Artificial intelligence is steadily seeping into every profession, but few places feel as sensitive as the therapist’s chair.
A recent investigation by MIT Technology Review has revealed that some mental health professionals are quietly leaning on tools like ChatGPT during sessions—without telling their patients. For those who discover it, the fallout is often a mix of betrayal, disbelief, and deep unease.
The Los Angeles patient who caught his therapist in the act
Declan, a 31-year-old from Los Angeles, might never have found out if not for a technical glitch during an online therapy session. When the video connection faltered, he suggested turning off cameras. Instead of a blank screen, his therapist accidentally shared his desktop. “Suddenly, I was watching him use ChatGPT,” Declan told MIT Technology Review. His therapist was pasting parts of their conversation into the chatbot and then reading back AI-generated prompts as if they were his own.
Flabbergasted, Declan stayed quiet and decided to play along. “I became the best patient ever,” he recalled. “ChatGPT would ask if I thought my thinking was too black and white, and I’d respond exactly that way. My therapist seemed thrilled. I’m sure it was his dream session.”
The confrontation came later. At their next meeting, Declan brought it up. The therapist broke down in tears, admitting he had been “out of ideas” and resorted to ChatGPT for guidance. Declan described it as “a weird breakup”—made worse when the therapist still billed him for the session.
When comfort feels copy-pasted
Declan’s experience is not isolated. Laurie Clarke, the journalist behind the MIT Technology Review report, described receiving an unusually polished, lengthy email from her own therapist. At first it felt thoughtful. On closer reading, subtle hints like American-style punctuation convinced her AI had a hand in crafting it. Another patient, Hope, 25, noticed a stray AI prompt in a consoling message she received after her dog died. Instead of healing, it left her unsettled. “It was just a very strange feeling,” she said. “Then I started to feel kind of betrayed. Trust issues were the very reason I was in therapy.”
Experts warn of a trust crisis
The ethical dilemma is clear: AI might help therapists phrase responses, but secrecy undermines the foundation of therapy—authenticity and trust. Adrian Aguilera, a clinical psychologist at the University of California, Berkeley, told MIT Technology Review, “People value authenticity, particularly in psychotherapy. Using AI without disclosure can feel like you’re not taking the relationship seriously.” Privacy is another red flag. As Duke University computer science professor Pardis Emami-Naeini explained, general-purpose AI tools like ChatGPT are not HIPAA compliant, which means patient information could be at risk if entered into the system.
Between burnout and betrayal
With high burnout rates among therapists, the lure of AI assistance is obvious. Companies like Heidi Health and Upheal are already pitching HIPAA-compliant AI tools for note-taking and session transcription. But until transparency becomes the norm, patients may be left wondering whether their most personal confessions are being heard by a human—or a chatbot.
As Declan put it, his revelation was more surreal than shattering. But he added a chilling caveat: “If I was suicidal, or on drugs, or cheating on my girlfriend—I wouldn’t want that to be put into ChatGPT.”
