Therapists’ attitudes toward generative artificial intelligence adoption in South Korea: professional, workplace, and ethical perspectives

This study examined South Korean therapists’ acceptance of generative artificial intelligence (GenAI) at two levels—augmentation versus replacement—and identified factors predicting their behavioral intention (BI) to use GenAI in professional work. A total of 211 therapists in South Korea completed an online survey assessing acceptance of GenAI-augmented versus GenAI-replacement therapy, attitudes toward GenAI use at work, and ethical awareness. Data were analyzed using a mixed model for repeated measures and hierarchical regression analyses. Therapists rated the GenAI-augmented condition significantly more favorably than the GenAI-replacement condition across most dimensions, except in convenience. Higher ethical awareness was associated with larger condition differences in therapy quality expectancy and social influence, whereas greater job insecurity was associated with smaller differences in therapy quality expectancy and human connection concern. In the model with augmented-condition attitudes, personal utility, perceived adaptability, and therapy quality expectancy positively predicted—but ethical awareness negatively predicted—general BI to use GenAI in professional practice. Meanwhile, in the model with replacement-condition attitudes, no acceptance variables significantly predicted BI once workplace attitudes and ethical awareness were controlled. Findings suggest therapists’ dual identity as professionals prioritizing therapy quality and as workers weighing utility and adaptability, with ethical awareness serving as a cautious counterbalance to GenAI adoption.