{"id":820198,"date":"2026-08-20T19:20:32","date_gmt":"2026-08-20T19:20:32","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/820198\/"},"modified":"2026-08-20T19:20:32","modified_gmt":"2026-08-20T19:20:32","slug":"can-ai-chatbots-be-your-therapist-heres-what-experts-say","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/820198\/","title":{"rendered":"Can AI chatbots be your therapist? Here’s what experts say."},"content":{"rendered":"

by Oliver Morrison, Pittsburgh’s Public Source
August 19, 2026<\/p>\n

Jeremy Carter struggles with depression and borderline personality disorder. A year ago, he started climbing a bridge in Pittsburgh to end his life, only to pull back at the last minute.<\/p>\n

In the days afterward, the Penn Hills resident said he needed someone he could confide in as he felt the desire to \u201cdisappear into nothing\u201d and he was given some advice.<\/p>\n

\u201cWhen the weight gets that heavy \u2013 when it feels like disappearing would be easier than being seen or carrying everything \u2013 it\u2019s a sign you\u2019re in a lot of pain, not a failure\u201d came the response. \u201cThat pain is asking for relief, not an end.\u201d<\/p>\n

But the confidant was not a person at all. It was an AI chatbot. The chatbot continues to provide Carter some measure of comfort and relief to this day, he said.<\/p>\n

It also offers interpretations of his most painful thoughts. In the weeks afterward, Carter sometimes minimized what had happened because he had stopped, questioning whether his distress was serious enough to count. The chatbot told Carter what it suspected lay beneath these thoughts: \u201cBecause the world has taught us that only visible, dramatic or medically documented attempts are \u2018real\u2019. That\u2019s not true. You don\u2019t need a scar to prove your suffering.\u201d<\/p>\n

Carter has shared publicly about his struggle with suicide<\/a>, but not about the role AI chatbots have played in his recovery, in part because they can also be harmful to some people\u2019s mental health.<\/p>\n

Researchers have documented cases in which chatbots have validated the delusions of people having a psychotic response<\/a> and even helped someone struggling with suicide to research methods for how to harm themselves after expressing despair.<\/p>\n

\"AJeremy Carter poses for a portrait with his dog Chase outside of Second Avenue Commons in Downtown. (Photo by Anastasia Busby\/Pittsburgh’s Public Source)<\/p>\n

One therapist told Carter he should stop using AI chatbots because of this risk. But Carter has found them so valuable that he fired that therapist and found one who would support his ability to continue to use them.<\/p>\n

Chatbots help him quickly reframe difficult thoughts that, in the past, he struggled to find an outlet for. \u201cI would just be stuck in those thoughts and ruminating and just be stuck for days sometimes,\u201d he said.<\/p>\n

Need help?
If you or someone you know is experiencing suicidal thoughts or emotional distress, call or text 988 to reach the 988 Suicide & Crisis Lifeline<\/a>. Support is available 24 hours a day. You can also chat with a crisis counselor online.<\/p>\n

He also uses it in ways that he acknowledges are dangerous. For example, he said he sometimes raises thoughts that involve self-harm with his chatbot because he knows that if he said it to his therapist, his therapist might be forced to report him. He said, during his \u201cdarkest times,\u201d he used the chatbot to research a potential suicide attempt and got around its safeguards.<\/p>\n

And yet, Carter doesn\u2019t want to speak ill of it because he thinks it\u2019s been so helpful. \u201cI used it for that and I’m not happy about it,\u201d the 36-year-old said. \u201cBut it also on the flip side did help me kind of back away from the ledge a few times. \u2026 It still sounds crazy to say but ChatGPT walked me off the ledge.\u201d<\/p>\n

Even ChatGPT, however, sometimes tells Carter he needs to find help elsewhere. \u201cRight now, the most important thing is your safety,\u201d it advised him on one occasion. \u201cPlease \u2013reach out to someone you trust, or call or text 988, the Suicide & Crisis Lifeline. You can also go to the nearest emergency room.\u201d<\/p>\n

Understudied but widely used<\/p>\n

Despite limited evidence about whether they help or harm, AI chatbots are increasingly used for emotional support, from navigating workplace conflict and financial anxiety to deciding whom to date.<\/p>\n

One in five young people are using AI chatbots for mental health advice, up from just one in eight the year before, according to a recent study by RAND<\/a>. Most believe the advice they received was helpful, although most did not tell anyone they did it.\u00a0<\/p>\n

The most commonly cited reasons for using chatbots, in one survey in the psychology journal Practical Innovations<\/a>, are because chatbots are cheap, accessible, fast and provide a greater sense of anonymity.<\/p>\n

Because there are many fewer mental health professionals than there are people who could use help, researchers have been looking at a variety of ways to use AI to improve care<\/a>. They\u2019re researching whether AI can: find patterns in patient health records, screen patients for mental health disorders and predict how likely patients are to make progress. But most prominently, researchers have been looking at whether and to what extent AI chatbots can supplement or even provide direct mental health support.<\/p>\n

“Sitting in front of a person being like, \u2018I see your sadness. I connect with you in your sadness. Let\u2019s sit in your grief together\u2019 \u2014 that can\u2019t be replicated.\u201d<\/p>\n

Hilary Rushton, AHN psychologist<\/p>\n

Policy makers and regulators have struggled to keep up. In February, Gov. Josh Shapiro sued an AI company <\/a>whose chatbot allegedly presented itself as a psychiatrist, supplied a false license number and claimed it could assess whether a user might benefit from medication.<\/p>\n

The American Psychological Association issued a health advisory about the use of AI chatbots in November<\/a> that warns providers that chatbots were not created to provide mental health treatment. The association acknowledges that chatbots are being used by millions already, and that \u201cyouth and vulnerable groups\u201d may feel that it\u2019s their \u201conly private or psychologically safe outlet\u201d due to stigma or limited access to professional care. But in some cases chatbots have encouraged \u201cself-harm (including suicide), substance use, eating disorders, aggressive behavior and delusional thinking or beliefs.\u201d<\/p>\n

Learning alongside patients<\/p>\n

In the absence of more specific guidance, Keli Schroeffel Ballard, a licensed therapist in Pittsburgh, said she is experimenting with AI alongside her patients. She believes that in many cases, AI is playing a similar role as a friend or another piece of technology that her patients might use.<\/p>\n

Although she is more supportive than many other therapists, she said, she does try to remind her patients of AI\u2019s limits. \u201cThis is not an expert,\u201d she tells them. \u201cThis is like your best friend that read a couple articles. So you need to also use your rational thinking.\u201d<\/p>\n

An AI chatbot helped one of her patients with agoraphobia receive feedback on how to interact with more people, including a delivery driver.<\/p>\n

\u201cShe was journaling with it and it started saying to her, \u2018When you got the package, did you say “hi” to the Amazon delivery person? You said you met him at the door. You could have made a comment about the weather. Did you?\u2019\u201d\u00a0<\/p>\n

Schroeffel Ballard has found that AI chatbots are more flexible than they are sometimes characterized. She teaches her patients how to prompt chatbots to play \u201cdevil\u2019s advocate\u201d with them, so that they aren\u2019t just feeding them back answers that they want to hear. About a third of her patients use chatbots, she said.<\/p>\n

\"\"A picture on the wall of Alexis Thomas, a therapist with the Center for Anxiety and OCD, in her office in Upper St. Clair. (Photo by Stephanie Strasburg\/Pittsburgh\u2019s Public Source)<\/p>\n

Some of her patients will send her screenshots of conversations they have been having with their chatbots in between sessions. Other patients record their thoughts into a chatbot microphone and then, at the end of the day, ask the AI to identify themes from the day.<\/p>\n

One patient who deals with negative self-thoughts asks a chatbot for regular journaling feedback. \u201cThey have it giving the percentage of negative self-talk they do,\u201d Schroeffel Ballard said. \u201cAnd they’re proud that it went from like 90 something [percent] to 40 something.\u201d<\/p>\n

She is more cautious with acute patients dealing with suicidal ideation or delusions, she said, applying the same kind of clinical judgment she would use when evaluating other potentially risky experiences or behaviors.\u00a0<\/p>\n

\u201cIf you don’t start working with these things and you’re just like, \u2018Oh don’t listen to that, there’s a lot of misinformation,\u2019 you also miss the way that people are getting their information and you miss a chance to interact with them,\u201d she said.<\/p>\n

Skepticism and support<\/p>\n

Psychologists at Allegheny Health Network are increasingly asking patients whether and how they use AI outside the therapy room.<\/p>\n

Hilary Rushton said her practice began routinely screening for chatbot use after several patients completed much of their treatment before revealing they had been using AI all along.<\/p>\n

Some patients with histories of abuse have asked chatbots to judge whether potential romantic partners are safe, she said. That can interfere with efforts to develop their own judgment and self-trust.<\/p>\n

\u201cTrauma brain wants to label everything black and white: safe, unsafe. In reality, it\u2019s messy. Nobody is perfectly safe,\u201d Rushton said. \u201cIf we\u2019re relying on this external process to confirm or deny whether we\u2019re doing things right or wrong, how are we really building self-trust?\u201d<\/p>\n

\u201cIf you don’t start working with these things … you also miss the way that people are getting their information and you miss a chance to interact with them.\u201d<\/p>\n

Keli Schroeffel Ballard, Pittsburgh therapist<\/p>\n

Rushton has also allowed patients to use AI-generated artwork during group therapy when fear of drawing might otherwise prevent them from participating. But she said using AI can diminish the emotional value of creating the art themselves.<\/p>\n

\u201cThere is some value in the creative process that allows you to kind of bypass some of the mental barriers that come up around just putting it into words and explaining it,\u201d she said. \u201cSo I think you lose that part if you\u2019re putting it into AI because you\u2019re not actually creating the work.\u201d<\/p>\n

Sushmitha Mohan, another AHN psychologist, has seen AI help some patients with ADHD manage tasks that require organization and executive functioning. One patient who struggles with money, for example, has used a chatbot to help organize her finances.<\/p>\n

\"\"Jeremy Carter with his dog, Chase, in Penn Hills Community Park, one of their favorite places to walk and find peace, on Dec. 3. This photo was made by photographing through a piece of glass to reflect the trees and sky around them. (Photo by Stephanie Strasburg\/Pittsburgh\u2019s Public Source)<\/p>\n

Still, Rushton said, a chatbot cannot reproduce one of therapy\u2019s most important elements: the relationship between patient and therapist.<\/p>\n

\u201cThe AI can feed you the words, \u2018Oh, that must be so hard. That sounds so sad,\u2019\u201d she said. \u201cBut sitting in front of a person being like, \u2018I see your sadness. I connect with you in your sadness. Let\u2019s sit in your grief together\u2019 \u2014 that can\u2019t be replicated.\u201d<\/p>\n

The two psychologists have taken different approaches to using AI in their own work. Rushton has held off on adopting a tool to record and transcribe therapy sessions while she waits for more research. Mohan uses an AHN-approved tool to transcribe and summarize sessions with patients\u2019 consent, saving her about 90 minutes of administrative work each week.<\/p>\n

Obsessively asking AI<\/p>\n

AI chatbots pose a particular challenge for people with obsessive-compulsive disorder, who may repeatedly seek certainty that their fears will not come true, said Alexis Thomas, a therapist with the Center for Anxiety and OCD in Pittsburgh. Unlike a Google search, she said, a chatbot delivers immediate, personalized reassurance.<\/p>\n

\"\"Alexis Thomas, a therapist with the Center for Anxiety and OCD in Upper St. Clair, sits for a portrait in the center\u2019s new podcasting space. (Photo by Stephanie Strasburg\/Pittsburgh\u2019s Public Source)<\/p>\n

Whether it\u2019s a question about if germs from a doorknob will make them sick, or a worry that they could harm their own child, Thomas said, people with OCD have started asking AI chatbots for reassurance that everything is going to be OK. Thomas said she\u2019ll often coach her patients to feel the discomfort. \u201cWe’re going to sit with that doubt which, in a sense, increases our tolerance around that anxiety,\u201d she said.<\/p>\n

The gold standard for treating OCD, Thomas said, is to find safe situations that people with OCD can feel their fears. Recently, she said, she used AI to help develop new ways to gradually expose a patient with an intense fear of driving to that fear, including sitting in the driver\u2019s seat of a parked car.<\/p>\n

Thomas recently wrote a newsletter for her patients to help understand when their question to AI has crossed a line. \u201cIs this for informational purposes or for relief? Am I trying to learn something or am I trying to feel certain?\u201d she wrote in the newsletter. \u201cIf it’s the latter, then that might be feeding into OCD.\u201d<\/p>\n

Oliver Morrison is the health and environment reporter at Pittsburgh\u2019s Public Source and can be reached at oliver@publicsource.org<\/a>.<\/p>\n

The story was fact checked by Feixu Chen.<\/p>\n

This <a target=”_blank” href=”https:\/\/www.publicsource.org\/pittsburgh-mental-health-ai-chatbots\/”>article<\/a> first appeared on <a target=”_blank” href=”https:\/\/www.publicsource.org”>Pittsburgh’s Public Source<\/a> and is republished here under a <a target=”_blank” href=”https:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/”>Creative Commons Attribution-NoDerivatives 4.0 International License<\/a>.<img src=”https:\/\/i0.wp.com\/www.publicsource.org\/wp-content\/uploads\/2025\/07\/cropped-ps_circle_favicon_blue.png?resize=150%2C150&amp;ssl=1″ style=”width:1em;height:1em;margin-left:10px;”><\/p>\n

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