Does Psychotherapy Still Need a Human?

Depth therapy is having a moment just as AI reshapes the ground beneath it.

Updated May 24, 2026 | Reviewed by Tyler Woods

Not a day goes by that I don't scroll past dozens of posts about psychotherapy . Short videos on Instagram or TikTok — often with a gajillion likes and comments — or politicized and sometimes genuinely sophisticated threads on X: everywhere I look, there's surging interest in psychoanalysis and psychodynamic therapy.

As someone who fell in love with psychoanalysis early (a searching pre- teen finding in psychoanalysis, and other fields, a way to make sense of what I was experiencing following the death of my mother) I'm relieved to see this happening — despite being frustrated by the often vitriolic in-fighting, sometimes well-founded but often personally and politically-driven.

The pull for depth isn't only cultural, though the cultural part is real: in an age of existential crisis and diluted meaningfulness, depth-oriented therapy has grown more appealing, and its depictions in entertainment and reality TV are increasingly compelling. People need depth — more so in an increasingly superficial culture.

Visibility cuts both ways: the therapist the public pictures is a composite of stereotypes, spanning malevolence to beneficence, instability to stability, inappropriateness to appropriateness.

Public information about efficacy — and information demystifying psychoanalytic and psychodynamic models — is increasingly accessible, and often in plain language. The meta-analytic record is not thin: psychodynamic therapy posts effect sizes on par with treatments marketed as "evidence-based," with gains that tend to widen rather than fade after treatment ends (Leichsenring et al., 2023; Shedler, 2010; Steinert et al., 2017). Public interest is higher, too, as the more superficial therapies, helpful as they are, don't get at the real person, the "deeper" roots of problems in living, and the ways to invite satisfaction to arrive.

The specter of looming obsolescence?

Artificial intelligence disrupts the overall landscape, in notable ways, across the overlapping domains of healthcare and mental healthcare. Psychotherapy is facing "replacement distress," as are many other industries. We know there aren't enough mental health clinicians to go around — more than 137 million Americans now live in a federally designated mental health shortage area, where barely a quarter of the need is met (HRSA, 2026) — at a time when mental health issues grow more and more costly in terms of human suffering and resource depletion. More than a billion people now live with a mental health condition, and depression and anxiety alone drain an estimated US$1 trillion a year in lost productivity (World Health Organization, 2025).

Given that you "can't hire yourself out of this," AI is stepping into the space once held by self-help books, apps, and other user-facing tools — several of which, bibliotherapy and guided self-help among them, already carry a research base. A generative-AI therapy chatbot has now been tested in a randomized trial too, with clinically significant drops in depression and anxiety and a therapeutic alliance users rated as comparable to a human's, though its wait-list design and small sample invite caution (Heinz et al., 2025).

AI is good for being there all the time, any time, for practically anything — for better or for worse. Immediate support in the moment, on demand, from a thing that never gets tired and — if we're honest — isn't really there and can't really care, is undeniably useful. For someone stuck on a waiting list for months, something responsive at two in the morning beats nothing at all; others may do fine without a human therapist at all. The harder case is the person who wants a human, clearly, and can't get one — no opening, no in-network provider, no insurance authorization — routed to AI by constraint rather than choice.

That same constant availability can also be avoidant — a way of avoiding the distinct tension, and the ensuing opportunities, that come from contact with another human being. Knowing a real person cares, and is there. The empathy research holds two truths at once. People rate AI's replies to patient questions as more empathetic than physicians' (Ayers et al., 2023) — AI can convey care, sometimes more reliably than a rushed clinician. They also rate the very same response as more empathic when they believe a human wrote it, whether or not one did (Ruben et al., 2026). The skillful words land; the sense that a person is genuinely present does something else. AI can deliver structured approaches well, elbowing in on some forms of therapy — but even if perfectly executed, the lack of a human being, when essential, is the missing ingredient, the "special sauce."

Crucially — from both ethical and pragmatic postures — psychotherapy is fundamentally a human-to-human relationship, which many, if not most, therapists would assert is not only therapeutic but definitional. The connection it rests on is only possible between people; even if perfectly simulated, it is irreplaceable. We ourselves are human, and being in the presence of one another is a deep evolutionary and cultural experience of belonging and identification, needed to evoke our most profound experiences. Knowing that another person is actually there is fundamentally unique, and evokes themes and conversations impossible with AI: What does it mean to be human? What does it mean to share that recognition, in a therapeutic context, with another human being? Existential questions — purpose, mortality. AI can do genuine therapeutic work, sometimes better than what's otherwise within reach; the human experience is, even so, irreducible — ineluctable, ineffable. Given the extent to which AI is infiltrating human relatedness, an important mission for therapists becomes a humanistic one, literally and figuratively. That imperative is surfacing on the engineering side, too: a recent proposal for "positive alignment" argues that AI should be built not merely to avoid harm but to actively support human flourishing — much as psychology had to move beyond treating illness toward cultivating well-being (Laukkonen et al., 2026). Aligned that way, AI is less a rival to the human relationship than an ally to it.

The trillion-dollar question

When is a human needed? There may be something unique about human agency — not least our indisputably more based ontological standing. The role of such possibly unique human qualities will shift and expand as AI becomes more and more advanced.

Psychotherapists are scrambling, acting quickly and without a crystal ball, as an uncertain economic future demands adaptation. The economic transition ought to be as smooth as possible, but it does not seem to be a main focus for decision-makers. The next few years will be definitive on many of the outstanding questions. AI will continue to transform mental healthcare.

Ayers, J. W., Poliak, A., Dredze, M., Leas, E. C., Zhu, Z., Kelley, J. B., Faix, D. J., Goodman, A. M., Longhurst, C. A., Hogarth, M., & Smith, D. M. (2023). Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Internal Medicine, 183 (6), 589–596. https://doi.org/10.1001/jamainternmed.2023.1838

Health Resources and Services Administration. (2026). Designated health professional shortage areas statistics: First quarter of fiscal year 2026 designated HPSA quarterly summary. U.S. Department of Health and Human Services. https://data.hrsa.gov/topics/health-workforce/shortage-areas

Heinz, M. V., Mackin, D. M., Trudeau, B. M., Bhattacharya, S., Wang, Y., Banta, H. A., Jewett, A. D., Salzhauer, A. J., Griffin, T. Z., & Jacobson, N. C. (2025). Randomized trial of a generative AI chatbot for mental health treatment. NEJM AI, 2 (4), Article AIoa2400802. https://doi.org/10.1056/AIoa2400802

Laukkonen, R., Krier, S., Bakalar, C., Chandaria, S., Kringelbach, M., Elwood, A., Ford, D., Rosas, F., Bohacek, M., Franklin, M., Tomašev, N., Chan, S., Rieser, V., Patel, R., Levin, M., & Rao, A. (2026). Positive alignment: Artificial intelligence for human flourishing. arXiv. https://doi.org/10.48550/arXiv.2605.10310

Leichsenring, F., Abbass, A., Heim, N., Keefe, J. R., Kisely, S., Luyten, P., Rabung, S., & Steinert, C. (2023). The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders — An umbrella review based on updated criteria. World Psychiatry, 22 (2), 286–304. https://doi.org/10.1002/wps.21104

Ruben, M. A., Blanch-Hartigan, D., & Hall, J. A. (2026). What is artificial intelligence (AI) "empathy"? A study comparing ChatGPT and physician responses on an online forum. Journal of General Internal Medicine, 41 (5), 1304–1311. https://doi.org/10.1007/s11606-025-10068-w

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65 (2), 98–109. https://doi.org/10.1037/a0018378

Steinert, C., Munder, T., Rabung, S., Hoyer, J., & Leichsenring, F. (2017). Psychodynamic therapy: As efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. American Journal of Psychiatry, 174 (10), 943–953. https://doi.org/10.1176/appi.ajp.2017.17010057

World Health Organization. (2025, September 2). Over a billion people living with mental health conditions — services require urgent scale-up [News release]. https://www.who.int/news/item/02-09-2025-over-a-billion-people-living-w… Resources and Services Administration. (2026). Designated health professional shortage areas statistics: First quarter of fiscal year 2026 designated HPSA quarterly summary. U.S. Department of Health and Human Services. https://data.hrsa.gov/topics/health-workforce/shortage-areas

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65 (2), 98–109. https://doi.org/10.1037/a0018378

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Grant Hilary Brenner, M.D., a psychiatrist and psychoanalyst, helps adults with mood and anxiety conditions, and works on many levels to help unleash their full capacities and live and love well.

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