As the use of AI therapy chatbots increases, so do the potential dangers
Will AI help close the mental health gap, or will it do more harm than good?
Daniel Fountainberry met his wife during the coronavirus lockdown. A year later they got married and also had a child.
Still in the “discovery” phase of their relationship, as Fountainberry puts it, they decided to undergo couples therapy to better navigate their new marriage.
However, the price for each session was shocking. According to the Cerebral Institute, in-person couples therapy sessions in the United States range from $100 to $300 per hour. While looking for a therapist, Fountainberry found that some were charging as much as $350 for a 50-minute session.
The experience itself was very tiring. He often felt that his therapist did not listen to him during sessions, or that session time ended when he was on the brink of a problem.
Fountainberry started working in the AI and educational technology field in 2020 and shared her frustrations about couples therapy with another friend who works in the technology field. He decided he needed another intervention, not another therapist. He had the idea of creating a “neutral referee,” an AI model that could help people understand and change their behavior.
He believes that “therapy doesn’t necessarily have to be given to you.” “Instead of believing that there are people who do magic with this secret knowledge, we believe that that knowledge is out in the public domain,” he says.
Therefore, CoupleRef, a US-based “AI couple referee” platform, was launched in February 2026. Fountainberry said CoupleRef uses AI to restructure evidence-based practice and evaluation to provide an experience similar to meeting with a doctoral-level clinical psychologist.
“I decided to build this facility for my own marriage and relationships,” he says. “But we also decided to build this facility for other people who are frustrated or who are looking for an alternative to additional treatments.”
So, is AI couples therapy the new frontier for AI wellness? AI therapy is becoming increasingly popular with the emergence of “chat GPT-induced psychosis” and lawsuits against OpenAI for mental health harm. Mental health experts warn that AI chatbots cannot replace humans, especially therapists.
AI Alternatives Could Reduce Cost Barriers to Couples Therapy
coupleRef plans to charge users $12 per week. It’s a cheaper alternative to real-life couples therapy, but it doesn’t have the added benefit of having a real person on the other end of the conversation. Fountainberry said the high cost of couples therapy can eat away at vacation funds and other essential expenses, and he wants his platform to be accessible to couples regardless of their income.
“I would rather couples get to the heart of their issues, understand their emotional needs and their partner’s emotional needs, and then go on vacation and spend quality time together,” Fountainberry says.
Fountainberry said he and his wife, Cecelia Weary, speak to CoupleRef every day. With his wife’s permission, Fountainberry shared with CoupleRef a transcript of a conversation the couple had on December 26, 2025. She said she used it uniquely to understand how to process her emotions and overcome friction points in her marriage regarding household responsibilities.
“The kitchen is a war zone,” wrote Weari, who went by the username “Joz” on the platform.
The chatbot elicited a “Five-Factor Personality Assessment” that both partners took during the intake and responded, “Jos, for you, cleaning while cooking is a logical and efficient process…From Daniel’s perspective, his very low conscientiousness means he thrives on spontaneity and adaptability.”
The answers are similar to what users would expect from an astrology app like Co-Star or The Pattern. These apps provide general explanations of behavioral patterns based on the astrological signs of your birth chart and allow you to apply them to your own life. CoupleRef, on the other hand, explains how these overarching patterns influence user behavior in specific situations shared with chatbots.
By the end of the exchange, CoupleRef had communicated his needs to Weary and suggested steps to set boundaries to mitigate Fountainberry’s behavior.
“There are some cases where it’s better to treat you and your therapy partner in person,” Fountainberry acknowledges. “But without money or access, it’s not an option. So everyone needs options.”
Online interventions are not new for couples
CoupleRef is not the first platform to offer online interventions. Arya is a sex subscription box founded in 2022 that also allows couples to address tension points in their relationships and their sex lives with a third person called a “concierge.” A real human is involved, but AI informs the concierge’s response.
According to the company, Arya integrates AI and human monitoring to extend personalized support. Customer service responses are automated, but relationship guidance is more complex. Arya’s AI models are privately trained with knowledge from in-house relationship experts and sexologists and can provide instant responses, but a human concierge reviews and confirms the AI’s recommendations. If an issue is flagged as requiring deeper expertise or personalization, it will be escalated directly to a human expert, Aria said.
Safeguards are essential to reduce harm from AI therapy
Fountainberry said CoupleRef is not suitable for individuals experiencing intimate partner violence, but the platform does not manually review conversations to protect user privacy.
Mental health experts have warned that using AI tools as a substitute for mental health support can reinforce negative behaviors and thought patterns, especially if these models are not equipped with appropriate safeguards.
“ChatGPT is going to be consensus-based and we’re going to do it relentlessly. It’s not helpful at best, but it can be incredibly harmful in extreme cases,” Dr. Jenna Glover, Headspace’s chief clinical officer, previously told USA TODAY while discussing the rise of AI therapeutics. “On the other hand, as a therapist, I’m going to validate you, but I can do that by acknowledging what you’re going through. I don’t have to agree with you.”
