The Current Legal and Research Status on AI and Psychotherapy

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

I saw this headline in the Washington Post and thought it might be a joke: “Illinois bars AI therapy as some states begin to scrutinize chatbots.”¹ I thought, how could state laws monitor whether AI was involved in psychotherapy, and how did we already know in this fast-changing AI development what may be helpful or not for psychotherapy? I quickly found out that the article was true.

The new Illinois law, HB1806, prohibits AI use in making psychotherapeutic decisions and the delivery of psychotherapy. It is the Wellness and Oversight for Psychological Resources Act and covers licensed professionals. It still allows AI help with administration. Nevada and Utah have passed similar laws. Some feel the enforcement is inadequate. The rationale for the law is that humans are essential for appreciating nonverbal information and exercising ethical priorities. AI also could answer inappropriately and compromise confidentiality.

Then, as if right on cue, the American Psychiatric Association Psychiatric News Alert on August 18th had this headline: “Human Therapists Outperforms AI in Delivering CBT.” The story came out in the American Journal of Psychotherapy.² At least for the cognitive behavior therapy type of psychotherapy, the results were not close:

• Approximately 29% of subjects rated the human therapist as highly effective, but only 9% rated ChatGPT-3.5 similarly.
• Over 50% rated the human therapist’s agenda highest, twice as high as AI.
• AI was felt as less personalized and more rigid.

However, as you may have noted, even the relative success of human therapists left much room for improvement. Perhaps a certain kind of partnership of AI and humans over time will provide that.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. Wu D. Illinois bars AI therapy as some states begin to scrutinize chatbots. Washington Post. August 12, 2025. Accessed August 22, 2025. https://www.washingtonpost.com/nation/2025/08/12/illinois-ai-therapy-ban/

2. Acevedo S, Aneja E, Opler DJ, et al. Evaluating the efficacy of ChatGPT-3.5 versus human-delivered text-based cognitive-behavioral therapy: a comparative pilot study. Am J Psychotherapy. 2025. Online ahead of print.