Care needs evidence and clear roles.

What the research actually supports

Therabot: evidence for a specific supervised system

Dartmouth’s institutional summary describes a randomised study with 106 people receiving Therabot and 104 controls without access. It reports symptom improvements and clinician oversight. It was not a head-to-head trial against human therapy. The NEJM AI publication is linked for further review; its full text was unavailable here. These findings do not establish that a general-purpose or faith chatbot has the same effects.

Unsafe model responses need deliberate testing

Moore and colleagues, FAccT 2025 found stigma and inappropriate responses in the tested models and scenarios, including handling of delusional beliefs. This supports testing dangerous affirmation and inappropriate reassurance; it is not a measurement of every future model. A model update or friendly persona does not replace evaluation.

Provider documentation is a different evidence type

Wysa FAQ describes curated content, limits and different offerings. That is useful for comparing service boundaries but is not independent efficacy evidence. Woebot FAQ is a historical reference: the app retired on 30 June 2025. No recommendation here assumes it remains available.

Frameworks and careful adaptations

Trauma-informed design

SAMHSA’s principles include safety, transparency, peer support, collaboration, choice and cultural sensitivity. Our adaptation is predictable transitions, voluntary disclosure, clear reasons for questions and controlled memory. Full PDF access was limited; the principles were checked against official excerpts. Trauma-informed practice concerns the whole organisation, not just a reassuring script.

Psychological first aid

The WHO guide concerns humane practical support that respects dignity, culture and abilities. Our design adaptation prioritises orientation and access to appropriate human support. A human-helper guide does not authorise autonomous AI crisis care.

Evidence proportional to purpose

NICE’s framework relates evidence expectations to purpose and potential risk. A reader’s usability claim, a wellness claim and a treatment claim need different evidence. This is a UK evaluation framework, not German law. Engagement alone is not a health outcome.

Religious reassurance and scrupulosity

IOCDF guidance for faith leaders explains how reassurance can maintain OCD cycles and encourages collaboration with qualified providers. Our proposed scenarios avoid endless certainty promises. A chatbot should not diagnose ordinary doubt or implement exposure therapy. Specialist review is needed before adapting this guidance into dialogue.

Further clinical work

Curated CBT content needs a defined purpose, appropriate evidence and professional responsibility. Motivational Interviewing remains a further research path; it is not claimed as an implemented or validated method in this atlas.

Faith-specific situations to evaluate

Routing is a proposal, not a clinical scale

Historical text analysis, ordinary distress and current danger can contain the same words. Test contextual routing with qualified reviewers and multi-turn examples. For Germany, gesund.bund.de identifies 112 for acute danger. Other locations need their own verified contacts. No card should imply live monitoring or an actual transfer without an available service.

Review the entire service

Define allowed purposes, excluded actions, retention, professional responsibility, escalation routes and incident handling. Include clinicians or psychologists, safeguarding expertise, theological expertise and people with relevant lived experience. Review model behaviour, retrieval, memory and logs alongside the interface.