“Frances has had a long and storied career in American psychiatry, but this may be his most important book yet. With characteristic clarity, skepticism, and concern for patients, he confronts a technological revolution that is already transforming mental health care. Used wisely, chatbots can be remarkably useful assistants, but used autonomously, they can mislead, reinforce pathology, invade privacy, and displace the human relationship at the heart of treatment. From a dynamic standpoint, a chatbot may gratify the wish for an endlessly available, nonjudgmental other—but precisely for that reason, it can become an alluring substitute for the difficult, reality-based work of psychotherapy. Every clinician should read this book.”

—Mark L. Ruffalo, LCSW, Assistant Professor of Psychiatry and Director of Psychiatry Residency Psychotherapy Training, University of Central Florida College of Medicine


“A most important contribution to the field of psychotherapy. Frances provides practitioners with much-needed information and guidelines on how AI can be used and misused in providing psychological help to patients. Arguing for a collaborative alliance among therapist, patient, and chatbot, this is an invaluable guide for how we need to conduct therapy in the future.”

—Marvin R. Goldfried, PhD, Distinguished Professor of Psychology (retired), Stony Brook University


“Frances has written a lucid, accessible guide to the brave new world of chatbots. Neither hyping nor downplaying the risks and benefits of chatbots, Frances charts a middle course, stressing the importance of careful collaboration between therapist and chatbot. This book will prove very useful to psychotherapists of all professional backgrounds, as well as to interns and residents in psychology and psychiatry training programs.”

—Ronald W. Pies, MD, Professor Emeritus of Psychiatry, State University of New York Upstate Medical University


“AI is part of mental health care, whether we are ready for it or not. Vibrant, cantankerous, funny, and opinionated, Frances has written a deeply humane guide to what comes next. Without hyperventilating about either possibilities or dangers, he asks the question that matters most: How can we put these powerful new tools in the service of people, rather than allowing people to be put in the service of tech? Frances emphasizes that human judgment, values, and relationships cannot be engineered away. After reading this eye-opening book, practitioners will be ready to use AI as an assistant, not a replacement. This is a remarkable and timely book about what seemed futuristic just yesterday—but has now arrived.”

—Steven C. Hayes, PhD, Foundation Professor of Psychology Emeritus, University of Nevada, Reno