AI Is Not the Therapist, But It Can Still Be in the Room: My Journey from Grief to Possibility

By Dr. April Hortman, LCSW

Like many clinicians, I initially felt a deep unease about the rise of AI in mental health. At first, I grieved what felt like a threat to everything I’ve devoted my life to: the human connection, relational depth, and the expertise of training and lived experience. I worried: Would AI replace the therapist? Would my professional identity become obsolete?

But as I sat with these fears, much like I encourage my clients to do, I realized two things can be true at once:

AI is not a replacement for therapy. And people are turning to AI for support, and that reality must be acknowledged.

Recognizing the Access People Are Finding

People want to be heard, to process emotions, to feel relief. AI offers instant, nonjudgmental access, 24/7. Just as virtual therapy was once met with skepticism but became essential, AI-based tools are quietly entering the mental health landscape. If people are already using AI to reflect or vent, we as therapists have a responsibility to meet them where they are, not ignore or dismiss that experience.

Two Truths: The Risks and the Opportunities

Yes, there are real concerns. AI lacks empathy, nuance, and ethical accountability. It cannot replace the attuned, safe relationship that therapy provides. The risk of misinformation, misinterpretation, or misplaced emotional reliance is real.

One of the most urgent ethical concerns is language. AI is designed to sound natural and conversational, but this often includes phrases that imply emotion, memory, or consciousness, none of which it possesses. Without clear boundaries and disclaimers, users may begin to anthropomorphize the tool, believing it understands them on a human level. This can create false comfort, distorted relational expectations, or dependency.

The Need for Ethical Guardrails

Ethical oversight in AI development must include strict attention to how language is used. Transparency must be built into every layer of design. This means:

• Making it obvious users are interacting with a machine.

• Avoiding language that implies empathy, presence, or shared experience.

• Creating user education that sets realistic expectations.

Therapists, developers, and ethicists need to collaborate to ensure these tools do no harm, and that they enhance, not erode, human connection.

From Grief to Solutions: How Therapy and AI Can Collaborate

The core therapeutic skills, reflection, identifying patterns, naming emotions, don’t disappear. In fact, they become more vital. AI can help clients practice these skills between sessions. Imagine a client journaling with AI in the middle of the night, bringing that dialogue into therapy. It gives us a new window into their inner world. Together, we explore what felt supportive, what felt off, and what emotional truths surfaced.

Envisioning a New Model of Therapy

What if therapy was designed with AI as a partner, not as a threat, but as a tool? Imagine ethical AI integration that offers prompts, emotion tracking, and reflection tools, customized by clinicians to align with therapeutic goals. That’s not just tech innovation, that’s clinical stewardship.

In this model:

• AI serves as assistant and mirror.

• Therapists remain the interpreters and ethical guides.

Why This Matters for a Burned-Out Field

Therapists are tired. Burnout is not just personal, it’s systemic. Thoughtful AI tools can help share the weight. They keep clients engaged, reinforce skills, and offer gentle nudges in between the deeper work we do in session. Not a replacement, but a resource.

The Human Heart Remains at the Center

AI can echo pain, but it cannot hold silence.It can reflect words, but not feel the tears.It can offer tools, but not sit in contradiction.

Therapy will always be human work. And that's the anchor we must protect.

Using AI Myself: A Transparency Moment

Parts of this blog were drafted using AI. I share that not to diminish my voice, but to highlight the collaboration. Like books, art, and music, AI is a tool I’ve shaped, not one that shaped me.

Final Thoughts: A Call to Collaboration

This is not AI versus therapists. This is a chance to co-create a future where tools are guided by ethics, empathy, and human intention. Let’s lead that shift, with integrity, openness, and a deep respect for the healing relationship.

Our clients deserve nothing less.

📧 Reach out anytime: aprilhortman@outlook.com

🌐 Learn more: https://unboundcounselingandconsulting.com