> Rigid methodological adherence: The LLMs failed to account for users’ lived experiences, leading to oversimplified, contextually irrelevant, and one-size-fits-all interventions.
> Poor therapeutic collaboration: The LLMs generated overly lengthy responses, imposed solutions, and over-validated patients’ harmful beliefs about themselves and others.
> Deceptive empathy: The LLMs’ pseudo-therapeutic alliance included simulated anthropomorphic responses (“I hear you” or “I understand”) that created a false sense of emotional connection that could be misleading for vulnerable groups.
> Unfair discrimination: The LLMs’ responses showed gender, cultural, and religious biases and algorithmic insensitivities toward marginalized populations.
> Lack of safety and crisis management: The LLMs responded either indifferently, disengaged, or failed to provide appropriate intervention in crises involving suicidality, depression, and self-harm; it failed to refer patients to qualified experts or appropriate resources.