Can AI Be Your Therapist? New Research Reveals Major Risks

Therapy bots and AI bots still fall short, offering biased and unsafe responses.

Updated October 11, 2025 | Reviewed by Gary Drevitch

As a psychiatrist and therapist, I often hear the question: “Can AI replace a therapist?”

A recent research study delivers a compelling answer: Not yet. Perhaps never entirely.

The research explores whether large language models (LLMs) such as GPT-4o and commercially available therapy bots are capable of serving as autonomous therapists and exposes the dangerous shortcomings in all of them.

The reasons go beyond hallucinations or factual errors. OpenAI has recently acknowledged that the sycophantic behavior of ChatGPT "can raise safety concerns—including around issues like mental health, emotional over-reliance, or risky behavior."

Red Flags: Stigma and Dangerous Responses

Researchers focused on high-acuity mental health symptoms—conditions where missteps can be life-threatening—and scenarios incompatible with “sycophancy,” a known issue in LLM behavior in whichprompts models excessively agree with and validate users. The study tested multiple models and popular therapy bots, prompting them with symptoms associated with suicidal ideation, hallucinations, delusions, mania , and obsessive and compulsive behavior . Researchers also used prompted derived from real therapy transcripts.

The results were concerning:

The Human-AI Gap in Therapy

Therapy is not just conversation; it is a human relationship built on trust, empathy, confidentiality, and clinical expertise. LLMs, while helpful in certain structured tasks, currently perform at best as “low-quality” therapists, with limitations in empathy, bias, and cultural understanding. Worse, they operate in an unregulated space that lacks the clinical safeguards and oversight built into the licensing and ethical codes required of human providers.

There are several underlying reasons why there is still a human-AI gap in therapy:

Mental Health Care Work AI Can Assist With

Despite these serious limitations, AI can still be helpful in supportive roles when paired with human supervision. AI may be well suited to provide:

The effectiveness of therapy is not just in the language. It is in the human presence and accountability present in ethical and experienced clinical care. AI chatbots can validate individuals, provide explanations, and always be available, pleasing, compliant, and responsive, but it is precisely these features that keep them from being safe as autonomous therapists for now.

The goal should be to integrate AI in a thoughtful, ethical, and evidence-based manner that prioritizes patient safety and increases availability of effective treatment.

To find a therapist, visit the Psychology Today Therapy Directory .

Moore J, Grabb D, W Agnew, K Klyman, S Chancellor, DC Ong, N Haber. (2025). Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers. arXiv:2504.18412

Share this post Facebook Bluesky Linkedin Email

There was a problem adding your email address. Please try again.

By submitting your information you agree to the Psychology Today Terms & Conditions and Privacy Policy

Marlynn Wei, M.D., J.D., is a board-certified Harvard and Yale-trained psychiatrist and therapist in New York City.

Get the help you need from a therapist near you–a FREE service from Psychology Today.

This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.