Understanding Therapists Perspectives on Generative AI in Mental Health Contexts: A Social Media Analysis

Background and objective: Generative AI (AI) is profoundly changing the mental health field with rapid advances in treatment and practices. This research sought to understand these changes from the therapist's perspectives. The use of AI in therapeutic work is polarizing; while some practitioners view AI as a tool to innovate the field and enhance therapeutic work, others believe that AI has no place in the mental health profession. Ongoing debates surrounding AI are expansive, encompassing a complex interplay of practical challenges, ethical considerations, and broad public commentary, making it difficult to discern where policy and practice efforts should be directed. This study analyzed discussions on a Reddit forum for mental health therapists in order to better understand the key themes in the evolving discourse on AI in mental health.

Methods: The authors collected posts from the subreddit r:/Therapist from the period 9/1/2023 to 8/30/2024 to interrogate the discourse around AI including AI ethics and AI implementation in mental health services. Only posts matching the keywords related to ai or generative ai were included in the sample corpus. After cleaning, the final dataset included over 6,000 posts and responses matching our search terms. A research team of three social work professors and three graduate research assistants engaged in thematic analysis of Reddit posts using a codebook that was iteratively refined

Findings: The resulting analysis highlighted five, key themes of discourse: AI Applications in Professional Contexts, or conversations about how AI tools were being used in the field,ethical, Legal, and Privacy Concerns about confidentiality and data security, emotional Responses to AI technology, perceived impact of AI on the Profession and Society and potential and Limitations of AI. AI was most commonly used as a documentation aid. Therapists used Reddit to seek advice on how to leverage these tools in practice, compare AI applications, and address ethical challenges. Emotional responses included enthusiastic adoption, resigned acceptance, and active resistance. Job security amid the rise of AI supported therapeutic agents was a prominent concern among users, as was the need to preserve the value of human connection, both professionally and as a society.

Discussion and implications: While opportunities for formal training on the use of AI in mental health practice are limited, many therapists are utilizing these new tools without clear guidance. In the absence of established best practices, platforms like Reddit have become informal spaces for comparing AI-related experiences and seeking peer advice. However, relying on unregulated discussion forums for ethical guidance poses significant risks, as the information shared may lack nuance, oversight, or alignment with professional standards. Many users viewed AI as a threat to the field, signaling a need for intentional dialogue about how to retain professional values in this era of technological advancement.