Artificial Intelligence and Psychotherapy: Opportunities, Challenges, and Recommendations

Cooper, S., Ardlan, F., Gavazzi, J., et al. (2026).

A Report of the AI and Psychotherapy Work Group, 

Society for the Advancement of Psychotherapy, 

American Psychological Association, Division 29.

Executive Summary

Psychologists are already using artificial intelligence (AI) to draft progress notes, screen literature, generate case conceptualizations, and rehearse clinical skills with simulated patients. Technology has shaped professional psychology for decades, but no earlier development moved this quickly into so many parts of the work at once. A model can be given every word a patient has spoken and still have nothing at stake in what happens next. That disparity organizes the analysis in this report.

Emerging from the October 2025 SAP Board discussion of mega-level issues and opportunities for the Society for the Advancement of Psychotherapy, the Presidential Work Group on AI and Psychotherapy was established in 2026 by Society President Joshua Swift to examine AI’s implications for psychotherapy practice, supervision, education and training, and research. What follows is guidance from a Society work group. It is not APA policy and not a practice guideline.

The authors of the four domain sections worked independently and drew on different literatures. Their analyses converged: AI can substantially augment psychological work, but it cannot replace the human judgment, relationships, and accountability on which psychotherapy depends.

Six principles follow.

1. AI augments rather than replaces humans.
2. Human accountability remains essential.
3. AI output requires critical evaluation.
4. Implementation must be ethical and safe.
5. Human relationships remain central.
6. Continuous learning and governance are necessary.

Across all four domains the Work Group identified the same risks: automation bias, professional deskilling, cultural and demographic bias, threats to privacy and confidentiality, and overreliance on AI-generated recommendations. Beneath them sits a single concern. AI generates plausible interpretations from patterns in data, while psychotherapy requires understanding a particular person within a particular cultural, historical, and relational context. Pattern recognition can look like clinical understanding and be something else entirely.

The Work Group recommends evaluating any AI application against three questions: whether it enhances or erodes the human relationships the work depends on, whether it preserves psychologist accountability, and whether it respects the patient’s narrative integrity and cultural context. Evaluate a tool before it becomes embedded in practice, because a tool is far easier to decline than to remove.

Four practices follow. Psychologists should reason independently before consulting AI models whenever feasible, verify what AI produces, protect confidentiality in data handling, and review AI-assisted documentation before it enters a record.

Underlying these recommendations is a commitment to human dignity. Persons must not be reduced to data, classifications, or algorithmic predictions. The tools named in this report will be superseded and the studies cited will be replaced by better ones, but the question they raise will not date: what parts of psychological work can be augmented by technology, and what responsibilities cannot be delegated at all.

The entire work group report is here.

The Mercy Workers

Melanie Garcia

The Marshall Project

Originally published 2 March 2023

Here are two excerpts:

Like her more famous anti-death penalty peers, such as Bryan Stevenson and Sister Helen Prejean, Baldwin argues the idea that people should be judged on more than their worst actions. But she also speaks in more spiritual terms about the value of unearthing her clients’ lives. “We look through a more merciful lens,” she told me, describing her role as that of a “witness who knows and understands, without condemning.” This work, she believes, can have a healing effect on the client, the people they hurt, and even society as a whole. “The horrible thing to see is the crime,” she said. “We’re saying, ‘Please, please, look past that, there’s a person here, and there’s more to it than you think.’”

The United States has inherited competing impulses: It’s “an eye for an eye,” but also “blessed are the merciful.” Some Americans believe that our criminal justice system — rife with excessively long sentences, appalling prison conditions and racial disparities — fails to make us safer. And yet, tell the story of a violent crime and a punishment that sounds insufficient, and you’re guaranteed to get eyerolls.

In the midst of that impasse, I’ve come to see mitigation specialists like Baldwin as ambassadors from a future where we think more richly about violence. For the last few decades, they have documented the traumas, policy failures, family dynamics and individual choices that shape the lives of people who kill. Leaders in the field say it’s impossible to accurately count mitigation specialists — there is no formal license — but there may be fewer than 1,000. They’ve actively avoided media attention, and yet the stories they uncover occasionally emerge in Hollywood scripts and Supreme Court opinions. Over three decades, mitigation specialists have helped drive down death sentences from more than 300 annually in the mid-1990s to fewer than 30 in recent years.

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The term “mitigation specialist” is often credited to Scharlette Holdman, a brash Southern human rights activist famous for her personal devotion to her clients. The so-called Unabomber, Ted Kaczynski, tried to deed his cabin to her. (The federal government stopped him.) Her last client was accused 9/11 plotter Khalid Shaikh Mohammad. While working his case, Holdman converted to Islam and made a pilgrimage to Mecca. She died in 2017 and had a Muslim burial.

Holdman began a crusade to stop executions in Florida in the 1970s, during a unique moment of American ambivalence towards the punishment. After two centuries of hangings, firing squads and electrocutions, the Supreme Court struck down the death penalty in 1972. The court found that there was no logic guiding which prisoners were executed and which were spared.

The justices eventually let executions resume, but declared, in the 1976 case of Woodson v. North Carolina, that jurors must be able to look at prisoners as individuals and consider “compassionate or mitigating factors stemming from the diverse frailties of humankind.”

The article is here.

The death penalty: The past and uncertain future of executions in America

C. Geidner, J. Lambert & K. Philo

Grid News

Originally posted 28 APR 22

Overview

South Carolina may soon carry out the United States’ first executions by firing squad in more than a decade. State officials have said that they plan to execute Richard Moore and Brad Sigmon using guns, the first such use of a firing squad since Ronnie Gardner was shot to death by the state of Utah on June 18, 2010.

Last week, nine days before Moore was to be executed, South Carolina’s Supreme Court put the execution on hold, but there’s no way of knowing how long that will last. Days later, the court also put Sigmon’s execution — scheduled for May — on hold. Although the court did not explain its reasoning, both men have an ongoing challenge to the state’s execution protocol, including its planned use of a firing squad.

How did we get here?

More than 45 years after the Supreme Court allowed executions to resume in the United States after a four-year hiatus, America is in a monthlong period in which five states planned to carry out six executions — the most in several years.

The situation offers a window into changing attitudes toward the death penalty and the complex brew of factors that have made these executions harder to carry out but also harder to challenge in courts. And the individual stories behind some of these current cases serve as a reminder of the well-documented racial bias in the way death sentences are handed down.

The death penalty’s popularity with the public has diminished in recent decades, and the overall number of new death sentences and executions has dropped significantly.

That’s due in part to the increased difficulty of carrying out lethal injection executions after death penalty opponents made it substantially harder for states to obtain the necessary drugs. States responded in part by adopting untried drug combinations. A series of botched executions followed — including the longest execution in U.S. history, when Arizona spent nearly two hours trying to kill Joseph Wood by using 15 doses of its execution drugs on the man before he died.

During that same time, the Supreme Court has made it more difficult to challenge any method of execution, setting a high bar for a method to be disallowed and by requiring challengers to identify an alternative method of execution.

Robert Dunham, the executive director of the Death Penalty Information Center, a nonpartisan organization that maintains a comprehensive database of U.S. executions, told Grid that part of the current influx of execution dates is a result of most states halting executions during the first year of the pandemic, before a covid vaccine was available.

This past week, Texas carried out its first execution of the year when it executed 78-year-old Carl Buntion. Tennessee also had planned an execution for last week, but it was called off with an announcement that highlighted two key elements of the modern death penalty: secrecy and errors. Hours before the state was slated to execute Oscar Franklin Smith by lethal injection, Gov. Bill Lee (R), citing “an oversight in preparation for lethal injection,” announced a reprieve. The execution will not happen before June, but state officials have not yet said anything more about what led to the last-minute reprieve.

The info is here.