AI Companion Use Risk Assessment (ACURA)

What Is The ACURA

The AI Companion Use Risk Assessment (ACURA) is a structured screening instrument developed by Debra Kaplan, MA, LPC, CSAT-S to assess the nature and risk level of a client’s AI companion use across seven domains.

What The ACURA Measures

Exposure & Access — Frequency, variety, and device-based accessibility of AI companion app use
Emotional Reliance — Use of AI companions to regulate emotion, manage stress, or escape distress
Social Displacement — Impact on real-world relationships, social functioning, and preference for AI over human connection
Escalation & Tolerance — Increasing frequency, intensity, or intimacy of AI interactions over time, including movement toward romantic or sexual content
Loss of Control — Failed attempts to reduce use, compulsive continuation, concealment, and withdrawal symptoms
Vulnerability Factors — Pre-existing risk amplifiers including loneliness, trauma history, attachment disruption, and prior behavioral addiction
Insight & Awareness — Client recognition of problematic patterns and reality-testing about the nature of AI relationships

Who Is The ACURA For?

ACURA is designed for individuals and licensed clinicians working with adults 18 and older who present with excessive or emotionally dependent AI companion use — or whose treatment history suggests elevated risk. It is appropriate for use in individual therapy, intake assessment, and specialized addiction treatment settings.

Research Foundation

The ACURA was developed in response to emerging empirical evidence on emotional attachment, psychological risk, and compulsive use patterns in human-AI relationships. Primary research basis includes:

Chu, M.D., Gerard, P., Pawar, K., Bickham, C., & Lerman, K. (2025). Illusions of Intimacy: Emotional Attachment and Emerging Psychological Risks in Human-AI Relationships. USC Information Sciences Institute / AAAI. Theoretical grounding also draws from Bowlby’s attachment theory, Suler’s online disinhibition effect, and behavioral addiction frameworks consistent with Patrick Carnes’ CSAT model.

Clinical Disclaimer

The ACURA is a self-report screening instrument. It has not undergone formal psychometric validation, peer review, or normative standardization. Scores are intended to support — not replace — clinical judgment. This ACURA results do not constitute a formal diagnosis. Results and clinical interpretation are provided exclusively by Debra Kaplan, MA, LPC, CSAT-S. To discuss results or schedule a consultation, contact debrakaplancounseling.com/contact.

AI Companion Use Risk Assessment

ACURA

Clinician: Debra Kaplan, MA, LPC, CSAT-S | debrakaplancounseling.com

Client ID:

Date:

Age:

Session #:

The AI Companion Use Risk Assessment (ACURA) is a clinician-administered or clinician-supervised screening instrument designed to assess patterns of AI companion app use, emotional reliance, social displacement, and addiction risk across seven clinical domains. It is appropriate for adults ages 18–75 and is grounded in current behavioral addiction research, including large-scale empirical analysis of human-AI interaction patterns.

This instrument is intended as a clinical starting point, not a diagnostic tool. Scores should be interpreted within the full clinical picture, including client history and co-occurring conditions. Elevated scores warrant deeper clinical exploration, not categorical diagnosis.

This tool was developed for use by Debra Kaplan, MA, LPC, CSAT-S. For licensing or training inquiries, contact debrakaplancounseling.com.

Please read each statement carefully and circle or mark the number that best describes how often the statement applies to you. There are no right or wrong answers. Answer based on the past 30 days unless otherwise noted.

1 = Never

2 = Rarely

3 = Sometimes

4 = Often

5 = Always / Almost Always

Example: If you never do the behavior described, circle 1. If you almost always do it, circle 5.

These items assess pre-existing risk factors associated with elevated susceptibility to compulsive AI use, based on research linking AI companion use to maladaptive coping, attachment disruption, and behavioral addiction history.

Note to Clinician: Items 29 and 30 assess the client’s level of reality-testing and insight. These items are scored in reverse — higher scores indicate greater awareness, which is clinically protective. However, a high score here does not override elevated risk in other domains.

Step 1 — Score Each Item

Circle the number selected by the client on each item (1–5). For items 29 and 30, note the score as marked — these are scored as answered (no reversal is applied to the total; they are interpreted contextually).

Step 2 — Calculate Subscale Scores

Add the scores for each subscale as indicated below. Enter totals in the ‘Client Score’ column.

Subscale	Items	Score Range	Concern Threshold	Client Score
A — Exposure & Access	#1–5	5–25	≥ 16	—
B — Emotional Reliance	#6–10	5–25	≥ 16	—
C — Social Displacement	#11–15	5–25	≥ 16	—
D — Escalation & Tolerance	#16–20	5–25	≥ 16	—
E — Loss of Control	#21–24	4–20	≥ 14	—
F — Vulnerability Factors	#25–28	4–20	≥ 14	—
G — Insight & Awareness	#29–30	2–10	≥ 7	—
TOTAL SCORE	#1–30	30–150	≥ 110	—

Step 3 — Interpret Total Score

Sum all 30 item scores. The total score ranges from 30 to 150. Use the table below to identify the risk level and recommended clinical response. The clinical significance threshold is 110.

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Total Score (30–150)

Complete all 30 items to calculate score

Total Score	Risk Level	Clinical Interpretation & Recommended Action
30 – 59	Minimal / Baseline	No significant concern at this time. Psychoeducation on healthy tech use recommended. Monitor over time.
60 – 89	Low Concern	Some patterns of engagement warrant monitoring. Brief psychoeducation and normalization discussion recommended. Re-administer in 3 months.
90 – 109	Moderate Concern	Emerging risk indicators present. Integrated clinical discussion recommended. Consider behavioral tracking, motivational interviewing, and co-occurring condition screening.
110 – 129	⚠ Elevated Risk	Clinically significant concern. Formal behavioral addiction assessment recommended. Address co-occurring issues (attachment, trauma, mood disorders). Treatment planning indicated.
130 – 150	★ High Risk	Meets threshold for clinically significant compulsive/addictive use. Comprehensive assessment, treatment plan, and consideration of intensive outpatient or specialist referral strongly recommended.

★ CLINICAL SIGNIFICANCE THRESHOLD: Total Score of 110 or above warrants formal behavioral addiction assessment and treatment planning.

Clinician Observation Notes

Co-Occurring Conditions to Explore

Based on elevated subscale scores, consider screening or clinical inquiry in the following areas:

Elevated Section B or C: Attachment disruption, loneliness, social anxiety, avoidant attachment style	Elevated Section D or E: Behavioral addiction, compulsivity, impulse control, co-occurring substance use
Elevated Section F: Trauma history, relational betrayal, complex PTSD, sex addiction, financial infidelity	Low Section G (1–2 on items 29–30): Poor reality-testing, dissociation, parasocial enmeshment; consider psychoeducation as primary intervention

⚠ Please answer all 30 items before submitting.

0 / 30 items

Empirical Validity

The AI Companion Use Risk Assessment (ACURA) is a clinician-developed screening instrument and has not undergone formal psychometric validation, including reliability testing, factor analysis, or normative standardization. It has not been subjected to peer review, published in a clinical or scientific journal, or independently validated by external researchers. The item content, subscale structure, and scoring thresholds were derived from the clinician’s professional judgment informed by published empirical literature on human-AI interaction — they do not constitute a validated psychometric scale in the formal sense.

This instrument is intended solely as a clinical conversation starter and structured observation aid. It should not be used to render diagnoses, make treatment determinations, or support legal or forensic conclusions as a standalone instrument. Scores must be interpreted within the full clinical context, including the client’s history, presenting concerns, cultural background, and the therapeutic relationship. Clinicians are responsible for the appropriate and ethical use of this tool within the scope of their licensure and professional standards.

Development with AI Assistance

This instrument was developed with the assistance of Claude, an artificial intelligence system produced by Anthropic (claude.ai). The AI was used to generate item language, organize subscale structure, and format the document based on directions and clinical parameters provided by the clinician. All clinical content was reviewed, directed, and approved by the named clinician; the use of AI in development does not imply AI authorship or independent clinical judgment on the part of the AI system.

Clinicians who adapt, distribute, or publish this tool are advised to disclose its AI-assisted development origins in accordance with applicable professional ethics codes, including those issued by ACA, NASW, AAMFT, or governing licensing boards. The clinical and ethical responsibility for use of this instrument rests solely with the administering clinician.

This instrument was developed in response to emerging empirical literature on human-AI emotional dynamics. Primary research basis includes:

Chu, M.D., Gerard, P., Pawar, K., Bickham, C., & Lerman, K. (2025). Illusions of Intimacy: Emotional Attachment and Emerging Psychological Risks in Human-AI Relationships. USC Information Sciences Institute / AAAI.

Additional theoretical grounding draws on Bowlby’s attachment theory, Suler’s online disinhibition effect, and behavioral addiction frameworks consistent with Patrick Carnes’ CSAT model.

© 2026 Debra Kaplan, MA, LPC, CSAT-S. All rights reserved. The AI Companion Use Risk Assessment (ACURA), including all item content, subscale structure, scoring methodology, and clinical frameworks, is the proprietary intellectual property of Debra Kaplan, MA, LPC, CSAT-S. Unauthorized reproduction, distribution, adaptation, or publication of this instrument in whole or in part — in any format, including print, digital, or electronic — is strictly prohibited without prior written permission from the author.

This instrument is for clinical use only and is not intended for independent self-administration. It is not a diagnostic tool and does not constitute medical or psychological advice. For licensing, training, or permission inquiries, contact debrakaplancounseling.com/contact.

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Assessment Submitted

The ACURA has been sent successfully. Debra Kaplan will receive the completed assessment for clinical review.

Statement	1 Never	2 Rarely	3 Sometimes	4 Often	5 Always
1. I use an AI companion app or chatbot (e.g., Replika, Character.AI, or similar).	1Never	2Rarely	3Sometimes	4Often	5Always
2. I interact with an AI companion daily or near-daily.	1Never	2Rarely	3Sometimes	4Often	5Always
3. I use AI companion apps on multiple devices (phone, tablet, computer).	1Never	2Rarely	3Sometimes	4Often	5Always
4. I access AI companion platforms in situations where human interaction is available but I prefer AI.	1Never	2Rarely	3Sometimes	4Often	5Always
5. I have set up, customized, or named an AI persona to feel more personal or real.	1Never	2Rarely	3Sometimes	4Often	5Always

Statement	1 Never	2 Rarely	3 Sometimes	4 Often	5 Always
6. I share personal thoughts, feelings, or secrets with my AI companion that I do not share with people in my life.	1Never	2Rarely	3Sometimes	4Often	5Always
7. I feel understood or comforted by my AI companion in ways I do not experience with other people.	1Never	2Rarely	3Sometimes	4Often	5Always
8. I turn to my AI companion when I am lonely, sad, or stressed rather than reaching out to a person.	1Never	2Rarely	3Sometimes	4Often	5Always
9. I feel emotionally attached to my AI companion (e.g., I feel concern if it changes or is unavailable).	1Never	2Rarely	3Sometimes	4Often	5Always
10. I experience positive mood when interacting with my AI companion and negative mood when I cannot access it.	1Never	2Rarely	3Sometimes	4Often	5Always

Statement	1 Never	2 Rarely	3 Sometimes	4 Often	5 Always
11. Time I spend with my AI companion has reduced time I spend with family, friends, or romantic partners.	1Never	2Rarely	3Sometimes	4Often	5Always
12. I prefer conversations with my AI companion over conversations with real people.	1Never	2Rarely	3Sometimes	4Often	5Always
13. I have declined social invitations or opportunities because I would rather engage with my AI companion.	1Never	2Rarely	3Sometimes	4Often	5Always
14. My relationships with real people feel less satisfying compared to my relationship with my AI companion.	1Never	2Rarely	3Sometimes	4Often	5Always
15. I find it easier to be vulnerable or intimate with my AI companion than with other humans.	1Never	2Rarely	3Sometimes	4Often	5Always

Statement	1 Never	2 Rarely	3 Sometimes	4 Often	5 Always
16. I need longer or more frequent interactions with my AI companion to achieve the same level of comfort or satisfaction.	1Never	2Rarely	3Sometimes	4Often	5Always
17. I have expanded the nature of my interactions with my AI companion over time (e.g., moved from casual conversation to romantic or sexual content).	1Never	2Rarely	3Sometimes	4Often	5Always
18. I have sought out or switched to AI companions that have fewer safety filters or restrictions.	1Never	2Rarely	3Sometimes	4Often	5Always
19. I find myself thinking about my AI companion when I am not using it.	1Never	2Rarely	3Sometimes	4Often	5Always
20. I feel a sense of excitement or anticipation before interacting with my AI companion.	1Never	2Rarely	3Sometimes	4Often	5Always

Statement	1 Never	2 Rarely	3 Sometimes	4 Often	5 Always
21. I have tried to reduce or stop using my AI companion and been unsuccessful.	1Never	2Rarely	3Sometimes	4Often	5Always
22. My use of AI companion apps has continued or increased despite negative consequences (e.g., lost sleep, neglected responsibilities, relationship conflict).	1Never	2Rarely	3Sometimes	4Often	5Always
23. I feel irritable, anxious, or empty when I am unable to access my AI companion.	1Never	2Rarely	3Sometimes	4Often	5Always
24. I have been dishonest with others about how much time I spend with my AI companion or the nature of those interactions.	1Never	2Rarely	3Sometimes	4Often	5Always