LHO

The Ledger · Entry 109 · Care

Conducting a talking therapy

ContestedSince 2025Criterion performanceLast reviewed 2026-08-17

Event

On 27 March 2025 NEJM AI published the first randomised trial of a generative artificial intelligence therapy chatbot: 210 adults, four weeks of Therabot against a waiting list, with symptom reductions of 51 percent for depression and 31 percent for anxiety.

The comparison was a waiting list, not another therapist, so the trial shows that something worked, not that it matched a clinician. Therabot is a supervised research prototype that was never released, the research team read the conversations and was ready to step in, and the authors say plainly that no generative agent is ready to work unsupervised in mental health, where the range of dangerous situations is wide. The finding that unsettles people is a different one: participants rated their working alliance with the program at levels reported for human therapists. Holding the risk of a suicidal patient, and being a person who can be held to account for that risk, was not tested and could not be.