Is A.I. a replacement for psychotherapy?
AI tools are increasingly being used for emotional support because they’re immediate and free. For some, there can be long waitlists and financial barriers to care. Now more than ever, people are turning to AI to get advice and mental health resources.
For many people, typing into a chatbot feels less vulnerable than speaking to a therapist. There’s no perceived judgment, and if there is a good internet connection there are no awkward pauses.
Some research suggests AI-based conversational tools can reduce mild symptoms of anxiety and depression in the short term, particularly when they use structured cognitive behavioural strategies (Fitzpatrick et al., 2017). (It should be noted that participant incentive for the study referenced was partially funded by a mental health chatbot company).
What it can’t offer:
Therapy is not only information delivery. Decades of psychotherapy research shows that the therapeutic relationship referred to as the “therapeutic alliance” is one of the strongest predictors of positive outcomes (Horvath et al., 2011). Many clients agree that healing is largely relationally based.
What a therapeutic alliance offers:
Relational attunement
A therapist notices tone shifts, pauses, micro-expressions, and emotional incongruence. Human nervous systems co-regulate in a reciprocal emotional pattern in sessions. Research on stress and executive functioning shows that chronic dysregulation depletes attentional and cognitive resources (Liu et al., 2020). Therapy often works by restoring nervous system regulation through relational safety. When clients become more emotionally reactive, therapists tend to become more emotionally steady (Soma et al., 2020).
Clinical judgment
Therapists assess risk, suicidality, trauma complexity, dissociation, and safety concerns. Informed consent in suicide risk management reflects deep respect for patient autonomy, dignity, and self-governance. Framing safety planning as a collaborative effort between clinician and patient emphasizes shared responsibility while clearly outlining assessment procedures, decision-making processes, emergency referral criteria, and limits to confidentiality. This transparent approach upholds principles of privacy, veracity, and beneficence by standardizing best-practice assessment and minimizing risk. It also strengthens the therapeutic relationship by reducing shame, fear, and stigma, creating a safer space for patients to disclose suicidal thoughts and distress (Bernert & Weiss Roberts, 2012).Ethical responsibility and accountability matter in high-stakes situations.
Corrective emotional experience and challenging previous beliefs
Many psychological wounds occur and heal in relationships. Being witnessed, validated, and responded to by another human changes attachment patterns in ways algorithms cannot replicate. Beyond that, therapists can challenge clients in ways that a chatbot may not. Therapists deliver challenges sensitively, drawing on shared knowledge from prior interactions to minimize rejection.
Over-reliance on AI may also carry risks:
- Reinforce dominant cultural narratives
- Underrepresent minority perspectives
- Pathologize cultural norms
Realistically, the world is headed in the direction of integrating AI into almost all facets of our relational experiences. The question may not be “AI or therapy?” but rather “How can AI be used wisely?”
We believe that support should exist on a spectrum, and that cost should not be a barrier to accessing mental health resources. At Through the Woods Psychology in Calgary, we not only have psychologists and counsellors but also counselling therapist interns that can offer low-cost or no-cost therapy to those who are unable to afford sessions or do not have insurance. Sessions are done in person or online.
Visit our website to learn more or to book your free consultation today. You can also get in touch by email at info@throughthewoods.ca or phone at (403) 984-7922.
References
Bernert, R., & Weiss Roberts, L. (2012). Ethics commentary suicide risk: Ethical considerations in the assessment and management of suicide risk. FOCUS, 10(4). https://doi.org/10.1176/appi.focus.10.4.467
Fitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017). Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial. JMIR Mental Health, 4(2), e19.
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16.
Liu, Q., et al. (2020). Impact of chronic stress on attention control: Evidence from behavioral and event-related potential analyses. Neuroscience Bulletin.
Soma, C. S., Baucom, B. R. W., Xiao, B., Butner, J. E., Hilpert, P., Narayanan, S., Atkins, D. C., & Imel, Z. E. (2020). Coregulation of therapist and client emotion during psychotherapy. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 30(5), 591–603. https://doi.org/10.1080/10503307.2019.1661541