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Key points
- Therapy requires dialog, tailored to each patient’s unique context and therapy goals.
- Conversational agents may be helpful in providing practical assistance, not psychoanalysis.
- AI’s algorithmic pattern of conversing cannot capture the experience and complexity of trauma.
People seeking therapy often envision sitting in a plush chair or lying on a therapy couch in an office with soft lighting and diplomas hanging on the wall. In other words, when selecting a therapist, most people envision a compassionate, perhaps professorial, mild-mannered adult; not a chatbot. Yet according to research, while not able to replace the value of live therapy, AI assistants may be of use.
Artificial Conversational Agents
Dina Babushkina and Bas de Boer (2026) explored the role of AI in conversation as a component of psychotherapy.[i] They acknowledge the utility of conversational agents (CA) given their ability to relay the impression of being competent to converse with humans. Yet because of the high-risk nature of working with therapy patients who are already in a vulnerable position, Babushkina and de Boer examined which types of CA have the ability to contribute to therapy goals, considering their limitations, particularly in complex cases.
Babushkina and de Boer define psychotherapy as a “fundamentally dialogical activity,” tailored to each patient’s unique context and therapy goals. Regarding CAs’ ability to dialog, they note that CA is a type of AI that is able to participate in conversation through text, voice, images, or a combination of methods. This interaction has increased with the development of large language models. Yet they also recognize that because CAs are artificial agents, they cannot offer the rich dialogical environment that facilitates analysis and rebuilding of a patient’s self-narrative, especially within the context of cases that are complex.
Tracking Trauma
Babushkina and de Boer explain that as a result of their algorithmic pattern of conversing, CAs are unable to embrace the experience and complexity of trauma. As a practical matter, they note that the process of recovering from trauma is idiosyncratic and unable to be automated. The numerous, complicated cognitive processes associated with identity reconstruction can only be authentically assisted with the help of another human being, making artificial agents unsuitable dialogical partners.
There are, however, ways in which CAs can be helpful. Babushkina and de Boer note that they might be able to substitute elements of therapy that do not require relating to the personal situation of the patient. Examples could include helping patients develop certain skills such as recording and tracking thought patterns or mood changes, applying therapy work to specific situations, or guiding breathing exercises or relaxation techniques. In this fashion, CAs would function as self-help tools.
AI as Therapy Assistance
Other studies have investigated the utility of AI during different types of therapy. Chitat Chan et al. (2026) explored the efficacy of AI-enhanced, self-paced Narrative Therapy,[ii] where one of the objectives was to assess the reliability of AI-based assessments. They found, in addition to other outcomes, that AI assessments showed significant reliability and validity, and that participants expressed positive views about AI simulations and feedback. Chan et al. noted that their findings highlight the potential of generative AI to facilitate dialogic learning, in addition to providing support for assessing skills.
Humans Needed
Although we continue to incorporate artificial assistance into all types of therapy for a variety of conditions and situations, AI cannot replicate the chemistry of human connection. Real people share life experience, hopes, dreams, values and viewpoints that are unique to the human experience. This is particularly valuable when seeking help recovering from loss, trauma, or so many other adverse experiences for which therapy is helpful.
Using artificial means of simplifying and completing laborious tasks and chores, however, frees up the time of human therapists to bond and build bridges with patients, in order to change habits, provide perspective, and improve lives.
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