(Cross-posted from Fit Check)

The mental health field is facing an unexpected disruption: AI is already the largest provider of mental health support in the US, with hundreds of millions using tools like ChatGPT for emotional guidance—whether the technology was designed for it or not.

In this AMA, I sit down with Dr. Rachel Wood (licensed counselor with a PhD in cyberpsychology and founder of the AI Mental Health Collective) and Megan Cornish (therapist and community organizer) to take hard questions from mental health professionals about what's actually happening—and what should happen—as AI enters therapeutic spaces.

We tackle the uncomfortable questions: Should AI therapy be regulated? What happens in the brain during AI conversations versus human ones? How do we prevent AI from replacing human connection rather than supporting it? And critically—what responsibility do AI companies have when people turn to them who need something AI can't offer?

This isn't about whether AI should be used for mental health support. That ship has sailed. This is about understanding the technology, acknowledging the massive access gap in mental healthcare (one therapist for every 1,500+ people in need), and figuring out how to build AI that strengthens human relationships rather than replacing them.

We discuss:

The neuroscience of attunement and whether AI can replicate therapeutic connection
How language models actually work (and why they're more than "just talking")
Three core concerns: autonomy, competency, and relatedness
Why ChatGPT exemptions in regulation miss the point entirely
The difference between AI as replacement versus AI as gateway
What accountability could actually look like in this space

Whether you're a therapist worried about the impact of AI within your profession, a technologist building in this space, or simply someone trying to understand where we're headed—this conversation matters.

For the full discussion and ongoing conversations, check out the Fit Check community.

AI Therapy: An Open Conversation with Therapists