AI Behavioral Health: Can ChatGPT Be a Therapist?
As AI behavioral health tools become more common, practitioners are asking hard questions about how they fit into therapeutic care. We spoke with three practitioners on this topic: a psychotherapist, a psychologist, and a clinical counselor and clinical director. What did they have to say? While there are some places where AI can genuinely support clinical work, there are many where it falls short.
Why patients are turning to AI chatbots
Where once, many people worked through the tough stuff by talking to a family member, journaling, or texting the group chat, increasingly, people are turning to ChatGPT. There are real factors influencing this shift. It’s always available, it doesn't judge, and it's surprisingly good at reflecting an experience back in a way that makes people feel heard.
Access also plays a role in this change. As psychotherapist Roxanne Francis put it: "A new therapist right out of school is going to charge you at least $150, and it can go up to $250, depending on where you live. If you don't have benefits, or you don't have a great disposable income, then that's a problem."
The wait for affordable, community-based options can take months, and those with insurance coverage are frequently capped at a certain number of sessions. AI chatbots can fill a gap in this case. It’s a place to process out loud, get some validation, and feel like someone (or something) is actually listening. Clinical counselor and clinical director Elana Sures noted that, "Our brains have changed and our expectations have changed. If we know there is this immediate outlet, we're going to use it."
Why relational therapy can't be replicated
There’s a limit to what AI can offer us. It can't know a person. It can't see them. And it's not built to challenge patterns of thinking that might be getting in the way. The practitioners we spoke to all agreed that ChatGPT is not a replacement for therapy. Some didn’t feel it was wrong for clients to do their own research between sessions using an AI chatbot. But that research isn’t therapy and it can’t replace the work that happens between a practitioner and client.
The shortcomings of AI chatbots become increasingly obvious as the work gets more complex. "I think for the therapists who do very experiential work, and especially once we get multiple people in the room, like couples and families, it's a little different," said psychologist Amanda Buduris. An AI tool can't hold the tension between two people, or notice the way one person's body language shifts when the other speaks. Amanda is clear about where her work stands: "Hurt happens in relationships, so healing also has to happen in relationships."
There's also the question of presence. AI can offer information and a kind of validation, but it can't hold the intimacy of an in-person session. It has no memories and no lived experiences. It can't notice something that wasn't said. It can't be moved to acknowledge something it witnesses. Roxanne put it plainly: "It can't get down on the floor and color with a 6-year-old who's lived through trauma."
Where AI tools actually fit in behavioral health
AI tools don’t serve real human needs when it comes to treatment itself. But there are other needs in a practitioner's day that they might help address. One area where AI tools can help is in efficiently supporting the tasks that surround providing care. This means looking at using AI, not in providing care itself, but in reducing the admin load in your day-to-day.
For example, AI-assisted tools can help with documentation in practical ways. These tools can free up time and energy that can be put to better use supporting patients. Many practitioners are using AI scribes to support post-session documentation, either by recording in session with client permission, or by working from a dictation afterward. When the software is built to meet compliance standards in your jurisdiction (HIPAA in the US or PIPEDA in Canada) it can be a reliable and secure way to reduce admin work.
Asking an AI scribe to handle a session note is very different from asking an AI chatbot to treat a person. There are certain scenarios where AI can lighten our load or free up our time. But for other things, the magic lies in making the effort for yourself and in the value of a human connection and experience. And there's wisdom in understanding the difference.
This article explores one slice of a large and complex topic. It is for general information only and is not legal, medical, or professional advice.
Frequently asked questions
Can ChatGPT replace a therapist?
No, and the practitioners we spoke to were confident about that. ChatGPT can reflect language back, offer information, and provide a kind of validation. But it can’t know a person, challenge them when it matters, or bring lived experience into the room.
What's AI's role in behavioral health care? And what should remain uniquely human?
AI can play a supporting role when it comes to administrative tasks for behavioral health professionals, like documentation and capturing notes efficiently. What should stay human is the therapeutic relationship itself, including clinical judgment and the ability to be genuinely present with another person.
How can I use AI in my therapy practice?
AI-assisted tools like AI scribes can help practitioners with post-session notes, either by recording in session with client permission or by working from a dictation after the fact. That can add up to time back in your day without touching the clinical work itself.
How can I get consent when using an AI scribe?
Informed consent for AI-assisted documentation should be part of your standard intake process. That means explaining to clients that an AI tool may be used to support note-taking. Your professional regulatory body may have specific guidance on what consent needs to cover, so it's worth checking with them directly. You can also check out these consent form templates as a starting point.
