Perspectives of Individuals With Obsessive-Compulsive Disorder on the Role of Artificial Intelligence in Therapy and Treatment: Thematic Qualitative Study

Abstract

Abstract Background AI has become increasingly used in mental health care for applications such as diagnosis, monitoring, and treatment support. These include tools like clinician support systems, large language models, and conversational agents used to augment psychotherapy and clinical decision-making. While prior research suggests potential benefits of and concerns with AI, little is known within the domain of obsessive-compulsive disorder (OCD). Given the expanding role of AI in psychiatry, understanding these perspectives is essential to ensuring AI implementation aligns with patient priorities and values. Objective This study aims to explore the perspectives of individuals with OCD on the use of AI in health care, including perceived benefits, risks, and its role in relation to human clinicians. Methods We conducted semistructured interviews with 24 adults self-reporting OCD, recruited through online communities and advocacy networks. Eligible individuals (≥18 y with self-reported OCD) completed screening, provided informed consent, and participated in remote Health Insurance Portability and Accountability Act (HIPAA)-compliant Zoom (Zoom Communications, Inc) interviews (May-December 2024). Transcripts were deidentified, open-coded, and used to develop a codebook. Focused codes were applied using a thematic analysis framework in Dedoose (v9.2.22; Sociocultural Research Consultants, LLC). Each transcript was independently coded by 2 reviewers, with discrepancies resolved through consensus. Themes were developed through iterative interpretive analysis of code clusters. Results Participants’ perspectives encompassed concerns and benefits of AI in mental health care. Participants expressed concerns about the accuracy and efficacy of information provided by AI, as well as a limited ability for clinical judgment in psychiatric care. Additionally, participants emphasized the importance of human connection, particularly therapeutic alliance, empathy, and reassurance provided by clinicians, which they felt AI could not replicate. Concerns about data privacy, security, and downstream use of information were also highlighted. Despite concerns, many endorsed the use of AI as an adjunct rather than a replacement for clinicians, noting potential benefits in symptom monitoring, preliminary information gathering, and support for administrative tasks, provided that human oversight is maintained. Conclusions Individuals with OCD expressed nuanced views on AI in mental health care, balancing cautious optimism with several concerns. While AI may improve efficiency, standardization, and symptom monitoring, participants highlighted risks related to deindividualization, accuracy, and erosion of human connection. These findings underscore the importance of patient-centered, ethically guided AI integration that preserves the therapeutic alliance while leveraging technological benefits.