Computational and ethical considerations for using large language models in psychotherapy

Large language models (LLMs) hold great potential for augmenting psychotherapy by enhancing accessibility, personalization and engagement. However, a systematic understanding of the roles that LLMs can play in psychotherapy remains underexplored. In this Perspective, we propose a taxonomy of LLM roles in psychotherapy that delineates six specific roles of LLMs across two key dimensions: artificial intelligence autonomy and emotional engagement. We discuss key computational and ethical challenges, such as emotion recognition, memory retention, privacy and emotional dependency, and offer recommendations to address these challenges.