When it comes to receiving psychotherapy—whether face-to-face or via text—individuals significantly prefer communication free of AI assistance, according to a study published in The American Journal of Psychotherapy.Why It’s Relevant
AI tools are becoming more commonplace across mental health care, which is raising many ethical questions. In particular, the use of AI to support psychotherapy dialogue has significant implications for patient care, given that effective psychotherapy entails building a bond based on shared empathy and trust.
For this study, researchers surveyed 201 adults (average age 43) on their willingness to accept and continue therapy across five conditions—four involving AI assistance across treatment mode (live telehealth versus text-based dialogue) and transparency (transparent versus covert use), the fifth involving no AI use.
By the Numbers
- The AI-free psychotherapy scenario was the most well accepted, with a score of 6.57 (on a 1 to 7 scale).
- Transparent use of AI in text chats resulted in a 2.89-point decrease in acceptability, while transparent AI use in telehealth chats resulted in a 3.09-point decrease.
- Covert AI use was more maligned, resulting in a 4.65-point decrease in acceptability for telehealth and a 4.80-point decrease for text chats.
- Similar patterns were observed in patients’ willingness to continue with their psychotherapy across scenarios, with covert AI use associated with the least willingness.
What’s More
The unacceptability of AI in psychotherapy was consistent across patients of different demographics and therapy experience, though individuals who were familiar with therapeutic chatbots had slightly more positive reactions to transparent use of AI.
The Other Side
The researchers surveyed adults in the general population, so it’s possible that a more specific survey of people actively seeking psychotherapy would produce different results. The survey also focused solely on using AI to improve communication and not on other common uses in psychiatric care, such as transcribing notes.
Takeaway Message
The findings support the tenet that individuals prefer therapy that has authentic human engagement. “Even when disclosed, AI use was evaluated far less favorably than no AI, indicating that transparency may be necessary but insufficient to maintain perceived therapeutic integrity,” the researchers wrote.
Related Information
Source
Sidney Shaw and Darin Bell. Acceptability of AI-assisted psychotherapy to prospective patients and their intent to continue treatment: a vignette study. The American Journal of Psychotherapy. Published August 21, 2026. doi:10.1176/appi.psychotherapy.20260007
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