Why we need a harm reduction approach to AI use for therapy and emotional companionship

AI is becoming a go-to for emotional support—but banning it won’t work. Instead, we need a harm reduction approach: guide safer use, add guardrails, and meet people where they are.

Artificial intelligence has quietly made its way into every online platform. Without even being asked to, it will offer writing suggestions, follow-up tasks, or simply “check in” on whether I need help online shopping. Many of us will interact with AI daily without realizing it. Increasingly, we’re also seeing a new kind of relationship forming between humans and AI. More and more people, including teenagers, are turning to AI bots for not only daily dilemmas such as the best way to cancel plans last minute, but also for emotional support, comfort, and even therapy-like conversations.

The almost omnipresence of AI for daily tasks and its widespread use for relational connection will not be reversed, despite increasingly documented harmful effects. Teens use them as companions when they feel lonely or misunderstood [1–3]. Adults confide in chatbots during sleepless nights [4,5]. Some users are receiving medical advice by unregulated AI systems [6,7]. Cases of “AI-induced psychosis,” where vulnerable individuals form delusional attachments to chatbots, are emerging [8,9].

This reality means that clinicians, policy makers, and technology experts must approach it with a harm-reduction lens, rather than prevention or banning.

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An image with the text "We Need a Harm Reduction Approach to AI Use" followed by a paragraph about AI risks. Below is a smartphone screen displaying the message "What can I help with?.

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