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38 reviewsLarge language models (LLMs) hold great potential for augmenting Check for updatespsychotherapy by enhancing accessibility, personalization and engagement. However, a systematic understanding of the roles that LLMs can play in psychotherapy remains underexplored. In this Perspective, we propose a taxonomy of LLM roles in psychotherapy that delineates six specifc roles of LLMs across two key dimensions: artifcial intelligence autonomy and emotional engagement. We discuss key computational and ethical challenges, such as emotion recognition, memory retention, privacy and emotional dependency, and ofer recommendations to address these challenges.