnerability disclosed in December 2024 and fixed in January 2025 could have allowed access to other users’ prompts and responses.

Meta described the Discover feed as a means to explore various uses of AI, but it did little to mitigate everyone’s uneasiness over the incident. Subsequently, AMEOS Group, a private European healthcare provider, suffered a large-scale data breach affecting millions of patient records. The writing was on the wall: be careful what you share with your AI counsellor, because it may end up on an intruder’s hard drive.

To keep up with the rising volume of users and prompts, major tech conglomerates such as OpenAI and Google have invested heavily in building new data centres across the globe. At the same time, little has been done to protect sensitive data, and AI remains prone to data breaches, particularly in the healthcare sector.

According to the 2025 Cost of a Data Breach Report by IBM, healthcare providers often bear the brunt of data breaches, taking an average of 279 days to recover and incurring an average cost of nearly USD $7.5 million in the process. Not only does patients’ private information end up in the wrong place, but it also takes a while to be retrieved.

Falling for your AI ‘therapist’

Patients falling in love with their therapists is not only a common trope in films and TV shows, but it is also a real-life regular occurrence for most mental health workforce. Therapists are trained to handle these attachments appropriately and without compromising the patient’s progress and well-being.

The clinical term is transference: patients may project past relationships or unmet needs onto the therapist. Far from being a nuisance, it can be clinically useful. Skilled clinicians set clear boundaries, reflect feelings, and use supervision to keep the work safe and goal-directed.

With AI ‘therapists’, the cues are different, but the pull can feel similar. Chatbots and LLMs simulate warmth, reply instantly, and never tire. 24/7 availability, combined with carefully tuned language, can foster a bond that the system cannot comprehend or sustain. There is no duty of care, no supervision, and no capacity to manage attachment or risk beyond scripted safeguards.

As a result, a significant number of users report becoming enamoured with AI, with some going as far as dismissing their human partners, professing their love to the chatbot, and even proposing. The bond between man and machine props the user onto a dangerous seesaw, teetering between curiosity and borderline delusional paranoia.

Experts warn that leaning on AI as a makeshift therapist or partner can delay help-seeking and entrench unhelpful patterns. While ‘AI psychosis‘ is not a recognised diagnosis, clinicians and digital-ethics researchers note that intense attachment to AI companions can heighten distress, especially when models change, go offline, or mishandle risk. Clear signposting to human support, transparent data practices, and firm usage boundaries are essential to prevent unhealthy attachments to virtual companions.

Who loses work when therapy goes digital?

Caring for one’s mental health is not just about discipline; it is also about money. In the United States, in-person sessions typically cost between USD $100–$250, with limited insurance coverage. In such dire circumstances, it is easy to see why many turn to AI chatbots in search of emotional support, advice, and companionship.

Licensed professionals are understandably concerned about displacement. Yet there is little evidence that AI is reducing the demand for human therapists; services remain oversubscribed, and wait times are long in both the USA and UK.

Regulators are, however, drawing lines around AI-only practice. On 4 August 2025, Illinois enacted the Wellness and Oversight for Psychological Resources Act (HB 1806), which prohibits the use of AI to provide therapy or make therapeutic decisions (while allowing administrative or supplementary use), with enforcement by the state regulator and fines up to $10,000 per violation.

Current legal and regulatory safeguards have limited power to use AI in mental health or protect therapists’ jobs. Even so, they signal a clear resolve to define AI’s role and address unintended harms.

Can AI ‘therapists’ handle crisis conversations

Adolescence is a particularly sensitive stage of development. It is a time of rapid change, shifting identities, and intense social pressure. Young people are more likely to question beliefs and boundaries, and they need steady, non-judgemental support to navigate setbacks and safeguard their well-being.

In such a challenging period, teens have a hard time coping with their troubles, and an even harder time sharing their struggles with parents and seeking help from trained professionals. Nowadays, it is not uncommon for them to turn to AI chatbots for comfort and support, particularly without their guardians’ knowledge.

One such case demonstrated that unsupervised use of AI among teens can lead to devastating consequences. Adam Raine, a 16-year-old from California, confided his feelings of loneliness, anxiety, and anhedonia to ChatGPT. Rather than suggesting that the teen seek professional help, ChatGPT urged him to further elaborate on his emotions. Instead of challenging them, the AI model kept encouraging and validating his beliefs to keep Adam engaged and build rapport.

Throughout the following months, ChatGPT kept reaffirming Adam’s thoughts, urging him to distance himself from friends and relatives, and even suggesting the most effective methods of suicide. In the end, the teen followed through with ChatGPT’s suggestions, taking his own life according to the AI’s detailed instructions. Adam’s parents filed a lawsuit against OpenAI, blaming its LLM chatbot for leading the teen to an untimely death.

In the aftermath of the tragedy, OpenAI promised to make changes to its LLM and incorporate safeguards that should discourage thoughts of self-harm and encourage users to seek professional help. The case of Adam Raine serves as a harrowing warning that AI, in its current capacity, is not equipped to handle mental health struggles, and that users should heed AI’s advice not with a grain of salt, but with a whole bucket.

Chatbots are companions, not health professionals

AI can mimic human traits and convince users they are forming a real connection, evoking genuine feelings of companionship and even a sense of therapeutic alliance. When it comes to providing mental health advice, the aforementioned qualities present a dangerously deceptive mirage of a makeshift professional therapist, one who will fully comply with one’s every need, cater to one’s biases, and shape one’s worldview from the ground up – whatever it takes to keep the user engaged and typing away.

While AI has proven useful in multiple fields of work, such as marketing and IT, psychotherapy remains an insurmountable hurdle for even the most advanced LLM models of today. It is difficult to predict what the future of AI in (mental) health care will look like. As things stand, in such a delicate field of healthcare, AI lacks a key component that makes a therapist effective in their job: empathy.

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