Transformations, Applications, and Ethics of the AI-Supported Counseling Process
DOI:
https://doi.org/10.59759/educational.v5i3.2181Keywords:
Counseling Process, Artificial Intelligence, Artificial Intelligence Application, Ethical Standards.Abstract
The twenty-first century is characterized by a growing gap between the need for psychological counseling services and their limited availability, due to a shortage of qualified personnel, high costs, and social stigma. This study, through a narrative literature review of studies and research published between (2022 and 2026), aimed to analyze the impact of artificial intelligence on the counseling process in three themes: the transformation of the counseling process, its applications, and ethical considerations. The results revealed that chatbots, large language models, and digital mental health applications are redefining and expanding the scope of counseling practice, but they are accompanied by ethical challenges related to privacy, algorithmic bias, and the authenticity of the counseling relationship. The study concluded that there is a need to develop hybrid counseling models and renewed ethical frameworks that ensure the human presence of the counselor and the empathy and trust they provide in the counseling process.
Downloads
References
حسين، مها، السرحان، فايق. (2025). الإرشاد النفسي والتربوي في ضوء تطبيقات الذكاء الاصطناعي المعززة للرفاهية الرقمية (مراجعة ممنهجة). مجلة كلية التربية الأساسية للعلوم التربوية والإنسانية. 68 (17): 582-605.
المضحي، حفصة، البقمي، براءة، الحربي، نجود، المطيري، مريم، عزب، نوف. (2025). استخدامات الذكاء الاصطناعي في مجال التوجيه والإرشاد النفسي: دراسة تحليلية، مجلة العلوم التربوية والنفسية. 9 (12): 118-9.
https://doi.org/10.26389/AJSRP.D170625
حمدان، حلمي. (2024). توظيف الذكاء الاصطناعي والمنصات الإلكترونية التفاعلية في تصميم أنشطة الإرشاد والتوجيه. مجلة سلوك. 11 (1): 62-44.
مصطفى، صفاء. (2024). أثر استخدام تطبيقات الذكاء الاصطناعي في تحسين عملية الإرشاد النفسي لعينة من المعلمين بإدارة دسوق التعليمية. المجلة العربية للآداب والدراسات الإنسانية. 1: 195-234.
Aggarwal, A., Tam, C., Wu, D., Li, X., and Qiao, S. (2023). Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. J Med Internet Res, 24;25:e40789.
Aktan, M., Turhan, Z. and Dolu, I. (2022). Attitude and perspectives towards the preference for artificial intelligence in psychotherapy. Computers in Human Behavior, ELSEVIR, 133:
https://doi.org/10.1016/j.chb.2022.107273
Ali, M., Ali, S., Abbas, Q., Abbas, Z., and Lee, SW. (2025). Artificial intelligence for mental health: A narrative review of applications, challenges, and future directions in digital health. Digit Health, 17; https://doi.org/10.1177/20552076251395548
American Psychological Association. (2023). Informing the Role of Congress in Artificial Intelligence Regulation. APA Services. https://www.apaservices.org/advocacy/news/congress-artificial-intelligence-regulation
Beg, M., Verma, M., Verma, M., and Vishvak, M. (2025). Artificial Intelligence for Psychotherapy: A Review of the Current State and Future Directions. Indian Journal of Psychological Medicine, 47(4):314-325. https://doi.org/10.1177/02537176241260819
Békés, V., and Aafjes-van Doorn, K. (2020). Psychotherapists’ attitudes toward online therapy during the COVID-19 pandemic. Journal of Psychotherapy Integration, 30 (2): 238–247.
https://doi.org/10.1037/int0000214
Bloch-Atefi, A. (2025). Balancing Ethics and Opportunities: The role of AI in psychotherapy and counselling. Psychotherapy and Counselling Journal of Australia, 13 (1). https://doi.org/10.59158/001c.129884
Borges, L., Kumaraswamy, A., Ponnusamy, S., Gopalsamy, R., and Madavanakadu, D. (2025). Artificial intelligence (AI) in psychological counseling: a double-edged sword demanding ethical precision. EXCLI Journal, 5 (24):1478-1481. https://doi.org/10.17179/excli2025-8737
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Chen, J., Yuan, D., Dong, R., Cai, J., Ai, Z and Zhou, S. (2024). Artificial intelligence significantly facilitates development in the mental health of college students: a bibliometric analysis. Front. Psychol, 15:
https://doi.org/10.3389/fpsyg.2024.1375294
Cruz-Gonzalez, P., He, A., Lam, E., Ng, I., Li, M., Hou, R., Chan, J., Sahni, Y., Guasch, N., Miller, T., Lau, B. and Vidaña, D. (2025). Artificial intelligence in mental health care: A systematic review of diagnosis, monitoring, and intervention applications. Psychol Med, 55:e18. https://doi.org/10.1017/S0033291724003295
Erdemir, N. and Sumbas, E. (2026). Integrating Artificial Intelligence into Psychological Counseling: A Narrative Review and Governance Framework. The Journal of Health Care Organization, Provision, and Financing, 63: 1-16. https://doi.org/10.1177/00469580261438322
Evangelou, D., Mulders, M., and Träg, K. (2026). Bot or Not? Differences in Cognitive Load Between Human- and Chatbot-Led Post-Simulation Debriefings. Education Sciences, 16(2), 255.
https://doi.org/10.3390/educsci16020255
Fiske, A., Henningsen, P., and Buyx, A. (2019). Your Robot Therapist Will See You Now: Ethical Implications of Embodied Artificial Intelligence in psychiatry, psychology, and psychotherapy. Journal of Medical Internet Research, 21 (5): https://doi.org/10.2196/13216
Fulmer R. (2023). Counseling and Artificial Intelligence: Forging a Path Forward. Journal of Technology in Counselor Education and Supervision, 4 (1): https://doi.org/10.61888/2692-4129.1092
Gardiner, H., and Mutebi, N. (2025). AI and mental healthcare: Ethical and regulatory considerations. UK Parliament. https://doi.org/10.58248/PN738
Graham, S., Depp, C., Lee, E., Nebeker, C., Tu, X., Kim, H., and Jeste, D. (2019). Artificial intelligence for mental health and mental illnesses: An overview. Curr Psychiatry Rep, 21(11):116.
https://doi.org/10.1007/s11920-019-1094-0
Gray, M., Baird, A., Sawyer, T., James, J., Debroux, T., Barlett, M., Krick, J. and Umoren, R. (2024). Increasing Realism and Variety of Virtual Patient Dialogues for Prenatal Counseling Education Through a Novel Application of ChatGPT: Exploratory Observational Study. JMIR Medical Education, 10: https://doi.org/10.2196/50705
Green, B., Johnson, C. and Adams, A. (2006). Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade. Journal of Chiropractic Medicine, 5 (3), 101–117. https://doi.org/10.1016/S0899-3467(07)60142-6
Guo, Z., Lai, A., Thygesen, J., Farrington, J., Keen, T., and Kezhi, L. (2024). Large language models for mental health: A systematic review. JMIR Ment Health, 11: https://doi.org/10.2196/57400
Haque, M. and Rubya, S. (2023). An Overview of Chatbot-Based Mobile Mental Health App Insights From App Description and User Reviews. JMIR Mhealth Uhealth, 11:https://doi.org/10.2196/44838
Habicht, J., Dina, L., McFadyen, J., Stylianou, M., Harper, R., Hauser, T., and Rollwage, M. (2025). Generative AI-Enabled Therapy Support Tool for Improved Clinical Outcomes and Patient Engagement in Group Therapy: Real-World Observational Study. J Med Internet Res, 27: https://doi.org/10.2196/60435
Hua, Y., Siddals, S., Ma, Z., Galatzer-Levy, I., Xia, W., Hau, C., Na, H., Flathers, M., Linardon, J., Ayubcha, C. and Torous, J. (2025). Charting the evolution of artificial intelligence mental health chatbots from rule-based systems to large language models: a systematic review. World Psychiatry, (3):383-394. https://doi.org/10.1002/wps.21352
Huang, W., Xing, Y., Zhao, F. and Wang, Y. (2026). Mobile apps, AI, and teletherapy: a comprehensive review of digital mental health tools for nurses. Front. Public Health, 13:
https://doi.org/10.3389/fpubh.2025.1686766
Iftikhar, Z., Xiao, A., Ransom, S., Huang, J., and Suresh, H. (2025). How LLM Counselors Violate Ethical Standards in Mental Health Practice: A Practitioner-Informed Framework. 8 (2): 1311-1323. Proceedings of the Eighth AAAI/ACM Conference on AI, Ethics, and Society, https://doi.org/10.1609/aies.v8i2.36632
Jaiswal, C., Jaiswal, L., Kalia, N., & Sharma, O. (2025). Artificial Intelligence in Counseling: Evaluating Its Strengths, Limitations, and Ethical Considerations in Indian Schools. International Journal of Science and Social Science Research, 2(4), 328-331.
https://www.ijsssr.com/index.php/j/article/view/359/330
Jeong, D., Lee, H., Yang, H., Park, J., and Lee, S. (2025). AI Integration in Counseling Training: Aiding counselors-in-Training in self-Efficacy Enhancement and Anxiety Reduction. Journal of Counseling Development, 103: 346-360. https://doi.org/10.1002/jcad.12560
Lawrence, H., Schneider, R., Rubin, S., Matarić, M., McDuff, D., and Bell, M. (2024). The Opportunities and Risks of Large Language Models in Mental health. JMIR Mental Health, (11): 11:
Lei, X. (2025). The Ethical Challenges of AI-based Mental Health Interventions: Toward a Layered Accountability Framework. Communications in Humanities Research, 81,169-177.
https://doi.org/10.54254/2753-7064/2025.HT26261
Ma, Y., Zeng, Y., Liu, T., Sun, R., Xiao, M., and Wang, J. (2024). Integrating large language models in mental health practice: a qualitative descriptive study based on expert interviews. Front Public Health, 12: https://doi.org/10.3389/fpubh.2024.1475867
Marliana, T., Osman, S. B., Agustin, D., Mawarni, E. S., Azija, I., Trigono, A., & Wahyuningrum, M. A. (2026). Development of Ethical Guidelines for AI-Assisted Educational Counseling Decisions. International Journal of Research in Counseling, 4(2), 147–156.
https://doi.org/10.70363/ijrc.v4i2.302
Meadi, M., Sillekens, T., Metselaar, S., Balkom, A., Bernstein, J. and Batelaan, N. (2025). Exploring the Ethical Challenges of Conversational AI in Mental Health Care: Scoping Review. JMIR Ment Health, 12: https://doi.org/10.2196/60432
Mohamed, S., Naqishbandi, T., Bukhari, S., Rauf, I., Sawrikar, V., and Hussain, A. (2023). A hybrid mental health prediction model using Support Vector Machine, Multilayer Perceptron, and Random Forest algorithms. Healthcare Analytics, 3.
https://doi.org/10.1016/j.health.2023.100185
Morley, J., Machado, C., Burr, C., Cowls, J., Joshi, I., Taddeo, M., and Floridi, L. (2020). The ethics of AI in health care: A mapping review. Soc Sci Med. 260:113172. https://doi.org/10.1016/j.socscimed.2020.113172
Narimani, M. and Naeim, M. (2025). Artificial intelligence in mental health: integrating opportunities and challenges of multimodal deep learning for mental disorder prevention and treatment. Annals of Medicine & Surgery, 87 (9): 5757-5761.
https://doi.org/10.1097/MS9.0000000000003624
Nazer LH, Zatarah R, Waldrip S, Ke JXC, Moukheiber M, Khanna AK, et al. (2023) Bias in artificial intelligence algorithms and recommendations for mitigation. PLOS Digit Health, 2(6):
https://doi.org/10.1371/journal.pdig.0000278
Ni, Y., and Jia, F. (2025). A Scoping Review of AI-Driven Digital Interventions in Mental Health Care: Mapping Applications Across Screening, Support, Monitoring, Prevention, and Clinical Education. Healthcare, 13(10), 1205. https://doi.org/10.3390/healthcare13101205
Olawade, D., Wada, O., Odetayo, A., David-Olawade, A., Asaolu, F. and Eberhardt, J. (2024). Enhancing mental health with Artificial Intelligence: Current trends and future prospects. Journal of Medicine, Surgery and Public Health, (3): https://doi.org/10.1016/j.glmedi.2024.100099
Opland, C. and Torrico, T. (2024). Psychotherapy and Therapeutic relationship. (2024). In StatPearls. [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK608012/
Panduwiyasa, H. (2025). Leveraging AI-based digital systems in psychological interventions: a research opinion. Frontiers in Digital Health, 7:
https://doi.org/10.3389/fdgth.2025.1693504
Paré, G., and Kitsiou, S. (2017). Handbook of eHealth Evaluation: An Evidence-based Approach. Chapter 9 (Methods for literature reviews). In F. Lau & C. Kuziemsky (Eds.). University of Victoria.
https://www.ncbi.nlm.nih.gov/books/NBK481583
Pazer, S. (2024). Artificial Intelligence in Psychosocial Counseling: An Empirical Study of Mental Health Professionals’ Attitudes Toward AI Integration. International Journal of Engineering Applied Sciences and Technology, 9 (5): 61-67: https://doi.org/10.33564/IJEAST.2024.v09i05.007
Pillay, Y. (2025). Ethical Decision-Making Guidelines for Mental Health Clinicians in the Artificial Intelligence (AI) Era. Healthcare, 13(23):3057. Healthcare, 13 (23): 3057. https://doi.org/10.3390/healthcare13233057
Rousmaniere, T., Zhang, Y., Li, X., and Shah, S. (2025). Large language models as mental health resources: Patterns of use in the United States. Practice Innovations, Advance online publication,
https://dx.doi.org/10.1037/pri0000292
Saeidnia, H., Fotami, S., Lund, B., and Ghiasi, N. (2024). Ethical Considerations in Artificial Intelligence Interventions for Mental Health and Well-Being: Ensuring Responsible Implementation and Impact. Social Sciences, 13(7): https://doi.org/10.3390/socsci13070381
Saha, R., & Yadav, S. (2025). Artificial Intelligence and Mental Health: Opportunities & Challenges. Swami Vivekananda University Press, 1(2), 214–235. Retrieved from
https://swamivivekanandauniversitypress.com/index.php/svup/article/view/133
Sukhera, J. (2022). Narrative reviews: Flexible, rigorous, and practical. Journal of Graduate Medical Education, 14(4), 414–417. DOI: http://dx.doi.org/10.4300/JGME-D-22-00480.1
Svensson, E., Osika, W. and Carlbring, P. (2025). Commentary: Trustworthy and ethical AI in digital mental healthcare – wishful thinking or tangible goal?. Internet Interventions. SciencDirect, (41): https://doi.org/10.1016/j.invent.2025.100844
Torous, J., Bucci, S., Bell, I., Kessing, L., Faurholt-Jepsen, M., Whelan, P., Carvalho, A., Keshavan, M., Linardon, J., and Firth, J. (2021). The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality. World Psychiatry,20, (3):318-335.https://doi.org/10.1002/wps.20883

