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Main Authors: Quan, Jiatao, Li, Ziyue, Zhu, Tian Qi, Li, Yuxuan, Wang, Baoying, Pratt, Wanda, Gao, Nan
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2512.22462
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author Quan, Jiatao
Li, Ziyue
Zhu, Tian Qi
Li, Yuxuan
Wang, Baoying
Pratt, Wanda
Gao, Nan
author_facet Quan, Jiatao
Li, Ziyue
Zhu, Tian Qi
Li, Yuxuan
Wang, Baoying
Pratt, Wanda
Gao, Nan
contents As large language models (LLMs) are embedded into mental health technologies, they are often framed either as tools assisting therapists or autonomous therapeutic systems. Such perspectives overlook their potential to mediate relational complexities in therapy, particularly for systemically marginalized clients. Drawing on in-depth interviews with 12 therapists and 12 marginalized clients in China, including LGBTQ+ individuals or those from other marginalized backgrounds, we identify enduring relational challenges: difficulties building trust amid institutional barriers, the burden clients carry in educating therapists about marginalized identities, and challenges sustaining authentic self-disclosure across therapy and daily life. We argue that addressing these challenges requires AI systems capable of actively mediating underlying knowledge gaps, power asymmetries, and contextual disconnects. To this end, we propose the Dynamic Boundary Mediation Framework, which reconceptualizes LLM-enhanced systems as adaptive boundary objects that shift mediating roles across therapeutic stages. The framework delineates three forms of mediation: Epistemic (reducing knowledge asymmetries), Relational (rebalancing power dynamics), and Contextual (bridging therapy-life discontinuities). This framework offers a pathway toward designing relationally accountable AI systems that center the lived realities of marginalized users and more effectively support therapeutic relationships.
format Preprint
id arxiv_https___arxiv_org_abs_2512_22462
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Relational Mediators: LLM Chatbots as Boundary Objects in Psychotherapy
Quan, Jiatao
Li, Ziyue
Zhu, Tian Qi
Li, Yuxuan
Wang, Baoying
Pratt, Wanda
Gao, Nan
Human-Computer Interaction
Computers and Society
As large language models (LLMs) are embedded into mental health technologies, they are often framed either as tools assisting therapists or autonomous therapeutic systems. Such perspectives overlook their potential to mediate relational complexities in therapy, particularly for systemically marginalized clients. Drawing on in-depth interviews with 12 therapists and 12 marginalized clients in China, including LGBTQ+ individuals or those from other marginalized backgrounds, we identify enduring relational challenges: difficulties building trust amid institutional barriers, the burden clients carry in educating therapists about marginalized identities, and challenges sustaining authentic self-disclosure across therapy and daily life. We argue that addressing these challenges requires AI systems capable of actively mediating underlying knowledge gaps, power asymmetries, and contextual disconnects. To this end, we propose the Dynamic Boundary Mediation Framework, which reconceptualizes LLM-enhanced systems as adaptive boundary objects that shift mediating roles across therapeutic stages. The framework delineates three forms of mediation: Epistemic (reducing knowledge asymmetries), Relational (rebalancing power dynamics), and Contextual (bridging therapy-life discontinuities). This framework offers a pathway toward designing relationally accountable AI systems that center the lived realities of marginalized users and more effectively support therapeutic relationships.
title Relational Mediators: LLM Chatbots as Boundary Objects in Psychotherapy
topic Human-Computer Interaction
Computers and Society
url https://arxiv.org/abs/2512.22462