Can a Chatbot Be a Child’s Therapist?

A growing number of AI-powered mental health apps – from mood trackers to chatbots that simulate conversations with therapists – are becoming available as an alternative to mental health professionals to meet the demand. These tools promise a more affordable and accessible way to support mental well-being. But when it comes to children, experts are urging caution.

Many of these AI apps are aimed at adults and remain unregulated. Yet discussions are emerging around whether they could also be used to support children’s mental health. Dr Bryanna Moore, Assistant Professor of Health Humanities and Bioethics at the University of Rochester Medical Center, wants to ensure that these discussions include ethical considerations.

“No one is talking about what is different about kids – how their minds work, how they're embedded within their family unit, how their decision making is different,”

says Moore, in a recent commentary published in the Journal of Pediatrics. “Children are particularly vulnerable. Their social, emotional, and cognitive development is just at a different stage than adults.”

There are growing concerns that AI therapy chatbots could hinder children’s social development. Studies show that children often see robots as having thoughts and feelings, which could lead them to form attachments to chatbots rather than building healthy relationships with real people.

Unlike human therapists, AI doesn’t consider a child’s wider social environment – their home life, friendships, or family dynamics – all crucial to their mental health. Human therapists observe these contexts to assess a child’s safety and engage the family in therapy. Chatbots can’t do that, which means they could miss vital warning signs or moments where a child may need urgent help.

AI tools can also worsen existing health inequalities. Dr Jonathan Herington, a co-author and Assistant Professor in Philosophy and Health Humanities and Bioethics, explains: “AI is only as good as the data it’s trained on. To build a system that works for everyone, you need to use data that represents everyone.” Without representative datasets, these chatbots risk being ineffective or harmful to some groups.

Children impacted by poverty, racism, or trauma are more likely to face serious mental health challenges, and less likely to access quality care. “Children of lesser means may be unable to afford human-to-human therapy and thus come to rely on these AI chatbots in place of human-to-human therapy,” says Herington.

“AI chatbots may become valuable tools but should never replace human therapy.”

At present, most AI mental health apps aren’t subject to regulation. The U.S. Food and Drug Administration has approved just one AI-based app for treating major depression in adults. Without oversight, there’s little protection against misuse, poor data practices, or accessibility issues.

“There are so many open questions that haven’t been answered or clearly articulated,” says Moore.

“We’re not advocating for this technology to be nixed. We’re not saying get rid of AI or therapy bots. We’re saying we need to be thoughtful in how we use them, particularly when it comes to a population like children and their mental health care.”

Read how Dr Tom Bashford and his team at the University of Cambridge have been looking into how digital tools can help people recovering from trauma.