The ascent of the AI therapist

The Ascent of the AI Therapist: A Double-Edged Sword

More than a billion people worldwide suffer from a mental-health condition, according to the World Health Organization. The prevalence of anxiety and depression is growing in many demographics, particularly young people, and suicide is claiming hundreds of thousands of lives globally each year. The demand for accessible and affordable mental-health services has led people to seek therapy from popular chatbots like OpenAI's ChatGPT and Anthropic's Claude, or from specialized psychology apps like Wysa and Woebot.

On a broader scale, researchers are exploring AI's potential to monitor and collect behavioral and biometric observations using wearables and smart devices, analyze vast volumes of clinical data for new insights, and assist human mental-health professionals to help prevent burnout. However, this largely uncontrolled experiment has produced mixed results. Many people have found solace in chatbots based on large language models (LLMs), and some experts see promise in them as therapists, but other users have been sent into delusional spirals by AI's hallucinatory whims and breathless sycophancy.

The Dark Side of AI Therapy

The real-world consequences of AI therapy came to a head in unexpected ways in 2025 as we waded through a critical mass of stories about human-chatbot relationships, the flimsiness of guardrails on many LLMs, and the risks of sharing profoundly personal information with products made by corporations that have economic incentives to harvest and monetize such sensitive data. Several authors anticipated this inflection point, and their timely books are a reminder that while the present feels like a blur of breakthroughs, scandals, and confusion, this disorienting time is rooted in deeper histories of care, technology, and trust.

The Black Box of the Human Brain

LLMs have often been described as "black boxes" because nobody knows exactly how they produce their results. The inner workings that guide their outputs are opaque because their algorithms are so complex and their training data is so vast. In mental-health circles, people often describe the human brain as a "black box," for analogous reasons. Psychology, psychiatry, and related fields must grapple with the impossibility of seeing clearly inside someone else's head, let alone pinpointing the exact causes of their distress.

The Asylum of the Future

The advent of PAI, which extends well beyond chatbot therapy, is "the logical equivalent of grafting physics onto astrology." In other words, the data generated by digital phenotyping is as precise as physical measurements of planetary positions, but it is then integrated into a broader framework—in this case, psychiatry—that, like astrology, is based on unreliable assumptions. This approach cannot escape the fundamental issues facing psychiatry, and it could worsen the problem by causing the skills and judgment of human therapists to atrophy as they grow more dependent on AI systems.

The Exploitation of Mental Health

The capitalist mentality behind new technologies often leads to questionable, illegitimate, and illegal business practices in which the customers' interests are secondary to strategies of market dominance. The success of AI therapy depends on the inseparable impulses to make money and to heal people. In this logic, exploitation and therapy feed each other: Every digital therapy session generates data, and that data fuels the system that profits as unpaid users seek care.

The Future of Mental Health

The sudden ascent of the AI therapist seems startlingly futuristic, as if it should be unfolding in some later time when the streets scrub themselves and we travel the world through pneumatic tubes. However, this convergence of mental health and artificial intelligence has been in the making for more than half a century. The beloved astronomer Carl Sagan once imagined a "network of computer psychotherapeutic terminals, something like arrays of large telephone booths" that could address the growing demand for mental-health services.

Conclusion

As AI therapists arrive at scale, we're seeing them play out a familiar dynamic: Tools designed with superficially good intentions are enmeshed with systems that can exploit, surveil, and reshape human behavior. In a frenzied attempt to unlock new opportunities for patients in dire need of mental-health support, we may be locking other doors behind them. The future of mental health is uncertain, but one thing is clear: We must approach this new frontier with caution, awareness, and a deep understanding of the complex interplay between technology, humanity, and the human experience.

Source: https://www.technologyreview.com/2025/12/30/1129392/book-reviews-ai-therapy-mental-health/