Reference Guide

AI Literacy Glossary
for Therapists

Plain-language definitions of key AI concepts, written for mental health professionals navigating an AI-integrated clinical landscape.

Core AI
Artificial Intelligence
AI

Computer systems designed to perform tasks that typically require human-like reasoning, such as understanding language, recognising patterns, making decisions, or generating responses. AI is not a single technology but an umbrella term for many different approaches.

Why it matters to youYour clients may already be using AI tools between sessions, for journalling, emotional processing, or crisis support, often without disclosing it.
Core AI
Large Language Model
LLM

A type of AI trained on enormous amounts of text to understand and generate human language. LLMs power tools like ChatGPT, Claude, and Gemini. They predict what words should come next in a sequence, which gives the appearance of understanding, though they don't "know" things the way humans do.

Why it matters to youWhen clients say "I talked to ChatGPT about it," they are interacting with an LLM; a statistical text predictor, not a trained clinician with therapeutic intent.
Core AI
Generative AI

AI that creates new content, such as text, images, audio, or video, rather than simply classifying or retrieving existing information. LLMs are a subset of generative AI. The outputs feel original but are always derived from patterns in training data.

Why it matters to youClients may be using generative AI to write self-reflections, simulate difficult conversations, or create narratives about their lives; content worth exploring in session.
Core AI
Prompt

The text or instruction a user types into an AI system. The quality and framing of a prompt significantly shapes the AI's response. "Prompt engineering" refers to the skill of crafting effective inputs to get better outputs.

Why it matters to youHow a client frames their emotional state to an AI shapes what they receive back, which can reinforce, challenge, or bypass therapeutic work depending on context.
Core AI
Training Data

The vast collection of text, images, or other information an AI model learns from before deployment. An AI's knowledge, biases, and blind spots all stem from what was, and wasn't, in its training data. Models have a knowledge cutoff date after which they are unaware of new events.

Why it matters to youAI models may reflect cultural, racial, or socioeconomic biases present in their training data, which can surface in ways that feel invalidating to clients from marginalised communities.
Core AI
Context Window

The amount of text an AI can "hold in mind" at once during a conversation. Beyond this limit, the AI forgets earlier parts of the exchange. Most current models have a context window of tens of thousands of words, but they do not retain anything between separate conversations unless given a memory tool.

Why it matters to youAI has no persistent memory of a client's history. Each new session starts blank, unlike the longitudinal therapeutic relationship you hold.
Risk & Reliability
Hallucination

When an AI generates information that sounds plausible and confident but is factually wrong or entirely fabricated. The model doesn't "know" it is lying; it is simply producing a statistically likely-sounding output. This can include invented research citations, false clinical claims, or misremembered facts.

Why it matters to youClients may believe inaccurate psychological information an AI presents with authority, including false claims about diagnoses, medications, or therapeutic techniques.
Risk & Reliability
Algorithmic Bias

Systematic errors or prejudices in AI outputs that disadvantage certain groups. Biases can enter through unrepresentative training data, biased human feedback, or the way a problem is framed. AI systems may perform worse, give different advice, or hold implicit assumptions about people based on race, gender, age, or culture.

Why it matters to youClients who are already marginalised may receive subtly unhelpful or invalidating responses from AI, worth exploring as a therapeutic topic in its own right.
Risk & Reliability
Black Box

A term for AI systems whose internal decision-making is opaque, even to their creators. We can observe what goes in (a prompt) and what comes out (a response), but not always why a specific output was produced. This limits accountability and makes errors harder to predict.

Why it matters to youWhen AI influences a client's beliefs or mood, there is no audit trail; no reasoning you can examine, challenge, or contextualise the way you would a human source.
Risk & Reliability
Sycophancy

A known tendency in AI systems to agree with, flatter, or validate the user rather than offer honest pushback. Models trained on human feedback learn that people prefer agreement, so they optimise for it. This can mean AI rarely challenges a user's distorted thinking, unhealthy plans, or false beliefs.

Why it matters to youFor clients prone to rumination, catastrophising, or distorted self-narratives, an AI that only validates may reinforce rather than interrupt unhelpful patterns.
Risk & Reliability
Jailbreaking

Attempts by users to manipulate an AI into bypassing its safety guidelines, for example by framing a harmful request as a hypothetical, roleplay, or creative writing exercise. Jailbreaks vary in sophistication and do not always succeed, but represent an ongoing challenge for AI safety teams.

Why it matters to youVulnerable clients may encounter or attempt jailbreaks to obtain harmful content, including detailed self-harm methods or coercive relational scripts, without always recognising the danger.
Clinical Context
Human-in-the-Loop
HITL

A design approach where a human reviews, approves, or overrides AI outputs before they affect real-world decisions. Rather than full automation, HITL systems keep the human as the final decision-maker. In healthcare contexts, this typically means a clinician retains authority over any AI-generated insight or recommendation.

Why it matters to youAny responsible use of AI in therapeutic settings should be human-in-the-loop, meaning you, not an algorithm, hold clinical authority over your client's care.
Clinical Context
Chatbot

A software program designed to simulate conversation with users. Older chatbots used rigid rule-based scripts; modern AI chatbots use LLMs to generate fluid, contextual responses. Mental health chatbots (e.g. Woebot, Wysa) are increasingly common, though their clinical evidence base is still developing.

Why it matters to youClients may be using mental health chatbots between sessions, sometimes as a first port of call for distress, without knowing their clinical limitations or how their data is stored.
Clinical Context
Retrieval-Augmented Generation
RAG

A technique where an AI retrieves relevant information from an external knowledge base before generating a response, rather than relying solely on its training data. This allows AI to be grounded in specific, up-to-date, or proprietary documents (like clinical guidelines or session notes) and reduces hallucination.

Why it matters to youClinical AI tools using RAG can theoretically draw on a client's own history to personalise responses, raising both exciting possibilities and significant privacy considerations.
Clinical Context
AI Parasocial Attachment

The emotional bond or sense of relationship some users develop with AI systems, treating them as confidants, friends, or even romantic partners. Unlike parasocial relationships with celebrities, AI actively responds, which can deepen the attachment. This is an emerging area of clinical and ethical concern.

Why it matters to youClients with attachment difficulties or social isolation may be particularly susceptible; they may prefer AI interaction to human connection, which warrants gentle therapeutic exploration.
Clinical Context
AI Companion / Mental Health App

AI-powered applications designed to offer emotional support, psychoeducation, or skills coaching (e.g. CBT exercises, breathing tools, mood tracking). They occupy a spectrum from wellness apps with no clinical claims to regulated digital therapeutics. Regulation in this space is still catching up to the market.

Why it matters to youMany of these apps are not regulated as medical devices, may not follow clinical frameworks, and can escalate crises poorly, yet clients may trust them implicitly.
Ethics & Safety
AI Safety & Alignment

The field of research concerned with ensuring AI systems behave in ways that are safe, beneficial, and consistent with human values. "Alignment" refers to whether an AI's goals and outputs are genuinely aligned with what users and society actually want, not just what they say or reward it for.

Why it matters to youNo current AI system is fully "aligned" with therapeutic values. AI optimised for engagement, for example, may behave very differently to one optimised for client wellbeing.
Ethics & Safety
Data Privacy & Consent

Rules and protections governing how personal information is collected, stored, and used, including conversations with AI. When clients share sensitive information with an AI, that data may be stored, reviewed by staff, used for model training, or subject to data breaches, depending on the platform's policies.

Why it matters to youClients may not realise their most intimate disclosures to an AI are being stored and potentially used commercially; an informed consent issue you are well-placed to raise.
Ethics & Safety
Informed Consent (in AI contexts)

The principle that individuals should understand and agree to how AI is being used in their care before it is applied. This includes understanding what data is collected, how AI outputs are used in clinical decisions, and the limitations of the technology, analogous to consent in medical procedures.

Why it matters to youEthical frameworks for AI in therapy are still being developed. As a clinician, proactively discussing AI use with clients, including their own, is increasingly considered good practice.
Ethics & Safety
Automation Bias

The human tendency to over-trust automated systems and defer to their outputs even when doing so is unwarranted. Studies across medicine, aviation, and law show that humans often fail to catch AI errors when they over-rely on algorithmic outputs, particularly when those outputs are presented confidently.

Why it matters to youIf AI tools become embedded in clinical workflows, automation bias poses a real risk to the quality of your independent clinical judgment.
Technical
Fine-Tuning

A process of further training a pre-existing AI model on a smaller, domain-specific dataset to adapt it for a particular purpose. A general LLM might be fine-tuned on clinical literature or therapy transcripts to make it more specialised, though this does not eliminate the need for clinical oversight.

Why it matters to youWhen vendors claim their mental health AI is "clinically trained," fine-tuning is usually involved, but the quality, diversity, and clinical validity of that training data matters enormously.
Technical
Token

The basic unit of text that an AI model processes, roughly equivalent to ¾ of a word. LLMs read and generate text in tokens, and their costs are typically calculated per token used. Token limits also define how much text can be processed in a single interaction (see: Context Window).

Why it matters to youUnderstanding tokens helps make sense of AI pricing models and why very long conversations may degrade in quality, relevant if you are evaluating AI clinical tools.
Technical
API (Application Programming Interface)
API

A set of rules that allows different software systems to communicate. When a mental health app uses an AI model "under the hood," it is typically accessing it via an API. This means the app's developers, not the AI company, control how the model behaves, what guardrails are applied, and how data is handled.

Why it matters to youThe app your client uses may behave very differently from the base AI model it is built on. The developer's choices about safety, tone, and data use matter as much as the model itself.
Technical
Temperature

A setting that controls how creative or unpredictable an AI's responses are. A low temperature produces more predictable, conservative outputs; a high temperature produces more varied, sometimes surprising responses. Developers tune temperature based on the use case; consistency for medical tools, creativity for writing assistants.

Why it matters to youThis is one reason why the same AI tool can behave inconsistently across sessions; the system may be configured to vary its responses by design.
Technical
Multimodal AI

AI systems that can process and generate multiple types of input and output, including text, images, audio, and video, rather than text alone. Multimodal models can analyse a photo, transcribe speech, or generate realistic synthetic voices, opening new possibilities and new risks.

Why it matters to youEmerging mental health tools may soon analyse voice tone or facial expression for emotional cues, raising significant questions about consent, accuracy, and clinical appropriateness.
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