AI in the therapists' office: Uptake increases, caution persists

Artificial intelligence (AI) has moved from a fringe tool to a regular part of clinical practice, with more psychologists weaving it into their administrative routines and reporting a clearer understanding of its risks and benefits.

Almost 1 in 3 practitioners (29%) now use AI at least monthly in their practice, according to the 2025 Practitioner Pulse Survey, released by APA and its companion organization, APA Services, in December. Of 1,742 respondents, 56% have used AI to assist with their work at least once, pointing to a growing ease with the technology among many practitioners.

But plenty of concerns remain, including for the 38% of psychologists who worry that AI may one day make some or all their job duties obsolete.

Even clinicians who don’t use AI for practice management likely encounter it in some form. OpenAI recently reported that around 1 million users per week show signs of emotional reliance on ChatGPT, with similar numbers talking to the chatbot about suicide (Chatterji, A., et al., Working Paper 34255, National Bureau of Economic Research, 2025opens in new window).

“AI is already in your practice even if you’re not using these administrative tools because many of the people sitting on the couch across from you are turning to ChatGPT in between sessions,” said Rachel Wood, PhD, an expert in cyberpsychology and licensed professional counselor who runs the AI Mental Health Collectiveopens in new window.

For that reason, it’s critical for psychologists to ask patients about their AI use and to develop practical and ethical competence to support situations their patients may face and spot signs of misuse. APA’s recent health advisory provides guidance for clinicians on how to handle generative AI in therapy and other settings (“Use of Generative AI Chatbots and Wellness Applications for Mental Health,” APA, 2025).

“Whether you’re for or against AI is less important than having a baseline level of knowledge, information, and understanding so that you’re equipped to hold space for it,” Wood said.

Aside from AI, clinician reports indicate that the mental health crisis isn’t over. Nearly half (45%) have seen an increase in the severity of their patients’ symptoms. On the bright side, clinician capacity appears to be stabilizing post-pandemic, with plateaus or declines in burnout rates, waiting list length, and the ability of providers to meet patient demand.

“Providers are telling us: We’re still seeing patients who seem sicker, but our ability to meet and match that is going in the right direction,” said Marnie Shanbhag, PhD, who is with APA’s Office of Independent Practice.

Keeping pace with the increased use of AI across society, a greater number of psychologists are incorporating these tools into their work.

Fewer than half of psychologists (44%) say they have never used AI to assist with their practice, compared with 71% who said so in 2024. Nearly 3 in 10 (29%) use it at least monthly, up from just 11% last year.

“This is not only in our clinical world, but there’s a collective movement on a societal and global level where people feel really behind if they’re not using AI,” Wood said.

AI tools are now woven into many of the platforms psychologists already use, including electronic health records (EHRs). Practitioners most frequently report using AI tools for help with writing, such as drafting emails (52%), followed by generating content (33%), summarization (32%), and note-taking and dictation (22%).

Tools like ChatGPT have helped Cami Winkelspecht, PhD, a child and adolescent psychologist with a private practice in Wilmington, Delaware, with myriad practice-related tasks. These include generating summaries of newly published research, building structured outlines for presentations, and helping her patients with attention-deficit/hyperactivity disorder create checklists to help with studying or schoolwork. “Integrating it into our workflow in ways that don’t relate to confidentiality or patient privacy is a safe way to start experimenting with AI,” she said, compared with using AI for more sensitive tasks, such as note-taking during a therapy session.

APA’s AI tool guide for practitioners gives step-by-step advice for evaluating whether a given tool is appropriate for use in practice, while newly released guidelines provide more detailed tips for evaluating AI scribing technologies.

The survey results show psychologists were more aware of AI’s benefits and risks than they were the year before. About 4 in 10 (42%) say AI can help with operations and reduce practitioners’ administrative burden, up from 33% in 2024. Two thirds (67%) remain concerned about potential data breaches. In addition, at least 60% of psychologists surveyed are worried about biased inputs and outputs, inaccurate outputs, lack of rigorous testing, and unanticipated social harms. Most concerns about AI’s risks grew by around 10 percentage points from 2024 to 2025.

Such concerns are consistent with psychology’s focus on ethics and should inform how providers use AI, especially in situations where it could influence clinical judgment. For example, if using a notes-summarization tool, Wood recommends treating AI like a second pair of eyes—much like a supervisor offering feedback. Clinicians should always rely first and foremost on their own expertise. (For more advice, see “Ethical Guidance for AI in the Professional Practice of Health Service Psychology,” APA, 2025.)

To guide ethical use, Wood suggests practitioners include a clear statement about how they use AI in their disclosure to patients. It’s also a good idea to discuss this directly and be ready to make accommodations for those who are uncomfortable with the use of AI. Another useful step is adding a simple intake question: What role, if any, does AI play in your life?

“With the numbers of people using AI for emotional support, this needs to become standard,” Wood said. “Your client may have a best friend, boyfriend, or girlfriend that’s an AI. We need to be the place where people can safely talk about this and process it.”

Growing familiarity with AI hasn’t eliminated lingering fears about being replaced. Nearly 4 in 10 psychologists (38%) worry AI may make some or all their job duties obsolete in the future, up from 27% in 2024. That concern is not unfounded, Wood said, given how many people already talk to ChatGPT about personal issues. This year, she launched the AI Mental Health Collectiveopens in new window to give clinicians a space to reflect on AI, unpack its implications, and make personal and professional decisions about how to use it. For example, therapists in her network have explored how to support couples in therapy when one partner also has an AI companion.

Winkelspecht said that hesitation around AI mirrors clinicians’ early resistance to EHRs. She expects AI adoption to follow a similar path to EHRs—early enthusiasm from some, hesitation from others, and a small group who may opt out entirely. Despite early skepticism, most clinicians now routinely use EHRs in their practice.

“Having good education and opportunities to process these challenges is key. It’s something that people are really hungry for knowledge on,” Winkelspecht said.

While close to half (46%) of psychologists still do not have openings for new patients, that number has been trending downward since 2021. Nearly 9 in 10 (87%) providers now say they can see new patients within 3 months, similar to wait times for other nonurgent medical specialists.

“Things do seem to be stabilizing in terms of the crisis that psychologists themselves faced while serving the public during the pandemic,” Shanbhag said. “Our ability to meet demand has gone up, our burnout seems to be going down, and treatment length is stabilizing and not continuing to increase.”

The stress of the pandemic and the abrupt shift to telehealth placed emotional and administrative burdens on providers that now appear to be lifting, said Julie Wolter, PsyD, a psychologist in private practice in North Kingstown, Rhode Island.

At the same time, many patients continue to face significant challenges, with 45% of providers observing an increase in symptom severity. That may be the result of delayed care during the pandemic, which has had lasting effects on both physical and psychological health, Shanbhag said.

Psychologists’ ability to meet those needs continues to be hindered by insurance barriers. Less than two thirds of psychologists (62%) accept some form of insurance. Among providers who do accept insurance, 10% stopped participating in at least one private or commercial network in the past year.

“We’re continuing to see providers move away from accepting insurance, a trend that we expect to continue,” Shanbhag said. “That’s not a good thing for society, because a very small segment of the population can afford to access full-fee, cash care.”

Three quarters of psychologists cite insufficient reimbursement as a primary reason for not accepting insurance. Other barriers included administrative issues with payers (57%), concerns about payment reliability (43%), and denial of coverage for services they deem necessary and appropriate for patients (28%). (For more on how such barriers affect patients and providers, see: Abrams, Z., Monitor on Psychology, Dec. 17, 2024).

Low reimbursement rates have forced many providers to choose between financial stability and accepting insurance, said Wolter, who helps lead advocacy efforts for the Rhode Island Psychological Association and the New Hampshire Psychological Association. That can lead to feelings of guilt or distress for providers who entered the profession wanting to support underserved patients, she said.

These and other conditions contribute to a high rate of burnout (50%) among early career psychologists. The good news: Practitioners in the most advanced career stage report much lower burnout levels (16%). That disparity likely stems from the multiple competing demands many new psychologists face, Shanbhag said—including student loan debt, pressure to establish themselves professionally, and major life transitions such as partnering or starting a family.

“People assume that burnout gets worse over the course of a career, but in our profession it’s actually the inverse,” she said. “As psychologists gain experience and autonomy, things really do tend to get better.”