Why I Don’t Use AI Therapy Notes in My Practice

AI is becoming increasingly difficult to avoid.

It writes emails, summarizes meetings, organizes schedules, generates content, and answers questions in seconds. It is also making its way into therapy practices, particularly through tools that listen to sessions and automatically generate clinical notes.

I understand the appeal. Documentation takes time, and most therapists did not enter this profession because they love writing progress notes at the end of a long day.

Still, I have made a deliberate choice not to use AI therapy notes in my practice.

This is not because I think technology is inherently bad or that therapists should avoid every new tool. My hesitation is much more specific. Therapy is an unusually private relationship, and I believe the way we use technology within that relationship deserves careful consideration.

What Are AI Therapy Notes?

AI therapy note tools are designed to make clinical documentation easier. Depending on the platform, they may record or transcribe a therapy session and use artificial intelligence to generate a summary, progress note, treatment documentation, or suggested clinical language.

For therapists, the potential benefit is obvious: less time spent documenting and more time available for clinical work or life outside of work.

But efficiency is only one part of the decision.

When technology enters the therapy room, I also think we have to ask what information is being captured, where it goes, how it is processed, and whether its presence changes the experience of therapy itself.

Therapy Contains Information People Rarely Share Anywhere Else

People come to therapy to talk about things they may not tell their friends, partners, families, or physicians.

Sessions can include conversations about relationships, sexuality, trauma, shame, family conflict, fears, fantasies, identity, childhood experiences, and thoughts that may still feel confusing even to the person expressing them.

That level of disclosure is part of what makes therapy meaningful.

It is also why I am cautious about introducing additional systems into that space.

Even when an AI therapy notes platform is designed for healthcare settings and offers privacy protections, I still believe it is reasonable to ask whether every available convenience belongs in such a private environment.

For my own practice, I prefer to minimize the amount of sensitive information that passes through additional technology when I have another option.

A Therapy Session Is More Than Information to Be Summarized

There is another reason I remain hesitant about AI-generated therapy notes.

Therapy is not simply an exchange of information.

Sometimes what matters is what someone says. Sometimes it is what they avoid saying. A pause can matter. A contradiction can matter. Humor at an unexpected moment can matter. The way a person tells a story may be as important as the facts contained within it.

My understanding of a client develops through the relationship and through context accumulated over time.

AI can organize language remarkably well. But generating a coherent summary of a conversation is different from understanding the psychological meaning of that conversation within a therapeutic relationship.

That distinction matters to me.

Documentation Is Also a Clinical Process

Writing therapy notes can certainly feel administrative. But I don't experience documentation as entirely separate from clinical work.

Taking a few minutes after a session to decide what was significant requires me to think.

What shifted today?

What pattern appeared again?

What feels important to remember?

What belongs in the clinical record, and what does not need to be documented?

That process asks me to exercise judgment rather than simply preserve everything that was said.

In that sense, documentation can create a brief moment of reflection between one session and the next.

Automating that process might save me time. It may also remove a small but meaningful part of how I think about my work.

More Documentation Isn't Always Better Documentation

One of my concerns about AI in therapy documentation is the assumption that capturing more information necessarily creates a better clinical record.

I don't think it does.

Therapy notes should contain clinically relevant information. They do not need to become transcripts of a person's inner life.

In fact, given the sensitivity of what people discuss in therapy, restraint can matter.

The question I ask myself is not, How much of this session can I document?

It is, What actually needs to be documented?

Those are different questions.

What About HIPAA-Compliant AI Therapy Notes?

Some AI documentation tools are specifically built for healthcare providers and may advertise HIPAA-compliant features, Business Associate Agreements, encryption, or other privacy safeguards.

Those distinctions are important. Therapists considering these tools should understand exactly how a particular service handles data rather than assuming all AI products operate in the same way.

But compliance and personal clinical judgment are also different questions.

A technology can meet applicable requirements and still be something a therapist decides does not fit the way they want to practice.

For me, the decision comes back to how I want the therapy room to feel and how much technology I want mediating a deeply human process.

I Don't Think Every Therapist Has to Make the Same Choice

There are therapists who use AI documentation tools thoughtfully. There are clinicians working in settings where documentation demands are enormous, and reducing administrative burden may meaningfully improve their ability to care for clients.

I don't think my choice needs to become a universal rule.

It is simply one of the boundaries I have chosen for my own practice.

Technology will continue to change psychotherapy. Some of those changes will probably make our work better. Others will raise questions we haven't fully considered yet.

I would rather remain curious about those questions than adopt a tool simply because it makes something faster.

For now, I write my own notes.

And I am comfortable with the extra few minutes that takes.

Frequently Asked Questions

• What are AI therapy notes?

  AI therapy notes are clinical notes created with the assistance of artificial intelligence. Some tools can process recordings or transcripts of therapy sessions and generate draft progress notes, summaries, or other documentation for a therapist to review.

• Are AI therapy notes HIPAA compliant?

  It depends on the specific tool and how it is being used. Therapists should carefully evaluate a platform's privacy and security practices, whether it offers appropriate agreements for handling protected health information, and any professional, legal, or organizational requirements that apply to their practice.

• Can therapists use AI for clinical notes?

  AI documentation tools are available to mental health professionals, but whether a particular tool is appropriate depends on factors including privacy, security, informed consent, professional obligations, clinical setting, and applicable laws and regulations.

• Why might a therapist choose not to use AI notes?

  A therapist may have concerns about privacy, unnecessary collection of sensitive information, the role of technology in the therapeutic relationship, or the loss of clinical reflection that can occur when documentation is automated.

• Does AI replace a therapist's clinical judgment?

  AI can assist with tasks such as organizing or summarizing information, but clinical documentation still requires professional judgment. Therapists remain responsible for determining what information is clinically relevant and appropriate to include in a client's record.

• Do you use AI therapy notes at Apostrophe Wellness?

  No. I currently choose to write my own clinical notes rather than use AI-generated therapy notes. For me, this approach is consistent with how I think about privacy, clinical judgment, and the therapeutic relationship.