ABSTRACT Background Psychological assessment is not only a diagnostic procedure but also a clinical process that can influence clients' self‐understanding and their subsequent engagement in treatment. Despite this potential, validated instruments assessing clients' subjective experiences during psychological assessment remain scarce. Objective We evaluated the psychometric properties of the Italian version of the Assessment Questionnaire (AQ‐I), a measure originally designed to capture clients' experiential and relational responses to psychological assessment. Method In Study 1 ( N = 246), adults who had undergone a psychological assessment completed the Italian translation of the original AQ along with measures of satisfaction, usefulness and assessment‐related experiences. Confirmatory and exploratory factor analyses were conducted to evaluate factorial structure and reliability, and construct validity was examined through associations with assessment‐related variables. Study 2 ( N = 124) examined the structural replicability of the resulting four‐factor structure of the AQ‐I using a simulated assessment design and further tested construct validity. Results The AQ‐I demonstrated strong internal consistency (ω = 0.86–0.91) and a four‐factor structure reflecting New Self‐Awareness/Understanding, Self‐Enhancement, Positive Relationship with the Assessor and Feeling Hurt by the Assessment. AQ‐I scores showed moderate to strong associations with the help received, perceived usefulness, satisfaction with the information received and overall satisfaction with the assessment. Participants assessed in private settings or by a single professional reported more positive experiences than those assessed in public services or by multiple assessors, and participants assigned to warm, accurate and empathic assessments reported higher scores on the AQ‐I than those of less collaborative assessments. Conclusions Findings provide initial support for the AQ‐I as a reliable and valid measure for assessing clients' experiences of psychological assessment, representing a promising tool for future research on therapeutic mechanisms and assessment‐based interventions.
ABSTRACT Introduction Rapidly changing societies need counsellors capable of working effectively with individuals from diverse cultural backgrounds. However, multicultural and social justice topics in counsellor education are often scarce and mainly theoretical. There is limited understanding of how ongoing, practice‐focused inclusive training influences trainees' attitudes and skills. This research investigated the impact of inclusive teaching methods on counselling trainees' multicultural perspectives, perceived abilities and social justice views, as well as how trainees perceive and experience this learning process. Methods An explanatory sequential mixed‐methods approach was used. Over 10 weeks, a comprehensive training programme was conducted with 26 counselling trainees at a state university in Türkiye. The quantitative phase involved a pre‐/post‐test design with a single group, utilising the Multicultural Attitude Scale for Psychological Counsellors, the Social Justice Scale and the Cultural Acceptance component of the School Counsellor Self Efficacy Scale. Data analysis included paired‐samples t ‐tests and Wilcoxon signed‐rank tests. For the qualitative phase, semi‐structured interviews were examined through thematic content analysis. Results Post‐test scores were notably higher than pre‐test scores in areas such as multicultural attitudes ( t (25) = 3.43, p < 0.05), social justice ( Z = −2.57, p < 0.05) and cultural acceptance self‐efficacy ( Z = −2.65, p < 0.05). The interview results detailed these improvements, indicating increased cultural sensitivity, heightened awareness of systemic inequality and a greater willingness to advocate. Conclusion Inclusive practices enhance both the attitudes and skills essential for culturally responsive counselling, serving as teaching models for key therapeutic abilities. Counsellor training should incorporate inclusive, practice‐focused content that equips students to effectively work with clients from diverse backgrounds.
ABSTRACT Background The therapeutic alliance in psychotherapy is associated with clinical outcomes in borderline personality disorder (BPD). However, while psychotherapy training programmes vary in their inclusion of experiential components, structured and systematic training in alliance rupture recognition and repair specifically tailored to the relational demands of BPD treatment remains limited. Accordingly, strengthening alliance‐focused skills in BPD‐specific psychotherapy training is essential. Deliberate practice has emerged as a promising approach for enhancing psychotherapy skill acquisition, yet its application to alliance‐focused training in BPD contexts has not been empirically explored. The present study aims to investigate the efficacy of alliance‐focused‐DBT training (AF‐DBTT), a novel therapist training intervention integrating principles from alliance‐focused training (AFT) and dialectical behaviour therapy (DBT) to develop therapists' abilities to recognise and respond to alliance ruptures in BPD treatments. The secondary objective is to compare the effectiveness of deliberate practice versus reflective practice homework on alliance‐focused skills acquisition. A third objective is to explore whether therapist characteristics moderate the relationship between training and outcome. Methods A pilot randomised controlled trial will be conducted with N = 84 trainees randomised to one of two conditions: AF‐DBTT + reflective practice homework or AF‐DBTT + deliberate practice homework. All trainees will attend four, weekly synchronous online training sessions. The primary outcome is pre‐post change in facilitative interpersonal skills, which will be measured by the facilitative interpersonal skills task. Secondary outcomes include emotion recognition and alliance rupture recognition. Baseline therapist characteristics including empathy, intellectual humility, emotional reactivity and emotion regulation will also be assessed as potential moderators of the training intervention. Acceptability and feasibility of the training intervention will also be assessed. Discussion Results from this study will provide future directions for the improvement of psychotherapy training and practice in BPD treatments.
ABSTRACT Objective Session frequency has long been recognised as an important factor in psychotherapy effectiveness. Yet patients' experiences of different session frequencies have been barely explored, and transitions between frequencies even less so. In light of this research gap, we examined the experience of transitioning between session frequencies in adult patients who switched from once‐weekly to twice‐weekly or fortnightly therapy, and vice versa. Method Twenty‐six patients who had experienced a change in session frequency participated in semi‐structured interviews. Their narratives were analysed using thematic analysis, allowing for the identification of recurring patterns and themes in their experiences. Results Three main themes emerged from the data: Process before the transition, Adjustment to the transition and Aftermath of the transition. Participants transitioned for a wide range of reasons. Transitions were preceded by deep contemplation. The transition often led participants into a period of self‐reflection, marked by various struggles. Once the new session frequency was cemented, participants described the widespread impact of the transition on their therapy experience, relationship with the therapist, daily life and behaviour between sessions. Conclusions Session frequency transitions were significant experiences for patients, greatly influencing many aspects of their self‐perception and treatment experience, underscoring the importance of therapists proactively addressing the meaning patients assign to such changes.
ABSTRACT Introduction Many mental health practitioners train in multiple psychotherapy modalities throughout their careers. However, research has largely ignored how prior training in one modality affects the learning of a new one. This gap leaves us with a limited understanding of how practitioners with prior training in other modalities experience learning a new psychotherapy modality and how to design and deliver training that optimises learning in light of prior training. Therefore, this qualitative study investigated how practitioners' prior training influenced their initial experience of learning a new psychotherapy modality, Mentalization‐Based Therapy (MBT) for children. Methods Semi‐structured interviews were conducted with 11 practitioners with prior professional training in other modalities to explore their early experience of learning MBT and how prior training influenced this process. Interviews were analysed using Reflexive Thematic Analysis (RTA). Results The analysis produced three themes related to the role of prior professional training: (1) seeing MBT through the lens of prior therapeutic knowledge; (2) prior training shapes what is experienced as difficult; and (3) recalibrating prior therapeutic knowledge through guided practice. Discussion Learning a new therapy modality is an active process of reorganising previous therapeutic knowledge. Previous training functions as both a resource and a source of challenge, depending on the degree of alignment between existing and new therapy modalities. Training programmes should therefore explicitly engage with practitioners' prior therapeutic knowledge and skills to support learning of a new modality.
ABSTRACT Background Should psychotherapists use swear words during sessions? How might such language affect the way therapists are perceived? Method In this empirical analog study, participants ( n = 188) read original vignettes of a therapist‐client interaction and then completed a questionnaire assessing perception of the therapist. The vignettes differed in terms of swearing presence/sequence and gender of the therapist. Results Results produced no significant main effects for therapist gender or swearing presence/sequence. Conclusions Results suggest that therapists may not need to filter out swear words during sessions to obtain or preserve clients’ favorable perceptions. Limitations and future directions are discussed.
ABSTRACT Background As artificial intelligence (AI) continues to advance, its integration into mental healthcare offers both promise and uncertainty. Digital therapists have shown effectiveness in reducing symptoms of anxiety and depression, yet scepticism remains about AI's ability to provide human‐like empathy and authenticity. Aims This study aims to assess whether participant perceptions differ based on whether a therapist is described as AI generated or human. Materials and Methods Participants ( N = 300) listened to two therapist audio recordings identical in content and both from a human therapist. However, in one of these recordings the therapist was identified as AI generated; in the other recording the therapist was identified as human. After listening to each recording, participants evaluated therapist empathy, perceived credibility of treatment and expectation for treatment success. Results Analysis revealed that participants judged therapists labelled as human more positively across all measures. Although the results did not vary reliably as a function of therapist sex, prior therapy experiences moderated perceptions when considered alongside therapist sex. Discussion and Conclusion These findings suggest that the belief that the therapist is AI results in less favourable perceptions even when actual therapy content is identical, revealing ongoing challenges for the acceptance of artificial intelligence within the field of psychotherapy.
ABSTRACT Objectives Therapeutic agency refers to the client's perception of oneself as a proactive agent of change. This study aimed to translate and validate the Therapeutic Agency Inventory (TAI) in a Korean sample. Method Two independent samples ( N = 330 and 339, respectively) of Korean college students were obtained. Study 1 conducted exploratory factor analysis to examine the underlying structure of the Korean version of the TAI (K‐TAI). Study 2 used confirmatory factor analysis to validate its factor structure. Additional analyses tested reliability, convergent and discriminant validity and predictive validity of counselling goal attainment. Results The findings supported a 3‐factor 11‐item structure that was largely consistent with the original instrument, with minor cultural adaptations. The K‐TAI demonstrated acceptable reliability and validity. Furthermore, the inventory significantly explained additional variance in counselling outcomes beyond working alliance. Conclusions The K‐TAI is a psychometrically sound instrument for assessing client agency for Korean populations, contributing to a better understanding of therapeutic change mechanisms in a non‐Western sample.
ABSTRACT Objectives This study examined therapist–client physiological synchronisation, indexed by heart rate variability (HRV), in meditation versus emotionally supportive sessions (control condition) and its association with clients' affective evaluations. Methods This was a randomised experimental study. Participants were assigned to a meditation session ( n = 20) or an emotional support session ( n = 20). HRV was assessed at baseline and post‐session; an additional mid‐session HRV assessment was obtained in the meditation condition immediately following the meditation segment. Clients reported positive and negative affect and evaluated the session. Results No significant therapist–client HRV correlations were observed at baseline or at the end of the session in either condition. However, in the meditation condition, changes in therapists' HRV from baseline to mid‐session and from baseline to post‐session were associated with clients' affective evaluations, whereas no such associations emerged in the control condition. Finally, a factor analysis revealed two non‐coherent factors of therapists' and clients' HRV before and after the session in controls, and a single factor including all HRV measures of therapists and clients in the meditation condition. Conclusions Therapist autonomic regulation during meditation may relate to clients' immediate emotional experience. Further research using longitudinal and dynamic designs is needed to clarify mechanisms of physiological synchronisation in psychotherapy.
ABSTRACT Aim The current study examined the effects of the person‐centred intervention ‘ Listen to Me, Teacher ’ on primary school teachers' self‐esteem, self‐efficacy and self‐acceptance in Greece. Grounded in Carl Rogers’ theoretical framework, the intervention aimed to enhance self‐esteem, self‐efficacy and self‐acceptance—dimensions associated with teachers’ personal growth and professional functioning. Method A quasi‐experimental design was implemented with 281 teachers (intervention group: n = 140; control group: n = 141). The 12 experiential sessions (31 h in total) were delivered face to face during the pilot phase and online thereafter. Data were collected at three time points (pre‐, post‐ and 3‐month follow‐up) using validated self‐report instruments. Results Mixed‐design ANOVAs revealed significant group × time interactions across all variables, with the intervention group demonstrating sustained improvements. Conclusions The findings highlight the potential of person‐centred, experiential approaches grounded in authenticity, empathy and unconditional positive regard to develop teachers' self‐esteem, self‐efficacy and self‐acceptance, with potential implications for the development of supportive, trust‐based school environments.
ABSTRACT Introduction Practitioners implementing Routine Outcome Measures (ROMs) and Clinical Feedback Systems (CFS) in counselling and psychotherapy commonly encounter challenges due to the complex nature of therapeutic practice contexts. Healthcare systems have increasingly adopted ROM driven by policy demands for accountability, quality improvement and evidence‐based practice. Studies indicate the need for a comprehensive scoping review to fully elucidate the experiences of effective ROM, thereby bridging the gap between research evidence and the numerous contextual factors influencing real‐world adoption. Objectives This research aimed to inform guidelines by identifying the evidence for ROM/CFS effectiveness, clarifying key implementation factors, examining lived experiences of clients, practitioners and other stakeholders' perspectives. The study also aimed to gain insights into how research is conducted across diverse contexts and modalities, and identify gaps in knowledge regarding barriers and facilitators to successful adoption. Method A five‐stage scoping review protocol was operationalised to explore and analyse the existing literature and associated implementation factors by (a) identifying the research questions using the PICOT framework, (b) identifying the relevant literature through systematic database searches, (c) selecting the studies through four‐phase consensus screening, (d) charting the data using structured extraction methods and (e) collating, summarising, and reporting the results through narrative synthesis. Results The findings highlight the need for culturally responsive approaches, the development of organisationally informed strategies for ROM adoption and reveal significant gaps in research regarding the optimal integration across diverse therapeutic contexts. Conclusion The findings support the proposal of evidence‐based ROM frameworks and key themes for future research, including culturally informed approaches, organisational leadership development, digital equity considerations and therapeutic process integration, moving away from purely compliance‐based mandates toward contextually responsive, engagement‐focused implementation strategies.
ABSTRACT Background Autistic children and adults commonly experience co‐occurring mental health conditions. It is critical that we understand key therapeutic factors that promote positive therapy outcomes for autistic individuals. Prior research suggests that therapeutic alliance (TA) positively impacts psychotherapeutic outcomes, but most has been conducted with allistic populations. This scoping review broadly aimed to synthesise emerging research on TA for autistic individuals and identify gaps in the literature about TA for autistic individuals. Methods PRISMA scoping review guidelines were followed. A literature search conducted in January 2025 resulted in n = 15 studies meeting inclusion criteria. Studies included n = 657 autistic individuals aged 7–77 years. Results Findings supported the reliability of some standardised tools (e.g., TASC‐R , TPOCS‐A ) for measuring TA for autistic youth. No identified studies used standardised tools to assess TA for autistic adults older than 21 years of age. TA was positively associated with psychotherapeutic outcomes for autistic youth (e.g., greater reductions in anxiety symptoms) across most quantitative studies. Autistic children may be at risk for weaker TAs compared to allistic children. Some pretreatment child factors were identified that may be associated with TA (e.g., cognitive skills, emotional regulation, psychopathology) and several therapist characteristics were identified that may promote strong TAs for autistic adults based on qualitative findings (e.g., respect, autism knowledge, validation, providing structure and accommodations, self‐disclosure). Additional gaps in the literature are discussed. Conclusion TA can be reliably measured for autistic youth and appears to be connected to both pretreatment client factors and therapy outcomes, though additional work with more diverse samples is needed. Therapist behaviours and use of neuro‐affirming strategies can impact TA for autistic adults.
ABSTRACT Background Complex post‐traumatic stress disorder (CPTSD) is associated with significant relational, emotional and identity‐related difficulties, often rooted in prolonged interpersonal trauma. Despite increasing recognition of CPTSD, less is understood about how individuals experience accessing and engaging in psychotherapy, particularly within real‐world service contexts. This review synthesised qualitative research to develop a conceptual understanding of these experiences and the therapeutic journey from the perspective of those directly affected. Method Systematic searches across four databases identified 15 studies, representing the perspectives of 242 adults with CPTSD. A meta‐ethnographic approach was used to analyse and integrate findings, allowing for the development of higher‐order interpretations across studies. Results Three interconnected processes characterised participants' experiences of therapy. Establishing relational safety and trust was central to engagement and formed the foundation for therapeutic work. This enabled trauma processing and the development of coping strategies, often described as gradual and emotionally demanding. Over time, participants described increasing empowerment, self‐compassion and acceptance, alongside a growing capacity to make sense of their experiences. Recovery was experienced as cyclical rather than linear, with individuals revisiting earlier stages in response to new challenges and changing life circumstances. Conclusions Findings highlight the importance of relational, trauma‐informed and flexible approaches to psychotherapy. Improving access to specialist, consistent support and addressing systemic barriers remain essential to meeting the complex and evolving needs of people with CPTSD, particularly within stretched service systems.
ABSTRACT Objective Deliberate Practice (DP) is a promising approach to improve psychotherapy outcomes and skill acquisition. Based on theoretically derived core components of DP in psychotherapy, the aim of this study is to develop assessment instruments for measuring behaviours related to and attitudes towards DP. Method Two item sets were generated associated to DP's core components in psychotherapy and characteristics of DP. Two exploratory factor analyses were conducted to develop two scales (DP Behaviours [DPB] and DP Attitudes [DPA]). Data were collected from prospective psychotherapists in Germany ( N = 199). Furthermore, in a subsample ( N = 138) construct validity was tested using correlational analysis with convergent and discriminant constructs. Results The analysis supported a two‐factor structure ( activities and feedback and expert involvement ) for and construct validity of the DPB scale, indicating associations in expected directions. For the DPA scale, one factor emerged indicating a generalised attitude towards excellence and improvement. Construct validity was partially supported, with convergent correlations in expected directions, but inconsistencies regarding discriminant validity. Conclusion The scales developed in this study demonstrate potential for linking self‐assessments of DP to psychotherapy outcomes. Future research needs to consider the predictive validity of DP's core components in relation to psychotherapy outcomes and broader factors influencing DPB and DPA, such as a culture of excellence or trusting and healthy relationships with experts.
ABSTRACT Background and Aims The therapeutic relationship is a central component of psychotherapy and a well‐established predictor of treatment outcomes. However, despite extensive research in this area, the therapeutic relationship in psychological care for minority populations, particularly transgender clients, remains largely unexplored. This study aims to explore French psychologists' social representations of the therapeutic relationship with a transgender person. To do so, we relied on Abric's Central Core Theory as our theoretical framework. Methods The data were collected from a sample of 55 psychologists. We used prototypical analysis to identify the structuration of social representations and their central core element. Results Overall, psychologists view this relationship as grounded in empathic and compassionate listening, while emphasising the importance of alliance and respectful posture. Furthermore, the social representations appeared multidimensional. Notably, no elements appeared in the first periphery, suggesting a weak or insufficiently stabilised structuring of this concept. Conclusions These findings highlight the ongoing conceptual challenges in defining and operationalising the therapeutic relationship in this context, underscoring the need for more precise clinical guidelines and training to support work with stigmatised populations, in particular transgender clients.
ABSTRACT Background Self‐Practice/Self‐Reflection (SP/SR) has increasingly been recognised as a means of fostering therapists' personal and professional development. However, little is known about how mindfulness‐based SP/SR may support the cultivation of psychological flexibility (PF)—the capacity to remain open, present and engaged with difficult internal experiences while pursuing valued action—within therapeutic practice. Method This single‐case autoethnographic study explored the author's experience of engaging in mindfulness‐based SP/SR informed by principles of Acceptance and Commitment Therapy (ACT). The SP/SR process was conducted over 6 months using an ACT SP/SR workbook as a structured framework, supplemented by mindfulness notes, supervision reflections, and pre‐ and post‐AAQ‐II reflective entries. Reflexive thematic analysis was conducted on these materials, with the AAQ‐II used as a structured prompt for experiential and reflexive inquiry rather than as an outcome measure of psychological change. The analytic process followed a values‐based reporting framework, with co‐authors' feedback used to enhance reflexive rigour. Results Three themes were generated: (1) integrating personal values into therapeutic intentions, (2) recognising cultural and relational influences on identity and (3) expanding mindfulness as an embodied stance within clinical and personal contexts. Reflections on the AAQ‐II material suggested subtle shifts in PF, which were interpreted qualitatively rather than as evidence of measurable change. These findings are idiographic and illustrate one possible trajectory of SP/SR, offering insight rather than claims of transferability. Conclusions The findings suggest that mindfulness‐based SP/SR may support therapists' self‐awareness, relational understanding and professional grounding. Practical implications include attending to culturally informed values within ACT‐based reflection, incorporating compassion‐ and mindfulness‐informed exercises into therapist development, and embedding SP/SR within supervision to foster authenticity and therapeutic presence. Future research involving diverse samples and multi‐participant SP/SR designs may further clarify how personal practice influences therapist competencies across cultural contexts.
ABSTRACT Case Presentation This case study describes the therapeutic process with a 14 year‐old adolescent girl (‘Mary’) in residential care who presented depressive symptoms, suicidal ideation and non‐suicidal self‐injury. Early sessions revealed rigid and problem‐saturated narratives centred on abandonment, rejection and guilt. Therapeutic Intervention We illustrate how the Co‐Construction Life Narrative Interview with Adolescent (CLNIA; created by the authors, MA and MRH), an innovative narrative tool, was articulated with the Cognitive Narrative Therapy (CNT) to integrate the adverse experiences and support identity construction. CNT encourages the creation of new meanings for the lived experiences and the construction of narratives that are coherent, complex and multifaceted. Therapeutic Outcomes Throughout therapy, Mary showed significant improvements, including a decrease in non‐suicidal self‐injury, re‐engagement in leisure activities and strengthening of interpersonal relationships. She increasingly demonstrated authorship over her life story, empowering herself to deal with challenges and gaining renewed motivation towards life. Discussion and Clinical Implications We discuss how CLNIA informed the following intervention plan using CNT and gave support and guidance for the further narrative work. We also discuss the therapeutic utility of CNT for identity exploration in adolescence. Finally, we highlight the potential of combining CNT with CLNIA to support adolescents to move from adverse experiences and traumatic narratives, and foster more creative, flexible and adaptive life narratives.
ABSTRACT Introduction This scoping review explores the therapeutic use of collaborative writing in psychotherapeutic settings, focusing on three key concepts: collaborative writing, collaboration and reflexivity. The review investigates therapist‐client positioning, modes of collaboration and reflexivity, methods for analysing co‐produced texts and strategies for sharing results and managing disagreements. Aim The aims are to explore how collaborative writing functions as a collaborative practice within therapeutic relationships, to identify specific modes of reflexivity, to highlight the methodological approaches used to interpret co‐produced texts and to examine how disagreement is recognised and managed within collaborative writing practices. Method The scoping review was conducted in accordance with the PRISMA 2020 guidelines. After applying the inclusion and exclusion criteria, a reflexive thematic analysis was conducted on the twelve papers that met the eligibility criteria. This method was specifically applied to articles that explicitly examined co‐writing between therapists and clients in psychotherapeutic contexts. Findings Overall, collaborative writing emerges as a promising relational and meaning‐making intervention in psychotherapy and mental health services. It fosters a relational and collaborative approach, reconfiguring the power dynamics between therapist and client to create a more equal, shared process of meaning‐making. Conclusion This literature review provides an initial overview of the work and encourages scholars to consider how the collaborative writing approach can be applied in psychotherapeutic settings in future studies. Therapists are required to have relational and dialogical skills to manage disagreements, build solid collaborations and engage in shared reflection with patients. Mental health services should support contexts that encourage experimentation with co‐writing and provide spaces for joint reflection, thereby reducing power dynamics and promoting greater patient participation.
ABSTRACT Objective This exploratory multi‐case process study described within‐session emotional sequencing in Emotion‐Focused Therapy (EFT) with a Korean clinical research sample using the Classification of Affective‐Meaning States (CAMS) mapped onto the Sequential Model of Emotional Processing (SMEP). We focused on clinically interpretable nonlinearity patterns and the timing of first adaptive‐state emergence. Method Ten adults completed 12–19 sessions (148 sessions total). All sessions were observationally CAMS coded and mapped onto SMEP. We summarised fixation and recurrent return patterns and described time to first adaptive state as temporal context, defined as the session number from treatment onset in which Grief/Hurt, Assertive Anger, Self‐Compassion or Acceptance and Agency first appeared. Results Canonical SMEP dialectical cycles were observed but were commonly embedded within broader recurrent return patterns among early distress and evaluative states. The first adaptive state appeared at a median of Session 8.5. Chair work occurred in all cases and was first introduced between Sessions 3 and 11. Depressive symptoms and perceived stress decreased from pre‐treatment to post‐treatment on the CES‐D and K‐PSS‐11. Conclusions Findings are hypothesis‐generating and provide descriptive process markers for locating stalls and tracking adaptive‐state emergence in clinical practice, without implying causal effects of specific tasks or timing.
The growing prevalence of psychological distress worldwide has drawn attention to the limitations of conventional mental health care systems, particularly in terms of accessibility, affordability and social stigma. Artificial intelligence (AI)–driven chatbots are emerging as digital tools capable of extending mental health support beyond traditional clinical environments. This review examines existing literature on AI‐powered mental health chatbots, focusing on systems that utilise natural language processing and established psychological frameworks such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and mindfulness‐based approaches. AI‐driven chatbots facilitate emotional expression, provide round‐the‐clock availability and enable anonymous interactions, making them especially useful for individuals who are reluctant or unable to seek conventional therapy. Despite these advantages, concerns remain regarding limitations in empathy, data privacy, contextual awareness and clinical accountability. AI‐powered mental health chatbots hold significant potential to enhance access to mental health support; however, their meaningful and responsible integration into mental health care requires interdisciplinary collaboration, ethical design practices and careful alignment with human‐centred care to ensure safe, inclusive and trustworthy mental health ecosystems.
