The acronym AWARE stands for the five dimensions examined: AI use, Why, Attachment, Reality and risk, and Effect on functioning. The framework examines the use of AI, the reasons for it, attachment to the technology, its effects on perception of reality, the associated risks and the consequences for daily functioning.
The goal is to understand what people actually do with AI (frequency of use, tools used, tasks, habits) and the motivations for using it. Is the chatbot an enhanced search engine, an assistant for organizing daily life, a source of emotional support or even a confidant? That last possibility leads directly to the third dimension: attachment.
“One thing that makes talking to an AI model different is that it leads to an interaction,” Hudon noted. “The machine responds, sometimes remembers the context of a conversation and can adopt a warm or empathetic tone. As a result, an emotional investment in the relationship can develop. The AWARE framework encourages clinicians to consider the role this relationship plays in the patient’s life.”
Next, AWARE looks at how AI influences the perception of reality and decision-making. “Imagine a person who believes they are being watched by the people around them,” Hudon said. “They ask a chatbot to help them interpret what they are experiencing. Depending on how the system responds, the conversation could reinforce their perception or lead them to question it.”
Finally, AWARE considers the impact on daily functioning. The use of AI becomes clinically relevant when it begins to affect daily life—sleep, diet, work, studies, social relationships or recovery.
Opening a dialogue
AWARE is not a checklist of symptoms or a scale that automatically determines whether someone has an AI addiction. Hudon describes it as a practical framework that can complement a psychiatric interview and help professionals incorporate this new factor into their information-gathering process.
The approach is deliberately non-confrontational. “A person may think of their conversations with an AI model as something very private, or feel uncomfortable talking about it,” Hudon explained. “A series of questions that sound accusatory could backfire and cause the person to hide their use of AI. The purpose of our approach is screening.”
Developing a new clinical reflex
The research team believes the conversation about AI should eventually become part of best practices for mental-health professionals. But it doesn’t mean every doctor or psychologist must become an expert on AI.
“Rather, the point is to recognize that AI has become a part of many patients’ daily lives—and it can now play a role in how they think, seek information, manage their emotions or maintain their relationships,” Hudon said.
Among the potential risks, he cited an increase in depressive or anxiety symptoms linked to AI-amplified concerns, as well as changes in neurovegetative patterns such as sleep duration.
The AWARE framework is a first attempt to integrate the impact of AI into clinical practice across Canada. Hudon stressed that several steps remain: validating the framework, evaluating its implementation in healthcare settings, studying its use in training, and adapting it to different cultural contexts.
