General-purpose AI assistants used for emotional support

Domain IX · Biomedical, neuro & digital

What it is

This is not a therapy. It is a clinical framework for how a psychotherapist asks about, understands and works with a client's use of general-purpose AI assistants (for example ChatGPT, Claude, Gemini and similar) for emotional support, advice, companionship or self-diagnosis. These products are…

Format

• There is no published phased protocol; the stages below organise APA's clinician recommendations into a sequence. Format: woven into ordinary sessions, not a separate treatment; typically a few minutes at intake, a focused 15–30 minutes when use is significant, then brief reviews.

Who practises it, and how they are trained or regulated

• In APA's 2026 Chatbots and Mental Health Survey of 1,242 US licensed psychologists (April 2026), more than three-quarters said patients discuss AI in therapy; 39% reported patients using AI for self-diagnosis and 35% as an additional mental health professional.
• Regulatory status (as of October 2026, per the dated sources named): the FDA had authorised over 1,200 AI-enabled medical devices but none for mental health uses at the time of its Digital Health Advisory Committee meeting on generative-AI mental health devices (6 November 2025); whether this has changed since is. General-purpose assistants are not marketed or regulated as mental health treatments. Illinois'…

Evidence status, as the guide reports it

• Reported potential benefits (attributed, not causal): 68% of psychologists whose patients had ongoing chatbot conversations said patients felt supported or validated, and 41% said patients used chatbots to reinforce healthy coping skills; Anthropic found affective conversations ended slightly more…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• AI quietly replacing therapy after discharge. Working: the client has a plan for healthy use and for human support.
• the client hearing "you were stupid to use it"; correct this. Working: the client spontaneously questions an AI reply.
• presenting company safety claims as proven; products and policies change often, so date-stamp what you tell clients and recheck.
• rehearsal replacing action; the client asking the AI to do homework for them. Working: practice is followed by real-world steps.
• plans imposed by the therapist (low adherence); hidden use. Working: the client reports use within the agreed limits and more human contact.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.