{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:24:41Z","timestamp":1788337481985,"version":"build-2803163510"},"reference-count":39,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Social Science Fund later funded projects","award":["24FJKB021"],"award-info":[{"award-number":["24FJKB021"]}]},{"name":"Guangdong Provincial 2024 Educational Science Planning Project","award":["2024JKDYO16"],"award-info":[{"award-number":["2024JKDYO16"]}]},{"name":"Guangdong Provincial University Ideological and Political Education Project","award":["2025GXSZ023"],"award-info":[{"award-number":["2025GXSZ023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>In recent years, artificial intelligence (AI) technology has demonstrated potential in psychotherapy. However, there is currently a lack of systematic research that comprehensively assessed public acceptance of AI-based psychotherapy. The purpose of this study is to use meta-analysis to explore public acceptance of AI in psychotherapy and the sources of heterogeneity. A random-effects model was employed, using Hedges\u2019 g as the effect size, to pool the differences in acceptance between the AI group and the conventional psychotherapy group. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. The review included a total of 10 studies involving 1967 participants. Meta-analysis revealed no statistically significant overall difference in acceptance between AI-based psychotherapy and conventional therapy; however, substantial heterogeneity was observed across studies, indicating that this pooled estimate should be interpreted cautiously. Subgroup analysis suggested that the type of conventional psychotherapy, cultural background, and AI type may contribute to variations in acceptance; however, these findings should be interpreted cautiously due to the limited number of studies in some subgroups. Meta-regression analysis indicated that studies with later publication dates and larger sample sizes reported relatively lower AI acceptance. Public acceptance of AI-based psychotherapy may be influenced by multiple factors, including AI type, cultural background, and characteristics of comparison conditions. Future research should focus on cultural differences, the professionalism of AI tools, and the quality of research methodology to more clearly define the appropriate contexts for AI in psychotherapy.<\/jats:p>","DOI":"10.3390\/bs16091552","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"1552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Meta-Analysis of the Acceptance of Artificial Intelligence in Psychotherapy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5529-3436","authenticated-orcid":false,"given":"Meng","family":"Fan","sequence":"first","affiliation":[{"name":"Mental Health Education Center, Guangdong University of Technology, Guangzhou 510006, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4275-1561","authenticated-orcid":false,"given":"Xiaojing","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Art & Design, Guangdong University of Technology, Guangzhou 510090, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6943-2958","authenticated-orcid":false,"given":"Tiansheng","family":"Xia","sequence":"additional","affiliation":[{"name":"School of Art & Design, Guangdong University of Technology, Guangzhou 510090, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107273","DOI":"10.1016\/j.chb.2022.107273","article-title":"Attitudes and perspectives towards the preferences for artificial intelligence in psychotherapy","volume":"133","author":"Aktan","year":"2022","journal-title":"Computers in Human Behavior"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Aldaweesh, S. (2024). Understanding challenges and design opportunities for digital mental well-being in Saudi Arabia. CHI EA \u201924: Extended abstracts of the CHI conference on human factors in computing systems, Association for Computing Machinery.","DOI":"10.1145\/3613905.3638189"},{"key":"ref_3","first-page":"e60363","article-title":"Barriers to seeking mental health help in Saudi Arabia: A systematic review","volume":"16","author":"Alhumaidan","year":"2024","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3325\/cmj.2025.66.13","article-title":"Patients prefer human psychiatrists over chatbots: A cross-sectional study","volume":"66","author":"Arbanas","year":"2025","journal-title":"Croatian Medical Journal"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1001\/jama.1996.03540160054033","article-title":"Large trials vs meta-analysis of smaller trials: How do their results compare?","volume":"276","author":"Cappelleri","year":"1996","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e38067","DOI":"10.2196\/38067","article-title":"Assessing the impact of conversational artificial intelligence in the treatment of stress and anxiety in aging adults: Randomized controlled trial","volume":"9","author":"Danieli","year":"2022","journal-title":"JMIR Mental Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2307\/249008","article-title":"Perceived usefulness, perceived ease of use, and user acceptance of information technology","volume":"13","author":"Davis","year":"1989","journal-title":"MIS Quarterly"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"f2304","DOI":"10.1136\/bmj.f2304","article-title":"Influence of trial sample size on treatment effect estimates: Meta-epidemiological study","volume":"346","author":"Dechartres","year":"2013","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1093\/jpepsy\/jsp004","article-title":"How to select, calculate, and interpret effect sizes","volume":"34","author":"Durlak","year":"2009","journal-title":"Journal of Pediatric Psychology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e49936","DOI":"10.2196\/49936","article-title":"The potential influence of AI on population mental health","volume":"10","author":"Ettman","year":"2023","journal-title":"JMIR Mental Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"120971","DOI":"10.1016\/j.neuroimage.2024.120971","article-title":"Two distinct neural pathways for mechanical versus digital technology","volume":"305","author":"Federico","year":"2025","journal-title":"NeuroImage"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/17588928.2025.2542195","article-title":"An integrated account for technological cognition","volume":"17","author":"Federico","year":"2026","journal-title":"Cognitive Neuroscience"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e7785","DOI":"10.2196\/mental.7785","article-title":"Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial","volume":"4","author":"Fitzpatrick","year":"2017","journal-title":"JMIR Mental Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100841","DOI":"10.1016\/j.invent.2025.100841","article-title":"Artificial intelligence vs. Human expert: Licensed mental health clinicians\u2019 blinded evaluation of AI-generated and expert psychological advice on quality, empathy, and perceived authorship","volume":"41","author":"Zapel","year":"2025","journal-title":"Internet Interventions"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1016\/j.pec.2017.04.015","article-title":"Engaging women with an embodied conversational agent to deliver mindfulness and lifestyle recommendations: A feasibility randomized control trial","volume":"100","author":"Gardiner","year":"2017","journal-title":"Patient Education and Counseling"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"GBD 2019 Mental Disorders Collaborators (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9, (2), 137\u2013150.","DOI":"10.1016\/S2215-0366(21)00395-3"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1037\/0735-7028.35.3.275","article-title":"Cognitive bibliotherapy for depression: A Meta-Analysis","volume":"35","author":"Gregory","year":"2004","journal-title":"Professional Psychology: Research and Practice"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e40719","DOI":"10.2196\/40719","article-title":"Mental health chatbot for young adults with depressive symptoms during the COVID-19 pandemic: Single-blind, three-arm randomized controlled trial","volume":"24","author":"He","year":"2022","journal-title":"Journal of Medical Internet Research"},{"key":"ref_19","first-page":"69","article-title":"A study on the influencing factors and response strategies of AIGC information adoption behavior among Generation Z on social platforms using a mixed-method approach","volume":"43","author":"Huo","year":"2025","journal-title":"Information Science"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1001\/jama.279.14.1089","article-title":"Issues in comparisons between meta-analyses and large trials","volume":"279","author":"Ioannidis","year":"1998","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104440","DOI":"10.1016\/j.ijmedinf.2021.104440","article-title":"Mobile app-based chatbot to deliver cognitive behavioral therapy and psychoeducation for adults with attention deficit: A development and feasibility\/usability study","volume":"150","author":"Jang","year":"2021","journal-title":"International Journal of Medical Informatics"},{"key":"ref_22","unstructured":"Jensen, B., and Ceric, I. (1994). Community-oriented mental health care in Bosnia and Herzegovina: Strategy and model project, WHO Office for Bosnia and Herzegovina."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1037\/a0028086","article-title":"On effect size","volume":"17","author":"Kelley","year":"2012","journal-title":"Psychological Methods"},{"key":"ref_24","unstructured":"Kmet, L. M., Cook, L. S., and Lee, R. C. (2004). Standard quality assessment criteria for evaluating primary research papers from a variety of fields, Alberta Heritage Foundation for Medical Research."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1176\/appi.ps.56.11.1455","article-title":"Regional collaboration in reconstruction of mental health services in Bosnia and Herzegovina","volume":"56","author":"Kucukalic","year":"2005","journal-title":"Psychiatric Services"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100534","DOI":"10.1016\/j.chbr.2024.100534","article-title":"Human vs. AI counseling: College students\u2019 perspectives","volume":"16","author":"Kuhail","year":"2024","journal-title":"Computers in Human Behavior Reports"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.beth.2021.09.007","article-title":"Chatbot-delivered psychotherapy for adults with depressive and anxiety symptoms: A systematic review and meta-regression","volume":"53","author":"Lim","year":"2022","journal-title":"Behavior Therapy"},{"key":"ref_28","first-page":"12","article-title":"A proposal for the dartmouth summer research project on artificial intelligence, august 31, 1955","volume":"27","author":"McCarthy","year":"2006","journal-title":"AI Magazine"},{"key":"ref_29","unstructured":"Mi, N. (2017). A study on women\u2019s higher education in the Kingdom of Saudi Arabia. [Master\u2019s thesis, Northwest Normal University]."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"M\u00fchl, L., Stecker, L., Herter, E., Szczuka, J. M., Wischnewski, M., and Kr\u00e4mer, N. (2024). Integrating AI in psychotherapy: An investigation of trust in voicebot therapists. NordiCHI \u201924: Proceedings of the 13th Nordic conference on human-computer interaction, Association for Computing Machinery.","DOI":"10.1145\/3679318.3685353"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"52","DOI":"10.33847\/2712-8149.4.2_6","article-title":"Gender differences in perception of artificial intelligence-based tools","volume":"4","year":"2023","journal-title":"Journal of Digital Art & Humanities"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20552076241313401","DOI":"10.1177\/20552076241313401","article-title":"Chatbot-delivered mental health support: Attitudes and utilization in a sample of US college students","volume":"11","author":"Rackoff","year":"2025","journal-title":"Digital Health"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Rothstein, H. R., Sutton, A. J., and Borenstein, M. (2005). Publication bias in meta-analysis. Publication bias in meta-analysis: Prevention, assessment and adjustments, John Wiley & Sons, Ltd.","DOI":"10.1002\/0470870168"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.aej.2025.02.011","article-title":"Enhancing Arabic text-to-speech synthesis for emotional expression in visually impaired individuals using the artificial hummingbird and hybrid deep learning model","volume":"119","author":"Selim","year":"2025","journal-title":"Alexandria Engineering Journal"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Thakkar, A., Gupta, A., and De Sousa, A. (2024). Artificial intelligence in positive mental health: A narrative review. Frontiers in Digital Health, 6.","DOI":"10.3389\/fdgth.2024.1280235"},{"key":"ref_37","unstructured":"Topol, E. (2019). Deep medicine: K\u00fcnstliche intelligenz in der Medizin. Wie KI das gesundheitswesen menschlicher macht, Mitp."},{"key":"ref_38","unstructured":"World Health Organization (1996). Public mental health: Guidelines for the elaboration and management of national mental health programmes, World Health Organization."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zhang, W., and Lian, R. (2025). Counselor type (Human\/AI) and consultation intention: A moderated mediation model of trust and psychological counseling scenarios. BMC Psychology, 13, (1).","DOI":"10.1186\/s40359-025-02741-w"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1552\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:08:07Z","timestamp":1788336487000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":39,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["bs16091552"],"URL":"https:\/\/doi.org\/10.3390\/bs16091552","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}