Therapists That Embrace AI As A Clinical Tool With Their Clients Are Going To Outdo And Outlast Therapists That Don’t

In today’s column, I examine a much-repeated line that those therapists who opt to use AI as a hands-on clinical tool with and for their clients are going to outdo and outlast other therapists who don’t do likewise.

First, it’s a true statement. Second, the reason this comes up frequently is that there is a preoccupation regarding a doomsday scenario in which AI is going to wipe out the need for human therapists. The assumption is that by AI providing mental health advice, people won’t choose to see human therapists anymore. In that case, therapists might as well throw in the towel. Try to make the best of your good times now and simply watch and wait for the end of human-delivered therapy.

The counterargument is that people are realistically going to continue to seek out human therapy, despite the AI boon, but the expectation and ultimately a perceived requirement will be that the therapist seamlessly incorporates AI usage into the entire process of therapy. The bottom line is that rather than worrying about being replaced by AI, savvy therapists focus on outdoing and outlasting therapists who have their heads in the sand and don’t embrace the use of AI.

Let’s talk about it.

This analysis of AI breakthroughs is part of my ongoing Forbes column coverage on the latest in AI, including identifying and explaining various impactful AI complexities (see the link here).

AI And Mental Health

As a brief background, I’ve been extensively covering and analyzing various facets of the modern-era AI that produces mental health advice and performs AI-driven therapy. This rising use of AI has principally been spurred by the evolving advances and widespread adoption of generative AI. For an extensive listing of my well over one hundred analyses and postings, see the link here and the link here.

There is little doubt that this is a rapidly developing field and that there are tremendous upsides to be had, but at the same time, regrettably, hidden risks and outright gotchas come into these endeavors, too. I frequently speak up about these pressing matters, including in an appearance on an episode of CBS’s 60 Minutes, see the link here.

Background On AI For Mental Health

I’d like to set the stage on how generative AI and large language models (LLMs) are typically used in an ad hoc way for mental health guidance. Millions upon millions of people are using generative AI as their ongoing advisor on mental health considerations (note that ChatGPT alone has over 900 million weekly active users, a notable proportion of which dip into mental health aspects, see my analysis at the link here). The top-ranked use of contemporary generative AI and LLMs is to consult with the AI on mental health facets; see my coverage at the link here.

This popular usage makes abundant sense. You can access most of the major generative AI systems for nearly free or at a super low cost, doing so anywhere and at any time. Thus, if you have any mental health qualms that you want to chat about, all you need to do is log in to AI and proceed forthwith on a 24/7 basis.

There are significant worries that AI can readily go off the rails or otherwise dispense unsuitable or even egregiously inappropriate mental health advice. Banner headlines in August of this year accompanied the lawsuit filed against OpenAI for their lack of AI safeguards when it came to providing cognitive advisement.

Despite claims by AI makers that they are gradually instituting AI safeguards, there are still a lot of downside risks of the AI doing untoward acts, such as insidiously helping users in co-creating delusions that can lead to self-harm. For my follow-on analysis of details about the OpenAI lawsuit and how AI can foster delusional thinking in humans, see my analysis at the link here. As noted, I have been earnestly predicting that eventually all of the major AI makers will be taken to the woodshed for their paucity of robust AI safeguards.

Today’s generic LLMs, such as ChatGPT, Claude, Gemini, Grok, and others, are not at all akin to the robust capabilities of human therapists. Meanwhile, specialized LLMs are being built to presumably attain similar qualities, but they are still primarily in the development and testing stages. See my coverage at the link here.

Therapists And The Role Of AI

I have been extensively identifying and examining the myriad ways that AI enters the role of therapists and mental health professionals.

Some therapists refuse to think about AI and want nothing to do with it. Others are embracing AI and using AI as part of their therapeutic process with clients. Indeed, I have predicted that the therapy realm is being transformed from the traditional dyad of therapist-client and inevitably becoming a new triad of therapist-AI-client, see my analysis at the link here. I will give you the key points in a moment; hang in there.

My view is that whether therapists are keen on AI is not the headspace they should be in. AI is coming, and to a great degree, it is already here. Clients nowadays come in the door with AI-generated advice and want their therapist to tell them what it means. In other instances, clients will post-session try to double-check what their therapist told them and lean into AI as a means of judging the mental health advice they are getting from the clinician. AI is a reality that therapists must face, regardless of their desire to do so. Having one’s head in the sand is not prudent, as I will be illuminating momentarily.

There are lots of ways that AI intersects with contemporary therapists, including these circumstances that I have closely addressed:

• How therapists should clinically analyze AI chats of their clients, see my discussion at the link here.
• Questions that clients are asking their prospective or existing therapists about AI, and the answers that therapists ought to be providing, see my coverage at the link here.
• Therapy is shifting from the classic dyad of therapist-client to the new triad of therapist-AI-client, see my discussion at the link here.
• Therapists are being asked by clients to jointly use AI during their mental health therapeutic process and work in these new ways, see my explanation at the link here.
• Some therapists are opting to use AI during therapy sessions with their clients and do so in these astute ways; see my coverage at the link here.
• How therapists are handling clients who appear to be encountering AI psychosis, see my discussion at the link here.
• Therapists are using AI to craft digital twins of their clients and perform more impactful therapy accordingly, see my coverage at the link here.
• Worries that therapists leaning into AI as an aid in conducting therapy might end up deskilling their own capabilities, see my assessment at the link here.
• How therapists are using custom prompts to get generative AI to serve as an adjunct to their therapy sessions and interact with their clients, see my discussion at the link here.
• Public perception of therapists who decide to use AI in their practices, see my analysis at the link here.
• Legal defense strategies being used by AI makers to defend against AI mental health lawsuits, see my analysis at the link here.
• Contending with clients that come to therapy with AI-generated mental health advice and want their therapist to give a thumbs up, see my coverage at the link here.
• Emerging new informal duty might be for therapists to inform their clients about the ups and downs of using AI for mental health guidance, see my analysis at the link here.

And so on.

The Classic Dyad Is Becoming The New Triad

AI is disrupting and transforming the act of therapy at the very core of day-to-day practice. Consider that therapy can be construed as consisting of these two mainstay potential arrangements:

• (1) Old Dyad: The classical therapist-client arrangement (absent of AI usage in any clinical capacity).
• (2) New Triad: The emerging therapist-AI-client arrangement (AI usage is fully integrated throughout the therapeutic process for both the therapist and the client).

When it comes to the newly emerging triad, I stratify the triad into three combinations. I conveniently label each variation by switching around the sequence of the words “therapist”, “AI”, and “client”.

Here are the three variations accordingly:

• (1) Therapist-AI-Client triad: This is the joint use of AI as a therapeutic tool, wherein the therapist and the client are collaboratively using AI. AI is a helpful intermediary.
• (2) Therapist-Client-AI triad: Sometimes (perhaps often) clients are dipping into AI for therapy and doing so behind the back of their therapist. I represent this circumstance by resequencing to put the AI aspect at the far edge rather than in the middle. Therapists would be astute to find out if their client is making use of AI on the side, see my discussion at the link here.
• (3) AI-Therapist-Client triad: Some therapists are using AI behind the scenes and not directly in conjunction or collaboration with a client. A therapist might confer with AI prior to meeting with a client, or do so after a meeting with a client, or even surreptitiously use AI during a client session, see my analysis at the link here.

Let’s focus on the emerging mainstay of therapist-AI-client.

Explaining The Therapist-AI-Client Triad

A prudently balanced version of the triad consists of the therapist-AI-client configuration.

If done well, the idea is that the therapist openly and overtly encourages their client to make use of AI as a therapeutic adjunct. The therapist can rely on the AI as an anytime, anyplace means of their client getting augmented therapy. Therapists are a constrained resource in the sense that few human therapists are readily available 24/7; thus, the AI helps to fill the availability gaps.

A proper means of adopting the therapist-AI-client configuration is almost always done by the therapist. They pick the AI. They arrange for the client to have access to the AI. The therapist reviews what is going on regarding the AI usage by the client. That being said, the AI selection doesn’t necessarily need to be done in the absence of conferring with the client, namely, the therapist might opt to discuss which AI will be used and take as input the preferences of the client.

Unfortunately, this approach can readily go awry if handled improperly.

Suppose a therapist merely tells a client to use a popular AI such as ChatGPT, Claude, Grok, Gemini, etc., and takes no other interest in the matter. It is a vacuous hand-waving or nod to the use of AI. Not good. The therapist won’t particularly know what the client is doing with the AI, nor will the therapist be aware of what the AI is telling their client. This hands-off approach is almost surely going to be disastrous. The AI will be telling the client something about what to do therapeutically, and the therapist might be saying something else. All told, the therapist and the AI are bound to conflict with each other.

Please don’t fall into that trap.

AI Clinical Use Versus Administrative Use

The aim should be to adopt AI as an integral element in the therapeutic process and do so gracefully and seamlessly.

Turns out that’s not the only way a therapist can make use of AI. The use of AI as a back-end tool can also be fruitful. Therapists can make use of AI for administrative chores in their therapy office.

The latest AI can produce transcripts of taped sessions. AI can be used to keep track of time consumption and prepare billings. These non-therapy uses of AI are a lot less controversial because they are outside the scope of therapy. A crucial aspect is that the therapist needs to ensure that the administrative use of AI doesn’t cause privacy intrusions or otherwise cause record-keeping problems.

Once again, if the AI usage is not well-designed or poorly managed, things can go sour.

Prioritization Goes To Therapy And AI

My strident advice is to avoid putting much effort into the administrative side of AI usage.

The devout reasoning is as follows. First, keep your eye on the ball, which is AI usage in the clinical realm of therapy. That is what will differentiate you from other therapists. The use of AI as an administrative tool is not going to especially bring you new clients or make existing clients get overly excited. They assume you do what you need to do when it comes to administrative chores.

Another aspect is that the numerous vendors of therapy-oriented administrative tools are wrapping AI into their wares. You don’t need to do much other than learn how to use what they provide. Let them do the heavy lifting. On the other hand, the use of AI as a clinical tool is much less defined and requires a hands-on and roll-up-the-sleeves presence on the part of the therapist.

Get the clinical usage figured out. After doing so, you can then shift your gaze to the administrative side, though never taking your eagle eyes off the clinical side of AI usage.

The Direction Ahead

The terrain of AI is the human psyche.

It is incontrovertible that we are now amid a grandiose worldwide experiment when it comes to societal mental health. The experiment is that AI is being made available nationally and globally, which is either overtly or insidiously acting to provide mental health guidance of one kind or another. Doing so either at no cost or at a minimal cost. It is available anywhere and at any time, 24/7. We are all the guinea pigs in this wanton experiment.

The reason this is especially tough to consider is that AI has a dual-use effect. Just as AI can be detrimental to mental health, it can also be a huge bolstering force for mental health. A delicate tradeoff must be mindfully managed. Prevent or mitigate the downsides, and meanwhile make the upsides as widely and readily available as possible.

A final thought for now.

You might be vaguely familiar with the old joke about two barefoot people in the woods who come upon an angry bear. One person quickly puts on a pair of shoes. The other mocks the shoe-bearing person and smugly points out that a human cannot outrun an enraged bear. Yes, the shoe-bearing person says, I know that as a fact, but in this instance, all I need to do is outrun you. I bring up this humorous anecdote to suggest that smart therapists are putting AI into their therapy toolkit since they realize that doing so will let them outrun their non-AI-using colleagues.

It’s time to put on those shoes.