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

Elham Aghakhani, Rezvaneh Rezapour


Abstract
Large language models (LLMs) are increasingly used for emotional support and mental health–related interactions outside clinical settings, yet little is known about how people evaluate and relate to these systems in everyday use. We analyze 5,126 Reddit posts from 47 mental health communities describing experiential or exploratory use of AI for emotional support or therapy. Grounded in the Technology Acceptance Model and therapeutic alliance theory, we develop a theory-informed annotation framework and apply a hybrid LLM–human pipeline to analyze evaluative language, adoption-related attitudes, and relational alignment at scale. Our results show that engagement is shaped primarily by narrated outcomes, trust, and response quality, rather than emotional bond alone. Positive sentiment is most strongly associated with task and goal alignment, while companionship-oriented use more often involves misaligned alliances and reported risks such as dependence and symptom escalation. Overall, this work demonstrates how theory-grounded constructs can be operationalized in large-scale discourse analysis and highlights the importance of studying how users interpret language technologies in sensitive, real-world contexts.
Anthology ID:
2026.findings-acl.569
Volume:
Findings of the Association for Computational Linguistics: ACL 2026
Month:
July
Year:
2026
Address:
San Diego, California, United States
Editors:
Maria Liakata, Viviane P. Moreira, Jiajun Zhang, David Jurgens
Venue:
Findings
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Publisher:
Association for Computational Linguistics
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Pages:
11716–11736
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URL:
https://preview.aclanthology.org/ingest-acl-workshops/2026.findings-acl.569/
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Cite (ACL):
Elham Aghakhani and Rezvaneh Rezapour. 2026. Like a Therapist, But Not: Reddit Narratives of AI in Mental Health Contexts. In Findings of the Association for Computational Linguistics: ACL 2026, pages 11716–11736, San Diego, California, United States. Association for Computational Linguistics.
Cite (Informal):
Like a Therapist, But Not: Reddit Narratives of AI in Mental Health Contexts (Aghakhani & Rezapour, Findings 2026)
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https://preview.aclanthology.org/ingest-acl-workshops/2026.findings-acl.569.pdf
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