There 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 depends. We propose a reorientation from designing artificial intelligence tools that simulate 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 a more sustainable ecosystem of relationship-centered AI in mental health care.

翻译：随着人工智能驱动的对话代理（尤其是提供认知行为疗法（CBT）的代理）被部署于心理健康照护领域，学界对数字治疗联盟（DTA）的研究兴趣日益增长。我们的论点认为，当前旨在优化需要支持的患者与人工智能代理之间联结的设计范式存在一个微妙但影响深远的陷阱：它可能产生一种“联结的表象”，在不经意间破坏人类对相关性的根本需求，并可能取代长期心理康复所依赖的真实人际关系。我们提出从设计模拟人际关系的AI工具转向设计能够支撑人际关系的AI。为将这一论点付诸实践，我们提出一个跨学科模型，该模型通过自我决定理论（SDT）的视角解读负责任AI六领域框架，并特别聚焦于对相关性的基本心理需求。由此产生的模型为技术界和临床界提供了一套以关系为中心的设计指南及相关启示，旨在构建不仅作为陪伴者，更能催化强化患者整体关系生态（即其与治疗师、照护者、家人及同伴的联系）的AI系统。在此基础上，我们探讨了迈向更可持续的心理健康照护中以关系为中心的AI生态系统模型。