Patients Increasingly Use Chatbots as Therapists, Psychologists Report

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More than three-quarters of psychologists report their patients are discussing artificial intelligence (AI) in therapy, according to a survey by the American Psychological Association. Image for illustration purposes
More than three-quarters of psychologists report their patients are discussing artificial intelligence (AI) in therapy, according to a survey by the American Psychological Association. Image for illustration purposes
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American Psychological Association

WASHINGTON — More than three-quarters of psychologists report their patients are discussing artificial intelligence (AI) in therapy, according to a survey by the American Psychological Association. Patients are using the technology to seek additional support for their mental health, to find a diagnosis or for friendship and intimate relationships, the survey found.

The Chatbots and Mental Health Survey, conducted by APA among more than 1,200 licensed psychologists in the U.S., found that many patients appear to be supplementing their relationship with a mental health professional with advice from AI. Nearly two in five psychologists (39%) have had conversations with patients who used AI to self-diagnose, while approximately a third of psychologists said their patients are turning to AI for help with self-discipline, affirmations, or behavioral reminders (34%), to assist with their treatment (33%) and to act as an additional mental health professional (35%).

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This may not reflect the full scope of people turning to chatbots for mental health advice or companionship, as the survey only captures psychologists’ interactions with their patients. Many more people may be using AI chatbots for mental health advice without critical guidance from a mental health professional.

“Generally accessible chatbots appear to offer the path of least resistance for people in need of mental health support—they are supportive to a fault, readily available and easy to access without insurance. But they also don’t have the same capacity for nuance or alertness to potential warning signs as human professionals,” said APA CEO Arthur C. Evans Jr., PhD. “Before anyone relies on these tools for their mental health, they must understand how they work and how to think critically about the advice they provide.”

The survey also indicated that patients may see AI as more than a therapeutic tool; psychologists reported they had patients who engaged with chatbots for fun (33%), friendship (22%) and intimate relationships (13%). Among psychologists whose patients had ongoing conversations with chatbots, more than two-thirds (68%) said that they talked about or noticed that their patients felt supported or validated by a chatbot and two in five (41%) said their patients used chatbots to reinforce healthy coping skills. There were some negative side effects to engaging with chatbots, however, as 36% of psychologists said their patients were developing a level of dependency on a chatbot, and 15% said their patients were developing distorted thinking or delusions.

Psychologists had mixed views on this use of AI for mental health support. A little more than half (54%) said they were comfortable with some patients engaging with chatbots, while 93% said they had concerns about certain patients using the technology. This may be driven by worries that chatbots could cause unexpected harm to vulnerable users. Nearly all psychologists surveyed (97%) said that chatbots may inadvertently reinforce negative behaviors or delusional beliefs, 94% said today’s chatbots cannot treat conditions with an appropriate amount of nuance, and 89% said that chatbots may inadvertently encourage self-harm.

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APA is clear that AI is not a safe or effective replacement for a qualified mental health provider and should be used carefully. APA’s new Guide to Navigating AI-Generated Advice Thoughtfully and Safely offers evidence-based suggestions on appropriate and inappropriate uses of AI to address mental, emotional and behavioral health issues.

AI should always be used carefully. Developed with guidance from an advisory panel of experts in digital mental health, clinical psychology and youth and adolescent well-being, APA’s recommendations for users include:

  • Verifying any mental health or medical information generated by AI with a health care practitioner.
  • Asking for strategies aligned with research-backed therapeutic approaches.
  • Prompting AI to challenge your thinking or provide alternative perspectives.
  • Limiting your use of AI so it does not interfere with sleep, hobbies, school, work or social interaction.

While psychologists still have questions about the role of AI in clinical settings, two in five psychologists (40%) felt optimistic that chatbots will be able to help patients when a mental health professional is not available. This may be attributed to the growing interest in developing tools that have been designed to improve well-being based on psychological research and expertise.

“AI tools, when grounded in psychological science and developed in collaboration with mental health scientists, have the potential to meet the growing demand for mental health care and improve patient outcomes,” said Evans. “But these tools work best when used to complement a relationship with a licensed, human professional who understands how to treat a person, not a prompt.”

Still, only a quarter of psychologists (24%) said patients will one day prefer therapy chatbots to human mental health professionals, suggesting that psychologists are generally confident that human relationships between mental health professionals and their patients provide benefits that AI cannot yet replicate.

Methodology

The Chatbots and Mental Health Survey was conducted online within the United States by the American Psychological Association between April 9 and April 26, 2026, and distributed via email using a probability-based random sample. Invitations were sent to a sample of more than 22,000 licensed psychologists. The survey closed with 1,242 respondents—a completion rate of 6.3%. A full methodology is available.

Information source: American Psychological Association

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