AI as a medium of power in psychotherapy

TL;DR, in recent years, the integration of Artificial Intelligence (AI) into behavioral health systems has surged, raising significant questions about its potential impacts on psychotherapy. This advancement is reshaping the landscape of mental health practices, with AI now extending beyond basic tasks like diagnosis and documentation to more complex roles such as training therapists and developing AI-driven therapeutic chatbots. Our co-founder, Ian Felton, has written a research paper exploring the impact of AI on power dynamics and the therapeutic relationship. To read the complete research paper, you can find it here. Or, read on for a summary of the findings.

AI as a medium of power in psychotherapy

AI in the therapy room: opportunities and challenges

The introduction of AI in psychotherapy offers promising advancements, particularly in diagnosis and documentation where its precision and efficiency surpass current software capabilities. Yet, as AI ventures into roles like therapist training and in-session interventions, it’s crucial to consider the broader implications on power dynamics within institutions, culture, and therapy itself.

Institutional and cultural power dynamics

The implementation of AI in behavioral health is influenced by institutional and cultural authorities, shaping the norms and expectations in psychotherapy. This dynamic can potentially constrain the range of acceptable practices and treatments, raising concerns about the preservation of ethical and human-centric approaches in therapy.

Ethical implications and the role of therapists

The evolution of AI in psychotherapy necessitates a proactive approach from therapists. They must engage in the design and training of AI systems to ensure that these technologies align with diverse cultural perspectives and therapeutic orientations. The challenge is to find a balance between utilizing AI’s capabilities and preserving the sacred therapeutic relationship.

AI and ethics in psychotherapy

Adopting AI in therapy calls for an adherence to deep ethical considerations. Principles such as autonomy, beneficence, fidelity, justice, nonmaleficence, and veracity must guide the integration of AI in therapy. Insights from philosophers like Michel Foucault and psychoanalyst Ernest Becker provide a framework to understand these ethical concerns in the context of AI.

Power dynamics and AI’s influence

AI’s integration in psychotherapy is akin to altering the rules of a game, influencing the potential actions and outcomes within the therapeutic process. Foucault’s perspectives on power dynamics are particularly relevant here, as AI-driven systems will shape the knowledge and practices in therapy, potentially altering the professional landscape.

AI and cultural impact on mental health

The rise of AI also poses significant cultural implications. Ernest Becker’s theories on human civilization and heroism suggest that AI’s advancements could challenge our sense of significance and achievement, influencing mental health and the therapeutic process.

Therapeutic content and AI

The content of therapy is another area where AI’s influence must be carefully considered. AI tools must not restrict the exploration of diverse psychological themes, including complex topics like death and existential concerns. Ethical use of AI in therapy means ensuring freedom in content exploration and respecting patient autonomy.

Therapeutic relationship in the age of AI

The therapeutic relationship remains central in psychotherapy, and AI’s role should complement, not replace, this human connection. AI must be used to enhance the therapeutic relationship, not dictate or constrain it. The therapist’s role as a compassionate and ethical guide is irreplaceable, even in an AI-assisted therapeutic environment.

Case studies: ethical and unethical AI use

Exploring case studies of AI use in therapy can highlight the ethical considerations and potential pitfalls. Ethical use involves informed consent, respecting patient autonomy, and prioritizing the therapeutic relationship. In contrast, unethical use, driven by over-reliance on AI without patient engagement, can undermine the therapy’s effectiveness and ethical foundations.

The future of psychotherapy and AI

As AI becomes increasingly woven into the fabric of psychotherapy, therapists must navigate the challenges and opportunities it presents. Rejecting AI entirely is not feasible, but therapists must engage actively in shaping AI’s role in therapy, ensuring it aligns with ethical principles and enhances, rather than diminishes, the therapeutic relationship.


The integration of AI in psychotherapy is a complex and evolving journey. It requires a careful balance between leveraging technological advancements and maintaining the core ethical principles and human connections that define psychotherapy. Therapists play a crucial role in guiding this integration, ensuring that AI serves as a tool for enhancing therapy, not a replacement for the human elements that are fundamental to the healing process.