Perceptions of AI-CBT: Trust and Barriers in Chinese Postgrads

TL;DR

This study explores Chinese postgraduate students' perceptions of AI-CBT chatbots, revealing a cautious openness influenced by perceived usefulness, privacy concerns, social norms, and digital literacy, informing culturally sensitive mental health tool design.

Contribution

It provides qualitative insights into Chinese students' attitudes towards AI-CBT, highlighting cultural and contextual factors affecting adoption and offering design implications for mental health technologies.

Findings

Perceived usefulness and 24/7 access foster positive attitudes.

Data privacy and emotional safety concerns limit usage.

Social norms and digital literacy influence adoption decisions.

Abstract

The mental well-being of graduate students is an increasing concern, yet the adoption of scalable support remains uneven. Artificial intelligence-powered cognitive behavioral therapy chatbots (AI-CBT) offer low barrier help, but little is known about how Chinese postgraduates perceive and use them. This qualitative study explored perceptions and experiences of AI-CBT chatbots among ten Chinese graduate students recruited through social media. Semi-structured Zoom interviews were conducted and analyzed using reflexive thematic analysis, with the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) as sensitizing frameworks. The findings indicate a cautious openness to AI-CBT chatbots: perceived usefulness and 24/7 access supported favorable attitudes, while data privacy, emotional safety, and uncertainty about `fit' for complex problems restricted the intention to use. Social norms (e.g., stigma and peer views) and perceived control (digital literacy, language quality) further shaped adoption. The study offers context-specific information to guide the culturally sensitive design, communication, and deployment of AI mental well-being tools for student populations in China and outlines the design implications around transparency, safeguards, and graduated care pathways.