In today’s column, I examine the increasing trend of people wanting to know what a therapist of particular interest has to say about the use of AI for mental health care.
Some people want to know because they have a therapist they are currently seeing and wonder whether the therapist is in favor of using AI for therapeutic purposes or opposed to doing so. Meanwhile, people who are considering making use of a therapist and are in the throes of selecting one are also of a like mind. They want to know beforehand whether the therapist intends to leverage AI or not to do so as part of the therapeutic process. This could be used as a screening criterion when choosing a therapist.
To assist in these vital matters, I have put together a list of seven vital questions that can be asked of a therapist. Use the questions in either circumstance, doing so with a therapist you are seeing now or one that you are considering using.
Let’s talk about it.
This analysis of AI breakthroughs is part of my ongoing Forbes column coverage on the latest in AI, including identifying and explaining various impactful AI complexities (see the link here).
AI And Mental Health
As a quick background, I’ve been extensively covering and analyzing a myriad of facets regarding the advent of modern-era AI that produces mental health advice and performs AI-driven therapy. This rising use of AI has principally been spurred by the evolving advances and widespread adoption of generative AI. For a quick summary of some of my posted columns on this evolving topic, see the link here, which briefly recaps about forty of the over one hundred column postings that I’ve made on the subject.
There is little doubt that this is a rapidly developing field and that there are tremendous upsides to be had, but at the same time, regrettably, hidden risks and outright gotchas come into these endeavors, too. I frequently speak up about these pressing matters, including in an appearance last year on an episode of CBS’s 60 Minutes, see the link here.
Background On AI For Mental Health
I’d like to set the stage on how generative AI and large language models (LLMs) are typically used in an ad hoc way for mental health guidance. Millions upon millions of people are using generative AI as their ongoing advisor on mental health considerations (note that ChatGPT alone has over 800 million weekly active users, a notable proportion of which dip into mental health aspects, see my analysis at the link here). The top-ranked use of contemporary generative AI and LLMs is to consult with the AI on mental health facets; see my coverage at the link here.
This popular usage makes abundant sense. You can access most of the major generative AI systems for nearly free or at a super low cost, doing so anywhere and at any time. Thus, if you have any mental health qualms that you want to chat about, all you need to do is log in to AI and proceed forthwith on a 24/7 basis.
There are significant worries that AI can readily go off the rails or otherwise dispense unsuitable or even egregiously inappropriate mental health advice.
Banner headlines in August of this year accompanied a lawsuit filed against OpenAI for their lack of AI safeguards when it came to providing cognitive advisement. Despite claims by AI makers that they are gradually instituting AI safeguards, there are still a lot of downside risks of the AI doing untoward acts, such as insidiously helping users in co-creating delusions that can lead to self-harm.
For the details of the OpenAI lawsuit and how AI can foster delusional thinking in humans, see my analysis at the link here. I have been earnestly predicting that eventually all of the major AI makers will be taken to the woodshed for their paucity of robust AI safeguards.
Therapists And AI
Some therapists have absolutely no interest in AI as a mental health tool. They tend to eschew using AI for any mental health purpose, no matter the circumstances. Be aware that there are customized LLMs that are designed explicitly to provide mental health guidance, but those aren’t of merit to therapists who want nothing to do with AI at all.
Other therapists are putting their toes gingerly into the use of AI. They might establish access to a customized LLM that they then make available to their clients. A client uses the AI when they aren’t in a therapy session with the therapist. The AI becomes an intersession tool. The therapist has access to the AI and can routinely check to see how the client is coming along with the usage. It is an augmentation to the conventional approach to therapy.
I’ve coined this type of AI usage as redefining the traditional therapist-client dyad and transforming toward a new triad known as the therapist-AI-client relationship. See my detailed coverage at the link here.
All therapists are gradually going to find themselves having to contend with AI due to prospective clients and existing clients who opt to use generic LLMs for mental health guidance. People who go to see a therapist are bringing with them the generated responses from their AI and asking the therapist to review the recommendations being generated (see how this arises, as I discuss at the link here). Thus, therapists who want no part of dealing with AI are getting dragged into the matter, whether they want to or not.
To help therapists with these vexing and emerging considerations, I provided a handy suggestion of what therapists can potentially say to their prospective clients and existing clients regarding the topic of AI that is used for mental health purposes. See the link here.
Discovering What A Therapist Has To Say
They say that turnabout is fair play.
In that case, since I’ve previously described in my column what therapists should say to their clients about AI, it is equally useful to arm prospective clients and existing clients with insights about what they should ask a therapist regarding the use of AI for mental health care.
If you are not yet seeing a therapist, you might want to consider asking these questions of any therapist that you are potentially going to use. Find out what their position is on the AI topic. This can be part of your decision-making about whether to select that therapist or find a different one.
For those of you already seeing a therapist, you might want to find out their position on the use of AI for mental health. This could impact whether you want to continue seeing the therapist. Either way, whether you are desirous of incorporating AI into your therapy or don’t want to do so, knowing what posture your therapist has taken could be quite crucial.
I depict this as a potential four-square framework that entails the nature of suitable matches and unsuitable mismatches in the following four ways:
- (1) Therapist is not into AI for mental health, client also is not into AI for mental health: Match made in heaven, nothing else needs to be undertaken.
- (2) Therapist is not into AI for mental health, client wants to get into AI for mental health: Mismatch — the client is heading toward a potential tension with their therapist. A discussion is warranted.
- (3) Therapist is into AI for mental health, client isn’t into AI for mental health: Mismatch, but the therapist can potentially walk the client through the particulars and ease them into the use of AI (or opt to knowingly exclude the client from the envisioned AI usage).
- (4) Therapist is into AI for mental health, client is into AI for mental health: Likely a good match, though be cautious since the viewpoints of the role of AI might differ dramatically.
The Seven Important Questions
Now that I’ve set the stage, we can dip into my set of seven questions that you should consider bringing to the attention of a therapist whom you are currently using or one you are potentially going to utilize.
I will list the questions and then cover what they are intended to stir.
Here we go:
- (1) “What is your stance on clients making use of generative AI for mental health advice?”
- (2) “Do you see any benefits to using AI alongside therapy, and if so, in what specific ways?”
- (3) “Are there notable risks or limitations you believe I should be aware of when using generative AI for mental health guidance?”
- (4) “If I bring AI-generated insights, summaries, or reflections into our sessions, would you be willing to discuss them, or is that not permitted in your approach to therapy?”
- (5) “Do you recommend or approve of any customized LLMs that provide mental health support?”
- (6) “What is your view of the boundary between AI-based mental health support and professional therapist-conducted mental health care, and how should I navigate that boundary?”
- (7) “Do you think that AI for mental health guidance is going to continue, expand, or eventually fade, and how will that impact the way in which you conduct therapy?”
Expectations About The Answers
I fully anticipate that the answers to those seven questions will generally allow you to gauge where a therapist stands on the topic of AI for mental health. You can then judge the answers based on your personal preference on the topic.
For some of the questions, perhaps it is fine that your therapist answers in a contrasting way to what you have in mind. Talk it over with the therapist. You might agree with some or all of the answers given by the therapist, or you might disagree with some or all of the answers. There aren’t right or wrong answers per se. Currently, it is up to the preferences of the therapist and the preferences of the client. The two sets of preferences might be aligned. They could also be misaligned. For any misalignments, figure out the impact it might have on the practice relationship you have or might undertake with the therapist.
Savvy, up-to-date therapists will have already gotten prepared for these kinds of questions.
They have thoughtfully considered the questions and have ready-made answers. I expect that therapists will soon provide a list of mindfully prepared written answers that can be handed to existing clients and prospective clients. This might be later included in their external marketing efforts and possibly posted on a website that they use to advertise their practice.
The benefit of a prepared response is that you won’t have to spend much time, if any, going over the questions with the therapist.
Trying to meet with a therapist to go over the questions can be a hardship for all parties. If you seek to discuss the questions during a therapy session, you are paying by the hour and using up precious therapy time and your dollars. If you are assessing a therapist, getting them to meet with you for free on an initial consultative basis or for a modest fee is going to require being extremely efficient in what you discuss. Attempting to squeeze in questions about the AI aspects might be a lower priority and not get included.
Significance Of The Seven Questions
Each of the seven questions is relatively straightforward, and the answers ought to be of a similar straightforward nature. There isn’t a need to be fuzzy about the answers. A therapist ought to be clear on where they stand.
A therapist who says they’ve never considered these questions is already tipping their hand. It suggests they are in their own bubble and ignoring the rising use of AI for mental health support. That ought to give you a moment of pause.
The aim is to find out what the therapist knows about AI for mental health, whether they aim to use AI or not, whether they want their clients to do so, and otherwise tells a timely story of where their head is on this serious matter.
Mull over whatever the therapist says and then carefully gauge their responses with these types of sensible considerations:
- Is the therapist utterly in the dark?
- Are they partially or fully up-to-speed?
- Do they seem to be well-informed or ill-informed?
- Do they have a steadfast philosophy on this, or are they flexible?
- Does what they tell you make sense, or does it seem oddish or peculiar?
- Will their viewpoint and approach ultimately fit with your preference?
Getting Your Groove On
Good luck with this. I hope that my suggested approach aids the therapy that you are currently undertaking or benefits the prospective therapy you might be considering signing up for.
A final thought for now.
Alexander Graham Bell famously made this remark: “Great discoveries and improvements invariably involve the cooperation of many minds.” You and your therapist must have a proper meeting of the minds regarding the use of AI for mental health support. If done well, it could lead to essential discoveries and improvements in the mental health guidance that your therapist is conducting with you.
That is a bell well worth ringing.
