Artificial Intelligence in Therapy Under Illinois Public Act 104-0054: Legal Boundaries and a Framework for Establishing Safe, Effective AI Tools (Preprint)

<sec> <title>UNSTRUCTURED</title> Artificial intelligence (AI) applications in mental health have expanded rapidly, and consumers are already using freely available generative AI models for self-guided mental health support despite limited clinical validation. In August 2025, Illinois enacted Public Act 104-0054, the first state statute in the United States to explicitly define and regulate the use of AI in psychotherapy services, establishing boundaries around administrative support, supplementary support, and therapeutic communication. While the Act clarifies several aspects of AI use in therapy, it also leaves important gray areas, such as whether AI-generated session summaries, psychoeducation, or risk-flagging functions should be considered therapeutic communication. Drawing on the history of empirically supported treatments in psychology, we argue that a framework of evidence, safety, fidelity, and legal compliance could help determine when AI tools should be integrated into clinical care. This approach provides a concrete pathway for balancing patient protection with responsible innovation in the rapidly evolving field of mental health AI tools. </sec>