A Framework for Automation in Psychotherapy

Zac Imel, Torrey Creed, Brent Kious, Tim Althoff, Dana Atzil-Slonim and Vivek Srikumar

Current Directions in Psychological Science, 2025.

Abstract

Psychotherapy is a conversational intervention that has relied on humans to manage its implementation. Improvements in conversational artificial intelligence (AI) have accompanied speculation on how technologies might automate components of psychotherapy, most often the replacement of human therapists. However, there is a spectrum of opportunities for human collaboration with autonomous systems in psychotherapy, including evaluation, documentation, training, and assistance. Clarity about what is being automated is necessary to understand the affordances and limitations of specific technologies. In this article we present a framework for categories of autonomous systems in psychotherapy as a guidepost for empirical and ethical inquiry. Categories include scripted or rule-based conversations; collaborative systems in which humans are evaluated by, supervise, or are assisted by AI; and agents that generate interventions. These categories highlight considerations for key stakeholders as psychotherapy moves from unmediated human-to-human conversation to various forms of automation.

Links

Bib Entry 

@article{imel2025framework,
  author = {Imel, Zac E. and Creed, Torrey and Kious, Brent and Althoff, Tim and {Atzil-Slonim}, Dana and Srikumar, Vivek},
  title = {A {{Framework}} for {{Automation}} in {{Psychotherapy}}},
  journal = {Current Directions in Psychological Science},
  year = {2025}
}