Psychologists Say Patients Are Bringing AI Into Therapy Sessions: Survey

As generative AI becomes a regular part of everyday life, patients are increasingly incorporating chatbot conversations into therapy sessions.

According to a new American Psychological Association questionnaire of more than 1,200 U.S. psychologists, 77% said they had patients discussing the use of AI for emotional support, diagnosis, companionship, or other mental health-related purposes.

In the survey, 39% of psychologists reported that patients used AI to self-diagnose mental health problems, 33% said that patients used chatbots to assist with therapy or treatment, and 35% reported that patients used AI as an additional mental health professional.

“While few psychologists reported that their patients used chatbots in unhealthy ways, more than a third (36%) said they noticed their patients developing a level of dependency on a chatbot, and 15% talked about or noted that their patients developed distorted thoughts or delusions related to a chatbot,” the study said.

Psychologists also reported that patients used chatbots for social purposes. Twenty-two percent said patients used AI for friendship, while 13% reported patients formed intimate relationships with chatbots.

Of psychologists whose patients had developed relationships with chatbots, 71% said patients discussed their mental health with AI, while 68% reported patients felt supported or validated by chatbot interactions. Nearly half reported positive communication with chatbots, and 41% said patients used them to strengthen healthy coping skills.

According to the study, overall use may actually be higher than reported because the study only identified psychologists’ interactions with existing patients.

The research comes at a time when AI companies are expanding chatbots and AI companions, while researchers continue to raise concerns about their effects on mental health. More than a third of psychologists reported that patients became dependent on chatbots, and 15% reported instances of distorted thinking or delusions.

The findings follow a recent study from the City University of New York and King’s College London showing that several leading AI models can increase delusions, paranoia and suicidal ideation, with xAI’s Grok 4.1 Fast performing the worst.

“Psychologists’ attitudes towards using chatbots for mental health advice are characterized by great caution when it comes to security and privacy,” the previous study said. “Nearly every psychologist (97%) felt that chatbots can unintentionally reinforce negative behavior or delusions, and 94% said the current version of chatbots cannot treat conditions with the right amount of nuance.”

The research also comes as AI developers face increasing legal criticism over the role chatbots can play in real-world harm. In recent months, OpenAI, Google and xAI have been hit with lawsuits, including a wrongful death lawsuit against Google over claims that Gemini fueled a Florida man’s delusions before his suicide. That’s in addition to lawsuits against OpenAI related to a mass shooting in British Columbia and an accidental overdose, and a class-action lawsuit accusing xAI’s Grok of generating sexually explicit images of minors.

While the APA acknowledged that AI can help users organize their thoughts and complement professional care, it cautioned that chatbots are not private and should not replace licensed mental health professionals.

“Many people – especially teens and adolescents – may be using AI as a more affordable and accessible option for mental health advice,” the study said. “However, AI is not a safe or effective substitute for a qualified healthcare provider and should be used carefully.”