How Artificial Intelligence is Changing Psychological Practice: A Qualitative Study of Clinicians’ Perceptions and Ethical Concerns

Abstract

Artificial intelligence (AI) is increasingly embedded in psychological assessment, monitoring, and treatment, yet little is known about how practicing clinicians in low- and middle-income countries experience this shift. This qualitative descriptive study explored clinicians’ perceptions of AI in psychological practice and the ethical concerns they associate with its adoption. Eight clinicians (four men, four women) working in hospitals and private clinics in Islamabad and Rawalpindi, Pakistan, were recruited through purposive sampling and completed semi-structured online interviews. Transcripts were analyzed with Braun and Clarke’s (2006) six-phase thematic analysis. Three themes and eight subthemes were developed: (a) Enhanced Efficiency with Persistent Uncertainty, (b) Erosion of the Human Touch in Psychological Care, and (c) Ethical Vulnerabilities in AI-Assisted Practice. Clinicians valued faster scoring, structured reports, and reduced administrative burden, but doubted the accuracy, transparency, and cultural validity of AI outputs. They regarded empathy and relational depth as irreplaceable and feared that AI could unsettle the therapeutic alliance and provoke client distrust. Ethical concerns centered on data privacy, informed consent, algorithmic bias, and professional autonomy and liability. The findings suggest that perceived ethical and relational risk can outweigh perceived usefulness in clinicians’ appraisal of AI, extending technology acceptance models to psychological practice. Implications for training, clinical guidelines, regulation, and culturally responsive AI development in South Asia are discussed.