In Their Own Words: Psychologists Share Their Research

Created on August 5, 2017. Last updated on August 12th, 2026 at 02:37 pm

In Their Own Words: Further Down the AI Rabbit Hole: Responding to Salimi et al.’s “The Digital Empathy Paradox”

By Jonathan G. Perle

When thinking of artificial intelligence (AI), what comes to mind? R2-D2 from Star Wars? Rosey from The Jetsons?  Maybe even Hal9000 from 2001: A Space Odyssey? While once seen as science fiction, as of 2026, AI is everywhere, built into nearly every aspect of human life, from your phone to your car. AI is now also part of your healthcare. Among the large number of AI healthcare programs, one of the newest focuses on parent management training (PMT). PMT remains one of the most effective evidence-informed treatments for childhood attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior, two of the most diagnosed conditions of childhood. Unfortunately, finding a healthcare provider specifically trained in PMT can be pretty challenging. To expand PMT’s reach, Rivera-Cepeda and colleagues (2025) created and studied ParenteAI, an AI capable of delivering PMT without the need for a human healthcare provider. In response to this, Salimi et al. (2026) provided a follow-up paper both praising Rivera-Cepeda et al.’s (2025) work and expressing concerns with the use of a PMT-focused AI.

I was invited to respond to both Rivera-Cepeda et al. (2025) and Salimi et al. (2026), detailing what I saw as the pros and cons of their arguments for the use of AI for PMT. I provided three primary points:

1) While it is certainly possible that something “will be lost” if PMT is completely conducted via AI, and we should not put blind trust in any AI system, simply put, we currently don’t really know how good AI can (and will) be for PMT compared to humans. I made a comparison to telehealth, as when telehealth first became popularized during COVID-19, many healthcare providers and patients/families said that video-based healthcare could never be equal to in-person care, which was proven false. I’m not specifically implying that AI will or will not be judged as equal to human care, but rather, we shouldn’t assume anything until we actually test it.

2) Given the design of Rivera-Cepeda et al.’s (2025) research study that involved human students helping caregivers use the PMT AI before caregivers used it independently, it remains unclear how the PMT AI would have been rated if the human students weren’t involved at all. Maybe the human involvement made caregivers like the AI more, or helped them understand the PMT AI better than they would have if they had to figure it out without a human helping. Alternatively, maybe human involvement didn’t make a big difference at all. It remains unclear.

3) I responded to the notion that, “Moving forward, the challenge will no longer be simply proving that AI ‘can’ conduct parent training, but rather whether it ‘should’ replace the reflective function of humans in navigating the complexities of family dynamics.” While “should we” is an interesting question that should be addressed, I proposed that this question is potentially less important to the average healthcare provider and patient/family than “how” we actually use AI safely, ethically, legally, and via evidence-informed means. Since people will likely be using AI for healthcare regardless of what researchers say, it seems most important to clarify what works and does not work for different people.

When it comes to PMT, healthcare must find new ways of reaching the countless people in need who cannot get access to a specially trained PMT healthcare provider. While potentially never fully replacing a human, an AI-driven PMT does hold promise for helping those who would otherwise go without care, even if the AI is used as a “stop-gap” before people can get into seeing a human provider, or as a supplement/add-on to working with a human provider (i.e., outside of session practice).

References:

Perle, J. G. (2026). Further Down the AI Rabbit Hole: Responding to Salimi et al.’s “The Digital Empathy paradox”. Evidence-Based Practice in Child and Adolescent Mental Health, 11(2), 333-335. https://doi.org/10.1080/23794925.2026.2666766

Rivera-Cepeda, C. F., Vaclavik, D., Bagner, D. M., Hardan, A. Y., & Bunge, E. L. (2025). Feasibility, usability, and promise of a parent management training using a generative artificial intelligence platform. Evidence- Based Practice in Child and Adolescent Mental Health, 11(2), 309-328. https://doi.org/10.1080/23794925.2025.2602466

Salimi, M., Fajari, L. E. W., & Apriani, I. F. (2026). The digital empathy paradox: Beyond ParenteAI’s technical efficacy. Evidence-Based Practice in Child and Adolescent Mental Health, 11(2), 329-330. https://doi.org/10.1080/23794925.2026.2666767

– Past Features –

In Their Own Words: Transforming Pediatric Mental and Behavioral Healthcare Through a Regional
Learning Network: A Guide for Leveraging Implementation Science

By Jessica M. McClure, Melissa A. Young, Stephanie Eberle, Jillian E. Austin, Katherine Junger, Toria Reisman, Jeff Steller, Brandy Seger, & Ndidi Unaka

Pediatric mental and behavioral health (MBH) needs continue to exceed available resources, with most initiatives prioritizing expanded service capacity over measurable improvements in population-level clinical outcomes. To address this critical gap, the Pediatric Improvement Network for Quality (PINQ) was established as a learning network guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation science framework. PINQ was designed to foster strong partnerships among community mental health centers (CMHCs), hospital-based teams, and pediatric primary care providers to enhance access, improve service quality, and drive better outcomes for youth across the region.

Key findings from the implementation of PINQ include:

• Ten MBH teams—comprising 514 therapists—were onboarded and trained to use the Brief Outcome Survey (BOS), a three-item tool as part of a comprehensive measurement-based care (MBC) approach.
• Weekly case consultation groups, facilitated by doctoral-level psychologists, provided therapists with structured support in applying MBC throughout treatment. These sessions offered a collaborative space for clinical problem-solving, skill development, and real-time feedback, helping to strengthen treatment fidelity and promote continuous learning across teams.
• The network’s infrastructure leveraged behavioral health attribution to match patient panels from community organizations with hospital data via a health information exchange, enabling near real-time tracking of MBH emergency department and inpatient admissions for youth across the network.

Recommendations and future directions include:

• Before onboarding new organizations, ensure leaders are fully aligned with the network’s goals and have the authority to support implementation. Tailor onboarding to each organization’s readiness to foster long-term engagement.
• Expand the application of behavioral health attribution across all teams to enable near real-time tracking of emergency department and inpatient utilization, supporting more precise outcome monitoring and informed system-level interventions.
• Leverage aggregated network data to demonstrate impact, inform policy, and support value-based contracting that rewards effective and equitable care.
• Monitor outcomes across demographic groups to identify and address disparities in access to effective care, ensuring interventions promote equitable access and outcomes.
• Deepen partnerships between pediatric primary care and MBH providers to support whole-child care, streamline referrals, and reduce fragmentation across systems.

In Their Own Words: Delivery of Cognitive Behavioral Therapy with Diverse, Underresourced Youth Using Telehealth: Advancing Equity Through Consumer Perspectives

By Reyna J. Rodriguez, Ph.D., Maria J. Lewis, Ph.D., Bradley Hudson, Psy.D., and Amy E. West, Ph.D.

With the rise of telehealth during the COVID-19 pandemic, it is important that the quality of services are evaluated. Our study aimed to understand the experiences of children, their parents, and mental health providers in using telehealth to receive or provide therapy services for pediatric anxiety. 

The main findings of our study are listed below:

• Ensuring privacy of children via telehealth can be a challenge 
• Technological difficulties can detract from the ease and effectiveness of treatment
• Children are generally more comfortable with technology than their parents
• Building a relationship with a therapist via telehealth can be challenging; however, seeing the home environments of therapists can help families feel bonded to the provider
• Advantages to using telehealth include removing the need to commute to the provider’s office and children missing school to attend sessions
• Telehealth reduces risk of COVID-19 contagion 

The following recommendations to address identified challenges are provided:

• Therapists should spend time at the outset of treatment identifying and problem-solving challenges using telehealth
• Families can ask their providers to provide “cheat sheets” or brief introductions to using telehealth platforms to improve comfort with using technology
• Providers and families may reschedule/continue sessions via the phone if internet outages occur, and explore the use a parked car, headphones, and chat functions to increase privacy
• Use of online games may be used to form a relationship with a provider
• A provider may send materials to children and parents to use in treatment sessions

In conclusion, there are several strengths and limitations perceived by children, their parents, and mental health providers regarding telehealth. Working as a team – children, parents, and providers together – to address challenges can improve the quality of telehealth mental health services. 

Source(s):

Castro, M.J., Rodriguez, R.J., Hudson, B., Weersing, V.R., Kipke, M., Peterson, B.S., & West, A.E. (2022). Delivery of cognitive behavioral therapy with diverse, underresourced youth using telehealth: Advancing equity through consumer perspectives. Evidence-Based Practice in Child and Adolescent Mental Health. https://doi.org/10.1080/23794925.2022.2062687

In Their Own Words: Emotional Responses to Social Media Experiences Among Adolescents: Longitudinal Associations with Depressive Symptoms

By Jacqueline Nesi, Ph.D.

In two different homes, in two different towns, two teens are opening up Instagram, getting ready to post. Each scrolls carefully through recent photos, selecting a picture of a recent night out with friends, applies a filter or two, composes a clever caption, and posts. Then they wait. As they check back in on the photo’s status, each begins to realize that only a few “likes” are trickling in. A few hours later, the like count hasn’t budged. How do they react? One teen shrugs her shoulders, closes the app, and heads out to soccer practice, unbothered. The other teen gets a pit in her stomach and sits on her bed, ruminating over what was so wrong with the photo to make her peers despise it or – worse – ignore it completely.

The same social media experience can affect teens very differently.

In a recent study, my colleagues and I set out to learn more about how these different emotional responses to social media experiences might impact teens’ mental health. We asked almost 700 teens questions about how frequently they have negative emotional responses to social media (e.g., feeling bad about getting too few likes, feeling left out or excluded), and positive emotional responses (e.g., feeling happy because of a positive comment, feeling less alone). We also asked them about their symptoms of depression.

Here’s what we found: (1) Teens who reported more positive emotional responses to social media were actually more likely to experience depressive symptoms one year later. Why would this be? We suspect that teens who are more emotionally invested in their online experiences – relying on, for example, high numbers of “likes” to feel happy – may be at greater risk over time. (2) We also found that teens who were already experiencing depressive symptoms were more likely to report negative emotional responses to social media. Teens who are feeling depressed might be at higher risk for these difficult emotions when using social media – feeling bad after a negative comment, or feeling pressure to show a perfect version of themselves. (3) We found that, compared to boys, girls were more likely to report both positive and negative emotions in response to their social media use. It may be that girls are more emotionally sensitive to the experiences they have online.

When it comes to social media use, all teens are not the same. Encouraging teens to recognize how their online experiences affect their moods and emotions is an important first step toward helping them use social media in healthier ways.

Source(s):

Nesi, J., Rothenberg, W.A., Bettis, A.H., Massing-Schaffer, M., Fox, K.A., Telzer, E.H., Lindquist, K.A. & Prinstein, M.J. (2021) Emotional responses to social media experiences among adolescents: Longitudinal associations with depressive symptoms. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2021.1955370