<p>Deepfakes are becoming increasingly sophisticated and pervasive in society. While deepfakes are often associated with negative applications and risks (e.g., threats to privacy and security), more positive applications are also being explored, like the potential benefits that deepfakes could have for psychotherapy (e.g., to cope with grief or process trauma). To date, there has been insufficient discussion about the philosophical and ethical issues raised of these developments. In this paper, we therefore examine four ethical issues raised by the use of deepfakes for psychotherapy: (1) the deceptive nature of deepfakes, including self-deception, (2) the problem of obtaining consent from depicted persons, (3) treating depicted persons as mere means, and (4) the risks of unintended harmful effects, like increased emotional and psychological dependence on deepfakes. We also reflect on larger potential implications for society and human care practices. We finally offer two concrete recommendations, namely that more empirical research should be conducted to determine the effects of using deepfakes for psychotherapy, and that regulatory oversight is needed if deepfakes are to become more widely adopted as therapeutic tools in the future.</p>