The Problem with Big Tech in Mental Health Care

We’ve all seen the ads online: a young therapist posts a selfie video telling us about how an app can connect you with therapists with 24/7 availability, therapy over text messages, and freedom to switch your therapist anytime, and we’ve seen the Reddit posts “How AI Diagnosed My Symptoms.” Does this mean “big tech” online therapy companies and AI are taking over mental health care?

BetterHelp and TalkSpace are the two biggest tech platforms I see which have completely taken over the mental health care industry, promising accessibility and low fees to their customers. In the past couple years, ChatGPT has taken it a step further and practically become a substitute for therapy altogether.

But at what cost?

In this article, I dive into how big tech and AI are working directly against our values as mental health therapists, and what you can do to set yourself up for success in therapy.

How Convenience Is Replacing Quality of Therapy

The big appeal of using big tech and AI for therapy comes from the convenience. But how convenient are they, really?

The Illusion of Easy Access

The foundation of big tech’s marketing pitch is the ease of access for therapy services through their online platform. They direct customers to download the app, sign up, and fill out a questionnaire to be matched to an available therapist in as little as a few hours to a few days. Therapy services are all held in the app, including weekly audio-video sessions, messaging services, and supplemental material like worksheets. While the sign-up is easy, what is being sacrificed?

Attending virtual therapy with a local therapist (read: non-big tech) is a similar process, but with one big difference: the quality. Yes, clients may have to put in more effort to research a local therapist who offers care for their issues, but that effort is an investment into your mental health.

Connecting with big tech is quick and easy when all you need is a credit card and a questionnaire – and who knows how much the questionnaire is actually used when they might be scheduling you with the next available therapist?

Connecting with a local therapist may take longer but offers better quality because you get the benefit of your therapist’s undivided attention, focus on your experiences and story with an in-depth intake process, and a quality connection when working together (more on this later).

Don’t sacrifice the quality of your care for ease of access. Just because it’s quick, doesn’t mean it’s good – especially in healthcare.

Low Standards, High Costs

Big tech leans into “low-cost therapy” as their second reason to use their services. Most of these companies run off a subscription model – pay a monthly fee and you get four weekly sessions – that doesn’t accept insurance. This contradicts their offer of flexible scheduling and more accessible therapists and creates confusion and inconsistency regarding their billing practices.

Additionally, big tech’s monthly fees often end up being higher than the costs to clients seeing a local therapist and using their insurance or out-of-network benefits.

Many local therapists accept insurance for therapy sessions, and most provide superbills for clients to receive reimbursement for their out-of-pocket fees. At Keystone, we go a step further and provide courtesy billing for our out-of-network clients, so they receive reimbursement without having to manage a superbill. This is more convenient and cost-effective than a monthly subscription fee with no reimbursement.

When you meet with a local provider, the cost per session will likely be higher than big tech, but the quality of the therapist’s experience and training will far surpass that of big tech therapists. So yes, the cost is higher with a local therapist, but so is the value of the therapy you receive. Remember: therapy is an investment into yourself – don’t give yourself the “fast-food” big tech therapy when you can have “Michelin Star” therapy with a licensed, highly trained local therapist.

The Dangers of AI and Automation in Mental Health

While big tech is sacrificing quality of services for ease of access, AI Chatbots and ChatGPT sacrifice all mental health training and even a human touch. In the past couple years, I have had clients and friends use ChatGPT/AI for “therapy.” This is both helpful and dangerous at the same time. Here’s why:

Why Chatbots Can’t Replace Human Therapists

The basis of AI is that it works by pulling previously shared data from either the user or the vast internet. When a user submits a question, thought, or experience into the system, the system immediately breaks it down into data points, comparing it with data from all over the world. It then generates a response based on available data from the internet, or what the user has provided themself over time.

ChatGPT is great for helping users to summarize or organize their thoughts. If you have a mind that works quickly and feels overwhelmed or disorganized (ie anxiety or ADHD), you can “thought dump” into the system and the AI program can return your thoughts to you in a clear, succinct format. This can help you better understand your own thoughts and potentially improve your ability to communicate these newly organized thoughts with others.

Don’t forget that ChatGPT is a computer and will never understand your full lived experience or present context. It will miss things that are necessary to be considered when generating responses. ChatGPT can put clues together, but it can’t pick up on nuances of language, behaviors, non-verbals, tone, syntax, and emotion that a human therapist can.

A good therapist doesn’t just regurgitate your own thoughts as ChatGPT does, but they join with you in your emotional experience to offer safety and guidance to better understand yourself and your relationships with others or the world around you. ChatGPT can’t challenge unhealthy cognitions (like hallucinations or psychosis) or even pick up on when those may be occurring for someone like a human therapist can.

ChatGPT is a good tool for organizing thoughts in written communication, but it ultimately can only repeat back what the user provided it. AI cannot truly join with users through empathy and emotional experiences the way a human therapist can.

AI is not, and should never be, a substitution or replacement for therapy, but can be used as a tool or coping skill for organizing thoughts. What you do with those organized thoughts is for you and your therapist to navigate together towards real, lasting healing.

What Happens When AI Gets It Wrong?

Studies have shown for years that the most important factor indicating the success of therapy is the therapeutic relationship. AI is a tool, but not a relationship. Think of it as a computerized mirror: it reflects back what it receives. A therapist reimagines what they receive. For example, my clients show me an image of their trauma throughout their lives. My role at their therapist is to join with them in their trauma experience while establishing a new felt sense of safety for them which they were never provided before. This is something only a connected human can do.

ChatGPT can’t gauge when someone is at-risk and may push someone past their ability to safely regulate themselves. It also isn’t set up as a mandated reporter with knowledge of recognizing when action is necessary, and what resources are most appropriate. It doesn’t show true love and connection with users and can’t hold people accountable.

ChatGPT/AI should be recognized as a coping tool for organizing thoughts, just as journaling or meditation can. While those tools offer some benefits, none of them are a replacement for therapy. Googling your flu symptoms isn’t a replacement for going to a doctor (and can actually lead to more issues), just as chatting with ChatGPT isn’t a replacement for going to therapy with a licensed therapist.

The Ethics Crisis in Tech Therapy Platforms

Alongside quality, big tech and AI sacrifice the ethics and safety that a local therapist prioritizes.

Confidentiality and Data Privacy Concerns

When it comes to therapy, confidentiality is more than a guideline – it’s a foundational principle that protects clients and builds trust. Unfortunately, many tech-based therapy platforms fall short in safeguarding this trust. While traditional therapy practices follow strict privacy laws like HIPAA and prioritize secure, protected communication, some digital platforms take a looser approach.

Clients may not realize that their sensitive mental health information—such as session notes, personal disclosures, and even usage patterns—could be stored, analyzed, or shared in ways that are unclear or buried in lengthy terms of service. In some cases, data may be used for marketing purposes or sold to third parties, raising serious ethical red flags.

The use of AI-powered chatbots and automated tools further complicates privacy. Without clear oversight or clinical accountability, clients may unknowingly share vulnerable information with systems that lack human judgment and confidentiality protections.

When mental health becomes part of a profit-driven tech model, client safety can quickly be compromised. That’s why it’s critical to choose local therapy providers who are committed to ethical standards, transparent communication, and strong data security.

Burnout and Exploitation of Therapists

Have you ever had a conversation with someone and you could tell they were just not mentally present? Or have you been the other person, and realized partway through a conversation that you completely zoned out and have no idea what you’ve missed? Now image that person was your therapist, and they were so tired and burnt out they missed what you were saying. You likely wouldn’t go back to therapy.

In my experience, burn out is the #1 reason people leave the mental health field. It is a well-known pattern where the newest therapists end up with the most difficult caseloads, because they need the hours for their training, and the agency or hospital overloads them with clients to meet with. Most often, these employers offer very little to no emotional support to their staff, leaving therapists lonely, burnt out, and mentally checked out before they even meet their clients.

This is how big tech functions. While these companies promote accessibility and affordability, they often rely on business models that prioritize volume over quality – placing an unsustainable burden on their providers.

Therapists on these platforms are frequently underpaid, with rates that are significantly lower than industry standards. Many are expected to maintain high caseloads, respond to clients outside of normal work hours, or manage communication through chat-based systems with little compensation for their time or expertise. This not only leads to therapist burnout but also lowers the overall quality of care for clients.

Furthermore, some platforms limit therapists’ clinical autonomy – restricting how they deliver care, what tools they can use, and even discouraging long-term treatment in favor of brief interventions. These constraints can interfere with ethical and effective therapy practices.

When therapists aren’t supported, clients ultimately suffer. Ethical therapy requires space for thoughtfulness, connection, and care – none of which can thrive in a system that treats therapists like a tool for profit instead of skilled mental health professionals.

The Illusion of Personalization with AI and Algorithms

Many tech-based therapy platforms promise customized care using artificial intelligence or matching algorithms. While this sounds efficient, the reality is often much less tailored than advertised. “Matching systems” frequently rely on surface-level inputs – like age, location, or general symptoms – without truly assessing the complexities of a person’s mental health needs.

AI may help sort large amounts of data quickly, but it cannot replace human intuition, empathy, or clinical judgment. No algorithm can fully understand the nuances of trauma, cultural identity, or relational history that shape a person’s well-being. This leads to mismatches, brief or ineffective treatment, and in some cases, clients dropping out of therapy altogether.

Even when AI tools are used within a session – such as mood tracking, journaling prompts, or chatbot “therapy” – there’s a risk of depersonalizing the therapeutic experience. These tools may be helpful supplements, but they can never replicate the trust and healing that come from a genuine human connection with a trained therapist.

In a field that depends on deep understanding and emotional safety, tech-driven shortcuts can feel dismissive at best – and potentially harmful at worst.

What Real, Ethical Therapy Looks Like

Ethical therapy starts with a genuine, person-centered relationship. You’re not a data point or a profile to be matched by an algorithm – you’re a unique human being with experiences, emotions, and needs that deserve care and respect from a therapist who truly sees you. Real therapy is built on trust, confidentiality, and collaboration. Your therapist should listen deeply, tailor your treatment to your goals, and walk with you through the healing process – not rush to meet quotas or scripted outcomes.

The Importance of Human Connection in Healing

Therapy works best when there is a strong, trusting relationship between client and therapist. Research consistently shows that the therapeutic relationship is the most important predictor of positive outcomes. It’s the consistent presence of a real human being – someone who listens, reflects, and walks with you through difficulty – that creates a safe space for vulnerability and change.

Healing from trauma, navigating anxiety, or processing a life transition requires connection, empathy, and relational safety. I often refer to my relationships with my clients as “a professional friendship,” illustrating the connection, comfort, and safety maintained between us. None of these qualities can be replicated by AI chatbots or therapists who are pressured to maintain large caseloads and minimal contact. Authentic connection is essential.

How Keystone Therapy Group Is Different

Keystone Therapy Group isn’t just another name in a long list of providers. We’re a team of highly qualified, trauma-informed therapists who prioritize real relationships and ethical care. We don’t outsource your sessions to contractors or AI chatbots. When you reach out to us, you’re connecting with professionals who are committed to understanding your full story and supporting your healing.

Every member of our team is trained to work with each unique client, helping you develop insight, build resilience, and find meaningful change at your own pace. We believe that therapy should be a space where you feel known, not analyzed by an algorithm.

A Team That Sees You as a Whole Person

You are more than a diagnosis. You are not a symptom tracker, a productivity report, or a response rate. At Keystone, we see and honor every part of who you are – your emotions, your story, your relationships, your struggles, and your strengths.

Our therapists are trained to work holistically, helping you make connections between your past and present, your mind and body, and your internal world and external challenges. We offer therapy that embraces your full humanity, in a space where you can speak freely and be truly seen.

Care That Prioritizes Connection, Not Algorithms

We understand the appeal of convenience. Quick matching, automated check-ins, and text-based support sound easy. But the truth is, mental health care doesn’t work when it’s boiled down to speed and algorithms. At Keystone, we offer the opposite: a relationship-centered approach that honors your unique process. We build real therapeutic relationships based on trust, consistency, and care. We don’t use bots. We don’t rely on scripts. We rely on our training, our values, and our commitment to showing up fully for you, just as we show up for each other, and ourselves.

Choosing Ethical, Effective Mental Health Support

Choosing a therapist should never feel like swiping through a dating app. It’s important to ask the hard questions about what you need in therapy, and how care is delivered. True ethical therapy is transparent, collaborative, and grounded in evidence-based practices. It’s delivered by professionals who are accountable to ethical boards, not corporations.

Questions to Ask Before Starting Therapy Online

Before signing up for therapy through an app or platform, consider asking:

• Will I work with a licensed therapist in my state?
• How is my personal data stored and used?
• Will I meet consistently with the same therapist?
• Is the therapist trained in the issues I’m seeking help for?
• What happens if I experience a mental health crisis?
• Can I verify the therapist’s license and credentials?
• What does confidentiality look like on this platform?
• Are therapists encouraged to maintain long-term relationships, or are they rewarded for speed?

These questions help you assess whether the platform is designed for your healing or for company profits. Ethical care is about quality, not quantity.

How to Get Started with a Trusted Local Therapist

If you’re ready for therapy that is grounded in real connection and professional care, we’re here to help. Keystone Therapy Group offers in-person and virtual therapy across Virginia, delivered by licensed therapists who are committed to your growth and healing.

We know it can feel overwhelming to start the process, so we make it simple.

Our intake team will help you find the right therapist, navigate insurance questions, and schedule your first appointment. You can book your free 15-minute consultation directly with our therapists, or complete our form and our intake team will connect with you to talk you through our process.

Let us support you in taking this next step – toward care that sees you, hears you, and honors your journey. If we can’t help you, we have a network of local highly trained, quality therapists who can.