Psychologists Say Patients Are Bringing AI Into Therapy Sessions: Survey

As generative AI becomes a fixture of daily life, patients are increasingly bringing chatbot conversations into therapy sessions.

According to a new American Psychological Association survey of more than 1,200 U.S. psychologists, 77% said they have patients who discussed using AI for emotional support, diagnosis, companionship, or other mental health-related purposes.

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

“Though few psychologists reported their patients using 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 noticed their patients developing distorted thinking or delusions related to a chatbot,” the survey said.

Psychologists also reported patients using chatbots for social purposes. Twenty-two percent said patients were using AI for friendship, while 13% reported patients engaging in intimate relationships with chatbots.

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

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

The survey comes as AI companies expand chatbots and AI companions, while researchers continue to raise concerns about their effects on mental health. More than a third of psychologists reported patients developing a dependency on chatbots, and 15% reported cases involving distorted thinking or delusions.

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

“Psychologists’ attitudes toward the use of chatbots for mental health advice are characterized by significant caution regarding safety and privacy,” the previous study said. “Almost every psychologist (97%) felt that chatbots may inadvertently reinforce negative behaviors or delusional beliefs, and 94% said that the current version of chatbots cannot treat conditions with an appropriate amount of nuance.”

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

While the APA acknowledged that AI can help users organize their thoughts and supplement professional care, it warned 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 survey said. “However, AI is not a safe or effective replacement for a qualified mental health provider and should be used carefully.”