AI-enabled therapy platforms: Clinical promise, ethical challenges, and cultural considerations in mental health Care

The integration of artificial intelligence (AI) into mental health care presents significant opportunities to address gaps in access, affordability, and scalability, particularly in resource-constrained settings such as India. AI-enabled therapy platforms, including conversational agents and virtual therapists, promise personalized and continuous psychological support. However, alongside these clinical advantages, critical ethical and contextual challenges emerge, including concerns related to diagnostic validity, data privacy, informed consent, therapeutic alliance, and cultural misalignment. This narrative review critically synthesizes contemporary global and regional literature (2019-2025) to examine the clinical potential, ethical risks, and cultural implications of AI-driven psychotherapy. Drawing on a psychologist-centered perspective, the review emphasizes the necessity of rigorous validation, transparent governance, culturally adaptive design, and a collaborative therapist-AI model rather than full automation. Particular attention is given to the Indian sociocultural context, where mental health experiences are deeply embedded in relational, linguistic, and indigenous psychological frameworks. The review argues that ethically grounded and culturally informed AI-enabled therapy platforms can enhance mental health service delivery when integrated as adjunctive tools within professional care systems. By situating AI innovation within India's pluralistic psychological landscape, this paper offers a context-sensitive, evidence-informed set of recommendations for responsible and clinically meaningful AI integration in mental health care.