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More therapists are seeing how they can use artificial intelligence tools in their work. Supporters say recording sessions and using AI to create notes saves time. Critics worry it could alter the trust between patients and their clinicians at the heart of therapy. Here's NPR's Windsor Johnston.
WINDSOR JOHNSTON, BYLINE: Molly Quinn is a 31-year-old librarian in Fayetteville, Arkansas. For two years, she trusted her therapist with things she hadn't told anyone else. But during a session last November, something felt different.
MOLLY QUINN: It wasn't until halfway through the session that I realized that she wasn't taking notes herself, like she typically did. She was just, like, letting the iPad stand up.
JOHNSTON: Quinn kept talking. But later she realized the conversation had been recorded using an artificial intelligence note-taking tool without her consent.
QUINN: It felt like a violation. And the more that I thought about it, like, I don't know, I just started getting, like, more and more sick to my stomach.
JOHNSTON: Quinn left the session that day not knowing what to do. Across the country, a growing number of therapists are experimenting with AI tools that record sessions, transcribe conversations and automatically generate clinical notes. When activated, the software captures the discussion in real time and produces a structured draft note for the clinician to review, and in many cases, submit to insurance companies for reimbursement.
Companies behind the technology include Berries, Blueprint and SimplePractice, among others. They all say the systems are HIPAA-compliant and designed to help therapists spend less time on paperwork and more time focusing on patients. But some experts say the technology raises new ethical questions. Kellie Owens is a bioethics researcher at New York University.
KELLIE OWENS: We have a wide body of research showing us that a consent form on its own does not mean that a person is making an informed choice. We know that folks scroll through these, don't read them.
JOHNSTON: Owens also worries about accuracy. She says if clinicians aren't meticulously checking the notes that are generated by AI, an error can become part of a client's permanent record. But some therapists say the bigger concern may be what the technology does to the therapy session itself. Marisa Cohen is a couples and sex therapist in New York City.
MARISA COHEN: Even the presence of AI, it changes the therapeutic experience. It changes the room. Even if it's meant to and it actually does fade into the background, clients know something is still listening to them. And that can subtly alter their disclosure.
JOHNSTON: Other clinicians say the tools can help them be more present with their patients. Kym Tolson has been a therapist for 30 years. She says the administrative workload in mental health care can be overwhelming, and AI note-taking tools are making a huge difference in her day-to-day work.
KYM TOLSON: It helps us in so many ways. Just that - reducing the burnout and the amount of time we spent on the admin, it's giving therapists their lives back.
JOHNSTON: Tolson says she carefully reviews every AI-generated note and makes sure clients know they can opt out at any time. But for Molly Quinn, the issue wasn't just the technology. After learning that her therapist had recorded her session without her consent, Quinn never went back. She says she eventually found a new therapist and set one clear boundary from the start - no use of AI.
QUINN: We do have this right to not have our privacy violated, especially in a very intimate setting like a therapist office. This is something that is a private conversation.
JOHNSTON: And Quinn says that conversation doesn't include tech companies. Windsor Johnston, NPR News.
(SOUNDBITE OF JEFFREY SILVERSTEIN'S "NO RAIN") Transcript provided by NPR, Copyright NPR.
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