A Framework for Automation in Psychotherapy

Psychotherapy is a conversational intervention that has relied on humans to manage its implementation. Improvements in conversational artificial intelligence (AI) have accompanied speculation on how technologies might automate components of psychotherapy, most often the replacement of human therapists. However, there is a spectrum of opportunities for human collaboration with autonomous systems in psychotherapy, including evaluation, documentation, training, and assistance. Clarity about what is being automated is necessary to understand the affordances and limitations of specific technologies. As a guidepost for empirical and ethical inquiry, we present a framework for categories of autonomous systems in psychotherapy. Categories include scripted or rule-based conversations, collaborative systems where humans are evaluated by, supervise, or are assisted by AI, and agents that generate interventions. These categories highlight considerations for key stakeholders as psychotherapy moves from unmediated human-to-human conversation to various forms of automation.