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Cited by 216Digital Mental Health InterventionsEthics and Social Impacts of AIArtificial Intelligence in Healthcare and Education

The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.

Your robot therapist is not your therapist: understanding the role of AI-powered mental health chatbots

Open access
Khawaja, Zoha, Bélisle-Pipon, Jean-Christophe·2023·Frontiers in Digital Health
DOI 10.3389/fdgth.2023.1278186PMC PMC10663264
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Abstract

Artificial intelligence (AI)-powered chatbots have the potential to substantially increase access to affordable and effective mental health services by supplementing the work of clinicians. Their 24/7 availability and accessibility through a mobile phone allow individuals to obtain help whenever and wherever needed, overcoming financial and logistical barriers. Although psychological AI chatbots have the ability to make significant improvements in providing mental health care services, they do not come without ethical and technical challenges. Some major concerns include providing inadequate or harmful support, exploiting vulnerable populations, and potentially producing discriminatory advice due to algorithmic bias. However, it is not always obvious for users to fully understand the nature of the relationship they have with chatbots. There can be significant misunderstandings about the exact purpose of the chatbot, particularly in terms of care expectations, ability to adapt to the particularities of users and responsiveness in terms of the needs and resources/treatments that can be offered. Hence, it is imperative that users are aware of the limited therapeutic relationship they can enjoy when interacting with mental health chatbots. Ignorance or misunderstanding of such limitations or of the role of psychological AI chatbots may lead to a therapeutic misconception (TM) where the user would underestimate the restrictions of such technologies and overestimate their ability to provide actual therapeutic support and guidance. TM raises major ethical concerns that can exacerbate one's mental health contributing to the global mental health crisis. This paper will explore the various ways in which TM can occur particularly through inaccurate marketing of these chatbots, forming a digital therapeutic alliance with them, receiving harmful advice due to bias in the design and algorithm, and the chatbots inability to foster autonomy with patients.

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  1. Wintermeyer, 2021, Positive psychology apps: a systematic review of the quality and characteristics of a selection of current free-of-charge positive psychological apps aiming to enhance resilience available in the Google Play Store [Master's thesis]

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Metadata

Authors
Khawaja, Z., & Bélisle-Pipon, J.-C.
Affiliations
Simon Fraser University (CA)
ORCID
Khawaja, Zoha
Venue
Frontiers in Digital Health
Publisher
Frontiers Media SA
Published
2023-11-08
Volume
5
Pages
1278186-1278186
ISSN
2673-253X (ISSN-L)
DOI
10.3389/fdgth.2023.1278186
PMC
PMC10663264
OpenAlex
W4388524014
Cited by
214
References
50
Citations by year
2026: 95 · 2025: 87 · 2024: 32
FWCI
55.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Digital Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Physical Sciences › Computer Science › Artificial Intelligence › Ethics and Social Impacts of AI
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Keywords
mental health chatbots, therapeutic misconception, artificial intelligence in mental health care, algorithmic bias, chatbot marketing, patient autonomy, vulnerable populations, access to mental health care

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