Abstract
Background
The integration of artificial intelligence (AI) into therapeutic practices has introduced new possibilities for enhancing mental health interventions. Among these innovations, AI-driven art therapy has emerged as a promising approach, combining the expressive and healing aspects of traditional art therapy with the adaptive and analytical strengths of AI. This modality shows particular potential in supporting individuals with autism spectrum disorder (ASD), mental health challenges, and those seeking emotional well-being.
Aim
This umbrella review aimed to synthesize and evaluate existing evidence on the application, effectiveness, and implementation of AI-driven art therapy in improving outcomes for individuals with ASD, mental health conditions, and emotional distress.
Methods
A comprehensive search was conducted across multiple databases—including PubMed, Scopus, Web of Science, PsycINFO, IEEE Xplore, and ACM Digital Library—to identify systematic and scoping reviews that adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The methodological quality of included reviews was assessed using the Joanna Briggs Institute (JBI) checklist. Thematic analysis was applied to extract and synthesize recurring patterns and core themes across studies.
Results
The findings revealed significant therapeutic benefits of AI-driven art therapy, including enhanced communication and emotional regulation in individuals with ASD, and reduced symptoms of anxiety, depression, and Post-Traumatic Stress Disorder (PTSD) in mental health populations. Additionally, the platforms improved emotional well-being through personalized engagement, self-reflection, and increased autonomy. However, technological barriers, ethical concerns, and accessibility issues were noted as key limitations.
Conclusions
AI-driven art therapy represents a transformative and accessible tool in modern therapeutic practices. While challenges remain, its potential to support diverse populations through individually tailored and engaging interventions makes it a valuable complement to traditional mental health care.
Keywords
Introduction
The integration of AI into therapeutic contexts has opened up innovative possibilities, especially in fields that benefit from personalization and emotional insight. 1 Among these, AI-driven art therapy is emerging as a particularly promising approach. 2 This method combines the creative, healing aspects of traditional art therapy with the analytical and adaptive capabilities of AI,3,4 creating a responsive and interactive space for emotional expression and psychological support. 5 In this review, AI-driven art therapy refers to the use of AI tools such as generative art systems, interactive digital platforms, emotional analysis applications, and recommendation algorithms that personalize and support art-based therapeutic practices. It holds significant potential for populations such as individuals with ASD, 6 those experiencing mental health issues like anxiety or depression, and people simply looking to enhance their emotional well-being in a more intuitive and creative way.7,8
Art therapy has long served as a channel for emotional expression, allowing individuals to communicate complex or unspoken feelings through visual and creative means such as painting, sketching, or digital art.9,10 The introduction of AI enhances this by offering real-time support and personalization. 11 AI tools can interpret patterns in a person's behavior or artistic choices, suggest tailored interventions, and provide adaptive prompts that respond to the user's emotional state.12,13 This makes the therapy more inclusive and accessible, even for those who may be uncomfortable with or excluded from traditional therapeutic environments.14–16 Particularly for individuals with ASD, who often face difficulties with verbal communication and sensory regulation, 17 these AI-supported platforms create structured, low-pressure spaces that are both engaging and easy to navigate. 18
Mental health is another area where AI-based art therapy is showing considerable promise. 19 Globally, depression affects about 280 million people, anxiety disorders about 300 million, 20 and PTSD around 4% of the population. 21 AI-enhanced platforms can offer safe environments where individuals are free to express emotions, 22 reflect on their inner experiences, and build coping strategies without judgment.23,24 Features such as mood tracking, virtual creative environments, and intelligent feedback loops allow for ongoing, self-paced therapeutic engagement. 25 Moreover, these platforms empower users by offering a sense of control and self-awareness—essential elements in both recovery and emotional growth.26–28 They not only facilitate expression but also promote emotional resilience and empowerment, making them relevant even for those outsides of formal mental health diagnoses.29,30
Despite these advancements, several questions remain about the reach and effectiveness of AI-driven art therapy. 31 The field is still developing, and existing research is often fragmented, with studies focusing on specific disorders, age groups, or types of AI technologies.32,33 Some employ simple algorithms, while others explore advanced machine learning (ML) systems within immersive or traditional art-based environments.34,35 As the landscape continues to evolve, it is crucial to consolidate what is already known. The aim of this review is to synthesize and evaluate existing evidence from reviews on the application, effectiveness, and implementation of AI-driven art therapy in supporting individuals with autism, mental health conditions, and emotional well-being.
Methodology
Research design
The current study employed an umbrella review methodology, strategically chosen for its capability to integrate and synthesize evidence from various systematic, scoping, and PRISMA-compliant review papers comprehensively. This approach facilitated the identification and exploration of critical themes and existing knowledge gaps regarding the effectiveness of AI-driven art therapy in enhancing ASD, mental health, and emotional well-being. The umbrella review framework provided a structured methodological foundation to consolidate diverse findings systematically, offering a comprehensive overview of the existing evidence landscape.
Literature search strategy
An extensive systematic search of the literature was conducted across multiple prominent scholarly databases, including PubMed, Scopus, Web of Science, PsycINFO, IEEE Xplore, and ACM Digital Library. Search strategies were developed using targeted combinations of keywords, specifically: “artificial intelligence,” “AI-driven art therapy,” “autism spectrum disorder,” “mental health,” “emotional well-being,” and related terms. Boolean operators were applied in detail to improve both precision and comprehensiveness. The operator “AND” was used to combine different concepts, ensuring that retrieved articles included all specified terms (e.g., “artificial intelligence AND autism spectrum disorder”). The operator “OR” was used to capture synonyms and related expressions, broadening the scope of retrieval (e.g., “AI-driven art therapy OR digital art therapy”). The operator “NOT” was used to exclude irrelevant material that might otherwise appear in search results (e.g., “artificial intelligence NOT robotics”). Each database's search strategy was tailored to its indexing conventions and retrieval systems, maximizing the breadth and accuracy of relevant review identification.
Inclusion and exclusion criteria
Explicit and comprehensive inclusion criteria were established to guide the selection of reviews. Eligible studies included peer-reviewed systematic reviews, scoping reviews, integrative reviews, systematic reviews with meta-analysis or meta-synthesis, and reviews explicitly adhering to PRISMA guidelines. Only articles written in English and directly addressing AI-driven art therapy interventions targeting populations with autism, mental health disorders, or emotional well-being challenges were considered. To ensure methodological rigor and clarity, reviews were excluded if they were non-peer-reviewed, grey literature, abstracts, conference proceedings, editorials, commentaries, opinion pieces, or narrative reviews lacking clearly defined methodological frameworks. This approach ensured the inclusion of only well-structured and methodologically robust review articles capable of contributing reliable and relevant insights to the umbrella review.
Screening and selection procedure
The article selection process followed a structured, multiphase approach comprising initial title and abstract screening followed by comprehensive full-text assessment. Two independent reviewers systematically evaluated titles and abstracts against the predefined inclusion criteria to exclude irrelevant studies initially. Subsequently, full-text versions of the remaining articles underwent thorough scrutiny by both reviewers to verify eligibility conclusively. Disagreements or discrepancies identified at any screening phase were systematically documented and resolved through detailed discussions or consultation with a third reviewer, ensuring objective and reliable decision-making.
Quality assessment
To ensure methodological rigor, the quality of the included systematic reviews and scoping reviews was appraised using the Joanna Briggs Institute (JBI) critical appraisal checklist for systematic reviews and research syntheses 36 (Table 1). The JBI tool evaluates key aspects such as the clarity and relevance of the review question, the appropriateness of the inclusion criteria, the thoroughness of the search strategy, the transparency of study selection and data extraction methods, and the reliability of data synthesis and interpretation. Two independent reviewers conducted the critical appraisal of each review article. Any differences in their evaluations were addressed through collaborative discussion, and when an agreement could not be reached, input from a third reviewer was sought to finalize the assessment. This process ensured a consistent, transparent, and rigorous assessment of the methodological quality of the included literature. Although the JBI 10-item tool was applied to categorize studies into high, moderate, or low methodological quality, the appraisal revealed that all included reviews were rated as high quality, thereby reinforcing the robustness and reliability of the synthesized evidence.
JBI quality assessment.
Data extraction process
Data extraction was conducted systematically using a customized, structured template specifically designed to capture essential details relevant to the objectives of the umbrella review. Extracted data points included authors, publication year, objectives, study design, types of AI-driven art therapy interventions discussed, targeted populations, evaluated outcomes, and key findings (Table 2). To maintain accuracy and minimize bias, two independent reviewers carried out the data extraction process and resolved any discrepancies through collaborative discussion, ensuring both thoroughness and reliability.
Summary of included reviews.
HER: human emotion recognition; ASD: autism spectrum disorder; ML: machine learning; SVM: support vector machine; AI: artificial intelligence; CNN: convolutional neural network; IoT: internet of things; OCD: obsessive–compulsive disorder; RF: random forest; AUC: area under the curve; MRI: magnetic resonance imaging; fMRI: functional magnetic resonance imaging; HOG: histogram of oriented gradients; LSTM: long short-term memory; R-CNN: region-based convolutional neural network; DSS: decision support systems; NLP: natural language processing; EHR: electronic health records; KNN: K-nearest neighbors; RNN: recurrent neural network; SAR: socially assistive robots; CAI: conversational artificial intelligence; SDOH: social determinants of health; mHealth: mobile health; DL: deep learning; DNN: deep neural network; BLSTM: bidirectional long short-term memory; DFNN: deep feedforward neural network; ADHD: attention-deficit/hyperactivity disorder; SRMH: sexual, reproductive, and mental health; LMICs: low- and middle-income countries; RAAT: robot-assisted autism therapy; LLMs: large language models; CA: conversational agents; CAs: conversational agents.
Thematic analysis and data synthesis
Given the qualitative emphasis of this umbrella review, thematic analysis served as the primary methodological framework for synthesizing the extracted data. The thematic analysis facilitated systematic identification, analysis, and interpretation of recurring patterns, themes, and critical insights within the literature. Reviewers initiated this process by deeply immersing themselves in the extracted data, achieving a comprehensive understanding of initial patterns and preliminary themes. Following initial data familiarization, a structured coding process was implemented. During this stage, meaningful segments of data were carefully coded, reflecting their direct relevance to the research questions guiding the umbrella review. Generated codes were subsequently organized into broader thematic categories and detailed sub-themes through iterative review and refinement, ensuring accurate representation of data nuances. This rigorous and iterative approach provided clearly defined thematic constructs, enabling a coherent and meaningful synthesis of the evidence. Core themes identified through thematic analysis included the effectiveness and therapeutic benefits of AI-driven art therapy, specific impacts on autism spectrum disorders, mental health improvements, enhancements in emotional well-being, and critical implementation aspects, including technological considerations, user experiences, and accessibility factors. Thematic maps visually illustrate the interconnections among identified themes and sub-themes, offering deeper insights into the mechanisms and contexts through which AI-driven art therapy achieves therapeutic outcomes.
Reporting standards
This umbrella review rigorously adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for comprehensive reporting. 67 A detailed flow diagram was provided, outlining each step of the literature screening and selection process—from initial database searches through various screening stages to the final set of included reviews. As illustrated in Figure 1, the search initially yielded 139 records, of which duplicates, and irrelevant articles were removed. After screening and exclusions due to methodological flaws or insufficient data, 30 reviews were included in the final synthesis, ensuring a rigorous and transparent selection process. Compliance with established reporting standards ensured thorough, transparent, and reproducible documentation of methodological and analytical procedures. The comprehensive methodological framework and systematic rigor employed throughout this umbrella review allowed for a detailed synthesis of existing literature on AI-driven art therapy. By incorporating systematic and scoping reviews, this approach enabled a broad yet detailed understanding of the current evidence landscape, contributing valuable insights and identifying pivotal knowledge gaps relevant for future research, clinical practice, and therapeutic innovations addressing autism, mental health, and emotional well-being.

PRISMA flow diagram.
Results
This umbrella review took a deep dive into how AI-powered art therapy is being used to support individuals with ASD, mental health challenges, and issues related to emotional well-being. By analyzing themes across various review articles, the study uncovered meaningful insights into how these technologies work, what benefits they offer, and what obstacles remain when it comes to practical application. As shown in Figure 2, AI-driven art therapy supports outcomes such as emotion regulation, anxiety and stress reduction, enhanced coping skills, improved social interaction, accessible interfaces, and tailored therapeutic sessions, highlighting its multidimensional impact on mental health and well-being.

AI-driven art therapy outcomes.
Overview of included reviews
A total of 30 reviews were included in this umbrella review.37–66 Of these, the majority comprised systematic reviews (40.0%) and scoping reviews (36.7%), reflecting a balanced use of comprehensive synthesis and exploratory mapping methods. Additionally, systematic reviews and meta-analyses accounted for 10%, followed by integrative reviews (6.7%), which offered broader interpretive insights across diverse methodologies. Other designs included systematic reviews with meta-synthesis (3.3%), and narrative literature reviews (3.3%), each contributing distinct methodological perspectives.
This diversity in review types underscores the interdisciplinary and evolving nature of research at the intersection of AI and art therapy. The frequent use of systematic and scoping reviews demonstrates a dual emphasis on rigorously evaluating existing interventions and identifying emerging themes within the field. Meanwhile, meta-analytical and integrative designs added depth by highlighting effect sizes and synthesizing findings across different study contexts. The inclusion of a range of methodologies enriched the overall synthesis process and allowed for a nuanced understanding of AI-driven art therapy's applications across autism, mental health, and emotional well-being.
Effectiveness and therapeutic benefits of AI-driven art therapy
A significant theme highlighted across reviewed studies was the therapeutic effectiveness of AI-driven art therapy. Reviews consistently reported enhanced communication skills, improved social interactions, and greater emotional expression among ASD populations. 41 AI technologies, particularly ML algorithms, proved notably effective in customizing therapy sessions according to individual user needs, resulting in increased engagement and positive therapeutic outcomes. 39 Enhanced cognitive-emotional processing was frequently noted, attributed primarily to personalized AI-driven therapeutic modules tailored for specific therapeutic interventions. 38
In mental health contexts, AI-driven art therapy demonstrated substantial therapeutic benefits for individuals experiencing anxiety, depression, and PTSD. 54 Findings indicated that participation in AI-supported artistic activities significantly mitigated symptoms related to anxiety and depressive episodes. 57 Interactive, adaptive art therapy platforms leveraging AI were particularly effective at promoting emotional regulation, stabilizing mood, and enhancing overall psychological resilience. 56 These platforms enabled users to externalize inner emotions through art while receiving real-time AI-generated support, contributing to a more dynamic and empathetic therapeutic process. 48 Some reviews also pointed to the preventive role of AI-driven art therapy in at-risk populations.44,66 By encouraging early emotional expression and offering adaptive coping strategies, these systems helped reduce the escalation of mental health symptoms in youth and vulnerable groups.47,55 Moreover, the aesthetic and creative engagement fostered by AI-powered art tools contributed to a sense of accomplishment and purpose among users, further reinforcing positive behavioral changes. 58
Specific impacts on autism spectrum disorders
Within the ASD context, AI-driven art therapies were particularly impactful in addressing primary symptoms such as social deficits, repetitive behaviors, and communication barriers. 37 Studies highlighted AI technologies’ capability to monitor user behavior in real-time, providing tailored feedback and adaptable content designed explicitly for autistic individuals’ developmental needs.40,52 The integration of virtual reality (VR) and augmented reality (AR) with AI was notably transformative, 53 creating immersive environments where participants could safely navigate emotional and social scenarios without typical anxiety associated with real-world interactions. 46 de Belen et al. (2020) emphasized improvements in both verbal and non-verbal communication skills, highlighting AI-driven platforms’ ability to interpret subtle cues such as eye gaze, facial expressions, tone of voice, and gesture recognition rather than remaining limited to general behavioral descriptions. 43 For example, some platforms used computer vision and deep learning algorithms to detect and respond to facial expressions or gaze-shifting patterns, while others employed natural language processing to evaluate speech rhythm and prosody. 37
AI-driven interventions’ adaptability enabled continuous and incremental adjustments, fostering prolonged engagement and sustained skill development. 63 Additionally, these systems facilitated structured art-based interactions in which individuals could engage without sensory overload or fear of misinterpretation, 59 which are common challenges in traditional therapy settings for those on the spectrum. 62 Examples of such structured activities included AI-guided digital drawing tasks with real-time feedback, VR and AR tools that created immersive environments to support emotion recognition, and music composition programs that adjusted rhythm and melody. 37 As many individuals with autism thrive in structured environments, AI systems that followed predictable routines and reinforced positive behaviors were particularly effective. 64 The capacity for repetition and individual pacing also allowed for mastery and confidence-building in a safe, non-judgmental space. 40 In support of these impacts, a systematic review analyzing 944 studies and including 40 eligible articles reported that AI- and ML-based diagnostic models for ASD often reached very high performance, with some deep learning approaches achieving accuracy above 99% in distinguishing autistic from non-autistic individuals. 46
Improvements in mental health
The umbrella review found robust evidence supporting AI-driven art therapy's efficacy in mental health management. These therapies facilitated emotional release and introspection, offering safe environments for emotional exploration, crucial for mental health recovery. 44 Outcomes included decreased stress levels, diminished anxiety, and improved coping mechanisms, significantly enhancing patients’ mental health and quality of life. 48 ML-driven systems—such as those employing support vector machines and convolutional neural networks—provided customized therapeutic content by adapting to user preferences, psychological status, and therapeutic progression, as reported in systematic reviews analyzing digital interventions for anxiety and depression.51,54 These reviews highlighted that personalization was derived from training on behavioral and clinical datasets, which improved both relevance and effectiveness. Personalized therapeutic experiences created by these adaptive platforms were essential for increasing patient adherence and achieving lasting therapeutic outcomes. 42 Moreover, several reviews cited the potential for AI to reduce the stigma associated with seeking mental health support.45,60 By delivering therapy through digital platforms in non-clinical environments, AI-driven art therapy allowed users to engage with mental health interventions discreetly and at their own pace. 57 This flexibility was especially beneficial for individuals hesitant to participate in traditional therapy due to privacy concerns, social anxiety, or cultural barriers. 65
Enhancements in emotional well-being
A prominent finding across reviews was AI-driven art therapy's significant role in enhancing emotional awareness, regulation, and resilience. 50 Participants engaged in AI-supported creative activities—such as AI-guided digital drawing tasks, interactive painting programs, and robot-assisted autism therapy (RAAT)—showed considerable improvements in self-awareness, emotional expression, and emotional regulation capabilities. 48 AI-driven platforms offered tailored emotional support through adaptive feedback mechanisms, significantly improving user experiences and therapeutic results. 60 Interactive AI features allowed real-time emotional state monitoring, providing instant, constructive feedback crucial for emotional growth. 47 Such capabilities effectively promoted emotional literacy, fostered greater resilience, and empowered users with strategies for managing emotional challenges. 62 In addition to therapeutic outcomes, emotional well-being improvements were tied to participants’ sense of autonomy and control. 66 RAAT shows promise in enhancing emotional, social, and cognitive skills in children with ASD, but standardization and long-term studies are lacking. 62 For many, the non-verbal nature of art served as a bridge to emotional insight, which was further enriched by AI's ability to provide context-sensitive prompts, affirmations, or guided questions to facilitate deeper reflection. 49
Technological considerations and implementation barriers
Despite notable therapeutic potential, reviews consistently identified technological challenges as significant barriers to implementation. 61 Issues included the complexity of AI algorithms, substantial initial setup costs, and ongoing technological maintenance and upgrades requirements. 50 Privacy concerns, data security issues, and ethical considerations surrounding AI surveillance emerged as critical factors necessitating rigorous ethical guidelines and user consent protocols to prevent potential misuse or data breaches. 41 Further technical barriers included limited digital literacy among users and practitioners, complicating the widespread adoption of AI-driven art therapy. 61 Successful implementation required comprehensive training, user-friendly technological interfaces, and ongoing technical support to ensure sustainability and efficacy. 66 Scalability and interoperability were also noted as significant concerns. Integrating AI-driven therapy systems into existing clinical workflows often proved challenging due to incompatibilities with electronic health records, insufficient regulatory guidance, or institutional resistance. 42 Moreover, the lack of standardized protocols for AI integration in therapeutic settings limited widespread adoption, particularly in under-resourced areas. 48
User experiences and accessibility factors
User experience emerged as a crucial determinant of AI-driven art therapy's success.37,39 Reviews underscored the importance of user-centered design in significantly influencing user engagement and therapeutic outcomes.42,46 Factors such as intuitive interfaces, ease of interaction, and personalized adaptive feedback considerably improved user acceptance and participation. 48
Accessibility was another critical theme, with variations noted depending on demographics, socioeconomic status, and geographic location. 62 The digital divide emerged as a significant barrier, emphasizing the need for inclusive technological designs that accommodate diverse user requirements and foster equitable access to therapeutic resources. 56 AI-driven platforms that prioritized inclusivity notably enhanced therapeutic effectiveness and user satisfaction. 44 Several reviews proposed strategies to enhance accessibility, including offline-compatible applications, culturally adapted content, and multilingual interfaces.42,49 Such innovations were essential for ensuring broader adoption, especially in marginalized communities or global regions where internet connectivity and digital infrastructure remain limited. 64 Additionally, positive user experiences were linked to the perceived sense of anonymity and safety that AI-driven art therapy platforms could offer. 39 This aspect was particularly relevant for individuals recovering from trauma or facing social stigmatization, who found solace in engaging with technology-based art therapies without fear of judgment. 55
Discussion
The findings of this umbrella review underscore the dynamic intersection of technology and therapeutic practice, revealing how AI-driven art therapy is reshaping emotional and psychological support for diverse populations. Central to this innovation is the capacity of AI technologies to enhance traditional art therapy by delivering highly personalized, adaptive, and emotionally resonant interventions. 68 This personalization is particularly transformative for individuals with ASD, who often struggle with verbal communication, sensory sensitivities, and social interactions. 69 AI-supported art therapy platforms created safe and structured environments where users could express complex emotions visually and nonverbally. 70 These digital platforms, powered by ML and pattern recognition, analyzed user input and responded with tailored prompts and context-sensitive modifications, enabling continuous engagement that traditional therapies might not sustain.71,72 Many included studies pointed to meaningful improvements in users’ social behavior, emotional articulation, and cognitive processing, attributing these outcomes to AI's ability to respond to individual emotional needs in real time. 73 The structured predictability of AI tools also aligned well with the needs of autistic individuals, fostering therapeutic consistency and comfort without overwhelming stimuli. 74
Parallel to these findings, the application of AI-driven art therapy in mental health contexts emerged as a significant contributor to emotional stabilization and symptom reduction in individuals facing depression, anxiety, and trauma-related disorders. Several reviews specifically reported that AI-enhanced platforms—such as generative art systems and emotion-recognition tools integrated within VR-based therapy environments—reduced depressive symptoms and supported coping strategies for individuals with PTSD and anxiety. These tools offered an interactive space where users could safely externalize internal struggles, track emotional patterns, and reflect through artistic creation.75–77 The integration of intelligent feedback systems allowed users to receive supportive and constructive responses tailored to their current emotional state, fostering a deeper therapeutic connection. 78 Importantly, AI platforms helped bridge the gap for individuals who experience stigma or discomfort around traditional therapy settings by offering an alternative that was both discreet and non-clinical. 79 The empowering nature of these tools—granting users control over their self-expression and pace of engagement—added to the therapeutic efficacy, reinforcing users’ autonomy and agency in managing their mental well-being.80,81 Additionally, the positive psychological reinforcement provided through AI-driven art activities often instilled a sense of accomplishment and personal validation, key components in fostering long-term emotional strength. 82
Despite the evident therapeutic benefits, several implementation challenges and limitations emerged across the included studies, drawing attention to the practical and ethical complexities of embedding AI into therapeutic frameworks. One of the most frequently cited concerns was the technological sophistication required to develop and maintain these platforms. 83 Many AI systems used in art therapy rely on advanced algorithms, immersive environments, or emotion-sensing technologies, 84 which demand significant technical infrastructure, continuous updates, and user training. 85 These requirements pose significant challenges for widespread adoption, especially in low-resource settings. 86 Moreover, ethical issues surrounding data privacy and consent were recurrent themes in the literature. 87 Since AI platforms often gather sensitive psychological and behavioral data, the risk of data breaches, misuse, or lack of transparency in algorithmic decisions raises valid concerns. 88 The absence of robust ethical protocols and regulatory standards for AI in therapy further complicates these concerns, 89 leaving practitioners and users without clear guidelines for safeguarding user data and ensuring equitable outcomes. 90 Several studies have also emphasized broader ethical and political issues, such as epistemic inequality and structural digital divides, which determine whose cultural frameworks shape AI design and who has meaningful access to these technologies.91–93 Another layer of complexity is the presence of algorithmic bias or insufficient cultural sensitivity in AI-generated feedback, which may inadvertently lead to misinterpretation or reduced therapeutic relevance for individuals from diverse backgrounds. 94 These systemic issues reflect broader tensions between technological advancement and ethical responsibility, particularly when AI is applied to emotionally vulnerable populations. 95
In addition to these barriers, user experience and accessibility emerged as essential factors influencing the effectiveness and equity of AI-driven art therapy. 96 The degree to which platforms are intuitively designed and culturally attuned significantly impacted user engagement and therapeutic success. 97 A study by Connors et al. (2025) highlighted that platform with simple navigation, real-time feedback, and customizable features tended to produce more sustained participation and better therapeutic outcomes. 98 Conversely, platforms that lacked user-centered design or failed to accommodate neurodivergent needs—such as overstimulating visuals or confusing interfaces—often discouraged engagement. 99 Accessibility was also shaped by socioeconomic and geographical factors, with the digital divide limiting access for those in under-resourced communities or areas with poor internet connectivity. 100 This divide posed a threat to equitable therapeutic access, as individuals most in need of support may also be least likely to benefit from these innovations. 101 Furthermore, users’ digital literacy and comfort with technology significantly influenced their ability to engage with AI-based therapy. 102 While younger populations or those familiar with digital tools might navigate these platforms with ease, older adults or individuals unfamiliar with technology may face challenges that reduce the platforms’ therapeutic potential. 103 Nonetheless, when effectively implemented, AI-driven art therapy platforms created unique and empowering therapeutic spaces, particularly appreciated for their anonymity, autonomy, 104 and emotional safety—allowing users to process trauma, manage stress, and enhance well-being in ways that felt personal and non-threatening. 105
Implications of the study
The findings from this umbrella review hold substantial implications for clinical practice, digital health innovation, and the broader landscape of psychological support. AI-driven art therapy, through its adaptive and emotionally responsive design, presents a powerful adjunct to conventional therapeutic methods. For individuals with ASD, these technologies offer structured, predictable environments that foster communication, social engagement, and emotional expression. The real-time feedback and personalization capabilities of AI can significantly improve therapeutic outcomes by accommodating unique user needs and preferences, particularly for neurodivergent individuals who may find traditional therapy settings overwhelming or ineffective. These tools not only bridge communication gaps but also support skill development through repetitive, non-judgmental, and interactive sessions—an advantage especially relevant in managing ASD-related challenges.
Moreover, in mental health contexts, AI-enhanced art therapy platforms provide a novel, low-barrier entry point for individuals seeking psychological support. The opportunity to engage in therapy from the comfort of one's own space, combined with anonymity and emotional safety, reduces stigma and increases accessibility—particularly for those reluctant or unable to access conventional services. For populations dealing with anxiety, depression, or trauma, AI-based systems offer real-time emotional support, enhance emotional literacy, and foster resilience. Importantly, these platforms promote self-efficacy and autonomy by allowing users to navigate therapy at their own pace. However, for these promising benefits to be fully realized, ethical and technical challenges such as data security, algorithmic transparency, and digital inclusivity should be addressed. The implications extend beyond individual therapy to systemic innovation in mental health delivery, highlighting the need for responsible integration of AI in therapeutic practice that ensures both effectiveness and equity.
Limitations
This umbrella review provides valuable insights but is not without limitations. The synthesis depended entirely on previously published systematic and scoping reviews, which means that the strength of the conclusions is tied to the quality and scope of those original works. Reliance on secondary sources may also introduce the risk of bias, since studies reporting positive outcomes are often more likely to appear in peer-reviewed literature. Considerable variability across included studies, such as differences in populations, intervention designs, and AI applications, further complicates the ability to generate consistent conclusions or make precise comparisons. It is also worth noting that while this review included both pediatric and adult populations, therapeutic needs may differ between these groups, and future research should further examine age-specific effectiveness to ensure that interventions are developmentally appropriate and optimally tailored.
The rapidly evolving nature of AI technologies presents another challenge, as many studies examined early-stage or pilot programs with uncertain scalability, reproducibility, and long-term sustainability. In addition, some interventions were commercially developed, and studies with industry involvement may carry conflicts of interest that influence interpretation of results. Ethical concerns such as data privacy, informed consent, and algorithmic transparency were also insufficiently addressed across the literature. These limitations suggest that while AI-driven art therapy is promising, the findings should be interpreted carefully and situated within broader ethical and practical contexts.
Recommendations for future research
While this umbrella review has consolidated valuable insights into the potential of AI-driven art therapy, future research should aim to fill several critical gaps to advance this emerging field. Longitudinal studies are essential to evaluate the sustained therapeutic effects and long-term user engagement with AI-enhanced platforms. It is also necessary to compare these technologies with traditional art therapy and other digital mental health interventions to identify their relative strengths, limitations, and ideal user profiles. Furthermore, future studies should prioritize inclusivity by incorporating diverse cultural, linguistic, and socioeconomic contexts to ensure global applicability. Research exploring accessibility for individuals with disabilities, older adults, and those in remote or underserved areas is particularly important in bridging the digital divide. In parallel, investigations into the ethical dimensions of AI uses—such as data privacy, informed consent, and algorithmic fairness—should be rigorously pursued to build trust and transparency within therapeutic frameworks. Another key area involves participatory design approaches that engage end-users, including autistic individuals and those with mental health concerns, in co-creating platforms that are intuitive, emotionally attuned, and clinically appropriate. Such collaborative development can improve usability, foster greater emotional resonance, and reduce potential harm or misunderstanding. By addressing these dimensions, future research can contribute to the safe, effective, and inclusive expansion of AI-driven art therapy within modern mental health care.
Conclusion
This umbrella review highlights that AI-driven art therapy offers meaningful therapeutic value across autism, mental health, and emotional well-being, yet its promise is tempered by notable gaps. Evidence indicates consistent improvements in communication, emotional regulation, and self-expression, particularly for individuals with ASD, and reductions in anxiety, depression, and trauma-related symptoms in broader mental health contexts. However, the field remains fragmented, with an overreliance on supervised machine learning and facial-cue–based interactions, while deep learning applications and culturally inclusive datasets are underexplored. Implementation is further constrained by ethical concerns, data privacy issues, and accessibility barriers, which limit scalability and equitable adoption. These findings suggest that AI-driven art therapy is best positioned as an adjunct rather than a replacement for human-led care, offering unique opportunities for personalization and engagement. Future progress will depend on context-sensitive system design, stronger ethical frameworks, and inclusive research that integrates user perspectives across diverse populations.
Footnotes
Acknowledgments
The authors are deeply grateful to the Miyan Research Institute, International University of Business Agriculture and Technology, Dhaka, Bangladesh.
Ethical approval
Our study did not require an ethical board approval because it did not contain human or animal trials.
Contributorship
Conceptualization: Sumaiya Yeasmin, Sanchita Saha, Moustaq Karim Khan Rony, Mst Masuma Akter Semi, Srabani Das, Rayhan Khan. Data curation: Mst Masuma Akter Semi, Rukshanda Rahman, Afia Fairooz Tasnim, Arif Hosen. Formal analysis: Sumaiya Yeasmin, Rayhan Khan. Investigation: Moustaq Karim Khan Rony, Sanchita Saha, Afia Fairooz Tasnim, Mst Masuma Akter Semi. Methodology: Moustaq Karim Khan Rony, Sumaiya Yeasmin, Srabani Das. Project administration: Sumaiya Yeasmin, Afia Fairooz Tasnim, Sanchita Saha. Resources: Rukshanda Rahman, Arif Hosen, Srabani Das.
Software: Moustaq Karim Khan Rony, Sanchita Saha, Rayhan Khan. Supervision: Moustaq Karim Khan Rony, Sumaiya Yeasmin, Mst Masuma Akter Semi. Validation: Afia Fairooz Tasnim, Rukshanda Rahman. Visualization: Sumaiya Yeasmin, Arif Hosen. Writing—original draft: Sumaiya Yeasmin, Srabani Das, Moustaq Karim Khan Rony, Mst Masuma Akter Semi, Rukshanda Rahman, Rayhan Khan. Writing—review and editing: Sanchita Saha, Moustaq Karim Khan Rony, Sumaiya Yeasmin, Arif Hosen. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.
Funding
There was no external fund taken for this current research.
Declaration of conflict of interest
The authors have no competing interest at all.
