By Olivia L. Baylor, LCPC, NCC, BC-TMH, CFMHE
Clients are not arriving with the same concerns they had five years ago.
They are arriving exhausted by screens. They are lonely in the company of chatbots. They are comparing themselves into despair on platforms designed to keep them scrolling. And they are asking questions about a kind of suffering that did not exist when most of us completed our graduate training.
This is the new presenting concern. It asks something more of us than what we were given in school.
What it looks like in the room
Here is what I am seeing, and what clinicians tell me they are seeing.
Children are forming attachments to algorithms.
Teenagers are describing relationships with people and personalities they follow but have never met.
Adults are turning to AI for emotional support that used to belong to a human being. Sometimes that human being was a friend. Sometimes a therapist. Sometimes a partner.
None of these clients walk in and say, "My presenting concern is digital." They say they are tired. They say they are anxious. They say they feel alone. The digital part sits underneath, and it is easy to step over.
It is not a side issue
It is tempting to treat technology use as background. A lifestyle factor. Something to note at intake and move past.
I would ask you to resist that.
When a client tells you a chatbot is their closest confidant, that statement is not bad data. It is the conversation you are now sitting in.
When a client's screen time keeps coming up at the edges of every session, consider that it is not a side issue. It could be the central one.
When you work in a school and you see the relationship between social media and the rising anxiety in your hallways, trust what you are seeing.
You do not need all the answers
Here is what I have learned. The clinicians who serve their clients best in seasons of change are not the ones who have all the answers.
They are the ones who notice when the work is shifting and respond with a willingness to learn something new.
That does not mean a complete reinvention. It does not mean chasing the latest framework. It means three modest things:
A specific tool
A clearer language for what is happening
A structured way to bring it into the room with the people who trust you
These are quiet professional decisions. They will not announce themselves. Over time, they shape the kind of help you are offering.
Where most of us are improvising
Most clinicians received little to no training on screen overuse, AI chatbot dependency, or social media-driven distress.
So when a client describes exhaustion from being online, attachment to an AI companion, or anxiety they trace back to a feed, many of us improvise. We rely on frameworks that were never designed for digital presenting concerns.
A structured approach covers four skills:
Screening for digital overuse, beginning at intake.
Recognizing AI chatbot dependency when a client describes it, including when they describe it casually.
Working with social media-driven anxiety and comparison patterns.
Structuring sessions for a client who is in digital crisis.
The tools that support those skills are practical ones: intake prompts, session-by-session conversation guides, and harm-reduction frameworks.
Talk about technology without shame
There is one more tool, and I would put it first.
You need language for talking with clients about technology without shaming or pathologizing.
A client who feels judged for how much they scroll, or embarrassed about confiding in a chatbot, is less likely to keep telling you about it. Then you have lost the very information you need.
Curiosity keeps the door open. Ask what the chatbot gives them. Ask what the feed does for them on a hard day. Ask what they notice afterward. You are not excusing harm. You are learning what need is being met, so you can help them meet it in ways that serve them.
Who needs particular care
This work does not look the same with every client. Three groups deserve special attention:
Adolescents
Neurodivergent clients
Couples affected by digital infidelity, parasocial relationships, or asymmetric tech use within the relationship
That last one matters to anyone who works with partners. When one person lives much more of their life online than the other, the difference becomes part of the relationship. It belongs in the room.
We built these pieces into our course When the Algorithm Becomes the Therapist: AI, Mental Health & the New Digital Crisis, which includes a session-tools workbook so the learning goes into your client work and not only into your file cabinet.
The one question
Take an honest look at the cases on your caseload right now and ask yourself one question.
What part of this is digital, and do I have a real plan for it?
Whatever your answer is, that is where your next step lives.
Try this
Take these into your next week of sessions, or into supervision.
Pick three current cases. For each, answer the question: what part of this is digital, and do I have a real plan for it?
Read your intake paperwork. Note where you ask about screens, social media, or AI use, and where you do not.
The next time a client mentions a chatbot or an AI companion, treat it as clinical material. Ask one curious question before you move on.
Listen to your own language about technology in session. Notice anything that could land as shaming.
With a couple, ask how each partner uses technology and whether the difference between them has come up.
Where to go next
Technology shows up in premarital work too, and you can see how couples approach their hardest conversations in the book, The Before I Do Method™. If you want premarital work to be a specialty, the CPMS™ certification leads to the Certified Pre-Marital Specialist™ credential. If you already serve engaged couples, they can find you through the Premarital Counseling Directory™. The training named in this post is listed with the other courses at My Mental Health University®.
CE credit eligible through an Approved Continuing Education Provider (ACEP #7739).
