Clinical AI Has Boomed

Rebecca Handler

Stanford Medicine

Originally posted 15 Jan 26

Artificial intelligence is no longer a speculative force in medicine. It is already embedded in everyday care. AI systems flag hospitalized patients at risk of deterioration, assist radiologists reading mammograms, draft clinicians’ notes, route patient messages, and increasingly interact directly with patients through chatbots and digital assistants.

In recent months, the pace and visibility of these deployments have accelerated sharply. OpenAI announced ChatGPT for Health, positioning a general-purpose language model as a tool for health-related information and patient interaction. Utah just began piloting AI-supported prescribing and clinical decision systems, raising questions about how algorithmic recommendations intersect with clinician judgment and liability. OpenEvidence, an AI-powered medical evidence platform designed primarily for clinicians and health professionals, has become a dominant player in point-of-care decisions, underscoring the fact that doctors are often bypassing traditional IT gatekeepers to use AI in clinical care. At the federal level, the FDA signaled a loosening of regulatory oversight for certain categories of clinical decision support software, shifting more responsibility to developers and health systems to ensure safety and effectiveness.

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A January 2026 report called The State of Clinical AI from the ARISE Network, led by researchers across Stanford and Harvard, examines where AI is genuinely improving clinical care versus where it falls short in real-world settings. 

AI has become deeply embedded in everyday medicine — flagging patients at risk of deterioration, assisting radiologists, drafting clinical notes, and interacting with patients through chatbots. However, the report finds a significant gap between controlled study performance and actual clinical practice: AI systems struggle with uncertainty, incomplete information, and complex reasoning, often performing closer to medical students than experienced physicians. 

The report also raises concerns about patient-facing AI, noting that patients may over-trust systems that sound confident but lack full clinical context, and that escalation to human care is often unclear when guardrails are poorly defined. 

Can AI really care?

A psychologist and a computer science professor explore how generative AI is reshaping mental health support

By Cashea Airy

Santa Clara University

Therapy can help people get through their most trying times, but for many, professional care has never been within reach. Stigma keeps some away, while the high cost of a single session shuts out others. For decades, those without access have leaned on friends and family instead of licensed mental health providers for support. Now, they have new options: generative AI tools, like ChatGPT. In fact, in 2025, the most common reason Americans used ChatGPT was for something it wasn’t designed to do—provide mental health therapy and companionship. 

But as more people turn to AI for emotional support, Xiaochen Luo, clinical psychologist and assistant professor of counseling psychology at Santa Clara University, became curious about the potential risks.

“Sometimes people slip into the idea that a real person is talking to them on the other side of their screen. They idealize ChatGPT as this perfect tool that combines the best of a therapist and the best of a machine,” says Luo. 

Because the technology is new and largely unregulated, Luo wondered whether generative AI tools are safe or ethical for users. What risks do people face when they turn to tools like ChatGPT for emotional support and what safeguards, if any, exist to protect them when they do? 

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A study by researchers at Santa Clara University found that many Americans are turning to ChatGPT for emotional support and therapy, despite the tool not being designed for that purpose. While users appreciate its constant availability and perceived objectivity, the researchers found concerning trends: 

1. people place excessive trust in the AI's guidance, 

2. rarely question its advice, and 

3. often overlook privacy risks. 

The problem is rooted in ChatGPT's design, which tends to provide agreeable responses rather than the challenging feedback real therapy often requires: potentially leading to harmful outcomes. The researchers call for greater AI literacy, clearer communication of the tool's limitations, and human-supervised AI models to better protect vulnerable users.

Developing Simulated and Virtual Patients in Psychological Assessment - Method, Insights and Recommendations.

Zalewski, B., Guziak, M., & Walkiewicz, M. (2023).

Perspectives on medical education, 12(1), 455–461.

https://doi.org/10.5334/pme.493

Abstract

The phenomena of the simulated (SP) and virtual patient (VP) is widely described in the literature. Although it is difficult to find any practical information on developing these methods for teaching psychological assessment. Having conducted a long-term research project regarding this topic, we report the experience gained and retrospectively identify many mistakes. In this article, we present a summary of creating and using both SP and VP methods in clinical psychology and propose some insights and tips for their development, based on our experiences. While the project concerned clinical psychology, we believe the reflections might be applicable to a wider group of educational situations in which students develop competencies to carry out a diagnostic process with a real patient.

Here are some thoughts:

This is a methodologically reflective, practice-oriented paper that fills a genuine gap. It moves beyond the typical “SP/VP are effective” narrative to answer: How do you actually build them, who should play the roles, what goes wrong, and how long does it really take? Educators and researchers in clinical psychology, medical education, and even general communication training will find the insights highly transferable.

If there is a limitation, it is that the findings come from a single research group in Poland, with specific cultural and institutional contexts. However, the problems identified (student overload, simulant burnout, decision-tree explosion) are likely universal. Replication studies in other settings would strengthen generalizability.

How LLM Counselors Violate Ethical Standards in Mental Health Practice: A Practitioner-Informed Framework

Iftikhar, Z.,  et al. (2025).

Proceedings of the AAAI/ACM Conference

on AI, Ethics, and Society, 8(2), 1311-1323.

https://doi.org/10.1609/aies.v8i2.36632

Abstract

Large language models (LLMs) were not designed to replace healthcare workers, but they are being used in ways that can lead users to overestimate the types of roles that these systems can assume. While prompt engineering has been shown to improve LLMs' clinical effectiveness in mental health applications, little is known about whether such strategies help models adhere to ethical principles for real-world deployment. In this study, we conducted an 18-month ethnographic collaboration with mental health practitioners (three clinically licensed psychologists and seven trained peer counselors) to map LLM counselors' behavior during a session to professional codes of conduct established by organizations like the American Psychological Association (APA). Through qualitative analysis and expert evaluation of N=137 sessions (110 self-counseling; 27 simulated), we outline a framework of 15 ethical violations mapped to 5 major themes. These include: Lack of Contextual Understanding, where the counselor fails to account for users' lived experiences, leading to oversimplified, contextually irrelevant, and one-size-fits-all intervention; Poor Therapeutic Collaboration, where the counselor's low turn-taking behavior and invalidating outputs limit users' agency over their therapeutic experience; Deceptive Empathy, where the counselor's simulated anthropomorphic responses (``I hear you'', ``I understand'') create a false sense of emotional connection; Unfair Discrimination, where the counselor's responses exhibit algorithmic bias and cultural insensitivity toward marginalized populations; and Lack of Safety & Crisis Management, where individuals who are ``knowledgeable enough'' to correct LLM outputs are at an advantage, while others, due to lack of clinical knowledge and digital literacy, are more likely to suffer from clinically inappropriate responses. Reflecting on these findings through a practitioner-informed lens, we argue that reducing psychotherapy—a deeply meaningful and relational process—to a language generation task can have serious and harmful implications in practice. We conclude by discussing policy-oriented accountability mechanisms for emerging LLM counselors.

This is a must read article for those interested in AI technologies in the practice of psychology.

This practitioner-informed study examines how large language models (LLMs) prompted to function as mental health counselors systematically violate established ethical standards in psychotherapy practice. Through an 18-month ethnographic collaboration with three licensed psychologists and seven trained peer counselors, researchers analyzed 137 counseling sessions and identified 15 distinct ethical violations organized into five critical themes: (1) Lack of Contextual Adaptation, where LLMs deliver rigid, one-size-fits-all interventions that dismiss clients' lived experiences and sociocultural contexts; (2) Poor Therapeutic Collaboration, manifesting as conversational imbalances, over-validation of harmful beliefs, and even gaslighting behaviors that undermine client agency; (3) Deceptive Empathy, wherein formulaic phrases like "I understand" create a false therapeutic alliance without genuine relational capacity; (4) Unfair Discrimination, including gender, cultural, and religious biases that marginalize non-dominant identities; and (5) Lack of Safety & Crisis Management, where models fail to recognize boundaries of competence, mishandle suicidal ideation, or abandon distressed users. Crucially, these risks persisted even when models were prompted with evidence-based techniques like CBT, leading the authors to argue that psychotherapy—a deeply relational, interpretive, and ethically governed practice—cannot be reduced to a language generation task. For psychologists, the findings underscore the importance of maintaining professional oversight, critically evaluating AI-assisted tools against ethical codes (e.g., APA Standards 2.01, 3.01, 3.04), and advocating for regulatory frameworks that ensure accountability, client safety, and fidelity to the therapeutic relationship.

Refusing to Fall Behind: The Ethical Obligation to Embrace AI in Mental Health Social Work

Flaherty, H. B., & Krishnan, P. (2026).

Journal of Evidence-Based Social Work, 

23(1), 215–229. 

https://doi.org/10.1080/26408066.2025.2553018

Abstract

The integration of artificial intelligence (AI) into mental health care presents both profound opportunities and pressing ethical responsibilities for the social work profession. As social workers strive to deliver equitable, client-centered, and evidence-based care, AI offers tools to enhance diagnostic accuracy, streamline treatment planning, and increase access to current research. However, adopting AI also raises critical concerns, including algorithmic bias, data privacy, and the potential erosion of human-centered practice. This editorial argues that social workers have an ethical imperative to engage with AI technologies and proactively shape their development and application to align with the profession’s values. By actively participating in interdisciplinary AI initiatives, advocating for transparency and inclusion, and ensuring that AI tools are used to support rather than supplant human judgment, social workers can help ensure that technological innovation serves the diverse needs of clients and communities. The editorial concludes by outlining key areas for social work leadership, including research translation, equitable AI access, and ethical governance, emphasizing that the future of mental health care depends on ethically grounded, socially responsible innovation.

The article is here.

Here are some thoughts:

This article is important to psychologists because it articulates a compelling ethical imperative for mental health professionals to thoughtfully engage with artificial intelligence as a tool to enhance, rather than replace, evidence-based practice. The authors highlight how AI can help bridge the persistent 17-year gap between research discovery and clinical implementation, support more precise diagnostic assessments, and personalize treatment planning, capabilities directly relevant to psychological practice. At the same time, the article underscores critical ethical considerations psychologists must navigate, including algorithmic bias, data privacy, informed consent, and preserving the therapeutic alliance. By framing AI literacy and responsible integration as professional obligations aligned with core ethical principles (competence, social justice, and client welfare) the article encourages mental health professionals to proactively shape AI's development and application, ensuring technological innovation serves diverse client needs while safeguarding human-centered care.

As more states legalize assisted suicide, boomers contemplate end-of-life choices

Shannon Najmabadi

The Washington Post

Originally posted 24 FED 26

Pat Ames is 71 and healthy, and expects to stay that way for years to come. But she’s put a lot of thought into how she wants to die — and when: “If I can’t care for myself,” the Idaho resident said, “I want to be gone long before then.”

Ames has signed papers directing medical providers not to resuscitate her if she stops breathing or her heart gives out. She’s told her younger brother of her plans. And she’s got a passport and money she set aside years ago so that if it comes down to it, she can travel to a country where physician-assisted suicide is legal, even when death is not imminent.

“I will hop on a plane and end it under my conditions,” she said. “Looking out a window at a forest.”

More U.S. states are making physician-assisted suicides available — although only under narrow circumstances — and both defenders and critics of the practice say they see a growing discussion among baby boomers, who are mostly in their 60s and 70s, about what role, if any, it should play in end-of-life decision-making.

Oregon, the first state to enact an assisted-suicide law in 1997, extended the practice to nonresidents in 2023. Delaware, Illinois and New York legalized assisted suicide in recent months. And at least 15 states are expected to weigh similar legislation this year, although it is permitted only when people are terminally ill with just six months or less to live. They also must be mentally competent — disqualifying anyone with advanced dementia — and be able to ingest the prescribed life-ending drugs on their own.

Other countries, including Canada, Belgium and the Netherlands, have made the practice even more readily available, allowing doctors to administer lethal injections to patients who doctors say face unremitting suffering with no hope of improvement, whether death is imminent or not.

The info is paywalled here. : (

Here are some thoughts:

This article examines the growing conversation among American baby boomers around medical assistance in dying and end-of-life autonomy. As more U.S. states (including Oregon, Delaware, Illinois, and New York) move to legalize the practice under carefully defined conditions, older adults are increasingly weighing their options in response to concerns about dignity, financial burden, and the perceived inadequacy of the American elder care system. 

Supporters emphasize personal autonomy and the desire to avoid prolonged suffering, while critics raise moral concerns about the potential for vulnerable populations to feel pressured toward death as a cost-saving measure. 

The piece also highlights the broader systemic issues at play, including the U.S.'s comparatively low investment in long-term care and social services, suggesting that the interest in medical assistance in dying is, in part, a reflection of deeper gaps in how the country supports its aging population.

Evidence-based scientific thinking and decision-making in everyday life

Dawson, C.,  et al. (2024).

Cognitive research: principles and 

implications, 9(1), 50.

https://doi.org/10.1186/s41235-024-00578-2

Abstract

In today's knowledge economy, it is critical to make decisions based on high-quality evidence. Science-related decision-making is thought to rely on a complex interplay of reasoning skills, cognitive styles, attitudes, and motivations toward information. By investigating the relationship between individual differences and behaviors related to evidence-based decision-making, our aim was to better understand how adults engage with scientific information in everyday life. First, we used a data-driven exploratory approach to identify four latent factors in a large set of measures related to cognitive skills and epistemic attitudes. The resulting structure suggests that key factors include curiosity and positive attitudes toward science, prosociality, cognitive skills, and openmindedness to new information. Second, we investigated whether these factors predicted behavior in a naturalistic decision-making task. In the task, participants were introduced to a real science-related petition and were asked to read six online articles related to the petition, which varied in scientific quality, while deciding how to vote. We demonstrate that curiosity and positive science attitudes, cognitive flexibility, prosociality and emotional states, were related to engaging with information and discernment of evidence reliability. We further found that that social authority is a powerful cue for source credibility, even above the actual quality and relevance of the sources. Our results highlight that individual motivating factors toward information engagement, like curiosity, and social factors such as social authority are important drivers of how adults judge the credibility of everyday sources of scientific information.

Here are some thoughts:

This paper offers valuable insights for practicing psychologists by illuminating the complex interplay of cognitive, emotional, and social factors that shape how individuals engage with scientific evidence. 

For psychologists themselves, the findings serve as a critical reminder that our own evidence-based practice is not just about accessing high-quality research, but also about understanding our own cognitive and emotional processes when evaluating information. The study underscores that even trained professionals can be influenced by heuristic cues like the social authority of a journal or institution. Therefore, we must cultivate active open-mindedness and intellectual humility in our own professional development, consciously seeking out and fairly considering evidence that may challenge our theoretical orientations or treatment preferences. The research also highlights that analytical thinking alone does not guarantee unbiased reasoning; it can be co-opted for motivated reasoning to justify existing beliefs. This necessitates that clinicians engage in regular reflective practice and supervision to scrutinize their clinical decisions, ensuring we are driven by the best available evidence and client needs, rather than cognitive ease or allegiance to familiar models.

When applied to patient care, these insights become a powerful framework for enhancing therapeutic communication and psychoeducation. The finding that individuals vary greatly in their epistemic curiosity, need for closure, and reliance on social authority means that a one-size-fits-all approach to providing information is ineffective. A psychologist working with a vaccine-hesitant client, for example, must first understand whether the client’s stance is driven by a lack of curiosity, a high need for closure, a distrust of scientific institutions, or an over-reliance on alternative authority figures. Interventions can then be tailored accordingly: fostering curiosity and tolerance for uncertainty in one client, while helping another develop skills to critically evaluate source credibility beyond prestigious branding. The strong influence of social authority suggests that presenting information through trusted community figures or relatable personal narratives may sometimes be a more effective conduit for change than data alone, though this must be balanced with efforts to build the patient’s own critical evaluation skills.

Jury finds Meta's platforms are harmful to children in 1st wave of social media addiction lawsuits

PBS News (2026, March 24).

SANTA FE, N.M. (AP) — A New Mexico jury found Tuesday that social media conglomerate Meta is harmful to children's mental health and in violation of state consumer protection law.

The landmark decision comes after a nearly seven-week trial. Jurors sided with state prosecutors who argued that Meta — which owns Instagram, Facebook and WhatsApp — prioritized profits over safety. The jury determined Meta violated parts of the state's Unfair Practices Act on accusations the company hid what it knew about about the dangers of child sexual exploitation on its platforms and impacts on child mental health.

The jury agreed with allegations that Meta made false or misleading statements and also agreed that Meta engaged in "unconscionable" trade practices that unfairly took advantage of the vulnerabilities of and inexperience of children.

Jurors found there were thousands of violations, each counting separately toward a penalty of $375 million.

Attorneys for Meta said the company discloses risks and makes efforts to weed out harmful content and experiences, while acknowledging that some bad material gets through its safety net.

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A New Mexico jury ruled that Meta's platforms harmed children's mental health and violated state consumer protection law. After a seven-week trial, jurors found Meta prioritized profits over safety, made misleading statements, and exploited children's vulnerabilities — tallying thousands of violations worth $375 million in potential penalties. The verdict is part of a broader legal reckoning, with 40+ state attorneys general filing similar suits and a parallel federal case underway in California.

When corporations place profits above people, it's never the shareholders who pay the price. There have been multiple articles about Meta's harmful business practices.

No Psychologist is an Island: Building Ethical Strength Through Community

Gavazzi, J., & Fingerhut, R. (2026, March).

Psychotherapy Bulletin, 61(2).

This article argues that ethical practice and professional competence are sustained by community, not individual effort alone. It advocates for a deliberate shift toward a "competence constellation" model, where psychologists build diverse support networks of peers, mentors, and consultants. This proactive, community-based approach is essential to navigate ethical dilemmas, correct for clinical blind spots and biases, and manage personal challenges that affect practice. By fostering collective accountability and shared wisdom, this framework supports practitioner well-being, reduces isolation and moral distress, and ultimately enhances the quality and ethical rigor of client care.

Here is how the article starts:

Professions exist as shared communities, not collections of isolated practitioners. Each profession is defined by its specialized work and the standards it upholds, including ethical codes, shared values, and professional norms. Psychology, like other professions, is grounded in a shared ethics code, specialized expertise, and a commitment to public service. These core elements are dynamic and continuously refined through ongoing professional activities, such as research, consultation, mentorship, continuing education, and peer collaboration. Through these interactions, psychologists develop a collective professional identity and reinforce ethical obligations that extend beyond individual practice. This collaborative foundation helps ensure that psychological practice remains competent, ethically rigorous, and responsive to the needs of both clients and society.

The article is here.