[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-85545-en":3,"doc-seo-85545-105":29,"detail-sidebar-cat-0-en-105":82},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},85545,16904993612988,"Olivia Brown","https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd",7,"Healthcare","Relationship-Centered Care Relatedness and Responsible Design for Human Connections in Mental-Health Care","Relationship-Centered Care examines Digital Therapeutic Alliance (DTA) in AI-powered mental-health chat systems delivering CBT, and argues that optimizing the apparent bond between a patient and an agent can create an “appearance of connection” that disrupts the human psychological need for relatedness. The work proposes shifting from simulating relationships to scaffolding them. It presents an interdisciplinary model translating Responsible AI Six Sphere principles through Self-Determination Theory, focusing on relatedness and guiding AI design to strengthen patients’ broader relational ecology with therapists, caregivers, family, and peers.","arXiv :2603 . 18375v3 [ cs .HC] 10 Jul 2026  \nRelationship-Centered Care: Relatedness and Responsible Design for Human Connections in Mental-Health Care  \nSHIVAM SHUKLA, University of California, Santa Cruz, USA EMILY CHEN, University of California, Santa Cruz, USA MAHNAZ ROSHANAEI, Stanford University, USA  \nMAGY SEIF EL-NASR, University of California, Santa Cruz, USA  \nFig. 1. From simulating relatedness to scaffolding them  \nThere has been a growing research interest in Digital Therapeutic Alliance (DTA) as the field of AI-powered conversational agents are being deployed in mental health care particularly those delivering CBT (Cognitive Behaviour Therapy) . Our proposition argues that the current design paradigm which seeks to optimize the bond between a patient in need of support and an AI agent, contains a subtle but consequential trap: it risks producing an “appearance of connection” that unintentionally disrupts the fundamental human need for relatedness, which potentially displaces the authentic human relationships upon which long-term psychological recovery and overall well-being depends. We propose a reorientation from designing artificial intelligence tools that simulates relationships to designing AI that scaffolds them. To operationalize our argument, we propose an interdisciplinary model that translates the Responsible AI Six Sphere Framework through the lens of Self-Determination Theory (SDT), with a specific focus on the basic psychological need for relatedness. The resulting model offers the technical and other clinical communities a set of relationship-centered design guidelines and relevant provocations for building AI systems that function not just as companions, but as a catalyst for strengthening a patient’s entire relational ecology; their connections with therapists, caregivers, family, and peers. In doing so, we discuss a model towards amore sustainable ecosystem of relationship-centered AI in mental-health care.  \nAdditional Key Words and Phrases: Digital Therapeutic Alliance, Self-Determination Theory, Relational Ecology, Mental Health, Responsible AI, Human-AI Interaction, Relational Displacement  \nAuthors’ Contact Information: Shivam Shukla, University of California, Santa Cruz, USA, [sshukla3@ucsc.edu](sshukla3@ucsc.edu); Emily Chen, University of California, Santa  \nCruz, USA, [eche27@ucsc.edu](eche27@ucsc.edu); Mahnaz Roshanaei, Stanford University, USA, [mroshana@stanford.edu](mroshana@stanford.edu); Magy SeifEl-Nasr, University of California, Santa  \nCruz, USA, [mseifeln@ucsc.edu](mseifeln@ucsc.edu).  \n2 Shivam et al.  \n1 The Emotional Design Trap in Simulating Relatedness  \nThe rise ofAI-based systems for mental-health shifts the landscape of therapeutic care. Platforms like Limbic, Woebot, and Wysa have demonstrated considerable promise in delivering evidence-based interventions, particularly Cognitive Behavioral Therapy, showing efficacy in reducing symptoms of depression and anxiety at scale [6, 7, 9] . As this field is evolving a central focus has been the cultivation of Digital Therapeutic Alliance (DTA), with studies suggesting that users can form timely bonds with an AI conversational agent that is quantitatively (therapeutic alliance scores) comparable to the alliance formed with a human therapist [2] . Content analysis of user transcripts with agents reveals unprompted elements of bonding, including expressions of gratitude, self-disclosed impact, and even the personification of an AI agent [2] . In a recent integrative review done by Malounie et al. on 28 studies in the DTA in AI-driven psychotherapeutic interventions, they have found that users are prone to make a bond with conversational agents with empathic tones and anthropomorphic features [8]. Johnson et al. also found users returning back to share updates with chatbots about their emotions and experiences, reflecting about their long term engagement and sense of relatedness with the system [14] . This bond is a crucial driver","cbCaivKXqD5LaI9a","https://ap.wps.com/l/cbCaivKXqD5LaI9a","pdf",1432355,1,5,"English","en",105,"# The Emotional Design Trap in Simulating Relatedness\n## Digital Therapeutic Alliance and Bond Formation\n## Ethical and Relational Concerns\n# Reorientation: From Simulating to Scaffolding Relatedness","[{\"question\":\"What outcome does the relationship-centered approach aim to support for patients?\",\"answer\":\"The model is intended to help AI act as a catalyst that strengthens the patient’s entire relational ecology, including connections with therapists, caregivers, family, and peers.\"}]",1784204345,13,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":77,"head_meta":79,"extra_data":81,"updated_unix":27},"relationship-centered-care-relatedness-and-responsible-design-for-human-connections-in-mental-health-care","",{"@graph":35,"@context":76},[36,53,67],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/healthcare/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/relationship-centered-care-relatedness-and-responsible-design-for-human-connections-in-mental-health-care/85545/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":61,"encodingFormat":60,"isAccessibleForFree":62,"interactionStatistic":63},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-16",true,{"@type":64,"interactionType":65,"userInteractionCount":4},"InteractionCounter",{"@type":66},"ViewAction",{"@type":68,"mainEntity":69},"FAQPage",[70],{"name":71,"@type":72,"acceptedAnswer":73},"What outcome does the relationship-centered approach aim to support for patients?","Question",{"text":74,"@type":75},"The model is intended to help AI act as a catalyst that strengthens the patient’s entire relational ecology, including connections with therapists, caregivers, family, and peers.","Answer","https://schema.org",{"og:url":51,"og:type":78,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":80,"canonical":51},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":83},[84,88,92,96,100,105,108,113,118,121,125],{"id":20,"doc_module":4,"doc_module_name":45,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":46,"doc_module":4,"doc_module_name":45,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":45,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":21,"doc_module":4,"doc_module_name":45,"category_name":97,"show_sort_weight":98,"slug":99},"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":45,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":45,"category_name":12,"show_sort_weight":106,"slug":107},40,"healthcare",{"id":109,"doc_module":4,"doc_module_name":45,"category_name":110,"show_sort_weight":111,"slug":112},8,"Research & Report",30,"research-report",{"id":114,"doc_module":4,"doc_module_name":45,"category_name":115,"show_sort_weight":116,"slug":117},9,"Religion & Spirituality",20,"religion-spirituality",{"id":116,"doc_module":4,"doc_module_name":45,"category_name":119,"show_sort_weight":116,"slug":120},"World Cup","world-cup",{"id":122,"doc_module":4,"doc_module_name":45,"category_name":123,"show_sort_weight":122,"slug":124},10,"Lifestyle","lifestyle",{"id":126,"doc_module":4,"doc_module_name":45,"category_name":127,"show_sort_weight":21,"slug":128},19,"General","general"]