The AWARE Framework: An Educational Interview Framework for Assessing Patients' Use of Conversational AI in Mental Health Care

It proposes the AWARE framework, organizing assessment of patients' conversational AI use into five clinically relevant domains: AI use, why, attachment, reality and risk, and effect on functioning. Medical education has emphasized clinicians' own AI literacy and responsible use of generative AI, with comparatively little attention to preparing professionals to assess patients' use of conversational AI during clinical encounters; AWARE turns this gap into an interview structure. This is a Viewpoint article; the framework is not a diagnostic instrument or psychometric scale, and it draws on a review of emerging evidence and psychiatric interviewing practice rather than newly collected empirical data.

AWARE is positioned to complement existing psychiatric interviewing practices by supporting comprehensive history taking, clinical reasoning, risk assessment, documentation, and learner education. Rather than replacing existing interview processes, it brings patient-AI interactions into the scope of routine psychiatric interviewing, supporting patient-centered, evidence-informed practice. The article describes the framework's purpose and positioning discursively, without reporting validation studies, sample sizes, or effect sizes.

It describes how AWARE may be incorporated into undergraduate, postgraduate, and continuing professional education through simulation, objective structured clinical examinations, workplace-based assessment, and clinical supervision. It extends AI-related education from knowledge-level AI literacy toward teachable and assessable clinical skills for evaluating AI use. These are educational implementation suggestions; the article provides no outcome data from educational interventions.

It outlines priorities for future research, including validation, implementation, educational evaluation, and cross-cultural adaptation. It explicitly frames AWARE as a starting point requiring further validation and local adaptation rather than an established assessment standard. This is a research agenda statement; no validation results are reported.

AWARE is explicitly defined as an educational framework rather than a diagnostic instrument or psychometric scale, intended for mental health professionals to systematically assess patients' use of conversational AI and to serve as an organizing thread in undergraduate, postgraduate, and continuing professional education through simulation, objective structured clinical examinations, workplace-based assessment, and clinical supervision; its intended role is to complement existing psychiatric interviewing practices by supporting comprehensive history taking, clinical reasoning, risk assessment, documentation, and learner education.

The article lists validation, implementation, educational evaluation, and cross-cultural adaptation as priorities for future research, indicating that the framework's measurement properties, its performance across populations and care settings, and the effects of educational interventions remain to be examined; readers should keep these open questions in view before adoption.