ArticleFrontiers in digital health2021
Is the Automation of Digital Mental Health Ethical? Applying an Ethical Framework to Chatbots for Cognitive Behaviour Therapy.
Article in Frontiers in digital health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- "First, do no harm" in the digital era: examining the practicality of the European Health Data Space proposal and ethical implications of artificial intelligence: A systematic literature review.BMC medical ethics · 2026Pooled it
- Does the Digital Therapeutic Alliance Exist? Integrative Review.JMIR mental health · 2025Pooled it
- How Far Can Conversational Agents Contribute to IBD Patient Health Care-A Review of the Literature.Frontiers in public health · 2022Pooled it
- Cost Utility Analysis of Internet-Based Cognitive Behavioral Therapy for Major Depressive Disorder: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Artificial Intelligence Applications in Mental Health: A Systematic Review of Clinical Practice, Educational Transformation, and Ethical Governance.Healthcare (Basel, Switzerland) · 2026Review
- Why sycophantic LLMs may imperil interactive norms between humans.Communications psychology · 2026Review
- Conversational AI and Personal Growth: Insights from a Critical Integrative Review.Behavioral sciences (Basel, Switzerland) · 2026Review
- Behavior Emotion Therapy System and You: Co-Design and Evaluation of a Mental Health Chatbot and Digital Human for Mild to Moderate Anxiety in Healthy Participants.JMIR formative research · 2025Article
- A Scoping Review of AI-Driven Digital Interventions in Mental Health Care: Mapping Applications Across Screening, Support, Monitoring, Prevention, and Clinical Education.Healthcare (Basel, Switzerland) · 2025Review
- AI as the Therapist: Student Insights on the Challenges of Using Generative AI for School Mental Health Frameworks.Behavioral sciences (Basel, Switzerland) · 2025Article
- Exploring the Ethical Challenges of Conversational AI in Mental Health Care: Scoping Review.JMIR mental health · 2025Article
- The externalization of internal experiences in psychotherapy through generative artificial intelligence: a theoretical, clinical, and ethical analysis.Frontiers in digital health · 2025Article
- Generative multimodal large language models in mental health care: Applications, opportunities, and challenges.PLOS mental health · 2025Review
- Keeping an AI on the mental health of vulnerable populations: reflections on the potential for participatory injustice.AI and ethics · 2025Article
- Development, Acceptability and Engagement with the Mind Tutor: Lessons Learned from Testing a Novel Digital Application for First Year UK Undergraduate Student Wellbeing.Psychological studies · 2025Article
- Personalised care, youth mental health, and digital technology: A value sensitive design perspective and framework.Ethics and information technology · 2025Article
- Effectiveness of a Mental Health Chatbot for People With Chronic Diseases: Randomized Controlled Trial.JMIR formative research · 2024Article
- The now and future of ChatGPT and GPT in psychiatry.Psychiatry and clinical neurosciences · 2023Review
- Wearable Technologies and Stress: Toward an Ethically Grounded Approach.International journal of environmental research and public health · 2023Article
- GISSA intelligent chatbot experience - How effective was the interaction between pregnant women and a chatbot during the COVID-19 pandemic?Procedia computer science · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The COVID-19 pandemic has intensified the need for mental health support across the whole spectrum of the population. Where global demand outweighs the supply of mental health services, established interventions such as cognitive behavioural therapy (CBT) have been adapted from traditional face-to-face interaction to technology-assisted formats. One such notable development is the emergence of Artificially Intelligent (AI) conversational agents for psychotherapy. Pre-pandemic, these adaptations had demonstrated some positive results; but they also generated debate due to a number of ethical and societal challenges. This article commences with a critical overview of both positive and negative aspects concerning the role of AI-CBT in its present form. Thereafter, an ethical framework is applied with reference to the themes of (1) beneficence, (2) non-maleficence, (3) autonomy, (4) justice, and (5) explicability. These themes are then discussed in terms of practical recommendations for future developments. Although automated versions of therapeutic support may be of appeal during times of global crises, ethical thinking should be at the core of AI-CBT design, in addition to guiding research, policy, and real-world implementation as the world considers post-COVID-19 society.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.