Reimagining Therapy: Consumer Perceptions of Generative AI in Mental Health

Growing numbers of consumers are turning to Generative AI (GenAI) for mental health support, yet the psychological engagement processes underlying consumer–GenAI therapy interactions remain insufficiently understood. This gap limits our ability to explain why consumer experiences diverge, particularly in emotionally sensitive contexts requiring high levels of engagement. To address that, we examine why these experiences vary and what mechanisms contribute to these conflicting outcomes. Drawing on 30 semi‐structured interviews, we develop an integrative framework outlining an engagement process between consumers and GenAI therapy. Grounded in cognitive appraisal theory, the framework shows that GenAI operates simultaneously as a functional service and a relational agent, meaning that consumer decisions are shaped by both utilitarian and relational evaluations. By explaining how consumers appraise, reappraise, and cope with GenAI therapy, the framework clarifies the mechanisms underlying divergent outcomes and offers insights for identifying potential risks in GenAI mental health services.