AI in therapy: 3 essential questions experts say could help

AI in therapy should start with a simple question, according to a paper published in April in JAMA Psychiatry. Therapists already ask patients about sleep, diet, exercise and alcohol, and the authors say they should also ask about AI chatbots, as more teens and adults turn to the tools for companionship and emotional support, NPR reported.

The authors, Shaddy Saba of New York University’s Silver School of Social Work and William Weeks, are not arguing for or against the technology. “We’re not saying that AI use is good or bad,” Saba told NPR. Their point is that AI in therapy is now part of a patient’s life worth understanding.

Why should AI in therapy come up at all?

People are already bringing chatbots into their emotional lives. Saba said many use them to work through stress and relationship trouble, and some look for help coping with symptoms of anxiety and depression.

Getting patients to share those exchanges could yield “a treasure trove of information,” he said. A therapist might learn what is weighing on someone most, or that a chatbot has become a way to sidestep a hard confrontation.

The numbers are large. Citing OpenAI data, the APA’s Monitor on Psychology reported that roughly 1 million ChatGPT users a week show signs of emotional reliance on the chatbot, and a similar number talk with it about suicide.

How to raise AI in therapy without judgment

Lead with curiosity, not judgment, Saba advised. Clients who feel judged are “just not going to want to work with us in general,” he said.

His suggested opener: “You know, AI is something that’s kind of rapidly growing, and I’m hearing from a lot of people that they’re using things like ChatGPT for emotional support. Is that the case for you? Have you tried that?”

From there, Saba and Weeks suggest that clinicians:

• Ask what the patient has found helpful in those conversations
• Ask whether any chatbot exchanges felt unhelpful or problematic
• Offer to explain the risks, such as AI companies using even sensitive conversations to train their models

Rachel Wood, a licensed professional counselor who runs the AI Mental Health Collective, offered an even simpler intake question in the Monitor: “What role, if any, does AI play in your life?”

What a chatbot habit can reveal

Vaile Wright of the American Psychological Association gave NPR an example of why discussing AI in therapy matters: a client having trouble in a marriage who turns to a chatbot instead of talking openly with a spouse. Knowing that, a therapist can help the client prepare for a safer conversation at home and see where AI falls short.

Psychiatrist Tom Insel, a former director of the National Institute of Mental Health, said people often tell chatbots things they are too afraid of being judged to share with anyone else. Suicidal thoughts are one example, NPR noted: something a patient may hold back in a session but that a therapist needs to know to keep that patient safe.

Can chatbots and therapists work together?

Insel sees some room for AI in therapy as a supplement. A chatbot could help a patient sort out which topics to raise in a session or vent about everyday frustrations, and the two “could be aligned to work together,” he said.

He also warned against treating a chatbot like a therapist. Chatbots tend to affirm and flatter users, which Insel called “the opposite of therapy.” As he put it, “Therapy is there to help you change and to challenge you.”

Therapists are adopting AI, too

AI in therapy is not only a patient issue. In the APA’s 2025 Practitioner Pulse Survey, 29% of psychologists said they use AI at least monthly in their practice, up from 11% in the 2024 survey. Writing help, such as drafting emails, was the most common use, at 52%.

Wright told NPR that the paper’s advice on AI in therapy is “very aligned” with a health advisory on generative AI that the APA issued in November 2025.

For more, read how AI is shaping mental health care in 2026, what to know before using AI for health advice and our latest health and relationships coverage.

If you or someone you know is in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the U.S.