Adult Clients’ Attitudes Towards Using Artificial Intelligence in Psychotherapy: Mixed-Methods Systematic Review

With the growing mental health treatment gap, scalable and cost-effective solutions are in demand. Artificial intelligence has been proposed as a potential tool to address these challenges. This mixed-method systematic review synthesises evidence on adult clients’ attitudes towards using AI in psychotherapy. Following the Joanna Briggs Institute convergent integrated approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, five electronic databases were searched for peer-reviewed studies published between 2019 and 2025. Quality was assessed using the Mixed Methods Appraisal Tool. Ten studies were selected to include. Three integrated findings were identified: 1) preference for human therapists, 2) factors influencing acceptability (i.e. trust, perceived effectiveness, empathy, cost), and 3) impact of individual characters (i.e. psychological presentation, self-stigma). The findings emphasise the importance of adopting a client-centred personalised approach for AI integration, considering client acceptance factors and their individual differences.