Can Artificial Intelligence Replace Human Therapists?

Could artificial intelligence reduce the need for human therapists?

Websites, smartphone apps and social-media sites are dispensing mental-health advice, often using artificial intelligence. Meanwhile, clinicians and researchers are looking to AI to help define mental illness more objectively, identify high-risk people and ensure quality of care.

Some experts believe AI can make treatment more accessible and affordable. There has long been a severe shortage of mental-health professionals, and since the Covid pandemic, the need for support is greater than ever. For instance, users can have conversations with AI-powered chatbots, allowing then to get help anytime, anywhere, often for less money than traditional therapy.

The algorithms underpinning these endeavours learn by combing through large amounts of data generated from social-media posts, smartphone data, electronic health records, therapy-session transcripts, brain scans and other sources to identify patterns that are difficult for humans to discern.

Despite the promise, there are some big concerns. The efficacy of some products is questionable, a problem only made worse by the fact that private companies don’t always share information about how their AI works. Problems about accuracy raise concerns about amplifying bad advice to people who may be vulnerable or incapable of critical thinking, as well as fears of perpetuating racial or cultural biases. Concerns also persist about private information being shared in unexpected ways or with unintended parties.

The Wall Street Journal hosted a conversation via email and Google Doc about these issues with John Torous, director of the digital-psychiatry division at Beth Israel Deaconess Medical Center and assistant professor at Harvard Medical School; Adam Miner, an instructor at the Stanford School of Medicine; and Zac Imel, professor and director of clinical training at the University of Utah and co-founder of LYSSN.io, a company using AI to evaluate psychotherapy. Here’s an edited transcript of the discussion.

Leaps forward

WSJ: What is the most exciting way AI and machine learning are being used to diagnose mental disorders and improve treatments?

DR. MINER: AI can speed up access to appropriate services, like crisis response. The current Covid pandemic is a strong example where we see both the potential for AI to help facilitate access and triage, while also bringing up privacy and misinformation risks. This challenge—deciding which interventions and information to champion—is an issue in both pandemics and in mental health care, where we have many different treatments for many different problems.

DR. IMEL: In the near term, I am most excited about using AI to augment or guide therapists, such as giving feedback after the session or even providing tools to support self-reflection. Passive phone-sensing apps [that run in the background on users’ phones and attempt to monitor users’ moods] could be exciting if they predict later changes in depression and suggest interventions to do something early. Also, research on remote sensing in addiction, using tools to detect when a person might be at risk of relapse and suggesting an intervention or coping skills, is exciting.

DR. TOROUS: On a research front, AI can help us unlock some of the complexities of the brain and work toward understanding these illnesses better, which can help us offer new, effective treatment. We can generate a vast amount of data about the brain from genetics, neuroimaging, cognitive assessments and now even smartphone signals. We can utilize AI to find patterns that may help us unlock why people develop mental illness, who responds best to certain treatments and who may need help immediately. Using new data combined with AI will likely help us unlock the potential of creating new personalized and even preventive treatments.

WSJ: Do you think automated programs that use AI-driven chatbots are an alternative to therapy?

DR. TOROUS: In a recent paper I co-authored, we looked at the more recent chatbot literature to see what the evidence says about what they really do. Overall, it was clear that while the idea is exciting, we are not yet seeing evidence matching marketing claims. Many of the studies have problems. They are small. They are difficult to generalize to patients with mental illness. They look at feasibility outcomes instead of clinical-improvement endpoints. And many studies do not feature a control group to compare results.

DR. MINER: I don’t think it is an “us vs. them, human vs. AI” situation with chatbots. The important backdrop is that we, as a community, understand we have real access issues and some people might not be ready or able to get help from a human. If chatbots prove safe and effective, we could see a world where patients access treatment and decide if and when they want another person involved. Clinicians would be able to spend time where they are most useful and wanted.

WSJ: Are there cases where AI is more accurate or better than human psychologists, therapists or psychiatrists?

DR. IMEL: Right now, it’s pretty hard to imagine replacing human therapists. Conversational AI is not good at things we take for granted in human conversation, like remembering what was said 10 minutes ago or last week and responding appropriately.

DR. MINER: This is certainly where there is both excitement and frustration. I can’t remember what I had for lunch three days ago, and an AI system can recall all of Wikipedia in seconds. For raw processing power and memory, it isn’t even a contest between humans and AI systems. However, Dr. Imel’s point is crucial around conversations: Things humans do without effort in conversation are currently beyond the most powerful AI system.

An AI system that is always available and can hold thousands of simple conversations at the same time may create better access, but the quality of the conversations may suffer. This is why companies and researchers are looking at AI-human collaboration as a reasonable next step.

DR. IMEL: For example, studies show AI can help “rewrite” text statements to be more empathic. AI isn’t writing the statement, but trained to help a potential listener possibly tweak it.

WSJ: As the technology improves, do you see chatbots or smartphone apps siphoning off any patients who might otherwise seek help from therapists?

DR. TOROUS: As more people use apps as an introduction to care, it will likely increase awareness and interest of mental health and the demand for in-person care. I have not met a single therapist or psychiatrist who is worried about losing business to apps; rather, app companies are trying to hire more therapists and psychiatrists to meet the rising need for clinicians supporting apps.

DR. IMEL: Mental-health treatment has a lot in common with teaching. Yes, there are things technology can do in order to standardise skill building and increase access, but as parents have learned in the last year, there is no replacing what a teacher does. Humans are imperfect, we get tired and are inconsistent, but we are pretty good at connecting with other humans. The future of technology in mental health is not about replacing humans, it’s about supporting them.

WSJ: What about schools or companies using apps in situations when they might otherwise hire human therapists?

DR. MINER: One challenge we are facing is that the deployment of apps in schools and at work often lacks the rigorous evaluation we expect in other types of medical interventions. Because apps can be developed and deployed so quickly, and their content can change rapidly, prior approaches to quality assessment, such as multiyear randomized trials, are not feasible if we are to keep up with the volume and speed of app development.

Judgment calls

WSJ: Can AI be used for diagnoses and interventions?

DR. IMEL: I might be a bit of a downer here—building AI to replace current diagnostic practices in mental health is challenging. Determining if someone meets criteria for major depression right now is nothing like finding a tumour in a CT scan—something that is expensive, labour-intensive and prone to errors of attention, and where AI is already proving helpful. Depression is measured very well with a nine-question survey.

DR. MINER: I agree that diagnosis and treatment are so nuanced that AI has a long way to go before taking over those tasks from a human.

Through sensors, AI can measure symptoms, like sleep disturbances, pressured speech or other changes in behaviour. However, it is unclear if these measurements fully capture the nuance, judgment and context of human decision making. An AI system may capture a person’s voice and movement, which is likely related to a diagnosis like major depressive disorder. But without more context and judgment, crucial information can be left out. This is especially important when there are cultural differences that could account for diagnosis-relevant behaviour.

Ensuring new technologies are designed with awareness of cultural differences in normative language or behaviour is crucial to engender trust in groups who have been marginalised based on race, age, or other identities.

WSJ: Is privacy also a concern?

DR. MINER: We’ve developed laws over the years to protect mental-health conversations between humans. As apps or other services start asking to be a part of these conversations, users should be able to expect transparency about how their personal experiences will be used and shared.

DR. TOROUS: In prior research, our team identified smartphone apps [used for depression and smoking cessation that] shared data with commercial entities. This is a red flag that the industry needs to pause and change course. Without trust, it is not possible to offer effective mental health care.

DR. MINER: We undervalue and poorly design for trust in AI for healthcare, especially mental health. Medicine has designed processes and policies to engender trust, and AI systems are likely following different rules. The first step is to clarify what is important to patients and clinicians in terms of how information is captured and shared for sensitive disclosures.

David Beckham was at the World Economic Forum in Davos, Switzerland, on Tuesday with Bank of America chief executive Brian Moynihan to promote their new partnership. But all anyone wanted to talk about was his son.

After the obligatory questions about business and the World Cup, a host on CNBC’s “Squawk Box” lobbed Beckham an out-of-left-field query about how young people can preserve their mental health in the age of social media.

“Children are allowed to make mistakes,” Beckham, 50, said. “That’s how they learn. So, that’s what I try to teach my kids, but you have to sometimes let them make those mistakes as well.”

Just a day earlier, his 26-year-old son Brooklyn Beckham had posted a series of accusations about his soccer-famous father and pop-star-turned-fashion-designer mother, Victoria Beckham.

He said that his parents had controlled him for years, lied about him to the press and sought to damage his relationship with his wife, Nicola Peltz Beckham. Their goal, he said, was to affect the image of a “perfect family.”

“My family values public promotion and endorsements above all else,” he wrote on Instagram. “Brand Beckham comes first.”

That brand has been burnished over decades of professional triumphs, tabloid scandals and slick dealmaking.

Recently, both David and Victoria Beckham put their legacies on-screen in docuseries that cast them as hardworking entrepreneurs and devoted parents. Their image appeared stronger than ever. Now their firstborn child is throwing stones.

Representatives for David Beckham, Victoria Beckham and Brooklyn Beckham did not respond to requests for comment. A representative for Nicola Peltz Beckham declined to comment.

In the U.K., the Beckhams are as close as you can get to royalty without sharing Windsor DNA. David is perhaps the most famous English player in soccer history, while Victoria parlayed her Spice Girls fame into a career as a respected fashion designer.

Their partnership was forged in the cauldron of 1990s celebrity gossip, with their every move—in their careers, their bumpy personal lives and their adventurous senses of personal style—subject to tabloid scrutiny.

“They were Taylor Swift and Travis Kelce before Taylor Swift and Travis Kelce,” said Elaine Lui, founder of the website Lainey Gossip.

Over time, the couple became savvy managers of their own brand, a sprawling modern empire including a professional soccer team, fashion and beauty lines, investment deals and commercial partnerships.

In recent years they each released a Netflix docuseries—“Beckham” in 2023, “Victoria Beckham” in 2025—featuring scenes from their private family life. (Brooklyn and Nicola appeared in David’s series, but not Victoria’s.)

“The way they’ve performed their celebrity has been togetherness,” Lui said: Appearing and engaging with the world as a happily married couple, in both relative calm and amid scandal. And as their family grew, their four children became smiling ambassadors for Brand Beckham, too.

Until Monday night. In a series of Instagram Story posts, Brooklyn accused his parents of “trying endlessly to ruin” his marriage to Nicola, an actress and model, and the daughter of billionaire investor Nelson Peltz . Brooklyn declared, “I do not want to reconcile with my family.”

Where Victoria and David seemed to see press scrutiny as part of the job, Brooklyn and Nicola are operating in a manner more typical of their own generation. Brooklyn’s posts call to mind the “no contact” boundaries some children have enforced with their parents in recent years to much pop-psych chatter.

Andrew Friedman, managing director of crisis communications at Orchestra, said he’d advised many clients through family drama. “Going public,” he said, should be a “last resort.”

He’s also warned clients that using social media to air grievances opens a can of worms. “Nuance is not welcome in social-media feeding frenzies,” Friedman said. “Sensational and unusual details will overshadow the central issue.”

Brooklyn, the eldest of the Beckhams’ four children, has built a following in his parents’ image, though without the benefit (or burden) of a steady career.

He’s worked as a model, photographer, cooking-show host and most recently founded a hot-sauce brand. Brooklyn and Nicola went public with their relationship in 2020 and married in a lavish 2022 ceremony at her family estate in Palm Beach, Fla.

Rumors of a family feud flared almost immediately after the wedding, including whispers about the fact that Nicola didn’t wear a dress made by her fashion-designer mother-in-law.

Brooklyn on Monday recounted further grievances related to a mother-son dance and the seating chart. In the months and years that followed, celebrity journalists and fans closely tracked both generations of the family, looking for cracks in the relationship.

But official dispatches from Beckham World suggested that things were just fine. In a scene from the final episode of David’s Netflix series, the Beckham family, including Brooklyn and Nicola, joke around on a visit to their country home. It’s a picture of familial bliss.

“We’ve tried to give our children the most normal upbringing as possible. But you’ve got a dad that was England captain and a mom that was Posh Spice,” David says in voice-over.

“And they could be little s—s. And they’re not. And that’s why I say I’m so proud of my children, and I’m so in awe of my children, the way they’ve turned out.”

Can Artificial Intelligence Replace Human Therapists?

Three experts discuss the promise—and problems—of relying on algorithms for our mental health.

Leaps forward

Judgment calls

In a series of social-media posts, the eldest child of David and Victoria Beckham threw stones at the image of a ‘perfect family’.