Like a Therapist, But Not: Reddit Narratives of AI in Mental Health Contexts

Key Findings

• — Most common usage intents: emotional support 18.0%, functional support 12.6%, psychoeducation 11.7%, companionship 9.4%, reassurance seeking 7.6%, symptom assessment 7.3%.
• — 2,637 of 5,126 posts (51%) explicitly mentioned risks or limitations; the most common concern was addiction and dependence (14.1%), which co-occurred most strongly with companionship intent, followed by symptom escalation (11.7%), misinformation and error (9.6%), privacy and data (9.4%), therapy boundary confusion (8.7%) and reassurance loops (7.5%).
• — Self-harm risk was raised in 3.8% of posts and child safety in 1.2%, the latter concentrated in sexual role-play contexts.
• — Where posters compared AI with human therapy, 639 posts judged AI worse, 163 better and 478 complementary; crisis support and reassurance seeking were the intents most often judged worse.
• — Alliance constructs related to sentiment unevenly: task alignment and goal agreement tracked positive sentiment strongly while emotional bond did not, and bond without task alignment frequently co-occurred with reported dependency and harm.

Methodology Notes

Public self-report Reddit posts, English-language and US-skewed; annotation by GPT-5.2 validated against human labels (macro-F1 0.70); the authors state the results are not evidence of benefit or harm at the individual or population level. Affiliation: Drexel University. Published July 2026 (month precision), DOI 10.18653/v1/2026.findings-acl.569, pages 11716 to 11736; 21-page PDF and .bib verified from the Anthology. Annotations released on Zenodo (10.5281/zenodo.18751157, CC BY 4.0; raw post text not released) with code at github.com/social-nlp-lab/ai-therapy-reddit. Earlier version arXiv 2601.20747.

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