Idk, I'm not in the US but if a therapist was found to break confidentiality or to have possession of information unethically then there'd be a media and political storm on it. Particularly since covid, more therapy and healthcare is conducted online. For some people it may even be the only accessible option.

You are not stupid where I live to expect health organizations to abide by the laws around confidentiality 😅 You would expect health organizations to have the highest secured systems and if they were exposed it would be in a cyber attack from an outside party and the information available for that kind of attack would be limited, de-identified, - it would be an absolute top level scandal, mass class action suit, criminal charges if whole identifiable transcripts of sessions like this were being stored and released in a way that breached the law.

People seeking out therapy are already vulnerable, not stupid. They may be desperate and unfortunately, there are some shitty apps and stuff that DON'T fall under regulations. It's important to make sure you're talking to a real person and the organization is a registered provider ( however that works in various countries) but a person is not stupid for being intentionally preyed on in their vulnerablity and desperation by greedy, unethical people.

Users know the app is abusive

If this was the case, there would have been no shock, though. Have you thought at all, "Huh, yeah, Niantic is clever but also messed up to do this," with Pokémon Go being an AI-training data collector? Why focus only on the hurt, dumb users and ignore the higher body in power?

You know what? What about, "It didn't have to abuse in the first place?" Otherwise you're sounding awfully comfy with capitalism...