Human Therapists Outperform ChatGPT in Providing Cognitive Behavioral Therapy

Recent research presented at the American Psychiatric Association's Annual Meeting on May 17, 2025, has shed light on the differences between human and AI-delivered cognitive behavioral therapy (CBT). The study compared the effectiveness of traditional human therapists with an AI chatbot, specifically ChatGPT-3.5, in delivering text-based CBT sessions.

The study involved 75 mental health professionals and trainees who participated in a cross-sectional survey. They assessed two CBT transcripts—one from a human therapist and another from the AI—using the well-established Cognitive Therapy Rating Scale. Participants provided qualitative feedback and rated each transcript based on key CBT elements such as agenda-setting, which involves listing tasks to be completed during therapy, and guided discovery, which helps patients analyze their own life data to gain self-awareness.

Results indicated that 29% of participants rated human therapists as highly effective, compared to fewer than 10% who believed the AI met the same standard. In terms of specific skills, 52% of respondents rated human therapists highest in agenda-setting, while only 28% rated the AI similarly. For guided discovery, 24% scored the human therapist highly, whereas just 12% gave the AI the same rating.

Despite the AI’s ability to understand patients’ internal experiences similarly to humans, it was often perceived as more rigid and impersonal. Researchers concluded that while AI-based therapy shows promise for supporting mental health interventions, it should not replace human therapists but rather serve as an adjunct tool.

Esha Aneja, a member of the research team, emphasized that although ChatGPT-3.5 can apply basic structure elements of therapy, it currently lacks the nuanced empathy and therapeutic alliance that are critical for effective therapy. As such, current AI therapy is not suitable for standalone treatment but can complement human-delivered CBT.

This research underscores the ongoing need for human connection and empathy in mental health treatment, highlighting that AI technologies are best utilized to support, not replace, professional therapists.