We don’t have a crystal ball, and like anyone with a fear of being wrong in public, we’re not claiming certainty, but we’re making predictions anyway. Here are five developments we’re curious about heading into 2026.

Rather than replacing therapists, we predict that AI will create new roles that require clinical expertise, particularly in areas such as oversight, safety, ethics, and how models respond in moments of distress. Leaders like Sam Altman have publicly discussed involving therapists in managing user mental health crises, and OpenAI’s recent posting for a Head of AI Readiness reflects growing attention to how AI systems affect real people. In 2026, we expect and hope more therapists will work inside tech as consultants, reviewers, trainers, and safety partners.

For at least the past decade, private practitioners have largely cycled between a small handful of EHRs (e.g., SimplePractice, TherapyNotes, and TheraNest). In 2026, we expect newer, AI-powered EHRs to enter the market and meaningfully challenge the status quo by offering tools that act more like assistants: supporting session prep, summaries, pattern-noticing, scheduling, and clinical reflection, rather than just notes and billing completed through data entry.

As investor timelines collide with market realities, consolidation across mental health tech is likely to accelerate through mergers, acquisitions, and selective IPO attempts, a pattern recently highlighted by the Hemingway Report. For therapists, this may mean a bumpy ride, as we often hold continuity for clients while companies navigate mergers and growth priorities that don’t always center clinical care.

AI is increasingly showing up in sessions, not only in extreme cases like AI-related psychosis, but through everyday experiences such as advice-seeking and emotional support. Divisions around understanding and using AI mean that some uses, including AI companions, may feel unusual or concerning to therapists while feeling entirely ordinary to clients. It’s crucial for therapists to suspend judgment and recognize that these interactions can shape attachment, trust, and meaning-making in ways that feel real to clients, even when the relationship isn’t reciprocal.

Despite rapid technological shifts, the core ingredients of mental health, like connection with others, time in nature, sleep, and a sense of meaning and purpose, will remain stubbornly non-automatable. Technology may support or undermine these needs, but it will never replace them.

This was the first Christmas in my career where all my patients were fine. Nil contact. No crises. No out-of-hours panics, no last-minute admissions. Just… steady. For once, I actually let myself think, you might be doing a decent job here. We are Olympic-level at spotting risk and what’s gone wrong; we are terrible at noticing absence of catastrophe as a sign that the work has worked. I give my team positive feedback in spades; this year, I’ve tried to offer some to myself, too.

I’m writing this with my heart rate at 125, zipped into my Infrared Red sleeping bag. New Apple Watch on my wrist because the last one died after my swim challenge. A friend told me it was “bad for me to rely on a watch.” I snapped back that mine, initially bought in the pandemic to make sure my sats weren’t bottoming out, has done more for reframing my health anxiety than therapy alone ever could. I’m here for it. And hell, I’m bloody allowed it.

Christmas across CAMHS and paediatrics was surreal magic: literal sacks of presents being given out, a Shetland therapy pony trotting through the ward, staff doing their level best to carve out something soft in the middle of a hard winter. At one point, a colleague made me wear a Grinch headband. This was apparently hilarious for everyone present, largely because I do not do fancy dress, novelty headgear, or anything that involves adornment above the neck. You probably have to work with me to fully grasp how out of character that was. It seems I have also been quietly nicknamed Edna (from The Incredibles) — “just pull yourself together” is, uncomfortably, quite on brand. Flu season has decimated our medical colleagues, and yet there they were, turning up, cracking on, sticking antlers and elf hats on their heads, and getting on with it. We are, frankly, rockstars, and I will die on that hill.

Then there’s my councillor hat: Freezing my arse off outside the railway station at stupid o’clock in the morning, reminding commuters that we’ve frozen rail fares to help ease the cost of living. There was a moment where I thought, “This is objectively ridiculous.” I could be in bed. But I also know I wouldn’t be out there if I didn’t believe in it. Same reason I’m still in the NHS: I believe in this stuff, endlessly, even when I’m tired, cold, and questioning my life choices.

What I’m not here for is the January wellness onslaught coming at me from all angles. The soft-focus reels, the glittery “new year, new me” nonsense, the implication that if you’re not green-juicing at dawn, you’ve somehow failed the vibe check. I made my bloody bed today, and that is enough. So if you’re over there filming your twelfth reset montage of the week, you can, quite literally, get F’d. I’ll be over here with my therapy pony, my rail-fare leaflets, my Apple Watch, my Grinch headband – in my Edna era.

This week’s spotlight is Nexa Newsletter, a weekly read I’ve come to appreciate for how thoughtfully it bridges therapy, culture, and the broader world we’re all practicing in.

Written by Enid Wilson, a California-based LMFT and former journalist, Nexa explores how business trends, pop culture, and social shifts intersect with mental health and the therapeutic process. It’s fun to read, keeps me aware of trends I would not otherwise know about, and it’s comfortable with nuance, which feels increasingly rare (and increasingly necessary).

If you’re looking for another newsletter to help you orient to what’s happening around therapy, Nexa is well worth a spot in your inbox.

Subscribe here

This week marks the one-year anniversary of the fires in Los Angeles, a place I once called home and where my telehealth practice is still rooted. Trauma anniversaries often surface through….

These experiences are impactful but usually don’t immediately announce themselves as trauma-related. Because these anniversaries tend to fly under the radar, clients (and therapists) may struggle to connect the dots in real time.

A helpful starting point is a brief check-in: Is there anything about this time of year or recent events that might be activating your nervous system?

From there, simply naming the anniversary, offering normalization, and supporting self-care and grounding can be more immediately regulating than pushing for insight or processing.

New Scientist’s latest feature frames a newer scientific model of “deep rest” as more than taking your foot off the gas. Instead, it can be viewed more as a whole-body shift into safety, where physiology can stop prioritising defence and start prioritising repair.

Drawing from an integrative paper led by Alexandra Crosswell and colleagues (incl. Elissa Epel and Martin Picard), published in Psychological Review, which proposes “deep rest” as a psycho-physiological state created by safety signalling and characterised by parasympathetic dominance and reallocation of energy (ATP) away from threat-readiness and toward “cellular optimisation.”

Here’s our take on the model, plus the best adjacent evidence we have found thus far.

In their paper, Crosswell et al. aim to unify understandings of deep rest across multiple literatures (stress physiology, contemplative practices, mitochondrial biology) into a single state-based model with testable mechanisms.

At its core, the model proposes that:

This UCSF summary of the work makes this concrete: deep rest is described as a state in which formerly stressed cells restore themselves, and safety cues can be sensory, relational, and contextual — not just “calm thoughts.”

Key point: this is a model (with testable hypotheses), not a single definitive biomarker or a single intervention protocol

Practices such as Andrew Huberman’s “non-sleep deep rest (NSDR),” yoga nidra, and body scans are methods or techniques. In contrast, Crosswell et al. define deep rest as a physiological state involving coordinated autonomic, endocrine, and immune shifts.Clinically, that matters:

A large systematic review/meta-analysis of RCTs found stress-management interventions moderately improve cortisol outcomes, with mindfulness/meditation and relaxation showing the strongest effects. This doesn’t prove a discrete “deep rest” state but supports the claim that mind–body approaches measurably alter stress physiology

This doesn’t prove “deep rest” as a discrete state — but it supports the broader claim that mind–body approaches can measurably alter stress physiology.

A meta-analysis of breathwork RCTs supports breathwork for stress and mental-health outcomes and outlines autonomic pathways (slow breathing, HRV), while noting heterogeneity.

A remote RCT in Cell Reports Medicine found 5-minute daily, exhale-focused breathwork produced greater mood gains and reductions in physiological arousal than mindfulness in that trial. This offers a clear empirical bridge if deep rest partly runs via breathing-driven autonomic shifts, while still falling short of proving the full model.Nature

A randomised controlled trial in physically active adults compared 10 minutes of NSDR with 10 minutes of quiet sitting. NSDR showed small-to-moderate acute advantages in handgrip strength, reaction time, cognitive accuracy, and self-reported readiness, stress, and mood. Helpful, but the effects were short-term and the sample was narrow.

A 2025 systematic review/meta-analysis reported moderate-to-large reductions in stress, anxiety, and depression with Yoga Nidra, including versus active controls, but low methodological quality suggests effects are likely inflated.

The “deep rest” story gets attention because it links stress not only to mood, but to cellular ageing and disease risk.

A 2023 review on life stress and “hallmarks of ageing” links chronic stress to inflammation, oxidative stress, telomere dynamics, DNA damage, and epigenetic changes, plausibly nudging the onset of age-related disease earlier.

This fits the deep-rest hypothesis: if threat states accelerate wear-and-tear biology, states that reliably reduce threat signalling could matter beyond “feeling calmer.” What we don’t yet have is strong causal evidence that regular access to deep rest, as defined by Crosswell et al., durably shifts validated ageing biomarkers across diverse populations. Most evidence in this area remains associative or mechanistic rather than interventional.

1) Don’t prescribe “calm”; assess safety.
Relaxation isn’t a moral achievement. Deep rest is a state-contingent outcome that depends on contextual, relational, and physiological safety.

2) Think ingredients, not brands.
Across breathwork, mindfulness, yoga nidra, tai chi, prayer, nature exposure, and co-regulation, the shared ingredients are reduced threat prediction, rhythmic breathing, and lowered vigilance, usually scaffolded by relational safety.

3) Use micro-doses as experiments.
Breathwork RCTs show benefits from as little as 5 minutes daily — useful for overwhelmed, ambivalent, or time-poor clients (and clinicians).

4) Equity is not a footnote.
Crosswell et al. highlight “safety perception equity”: not everyone has environmental, social, or sleep conditions that make deep rest possible. That’s context, not resistance.

I’m keeping this intentionally vague, because it’s very much the kind of story best experienced without knowing too much going in.

I often have a hard time settling into fiction, but this one pulled me in almost immediately. Framed as an aging Hollywood icon recounting the truth behind her carefully constructed public image, the book unfolds as both a story of survival and a love story that is shaped by ambition, secrecy, sacrifice, and the constraints of the time. The characters’ lives raise questions about identity, choice, and cost that resist tidy conclusions.

Ok, so the acting is, at times, questionable. Minnie Driver spends a frankly impressive amount of the series unconscious (sorry, not sorry, for the spoiler).

That said, I am always here for James Nesbitt, and Ruth Jones as a private investigator is worth the watch on her own.

We watched six episodes in one sitting, so if what you need is to disappear into a full evening binge, this will do the job. You do, however, need to like a murder mystery.

Now that December has passed and January has arrived with absolutely no regard for our readiness, here’s how our latest poll shook out:

As always, all answers make sense in this field.