(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.

“Everyone should go to therapy.” It’s a common statement, but much harder to achieve than it looks. There’s only one therapist for every 10K would-be clients, and the gap is only growing every year.

That gap is what my latest guest - Dr. Derrick Hull - has spent his career trying to fix. Now serving as the founding Clinical Lead at Slingshot AI, Derrick previously led Clinical R&D at Talkspace, where he was instrumental in popularizing text-message therapy, a previously controversial modality now recognized as critical to increasing accessibility to mental health care. Derrick has had a fascinating career, serving as a practicing psychologist, a clinical advisor and researcher for top startups, and a highly accomplished academic with publications in Nature, the National Academy of Sciences, and Oxford University Press, with his research supported via R01 grants through NIH.

It’s been amazing getting to work with Derrick at Slingshot, and I’m so excited to share just a snapshot of the wisdom and insight I collect from him everyday.

In our latest conversation, we touch on...

• The ethical problems (and opportunities) of AI therapy
• The role of empathy in practicing psychology
• Why being a therapist can be an “impossible profession”
• The surprising literature on therapeutic effectiveness
• … and many, many things in between

For more conversations like this, be sure to subscribe to our Youtube channel (@ThinkingMachinesPodcast) and to our show in your favorite podcast player.

Artificial neural networks were designed to emulate the human brain - and their insane performance on a wide range of tasks is pretty good evidence to support the comparison.

Well, it's a bit more complicated than that, at least according to my guest Mark Ungless, former neuroscience lecturer at Imperial and Oxford and current Director of AI at the UK's Mental Health Innovations. Mark and I have collaborated on research for 5+ years, and I've long enjoyed his thoughts on the biology of the brain, the philosophy of the mind, and how AI is changing (and being changed) by our understanding of both. In our latest conversation, we touch on...

• His groundbreaking research on the biological root of loneliness
• How understanding neuroscience helps you understand humans
• How well neural networks represent our own minds (and whether it matters at all!)
• AI’s ability to do therapy
• What it means to have free will in a world where we understand more about our brains every day

For more conversations like this, be sure to follow our Youtube channel (@ThinkingMachinesPodcast) and subscribe to our show in your favorite podcast player.