The ascent of the AI therapist

We’re in the midst of a global mental-­health crisis. More than a billion people worldwide suffer from a mental-health condition, according to the World Health Organization. The prevalence of anxiety and depression is growing in many demographics, particularly young people, and suicide is claiming hundreds of thousands of lives globally each year.

Given the clear demand for accessible and affordable mental-health services, it’s no wonder that people have looked to artificial intelligence for possible relief. Millions are already actively seeking therapy from popular chatbots like OpenAI’s ChatGPT and Anthropic’s Claude, or from specialized psychology apps like Wysa and Woebot. On a broader scale, researchers are exploring AI’s potential to monitor and collect behavioral and biometric observations using wearables and smart devices, analyze vast volumes of clinical data for new insights, and assist human mental-health professionals to help prevent burnout. 

But so far this largely uncontrolled experiment has produced mixed results. Many people have found solace in chatbots based on large language models (LLMs), and some experts see promise in them as therapists, but other users have been sent into delusional spirals by AI’s hallucinatory whims and breathless sycophancy. Most tragically, multiple families have alleged that chatbots contributed to the suicides of their loved ones, sparking lawsuits against companies responsible for these tools. In October, OpenAI CEO Sam Altman revealed in a blog post that 0.15% of ChatGPT users “have conversations that include explicit indicators of potential suicidal planning or intent.” That’s roughly a million people sharing suicidal ideations with just one of these software systems every week.

The real-world consequences of AI therapy came to a head in unexpected ways in 2025 as we waded through a critical mass of stories about human-chatbot relationships, the flimsiness of guardrails on many LLMs, and the risks of sharing profoundly personal information with products made by corporations that have economic incentives to harvest and monetize such sensitive data. 

Several authors anticipated this inflection point. Their timely books are a reminder that while the present feels like a blur of breakthroughs, scandals, and confusion, this disorienting time is rooted in deeper histories of care, technology, and trust. 

LLMs have often been described as “black boxes” because nobody knows exactly how they produce their results. The inner workings that guide their outputs are opaque because their algorithms are so complex and their training data is so vast. In mental-health circles, people often describe the human brain as a “black box,” for analogous reasons. Psychology, psychiatry, and related fields must grapple with the impossibility of seeing clearly inside someone else’s head, let alone pinpointing the exact causes of their distress. 

These two types of black boxes are now interacting with each other, creating unpredictable feedback loops that may further impede clarity about the origins of people’s mental-­health struggles and the solutions that may be possible. Anxiety about these developments has much to do with the explosive recent advances in AI, but it also revives decades-old warnings from pioneers such as the MIT computer scientist Joseph Weizenbaum, who argued against computerized therapy as early as the 1960s.  

YALE UNIVERSITY PRESS, 2025

Charlotte Blease, a philosopher of medicine, makes the optimist’s case in Dr. Bot: Why Doctors Can Fail Us—and How AI Could Save Lives. Her book broadly explores the possible positive impacts of AI in a range of medical fields. While she remains clear-eyed about the risks, warning that readers who are expecting “a gushing love letter to technology” will be disappointed, she suggests that these models can help relieve patient suffering and medical burnout alike.

“Health systems are crumbling under patient pressure,” Blease writes. “Greater burdens on fewer doctors create the perfect petri dish for errors,” and “with palpable shortages of doctors and increasing waiting times for patients, many of us are profoundly frustrated.”

Blease believes that AI can not only ease medical professionals’ massive workloads but also relieve the tensions that have always existed between some patients and their caregivers. For example, people often don’t seek needed care because they are intimidated or fear judgment from medical professionals; this is especially true if they have mental-health challenges. AI could allow more people to share their concerns, she argues. 

But she’s aware that these putative upsides need to be weighed against major drawbacks. For instance, AI therapists can provide inconsistent and even dangerous responses to human users, according to a 2025 study, and they also raise privacy concerns, given that AI companies are currently not bound by the same confidentiality and HIPAA standards as licensed therapists. 

While Blease is an expert in this field, her motivation for writing the book is also personal: She has two siblings with an incurable form of muscular dystrophy, one of whom waited decades for a diagnosis. During the writing of her book, she also lost her partner to cancer and her father to dementia within a devastating six-month period. “I witnessed first-hand the sheer brilliance of doctors and the kindness of health professionals,” she writes. “But I also observed how things can go wrong with care.”

MIT PRESS, 2025

A similar tension animates Daniel Oberhaus’s engrossing book The Silicon Shrink: How Artificial Intelligence Made the World an Asylum. Oberhaus starts from a point of tragedy: the loss of his younger sister to suicide. As Oberhaus carried out the “distinctly twenty-first-century mourning process” of sifting through her digital remains, he wondered if technology could have eased the burden of the psychiatric problems that had plagued her since childhood.

“It seemed possible that all of this personal data might have held important clues that her mental health providers could have used to provide more effective treatment,” he writes. “What if algorithms running on my sister’s smartphone or laptop had used that data to understand when she was in distress? Could it have led to a timely intervention that saved her life? Would she have wanted that even if it did?”

This concept of digital phenotyping—in which a person’s digital behavior could be mined for clues about distress or illness—seems elegant in theory. But it may also become problematic if integrated into the field of psychiatric artificial intelligence (PAI), which extends well beyond chatbot therapy.

Oberhaus emphasizes that digital clues could actually exacerbate the existing challenges of modern psychiatry, a discipline that remains fundamentally uncertain about the underlying causes of mental illnesses and disorders. The advent of PAI, he says, is “the logical equivalent of grafting physics onto astrology.” In other words, the data generated by digital phenotyping is as precise as physical measurements of planetary positions, but it is then integrated into a broader framework—in this case, psychiatry—that, like astrology, is based on unreliable assumptions.  

Oberhaus, who uses the phrase “swipe psychiatry” to describe the outsourcing of clinical decisions based on behavioral data to LLMs, thinks that this approach cannot escape the fundamental issues facing psychiatry. In fact, it could worsen the problem by causing the skills and judgment of human therapists to atrophy as they grow more dependent on AI systems. 

He also uses the asylums of the past—in which institutionalized patients lost their right to freedom, privacy, dignity, and agency over their lives—as a touchstone for a more insidious digital captivity that may spring from PAI. LLM users are already sacrificing privacy by telling chatbots sensitive personal information that companies then mine and monetize, contributing to a new surveillance economy. Freedom and dignity are at stake when complex inner lives are transformed into data streams tailored for AI analysis. 

AI therapists could flatten humanity into patterns of prediction, and so sacrifice the intimate, individualized care that is expected of traditional human therapists. “The logic of PAI leads to a future where we may all find ourselves patients in an algorithmic asylum administered by digital wardens,” Oberhaus writes. “In the algorithmic asylum there is no need for bars on the window or white padded rooms because there is no possibility of escape. The asylum is already everywhere—in your homes and offices, schools and hospitals, courtrooms and barracks. Wherever there’s an internet connection, the asylum is waiting.”

ROUTLEDGE, 2025

Eoin Fullam, a researcher who studies the intersection of technology and mental health, echoes some of the same concerns in Chatbot Therapy: A Critical Analysis of AI Mental Health Treatment. A heady academic primer, the book analyzes the assumptions underlying the automated treatments offered by AI chatbots and the way capitalist incentives could corrupt these kinds of tools.  

Fullam observes that the capitalist mentality behind new technologies “often leads to questionable, illegitimate, and illegal business practices in which the customers’ interests are secondary to strategies of market dominance.”

That doesn’t mean that therapy-bot makers “will inevitably conduct nefarious activities contrary to the users’ interests in the pursuit of market dominance,” Fullam writes. 

But he notes that the success of AI therapy depends on the inseparable impulses to make money and to heal people. In this logic, exploitation and therapy feed each other: Every digital therapy session generates data, and that data fuels the system that profits as unpaid users seek care. The more effective the therapy seems, the more the cycle entrenches itself, making it harder to distinguish between care and commodification. “The more the users benefit from the app in terms of its therapeutic or any other mental health intervention,” he writes, “the more they undergo exploitation.” 

This sense of an economic and psychological ouroboros—the snake that eats its own tail—serves as a central metaphor in Sike, the debut novel from Fred Lunzer, an author with a research background in AI. 

Described as a “story of boy meets girl meets AI psychotherapist,” Sike follows Adrian, a young Londoner who makes a living ghostwriting rap lyrics, in his romance with Maquie, a business professional with a knack for spotting lucrative technologies in the beta phase. 

CELADON BOOKS, 2025

The title refers to a splashy commercial AI therapist called Sike, uploaded into smart glasses, that Adrian uses to interrogate his myriad anxieties. “When I signed up to Sike, we set up my dashboard, a wide black panel like an airplane’s cockpit that showed my daily ‘vitals,’” Adrian narrates. “Sike can analyze the way you walk, the way you make eye contact, the stuff you talk about, the stuff you wear, how often you piss, shit, laugh, cry, kiss, lie, whine, and cough.”

In other words, Sike is the ultimate digital phenotyper, constantly and exhaustively analyzing everything in a user’s daily experiences. In a twist, Lunzer chooses to make Sike a luxury product, available only to subscribers who can foot the price tag of £2,000 per month. 

Flush with cash from his contributions to a hit song, Adrian comes to rely on Sike as a trusted mediator between his inner and outer worlds. The novel explores the impacts of the app on the wellness of the well-off, following rich people who voluntarily commit themselves to a boutique version of the digital asylum described by Oberhaus.

The only real sense of danger in Sike involves a Japanese torture egg (don’t ask). The novel strangely sidesteps the broader dystopian ripples of its subject matter in favor of drunken conversations at fancy restaurants and elite dinner parties. 

The sudden ascent of the AI therapist seems startlingly futuristic, as if it should be unfolding in some later time when the streets scrub themselves and we travel the world through pneumatic tubes.

Sike’s creator is simply “a great guy” in Adrian’s estimation, despite his techno-messianic vision of training the app to soothe the ills of entire nations. It always seems as if a shoe is meant to drop, but in the end, it never does, leaving the reader with a sense of non-resolution.

While Sike is set in the present day, something about the sudden ascent of the AI therapist—­in real life as well as in fiction—seems startlingly futuristic, as if it should be unfolding in some later time when the streets scrub themselves and we travel the world through pneumatic tubes. But this convergence of mental health and artificial intelligence has been in the making for more than half a century. The beloved astronomer Carl Sagan, for example, once imagined a “network of computer psychotherapeutic terminals, something like arrays of large telephone booths” that could address the growing demand for mental-health services.

Oberhaus notes that one of the first incarnations of a trainable neural network, known as the Perceptron, was devised not by a mathematician but by a psychologist named Frank Rosenblatt, at the Cornell Aeronautical Laboratory in 1958. The potential utility of AI in mental health was widely recognized by the 1960s, inspiring early computerized psychotherapists such as the DOCTOR script that ran on the ELIZA chatbot developed by Joseph Weizenbaum, who shows up in all three of the nonfiction books in this article.

Weizenbaum, who died in 2008, was profoundly concerned about the possibility of computerized therapy. “Computers can make psychiatric judgments,” he wrote in his 1976 book Computer Power and Human Reason. “They can flip coins in much more sophisticated ways than can the most patient human being. The point is that they ought not to be given such tasks. They may even be able to arrive at ‘correct’ decisions in some cases—but always and necessarily on bases no human being should be willing to accept.”

It’s a caution worth keeping in mind. As AI therapists arrive at scale, we’re seeing them play out a familiar dynamic: Tools designed with superficially good intentions are enmeshed with systems that can exploit, surveil, and reshape human behavior. In a frenzied attempt to unlock new opportunities for patients in dire need of mental-health support, we may be locking other doors behind them.

Becky Ferreira is a science reporter based in upstate New York and author of First Contact: The Story of Our Obsession with Aliens.

AI Wrapped: The 14 AI terms you couldn’t avoid in 2025

If the past 12 months have taught us anything, it’s that the AI hype train is showing no signs of slowing. It’s hard to believe that at the beginning of the year, DeepSeek had yet to turn the entire industry on its head, Meta was better known for trying (and failing) to make the metaverse cool than for its relentless quest to dominate superintelligence, and vibe coding wasn’t a thing.

If that’s left you feeling a little confused, fear not. As we near the end of 2025, our writers have taken a look back over the AI terms that dominated the year, for better or worse.

Make sure you take the time to brace yourself for what promises to be another bonkers year.

—Rhiannon Williams

1. Superintelligence

As long as people have been hyping AI, they have been coming up with names for a future, ultra-powerful form of the technology that could bring about utopian or dystopian consequences for humanity. “Superintelligence” is that latest hot term. Meta announced in July that it would form an AI team to pursue superintelligence, and it was reportedly offering nine-figure compensation packages to AI experts from the company’s competitors to join.

In December, Microsoft’s head of AI followed suit, saying the company would be spending big sums, perhaps hundreds of billions, on the pursuit of superintelligence. If you think superintelligence is as vaguely defined as artificial general intelligence, or AGI, you’d be right! While it’s conceivable that these sorts of technologies will be feasible in humanity’s long run, the question is really when, and whether today’s AI is good enough to be treated as a stepping stone toward something like superintelligence. Not that that will stop the hype kings. —James O’Donnell

2. Vibe coding

Thirty years ago, Steve Jobs said everyone in America should learn how to program a computer. Today, people with zero knowledge of how to code can knock up an app, game, or website in no time at all thanks to vibe coding—a catch-all phrase coined by OpenAI cofounder Andrej Karpathy. To vibe-code, you simply prompt generative AI models’ coding assistants to create the digital object of your desire and accept pretty much everything they spit out. Will the result work? Possibly not. Will it be secure? Almost definitely not, but the technique’s biggest champions aren’t letting those minor details stand in their way. Also—it sounds fun! — Rhiannon Williams

3. Chatbot psychosis

One of the biggest AI stories over the past year has been how prolonged interactions with chatbots can cause vulnerable people to experience delusions and, in some extreme cases, can either cause or worsen psychosis. Although “chatbot psychosis” is not a recognized medical term, researchers are paying close attention to the growing anecdotal evidence from users who say it’s happened to them or someone they know. Sadly, the increasing number of lawsuits filed against AI companies by the families of people who died following their conversations with chatbots demonstrate the technology’s potentially deadly consequences. —Rhiannon Williams

4. Reasoning

Few things kept the AI hype train going this year more than so-called reasoning models, LLMs that can break down a problem into multiple steps and work through them one by one. OpenAI released its first reasoning models, o1 and o3, a year ago.

A month later, the Chinese firm DeepSeek took everyone by surprise with a very fast follow, putting out R1, the first open-source reasoning model. In no time, reasoning models became the industry standard: All major mass-market chatbots now come in flavors backed by this tech. Reasoning models have pushed the envelope of what LLMs can do, matching top human performances in prestigious math and coding competitions. On the flip side, all the buzz about LLMs that could “reason” reignited old debates about how smart LLMs really are and how they really work. Like “artificial intelligence” itself, “reasoning” is technical jargon dressed up with marketing sparkle. Choo choo! —Will Douglas Heaven

5. World models 

For all their uncanny facility with language, LLMs have very little common sense. Put simply, they don’t have any grounding in how the world works. Book learners in the most literal sense, LLMs can wax lyrical about everything under the sun and then fall flat with a howler about how many elephants you could fit into an Olympic swimming pool (exactly one, according to one of Google DeepMind’s LLMs).

World models—a broad church encompassing various technologies—aim to give AI some basic common sense about how stuff in the world actually fits together. In their most vivid form, world models like Google DeepMind’s Genie 3 and Marble, the much-anticipated new tech from Fei-Fei Li’s startup World Labs, can generate detailed and realistic virtual worlds for robots to train in and more. Yann LeCun, Meta’s former chief scientist, is also working on world models. He has been trying to give AI a sense of how the world works for years, by training models to predict what happens next in videos. This year he quit Meta to focus on this approach in a new start up called Advanced Machine Intelligence Labs. If all goes well, world models could be the next thing. —Will Douglas Heaven

6. Hyperscalers

Have you heard about all the people saying no thanks, we actually don’t want a giant data center plopped in our backyard? The data centers in question—which tech companies want to built everywhere, including space—are typically referred to as hyperscalers: massive buildings purpose-built for AI operations and used by the likes of OpenAI and Google to build bigger and more powerful AI models. Inside such buildings, the world’s best chips hum away training and fine-tuning models, and they’re built to be modular and grow according to needs.

It’s been a big year for hyperscalers. OpenAI announced, alongside President Donald Trump, its Stargate project, a $500 billion joint venture to pepper the country with the largest data centers ever. But it leaves almost everyone else asking: What exactly do we get out of it? Consumers worry the new data centers will raise their power bills. Such buildings generally struggle to run on renewable energy. And they don’t tend to create all that many jobs. But hey, maybe these massive, windowless buildings could at least give a moody, sci-fi vibe to your community. —James O’Donnell

7. Bubble

The lofty promises of AI are levitating the economy. AI companies are raising eye-popping sums of money and watching their valuations soar into the stratosphere. They’re pouring hundreds of billions of dollars into chips and data centers, financed increasingly by debt and eyebrow-raising circular deals. Meanwhile, the companies leading the gold rush, like OpenAI and Anthropic, might not turn a profit for years, if ever. Investors are betting big that AI will usher in a new era of riches, yet no one knows how transformative the technology will actually be.

Most organizations using AI aren’t yet seeing the payoff, and AI work slop is everywhere. There’s scientific uncertainty about whether scaling LLMs will deliver superintelligence or whether new breakthroughs need to pave the way. But unlike their predecessors in the dot-com bubble, AI companies are showing strong revenue growth, and some are even deep-pocketed tech titans like Microsoft, Google, and Meta. Will the manic dream ever burst? —Michelle Kim

8. Agentic

This year, AI agents were everywhere. Every new feature announcement, model drop, or security report throughout 2025 was peppered with mentions of them, even though plenty of AI companies and experts disagree on exactly what counts as being truly “agentic,” a vague term if ever there was one. No matter that it’s virtually impossible to guarantee that an AI acting on your behalf out in the wide web will always do exactly what it’s supposed to do—it seems as though agentic AI is here to stay for the foreseeable. Want to sell something? Call it agentic! —Rhiannon Williams

9. Distillation

Early this year, DeepSeek unveiled its new model DeepSeek R1, an open-source reasoning model that matches top Western models but costs a fraction of the price. Its launch freaked Silicon Valley out, as many suddenly realized for the first time that huge scale and resources were not necessarily the key to high-level AI models. Nvidia stock plunged by 17% the day after R1 was released.

The key to R1’s success was distillation, a technique that makes AI models more efficient. It works by getting a bigger model to tutor a smaller model: You run the teacher model on a lot of examples and record the answers, and reward the student model as it copies those responses as closely as possible, so that it gains a compressed version of the teacher’s knowledge.  —Caiwei Chen

10. Sycophancy

As people across the world spend increasing amounts of time interacting with chatbots like ChatGPT, chatbot makers are struggling to work out the kind of tone and “personality” the models should adopt. Back in April, OpenAI admitted it’d struck the wrong balance between helpful and sniveling, saying a new update had rendered GPT-4o too sycophantic. Having it suck up to you isn’t just irritating—it can mislead users by reinforcing their incorrect beliefs and spreading misinformation. So consider this your reminder to take everything—yes, everything—LLMs produce with a pinch of salt. —Rhiannon Williams

11. Slop

If there is one AI-related term that has fully escaped the nerd enclosures and entered public consciousness, it’s “slop.” The word itself is old (think pig feed), but “slop” is now commonly used to refer to low-effort, mass-produced content generated by AI, often optimized for online traffic. A lot of people even use it as a shorthand for any AI-generated content. It has felt inescapable in the past year: We have been marinated in it, from fake biographies to shrimp Jesus images to surreal human-animal hybrid videos.

But people are also having fun with it. The term’s sardonic flexibility has made it easy for internet users to slap it on all kinds of words as a suffix to describe anything that lacks substance and is absurdly mediocre: think “work slop” or “friend slop.” As the hype cycle resets, “slop” marks a cultural reckoning about what we trust, what we value as creative labor, and what it means to be surrounded by stuff that was made for engagement rather than expression. —Caiwei Chen

12. Physical intelligence

Did you come across the hypnotizing video from earlier this year of a humanoid robot putting away dishes in a bleak, gray-scale kitchen? That pretty much embodies the idea of physical intelligence: the idea that advancements in AI can help robots better move around the physical world. 

It’s true that robots have been able to learn new tasks faster than ever before, everywhere from operating rooms to warehouses. Self-driving-car companies have seen improvements in how they simulate the roads, too. That said, it’s still wise to be skeptical that AI has revolutionized the field. Consider, for example, that many robots advertised as butlers in your home are doing the majority of their tasks thanks to remote operators in the Philippines. 

The road ahead for physical intelligence is also sure to be weird. Large language models train on text, which is abundant on the internet, but robots learn more from videos of people doing things. That’s why the robot company Figure suggested in September that it would pay people to film themselves in their apartments doing chores. Would you sign up? —James O’Donnell

13. Fair use

AI models are trained by devouring millions of words and images across the internet, including copyrighted work by artists and writers. AI companies argue this is “fair use”—a legal doctrine that lets you use copyrighted material without permission if you transform it into something new that doesn’t compete with the original. Courts are starting to weigh in. In June, Anthropic’s training of its AI model Claude on a library of books was ruled fair use because the technology was “exceedingly transformative.”

That same month, Meta scored a similar win, but only because the authors couldn’t show that the company’s literary buffet cut into their paychecks. As copyright battles brew, some creators are cashing in on the feast. In December, Disney signed a splashy deal with OpenAI to let users of Sora, the AI video platform, generate videos featuring more than 200 characters from Disney’s franchises. Meanwhile, governments around the world are rewriting copyright rules for the content-guzzling machines. Is training AI on copyrighted work fair use? As with any billion-dollar legal question, it depends. —Michelle Kim

14. GEO

Just a few short years ago, an entire industry was built around helping websites rank highly in search results (okay, just in Google). Now search engine optimization (SEO), is giving way to GEO—generative engine optimization—as the AI boom forces brands and businesses to scramble to maximize their visibility in AI, whether that’s in AI-enhanced search results like Google’s AI Overviews or within responses from LLMs. It’s no wonder they’re freaked out. We already know that news companies have experienced a colossal drop in search-driven web traffic, and AI companies are working on ways to cut out the middleman and allow their users to visit sites from directly within their platforms. It’s time to adapt or die. —Rhiannon Williams