Is the Automation of Digital Mental Health Ethical? Applying an Ethical Framework to Chatbots for Cognitive Behaviour Therapy
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The COVID-19 pandemic has intensified the need for mental health support across the whole spectrum of the population. Where global demand outweighs the supply of mental health services, established interventions such as cognitive behavioural therapy (CBT) have been adapted from traditional face-to-face interaction to technology-assisted formats. One such notable development is the emergence of Artificially Intelligent (AI) conversational agents for psychotherapy. Pre-pandemic, these adaptations had demonstrated some positive results; but they also generated debate due to a number of ethical and societal challenges. This article commences with a critical overview of both positive and negative aspects concerning the role of AI-CBT in its present form. Thereafter, an ethical framework is applied with reference to the themes of (1) beneficence, (2) non-maleficence, (3) autonomy, (4) justice, and (5) explicability. These themes are then discussed in terms of practical recommendations for future developments. Although automated versions of therapeutic support may be of appeal during times of global crises, ethical thinking should be at the core of AI-CBT design, in addition to guiding research, policy, and real-world implementation as the world considers post-COVID-19 society.
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The integration of AI into healthcare alters traditional decision-making practices based on epistemic probability and prudence and raises ethical, legal, and medical dilemmas when making critical decisions about human lives and medical conditions.
“Additionally, the integration of AI into healthcare alters traditional decision-making practices based on epistemic probability and prudence (Parviainen, Rantala (2022)) and raises ethical, legal, and medical dilemmas when it comes to making critical decisions about human lives and medical conditions (Shaban-Nejad et al., 2021;Vilaza & McCashin, 2021).”
From Navigating the perils of artificial intelligence: a focused review on ChatGPT and responsible research and innovation (2024) · cites this paper as Vilaza & McCashin, 2021
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Artificial intelligence: a modern approach
Kumar, D. A., Balasubramanian, S., Byeon, D. H., & Manerkar, P. G. V. (1995) · Choice Reviews Online · doi:10.5860/choice.33-1577 · Cited by 22,182 · see citing works
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020) · General Psychiatry · doi:10.1136/gpsych-2020-100213 · Cited by 4,307 · see citing works
The EU General Data Protection Regulation (GDPR)
Voigt, P., & von dem Bussche, A. (2017) · doi:10.1007/978-3-319-57959-7 · Cited by 3,001 · see citing works
ELIZA — a computer program for the study of natural language communication between man and machine
Weizenbaum, J. (1983) · Communications of the ACM · doi:10.1145/357980.357991 · Cited by 2,765 · see citing works
Fitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017) · JMIR Mental Health · doi:10.2196/mental.7785 · Cited by 2,730 · cited 1× · see citing works
“In a study with a University sample, Woebot demonstrated clinical effectiveness for depression and anxiety in randomised controlled trial (RCT) conditions (22).”
BackgroundMental health care for medical staff in China during the COVID-19 outbreak
Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., He, L., Sheng, C., Cai, Y., Li, X., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30078-x · Cited by 2,233 · see citing works
The Ethics of AI Ethics: An Evaluation of Guidelines
Hagendorff, T. (2020) · Minds and Machines · doi:10.1007/s11023-020-09517-8 · Cited by 1,911 · cited 1× · see citing works
“Recent evaluations of AI ethics identified the absence of reinforcement mechanisms and consequences for ethics violations (48).”
BackgroundPsychological interventions for people affected by the COVID-19 epidemic
Duan, L., & Zhu, G. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30073-0 · Cited by 1,885 · see citing works
Conversational agents in healthcare: a systematic review
Laranjo, L., Dunn, A. G., Tong, H. L., Kocaballi, A. B., Chen, J., Bashir, R., Surian, D., Gallego, B., Magrabi, F., Lau, A. Y. S., et al. (2018) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocy072 · Cited by 1,388 · cited 1× · see citing works
“When it comes to conversational agents, according to a recent systematic review, most of them have not been tested using “end-user safety” as a criterion (35).”
BackgroundThinking and Depression: I. Idiosyncratic Content and Cognitive Distortions
BECK, A. T. (1963) · Archives of General Psychiatry · doi:10.1001/archpsyc.1963.01720160014002 · Cited by 1,308 · see citing works
Luger, E., & Sellen, A. (2016) · Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems · doi:10.1145/2858036.2858288 · Cited by 1,176 · see citing works
Value Sensitive Design and Information Systems
Friedman, B., Kahn, P. H., & Borning, A. H. (2008) · Wiley eBooks · doi:10.1002/9780470281819.ch4 · Cited by 1,149 · see citing works
Chatbots: History, technology, and applications
Adamopoulou, E., & Moussiades, L. (2020) · Machine Learning with Applications · doi:10.1016/j.mlwa.2020.100006 · Cited by 1,090 · see citing works
Inkster, B., Sarda, S., & Subramanian, V. (2018) · doi:10.2196/preprints.12106 · Cited by 1,063 · see citing works
Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape
Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719828977 · Cited by 1,048 · see citing works
It's only a computer: virtual humans increase willingness to disclose
Lucas, G. M., Gratch, J., King, A., & Morency, L.-P. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.04.043 · Cited by 977 · cited 1× · see citing works
“They are even said to be more suitable for psychoeducation, suicide prevention, and self-adherence than human therapists (17) because they can produce increased self-report due to the anonymity and absence of a human (18, 19).”
BackgroundMental health stigma as social attribution: Implications for research methods and attitude change.
Corrigan, P. W. (2000) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.7.1.48 · Cited by 954 · see citing works
Torous, J., Jän Myrick, K., Rauseo-Ricupero, N., & Firth, J. (2020) · JMIR Mental Health · doi:10.2196/18848 · Cited by 946 · see citing works
Morley, J., Floridi, L., Kinsey, L., & Elhalal, A. (2020) · Science and Engineering Ethics · doi:10.1007/s11948-019-00165-5 · Cited by 882 · see citing works
The COVID-19 pandemic: the ‘black swan’for mental health care and a turning point for e-health
Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020) · Internet Interventions · doi:10.1016/j.invent.2020.100317 · Cited by 782 · see citing works
Fulmer, R., Joerin, A., Gentile, B., Lakerink, L., & Rauws, M. (2018) · doi:10.2196/preprints.9782 · Cited by 715 · see citing works
A guide to treatments that work
(2015) · Oxford Clinical Psychology · doi:10.1093/med:psych/9780195304145.001.0001 · Cited by 647 · see citing works
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
(2010) · PsycEXTRA Dataset · doi:10.1037/e578662012-001 · Cited by 522 · see citing works
Embodied conversational agents in clinical psychology: a scoping review
Provoost, S., Lau, H. M., Ruwaard, J., & Riper, H. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6553 · Cited by 433 · see citing works
Thieme, A., Belgrave, D., & Doherty, G. (2020) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3398069 · Cited by 406 · see citing works
Physicians’ perceptions of chatbots in health Care: cross-sectional web-based survey
Palanica, A., Flaschner, P., Thommandram, A., Li, M., & Fossat, Y. (2019) · Journal of Medical Internet Research · doi:10.2196/12887 · Cited by 384 · see citing works
Evaluating and Informing the Design of Chatbots
Jain, M., Kumar, P., Kota, R., & Patel, S. N. (2018) · Proceedings of the 2018 Designing Interactive Systems Conference · doi:10.1145/3196709.3196735 · Cited by 376 · see citing works
Ly, K. H., Ly, A.-M., & Andersson, G. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.10.002 · Cited by 368 · see citing works
"I Hear You, I Feel You": Encouraging Deep Self-disclosure through a Chatbot
Lee, Y.-C., Yamashita, N., Huang, Y., & Fu, W. (2020) · Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376175 · Cited by 339 · cited 2× · see citing works
“Additionally, automated conversational agents and chatbots are increasingly promoted as potentially efficient emotional support tools for larger population segments during the pandemic (7) and afterwards (8).”
BackgroundDesign Justice: towards an intersectional feminist framework for design theory and practice
Costanza-Chock, S. (2018) · Proceedings of DRS · doi:10.21606/drs.2018.679 · Cited by 325 · see citing works
Chatbots in the fight against the COVID-19 pandemic
Miner, A. S., Laranjo, L., & Kocaballi, A. B. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0280-0 · Cited by 322 · see citing works
Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers
Lucas, G. M., Rizzo, A., Gratch, J., Scherer, S., Stratou, G., Boberg, J., & Morency, L.-P. (2017) · Frontiers in Robotics and AI · doi:10.3389/frobt.2017.00051 · Cited by 308 · see citing works
Morris, R. R., Kouddous, K., Kshirsagar, R., & Schueller, S. M. (2018) · Journal of Medical Internet Research · doi:10.2196/10148 · Cited by 273 · see citing works
Kretzschmar, K., Tyroll, H., Pavarini, G., Manzini, A., Singh, I., & NeurOx Young People’s Advisory Group (2019) · Biomedical Informatics Insights · doi:10.1177/1178222619829083 · Cited by 270 · see citing works
Empathic Robots for Long-term Interaction
Leite, I., Castellano, G., Pereira, A., Martinho, C., & Paiva, A. (2014) · International Journal of Social Robotics · doi:10.1007/s12369-014-0227-1 · Cited by 265 · see citing works
Artificial intelligence and the future of psychiatry: Insights from a global physician survey
Doraiswamy, P. M., Blease, C., & Bodner, K. (2020) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2019.101753 · Cited by 253 · see citing works
Martinez-Martin, N., & Kreitmair, K. (2018) · JMIR Mental Health · doi:10.2196/mental.9423 · Cited by 221 · see citing works
Data mining for health: staking out the ethical territory of digital phenotyping
Martinez-Martin, N., Insel, T. R., Dagum, P., Greely, H. T., & Cho, M. K. (2018) · npj Digital Medicine · doi:10.1038/s41746-018-0075-8 · Cited by 218 · see citing works
Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (2022) · Verhaltenstherapie · doi:10.1159/000501812 · Cited by 214 · see citing works
Ethics in Psychology and the Mental Health Professions: Standards and Cases
Koocher, G. P., & Keith-Spiegel, P. C. (1985) · Cited by 198 · see citing works
Watts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.025 · Cited by 188 · see citing works
Qualitative Meta-Synthesis of User Experience of Computerised Therapy for Depression and Anxiety
Knowles, S. E., Toms, G., Sanders, C., Bee, P., Lovell, K., Rennick-Egglestone, S., Coyle, D., Kennedy, C. M., Littlewood, E., Kessler, D., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0084323 · Cited by 177 · see citing works
A Misdirected Principle with a Catch: Explicability for AI
Robbins, S. (2019) · Minds and Machines · doi:10.1007/s11023-019-09509-3 · Cited by 175 · see citing works
Talking to machines about personal mental health problems
Miner, A. S., Milstein, A., & Hancock, J. T. (2017) · JAMA · doi:10.1001/jama.2017.14151 · Cited by 153 · see citing works
Luger, E. A., Moran, S., & Rodden, T. A. (2013) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/2470654.2481371 · Cited by 132 · see citing works
Ethical perspectives on recommending digital technology for patients with mental illness
Bauer, M., Glenn, T., Monteith, S., Bauer, R., Whybrow, P. C., & Geddes, J. R. (2017) · International Journal of Bipolar Disorders · doi:10.1186/s40345-017-0073-9 · Cited by 132 · see citing works
Philip, P., Micoulaud-Franchi, J.-A., Sagaspe, P., Sevin, E. D., Olive, J., Bioulac, S., & Sauteraud, A. (2017) · Scientific Reports · doi:10.1038/srep42656 · Cited by 128 · see citing works
Trust me, i'm a chatbot: how artificial intelligence in health care fails the Turing Test
Powell, J. (2019) · Journal of Medical Internet Research · doi:10.2196/16222 · Cited by 115 · see citing works
Empowering the digital therapeutic relationship: virtual clinics for digital health interventions
Torous, J. B., & Hsin, H. (2018) · npj Digital Medicine · doi:10.1038/s41746-018-0028-2 · Cited by 88 · see citing works
Assessing the Privacy of mHealth Apps for Self-Tracking: Heuristic Evaluation Approach
Hutton, L., Price, B. A., Kelly, R., McCormick, C., Bandara, A. K., Hatzakis, T., Meadows, M., & Nuseibeh, B. (2018) · JMIR mHealth and uHealth · doi:10.2196/mhealth.9217 · Cited by 79 · see citing works
Ad-me: wireless advertising adapted to the user location, device and emotions
Hristova, N., & O’Hare, G. M. P. (2004) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2004.1265673 · Cited by 73 · see citing works
Transforming Psychiatry into Data-Driven Medicine with Digital Measurement Tools
Hsin, H., Fromer, M., Peterson, B. E., Walter, C., Fleck, M. S., Campbell, A. T., Varghese, P., & Califf, R. M. (2018) · npj Digital Medicine · doi:10.1038/s41746-018-0046-0 · Cited by 65 · see citing works
Stigma, discrimination and mental illness
Penn, D. L., & Wykes, T. (2003) · Journal of Mental Health · doi:10.1080/0963823031000121579 · Cited by 58 · see citing works
New tests, new tools: mobile and connected technologies in advancing psychiatric diagnosis
Roberts, L. W., Chan, S. R., & Torous, J. B. (2017) · npj Digital Medicine · doi:10.1038/s41746-017-0006-0 · Cited by 57 · see citing works
Conversational Agents and Natural Language Interaction: Techniques and Effective Practices
Pérez-Marín, D., & Pascual-Nieto, I. (2011) · IGI Global eBooks · doi:10.4018/978-1-60960-617-6 · Cited by 55 · see citing works
Inkster, B., & Digital Mental Health Data Insights Group (DMHDIG) (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2020.578902 · Cited by 43 · see citing works
Eliciting caregiving behavior in dyadic human-robot attachment-like interactions
Hiolle, A., Cañamero, L. D., Davila‐Ross, M., & Bard, K. A. (2012) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/2133366.2133369 · Cited by 38 · see citing works
How users adjust trust in automation
Yang, X. J., Wickens, C. D., & Hölttä-Otto, K. (2016) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/1541931213601044 · Cited by 37 · see citing works
Conversational AI: How (Chat)Bots Will Reshape the Digital Experience
Gentsch, P. (2018) · Springer eBooks · doi:10.1007/978-3-319-89957-2_4 · Cited by 29 · see citing works
Mercurio, M., Larsen, M. E., Wisniewski, H., Henson, P., Lagan, S., & Torous, J. B. (2020) · Evidence-Based Mental Health · doi:10.1136/ebmental-2019-300137 · Cited by 23 · see citing works
Beyond transparency: a proposed framework for accountability in decision-making AI systems
Berscheid, J., & Roewer-Despres, F. (2019) · AI Matters · doi:10.1145/3340470.3340476 · Cited by 22 · see citing works
Implementing ethics for a mobile app deployment
Rooksby, J., Asadzadeh, P., Morrison, A., McCallum, C., Gray, C. M., & Chalmers, M. (2016) · Australian Conference on Computer-Human Interaction (OzCHI) · doi:10.1145/3010915.3010919 · Cited by 14 · see citing works
Hu, A. W., Anderson, K. N., & Lee, R. M. (2015) · Family Science · doi:10.1080/19424620.2015.1081007 · Cited by 10 · see citing works
Mobile Health Technologies to Deliver and Support Cognitive-Behavioral Therapy
Schueller, S. M., & Adkins, E. C. (2019) · Psychiatric Annals · doi:10.3928/00485713-20190717-02 · Cited by 9 · see citing works
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- [34]Ma T Sharifi H Chattopadhyay D. Virtual humans in health-related interventions: a meta-analysis. In: Extended Abstracts of the 2019 CHI Conference on Human Factors in Computing Systems CHI EA'19. New York, NY, USA: Association for Computing Machinery (2019). p. 1– 6.
Cited by
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Exploring the Ethical Challenges of Conversational AI in Mental Health Care: Scoping Review
Rahsepar Meadi, M., Sillekens, T., Metselaar, S., van Balkom, A., Bernstein, J., & Batelaan, N. (2025) · JMIR Mental Health · doi:10.2196/60432 · Cited by 211 · see citing works
The now and future of ChatGPT and GPT in psychiatry
Cheng, S., Chang, C., Chang, W., Wang, H., Liang, C., Kishimoto, T., Chang, J. P., Kuo, J. S., & Su, K. (2023) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13588 · Cited by 197 · see citing works
Does the Digital Therapeutic Alliance Exist? Integrative Review
Malouin-Lachance, A., Capolupo, J., Laplante, C., & Hudon, A. (2025) · JMIR Mental Health · doi:10.2196/69294 · Cited by 103 · see citing works
Ni, Y., & Jia, F. (2025) · Healthcare · doi:10.3390/healthcare13101205 · Cited by 124 · see citing works
Polyportis, A., & Pahos, N. (2024) · Humanities and Social Sciences Communications · doi:10.1057/s41599-023-02464-6 · Cited by 64 · see citing works
Chan, C. K. Y. (2025) · Behavioral Sciences · doi:10.3390/bs15030287 · Cited by 68 · see citing works
MacNeill, A. L., Doucet, S. A., & Luke, A. (2024) · JMIR Formative Research · doi:10.2196/50025 · Cited by 64 · see citing works
The Use of AI-Supported Chatbot in Psychology
Uludağ, K. (2025) · Advances in medical technologies and clinical practice book series · doi:10.4018/979-8-3693-3112-5.ch001 · Cited by 41 · see citing works
Are chatbots the new relationship experts? Insights from three studies
Vowels, L. M. (2024) · Computers in Human Behavior: Artificial Humans · doi:10.1016/j.chbah.2024.100077 · Cited by 42 · see citing works
Qi, Y. (2024) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2023.2301256 · Cited by 36 · see citing works
Villarreal‐Zegarra, D., Alarcon-Ruiz, C. A., Meléndez‐Torres, G. J., Torres-Puente, R., Navarro‐Flores, A., Cavero, V., Ambrosio-Melgarejo, J. I., Rojas-Vargas, J., Almeida-Huanca, G., Albitres‐Flores, L., et al. (2022) · JMIR Mental Health · doi:10.2196/34760 · Cited by 33 · see citing works
ChatGPT: A Pilot Study on a Promising Tool for Mental Health Support in Psychiatric Inpatient Care
Melo, A., Silva, I., & Lopes, J. (2024) · International Journal of Psychiatric Trainees · doi:10.55922/001c.92367 · Cited by 29 · see citing works
Han, S., Liu, M., Pan, Z., Cai, Y. C., & Shao, P. (2022) · International Journal of Artificial Intelligence in Education · doi:10.1007/s40593-022-00311-4 · Cited by 25 · see citing works
Haber, Y., Shoval, D. H., Levkovich, I., Yinon, D., Gigi, K., Pen, O., Angert, T., & Elyoseph, Z. (2025) · Frontiers in Digital Health · doi:10.3389/fdgth.2025.1512273 · Cited by 20 · see citing works
Wearable Technologies and Stress: Toward an Ethically Grounded Approach
Canali, S., Marchi, B. D., & Aliverti, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20186737 · Cited by 21 · see citing works
How Far Can Conversational Agents Contribute to IBD Patient Health Care—A Review of the Literature
Pernencar, C. A. D. C., Saboia, I., & Dias, J. C. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.862432 · Cited by 16 · see citing works
Teaching User Experience Design Ethics to Engineering Students: Lessons Learned
Vilaza, G. N., & Bækgaard, P. (2022) · Frontiers in Computer Science · doi:10.3389/fcomp.2022.793879 · Cited by 15 · see citing works
Self-citationPozzi, G., & Proost, M. D. (2024) · AI and Ethics · doi:10.1007/s43681-024-00523-5 · Cited by 14 · see citing works
Venegas, M. D. R. A., Brooks, J., Myers, A. L., Storm, M., & Fortuna, K. L. (2022) · IEEE Pervasive Computing · doi:10.1109/mprv.2022.3141986 · Cited by 13 · see citing works
Robotic process automation in routine accounting tasks: A review and efficiency analysis
Oyeniyi, L. D., Ugochukwu, C. E., & Mhlongo, N. Z. (2024) · World Journal of Advanced Research and Reviews · doi:10.30574/wjarr.2024.22.1.1156 · Cited by 13 · see citing works
Nelson, J., Kaplan, J., Simerly, G., Nutter, N., Edson-Heussi, A., Woodham, B., & Broman‐Fulks, J. J. (2025) · Current Psychology · doi:10.1007/s12144-025-07320-1 · Cited by 17 · see citing works
Bird, J. J., Wright, D., Sumich, A. L., & Lotfi, A. (2024) · International Conference on PErvasive Technologies Related to Assistive Environments (PETRA) · doi:10.1145/3652037.3663893 · Cited by 10 · see citing works
Employee wellbeing: A computational review on the consequences of workplace automation
Valtonen, A., Kimpimäki, J., & Savela, N. (2025) · Technovation · doi:10.1016/j.technovation.2025.103424 · Cited by 10 · see citing works
Ni, Y., & Cao, Y. (2025) · Mental Health and Digital Technologies · doi:10.1108/mhdt-02-2025-0013 · Cited by 6 · see citing works
Cooney, O., Doherty, K., Barry, M., Coyle, D., Doherty, G. J., & Cowan, B. R. (2024) · ACM Conference on Conversational User Interfaces (CUI) · doi:10.1145/3640794.3665540 · Cited by 8 · see citing works
Silveira, R., Pernencar, C. A. D. C., de Sousa, F., Gomes, K., Oliveira, D., Saboia, I., Mourão, C., Monteiro, O., & Barrêto, I. C. D. H. C. (2023) · Procedia Computer Science · doi:10.1016/j.procs.2023.01.411 · Cited by 8 · see citing works
Heliades, G. P., Gkintoni, E., Panas, G., Halkiopoulos, C., & Boutsinas, B. (2025) · Springer proceedings in business and economics · doi:10.1007/978-3-031-78471-2_38 · Cited by 7 · see citing works
Zhou, W., Chen, Y., Wu, H., Zhao, H., Li, Y., Shi, G., Wang, W., Liu, Y., Liao, Y., Zhang, H., et al. (2024) · Journal of Medical Internet Research · doi:10.2196/67567 · Cited by 6 · see citing works
Teles, A. S., Chaturvedi, J., Wang, T., Scazufca, M., Msosa, Y. J., Stahl, D. R., & Roberts, A. (2025) · PLOS mental health. · doi:10.1371/journal.pmen.0000488 · Cited by 6 · see citing works
Rupani, N., Vasquez, D. H., Contreras, C. C., Alvirio, L. A. M., Kolevic, L., Franke, M. F., & Galea, J. T. (2025) · Journal of the International Association of Providers of AIDS Care (JIAPAC) · doi:10.1177/23259582251327911 · Cited by 5 · see citing works
Poulsen, A., Hickie, I. B., Chong, M. K., LaMonica, H. M., Turner, A., & Iorfino, F. (2025) · Ethics and Information Technology · doi:10.1007/s10676-025-09866-x · Cited by 5 · see citing works
Mateus, M., Alho, I., Neves, A. L., Lopes, H. F. M., & Correia, M. M. B. (2026) · BMC Medical Ethics · doi:10.1186/s12910-025-01372-5 · Cited by 7 · see citing works
Adaptive Mental Health And Mood Uplifting Chatbot
Siddiqui, T., Sharma, A., & Arora, M. (2023) · International Conference on Computing, Communication and Networking Technologies (ICCCNT) · doi:10.1109/icccnt56998.2023.10308236 · Cited by 5 · see citing works
Vowels, L. M., Sweeney, S. K., & Vowels, M. J. (2025) · Computers in Human Behavior Artificial Humans · doi:10.1016/j.chbah.2025.100141 · Cited by 6 · see citing works
Striegl, J., Rottmann, S., & Loitsch, C. (2024) · Lecture notes in networks and systems · doi:10.1007/978-3-031-66329-1_14 · Cited by 4 · see citing works
Thunström, A. O., Ali, L., Carlsen, H. K., Bohm, M., Wesén, L., Wrede, O., Vuković, I. S., Hellström, A., Larson, T., & Steingrímsson, S. (2025) · JMIR Formative Research · doi:10.2196/66163 · Cited by 4 · see citing works
Human AI: Ethics and broader impact for mental healthcare
Singh, S., Joshi, R., Jain, P., & Abilash, K. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-19096-4.00005-5 · Cited by 4 · see citing works
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Teixeira, R. (2025) · Lecture notes in computer science · doi:10.1007/978-3-032-04999-5_25 · Cited by 3 · see citing works
Yang, Y., Tavares, J., & Oliveira, T. (2026) · International Journal of Telemedicine and Applications · doi:10.1155/ijta/9055091 · Cited by 2 · see citing works
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Sharma, S., Vohra, P., & Vowels, L. M. (2026) · Behavioral Sciences · doi:10.3390/bs16050756 · Cited by 2 · see citing works
The Dual Imperative in AI for OCD: Bridging Ethical Frameworks and Explainable Diagnostics
Zaboski, B. A., & Muller, G. N. (2026) · AI in Medicine · doi:10.3390/aimed1030017 · Cited by 2 · see citing works
Al-Wahedi, M., Ismail, S., Alkhofani, W., & Azman, A. (2024) · Psychology · doi:10.4236/psych.2024.159087 · Cited by 1 · see citing works
Therapists' Perspectives on AI Integration in Couple and Family TherapyPreprint
Aviram, A. (2025) · Research Square · doi:10.21203/rs.3.rs-5677979/v1 · Cited by 2 · see citing works
Davies, E., Wilde, N., Lennon, O., Beck, A., Messenger, H., Sergiou, K., Hennelly, S. E., & Ehrlich, C. (2025) · Psychological Studies · doi:10.1007/s12646-025-00865-y · Cited by 2 · see citing works
État de la situation sur les impacts sociétaux de l'intelligence artificielle et du numérique - 2024
Obvia, Langlois, L., Cousineau, M., Gagnon, M.-P., Larnder, C. I., Naffi, N., Garneau, J., Lévesque, C., Brin, C., Guèvremont, V., et al. (2024) · doi:10.61737/cfrt3613 · Cited by 2 · see citing works
Ferreira, A. R., Alho, I., Neves, A. L., Lopes, H., & Correia, M. M. B. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5230369 · Cited by 1 · see citing works
Yi, X., Chen, Y. H., Loh, S. C., Siaw, Y.-L., Hao, L. J., & Abuhassna, H. (2026) · Research Square · doi:10.21203/rs.3.rs-7486943/v1 · Cited by 1 · see citing works
The Post-Pandemic Ethical Compass: Lost, Found, or Redefined?Preprint
Taiebine, M., & Nejjari, C. (2026) · Research Square · doi:10.21203/rs.3.rs-8918071/v1 · Cited by 1 · see citing works
Diogenes, C. N., de Paula, M. L., & Jorge, M. S. B. (2022) · RECIMA21 - Revista Científica Multidisciplinar · doi:10.47820/recima21.v3i11.2119
Geng, S., Shimojima, G., Yang, C.-L., Sramek, Z., Norihama, S., Takano, A., Hosio, S. J., & Yatani, K. (2025) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3711103
Striegl, J., Buchholz, M., Auguszt, T., & Loitsch, C. (2025) · Lecture notes in computer science · doi:10.1007/978-3-031-93505-3_17
AI-Driven Cognitive Behavioural Therapy (CBT) Using Wearables
Jain, N., & Chatterjee, E. (2025) · Advances in computational intelligence and robotics book series · doi:10.4018/979-8-3373-0467-0.ch002
Pasha, A., Jahanaray, M., Inusah, A. S., Li, X., & Qiao, S. (2026) · Research Square · doi:10.21203/rs.3.rs-8935464/v1
Transforming Mental Health Care Through AI Technology
Yashwant, R. P. B., & Wong, E. H. (2026) · Advances in computational intelligence and robotics book series · doi:10.4018/407379
Why sycophantic LLMs may imperil interactive norms between humans
Gu, R., Chen, Z., Peng, M., Liu, C., & Lin, Z. (2026) · Communications Psychology · doi:10.1038/s44271-026-00486-9
Probierz, E., Gałuszka, A., Grzejszczak, T., & Gałuszka, A. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-29760-0_51
da Silva, I. S., & Fernandes, M. G. (2026) · Revista de Geopolítica · doi:10.56238/revgeov17n8-023
Alhalawany, R. M., Khatatbeh, Y. M., & Jawkhab, A. A. (2026) · Healthcare · doi:10.3390/healthcare14172721
Matcham, F., Olivieri-Maalouf, V., Sami, I., & Markova, R. (2026) · doi:10.2196/preprints.114498
Apablaza-Noe, J. J., Cano, S. P., & Osega, J. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2739757
- Authors
- Vilaza, G. N., & McCashin, D.
- Affiliations
- Technical University of Denmark (DK)
- Dublin City University (IE)
- Corresponding author
- Vilaza, Giovanna Nunes
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2021-08-06
- Volume
- 3
- Pages
- 689736-689736
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC8521996
- OpenAlex
- W3187133801
- Cited by
- 60
- References
- 63
- Citations by year
- 2026: 14 · 2025: 22 · 2024: 13 · 2023: 5 · 2022: 6
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Technical University of Denmark, DTU Orbit (Technical University of Denmark, DTU) (submittedVersion, cc-by)
- Funders
- H2020 Marie Skłodowska-Curie Actions
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Safety Research › Ethics and Social Impacts of AI
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- AI chatbots, cognitive behavioral therapy, digital mental health, AI ethics, beneficence, non-maleficence, patient autonomy, justice, explainability, ethical frameworks, technology-assisted therapy
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