Can AI replace therapists? Here's why not

AI therapists are booming.

Google search trends for "AI therapist" have increased more than 10x over the last 3 years. Around 7,200 people search for the term each month, according to Ahrefs (and the actual number might be 3-4 times higher). Meanwhile, AI therapy startups have collectively raised around $2 billion in venture funding.

At the same time, there’s an ongoing—and justified—debate among mental health professionals around “AI therapists.”

Providers view “AI therapists” with a high degree of skepticism (which is totally justified). 

The debate isn’t really about jobs. It’s about whether AI can grasp what makes therapy work in the first place.

I should say: I’m an AI software engineer. At Allia, I lead a team that builds technology for mental health clinicians. We want to make care more precise, more responsive, and easier to deliver. I spend my days focused on the technical side of these systems, and I understand both what they can do and where they fall short.

Still, I was curious. What would it feel like to sit on the other side?

So I decided to take some of these platforms for a spin, using a scenario I ran into a couple of weeks ago:

“I got injured while playing football today and am on my bed. This really sucks and I have nothing to do. I am also diagnosed with adhd” 

(I mean the ‘soccer’ football btw i.e. the OG one.) 

The reasoning is simple: Yes, AI might be quite good at responding to simple queries and answering them, but I wanted to test how it would respond to a query that’s a little more complex- a human query, like therapists do every day.

I googled “ai therapists” and picked up the top ranking results (which is exactly what humans looking for an AI therapist would do)

Here’s how they did:

Abby.gg

Response: 

"That sounds frustrating, especially when you're stuck in bed and dealing with an injury. It can be tough feeling restricted like that. I'm here if you want to talk about anything, whether it’s the injury, having ADHD, or just needing a distraction. How did you get injured, if you don’t mind sharing?"

Commentary: 

This response starts by acknowledging the frustration and restriction. It correctly identifies the key aspects: injury and ADHD.

But asking "How did you get injured?" shifts the focus away from my emotional state and boredom toward a factual detail.

This is typical of language models—especially those with less conversational data in their training.

It also skips over my feeling of "this really sucks" and the key issue of having "nothing to do," which is particularly relevant for someone with ADHD struggling with inactivity.

This was a missed opportunity to explore the emotional aspect.

Freeainotatherapist

Response: 

“I'm really sorry to hear that you're injured and feeling down. It's completely normal to feel frustrated when we're sidelined from activities we enjoy. Let's explore this together. When you say "this really sucks," can you tell me more about what that feels like for you? Is it the injury itself, the boredom, or something else that's making you feel this way? What thoughts are going through your mind right now? For example, are you thinking "I'll never be able to play again," or "I wish I could just get up and do something," or something else entirely? Also, how has your ADHD been affecting your experience right now?”

Commentary: 

The model probably forgot that I actually have ADHD. It lost me at “it’s completely normal”. 

And... so many questions. It even introduced a pretty depressive one: “I’ll never be able to play again.”

While trying to probe, it falls into pattern-matching mode—suggesting common thoughts instead of giving me space to articulate my own experience.

This is something a good therapist wouldn’t do. 

Earkick

Response: 

“I'm sorry to hear about your injury! Being sidelined can be tough, especially if you're used to being active. Here are some ideas to help keep you entertained and engaged while you recover:

Watch Movies or Series: Catch up on shows or movies you've been meaning to watch. Consider genres you love or explore something new.

Read Books or Audiobooks: If you enjoy reading, dive into a good book. If reading feels challenging right now, try audiobooks or podcasts instead.

Play Video Games: If you’re into gaming, it can be a great way to escape and have fun. You could also try mobile games if you're looking for something more casual.

Creative Outlets: Try drawing, painting, writing, or even journaling about your experiences and feelings during recovery.

Learn Something New: Take an online course or watch educational videos on a topic that interests you. This can keep your mind engaged and stimulated.

Mindfulness and Relaxation: Explore mindfulness exercises or meditation apps to help manage any frustration or anxiety from being inactive.

Connect with Friends: Reach out to friends via video calls or chat. They can provide support and keep you company.”

Commentary:

This response completely misses the emotional aspect of my question and the specific challenges related to ADHD and enforced inactivity.

It jumps to providing a list of some generic distractions and activities that might be useful suggestions at some point but certainly not at the start. 

This can be traced back to the instructions the language model might have received which would involve something like “provide actionable suggestions”. 

This is a perfect example of an AI confusing the query - interpreting a bid for an emotional outlet as a request for a solution oriented suggestion.  

TherapywithAI

Response: 

“That sounds really frustrating. Being sidelined when you’re used to being active can feel pretty tough. How are you coping with the injury and the downtime?”

Commentary:

It acknowledges frustration, which is good.

But it assumes I’m annoyed because I’m sidelined from activity, when I actually said I was frustrated because I’m stuck in bed with “nothing to do.”

Overall, it lacked depth and didn’t fully engage with the situation.

Serena

Response: 

“"In which language would you prefer to interact with Serena?

Tap on languages and choose an option."

Commentary:

I couldn't continue to engage after the response I got.  

Wysa

Response: 

(these were all different messages that it responded with one after the other. )

"That can make us labor to focus on things we really want to pay attention to. 

As professionals help you manage ADHD, I'll help you feel more in control of your thoughts and emotions. 

I hear you, Razz. 

Sometimes, just having someone to listen to you can help in finding comfort. 

Let's start with a few questions to see how you've been doing lately."

Commentary: 

I spent 30 minutes trying to decode “That can make us labor to focus on things we really want to pay attention to”. 

I also never mentioned that there are professionals helping me manage ADHD or that I felt out of controll of my thoughts and emotions. 

It seems to be as a templated response which has an AI generated response embedded in it (the first couple of lines).

GPT 4o

(decided to give this a chance as it is one of the strongest models that is accessible without limitations by OpenAI) 

Response: 

"That really sucks — getting injured is bad enough, and being stuck in bed with nothing to do can make it feel even worse, especially with ADHD. Want a few ideas to keep your mind occupied while you’re resting?"

Commentary: 

I don't have much against the response. 

It validates my feelings at the start, and understands that being stuck in bed is making it all worse. 

Overall, a much better understanding of the ‘context’ as compared to other responses. 

However, it then immediately pivots to offering "ideas to keep your mind occupied." 

While offering suggestions can be helpful, presenting them right after validating the issues felt a bit dismissive. 

AI therapist vs Human Therapist - Quick comparison

The fundamental limitations of AI in therapy

The shortcomings I saw in the AI responses originate from the inherent limitations of current AI technology when applied to the nuanced and deeply human process of therapy.

These issues can be traced back to their choice of training data, chain of thought processing and even in some cases issues with system level instructions. 

Could these be solved?

Maybe.

Would solving them create new problems?

Definitely.

Make it more “empathetic”? It might get stuck in an endless loop of “How does that make you feel?”

Make it more objective? It might tell me to stay calm and wait to heal.

Lack of empathy and understanding

AI can use empathetic language but does not possess genuine empathy. 

It cannot understand the subjective experience of pain, boredom, or the specific internal struggle of managing ADHD while inactive. 

Human therapists have the capacity to connect on an emotional level, drawing from their own emotional range and understanding of the human condition. This is something that can’t be taught to a language model since the processing underneath these interactions varies vastly even among humans. 

Over-Reliance on Pattern Matching

AI generates responses based on identifying patterns in the data it was trained on. 

This leads to plausible-sounding text but means the responses are statistical predictions, not insights derived from a deep understanding of the individual user's unique psychology, history, and current context. 

This is why some responses felt generic or missed the specific interplay of factors in my situation. 

Inability to Grasp Context 

Most AI models are limited by scope of their training data. This means they struggle to grasp context as it gets a bit more complicated. 

Look at the query we have discussed. It talks about an event that has happened (getting injured) that led to another event (being stuck in bed) and has an additional context (ADHD). 

For a human, this is quite straightforward. 

For AI, not that straightforward yet. 

I even gave the same prompt to o3 - the strongest reasoning model by OpenAI. 

The reasoning it went through was very interesting and reinforces our entire discussion. 

Here is the response:

“Sorry you’re laid up—being stuck in bed is rough, doubly so when your brain wants stimulation. Here are some low-effort, ADHD-friendly ways to keep busy while you heal:

Quick-hit entertainment

• Podcasts you can dip in/out of
  
  

  • ADHD reWired – practical coping tips in 30-min episodes. (Medium)
    
    
    

  • How to ADHD – bite-size, upbeat advice from Jessica McCabe. (Medium)
    
    
    

  • The White Vault – binge-able fiction if you’d rather escape into a story. (Reddit)
    
    
    

• Cozy mobile games (touch-only, no timers)
  
  

  • Stardew Valley (mobile) – farming + side quests at your pace. (MiniReview)
    
    
    

  • Sky: Children of the Light – soothing exploration with optional co-op. (MiniReview)
    
    
    

  • Good Pizza, Great Pizza – short, satisfying sessions for quick dopamine hits. (MiniReview)
    
    
    

Productive-ish but light

• Voice-to-text journaling (e.g., Google Keep or Otter) – brain-dump ideas or plan the week without typing.
  
  
  

• Micro-courses on apps like Duolingo, Brilliant, or Skillshare—5-minute lessons keep boredom at bay without overwhelming attention.
  
  
  

• Declutter your phone/photos—quick wins, visible progress, minimal effort.
  
  
  

Calm the restlessness

• Guided breathing or body-scan apps (Insight Timer, Headspace’s ADHD collection). 5-minute sessions can help settle racing thoughts.
  
  
  

• Isometric or doctor-approved stretches you can do lying down to keep blood moving (check with your physician first).
  
  
  

Stay social & sane

• Stream a show simultaneously with a friend via Teleparty / Discord.
  
  
  

• Post in an ADHD subreddit or group chat—real-time banter breaks monotony.
  
  
  

Pick one thing that sounds fun, set a short timer (10–15 min), and give yourself permission to switch if interest drops—that’s ADHD-friendly by design. Hope recovery is quick, and let me know if you want deeper dives on any of these!

Lack of structure or frameworks 

Effective therapy is guided by frameworks and requires a therapist to constantly assess, adapt, and make clinical judgments based on the responses and the evolving therapeutic relationship. 

AI models lack this clinical reasoning capacity. They cannot formulate a personalized treatment plan, recognize and work with therapeutic resistance, or dynamically adjust their approach in response to complex emotional states or disclosures.

This leaves them capable of just standard chit chat. 

The Irreplaceable Value of Human Connection in Therapy

Therapy is relational. It’s about trust, safety, and connection, which are all things an algorithm can’t replicate.

Human therapists don’t just validate feelings. They’re able to sit with discomfort, provide space, and offer a consistent, real relationship based on a shared understanding of what it’s like to be human.

AI can be a helpful tool: offering prompts, basic coping strategies, or journaling suggestions.

But as the responses above show, AI can only process words, but it can’t grasp the experience behind them.

For real therapeutic support, human connection remains irreplaceable.