AI Scribes for Therapists

Title: AI Scribes for Therapists

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An AI scribe for therapists records and transcribes therapy sessions, generating progress notes in clinical formats like SOAP, DAP, and BIRP/PIRP/GIRP/SIRP.

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Using an AI scribe can significantly reduce the amount of time you spend each week writing notes. During sessions, it can also help you free up your attention to focus on your client without the distraction of note-taking.

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But before you start using an AI scribe for progress notes, you should:

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Ensure that it is HIPAA-compliant and sign a Business Associate Agreement (BAA)
Consult the terms of service (TOS) to understand how your data will be used
Inform your clients and obtain their written consent

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Here’s what you need to get started.

Key takeaways

AI scribes for therapy transcribe sessions or post-session dictation to generate notes compatible with clinical standards
Conservative estimates suggest using AI for notes can reduce time spent on documentation by 20% to 30%
An AI scribe platform must sign a Business Associate Agreement (BAA) in order to be HIPAA-compliant
Some HIPAA-compliant AI platforms may use anonymized client data to train AI or improve services
It’s essential to get client consent before using AI to record and transcribe sessions

What is an AI scribe for therapy?

An AI scribe typically has three functions:

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Recording: Making a sound recording of a therapy session or recording dictation (verbal notes—your own summary after a session)
Transcription: Using AI to transcribe the session or dictation into text
Notes: Using AI to prepare notes based on the transcript

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Besides these key features, an AI scribe platform may also be able to:

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Generate treatment plans based on progress notes
Track clients’ progress over time
Monitor changes in your relationship with clients (the therapeutic alliance) based on notes

AI scribe note formats

One of the most useful features of an AI scribe is the ability to format your notes to different clinical standards. Whether you use it to transcribe a dictation or a session recording, a full-featured scribe can generate notes to fit a variety of formats, including:

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Intake notes
Subjective, Objective, Assessment, Plan (SOAP)
Data, Assessment, Plan (DAP)
Behavior, Intervention, Response, Plan (BIRP)
Problem, Intervention, Response, Plan (PIRP)
Goal, Intervention, Response, Plan (GIRP)
Situation, Intervention, Response, Plan (SIRP)
Problem, Intervention, Evaluation (PIE)

AI scribes and EHR platforms

If you use an EHR, you can save time by using an AI scribe that integrates with it, automatically importing progress notes once they’re generated.

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Different platforms offer different levels of integration:

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Universal integration: Import your notes into any EHR platform, typically with the help of a browser plugin (eg. Mentalyc)
Partial integration: Import your notes automatically into select EHR platforms
Copy-and-paste: Copy notes from your AI scribe and paste them into you EHR (eg. Quill)
Native platforms: Some EHRs provide built-in AI note-taking (eg. Blueprint)

AI scribes and telehealth sessions

AI scribes offer different levels of support for recording telehealth sessions, including:

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Built-in telehealth: A telehealth tool hosted natively by the AI scribe, with the option to record and transcribe sessions
Standalone audio recording: An app that runs in parallel with any telehealth platform of your choosing, recording and transcribing the session
Mobile app: While designed for in-person sessions, an AI scribe’s mobile app may also be able to record and transcribe telehealth sessions, although the output will depend on factors like speaker and microphone quality

AI scribe popularity with therapists

It’s still early days for AI scribes, and a relatively small number of therapists have made them part of their workflows.

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In a 2024 SimplePractice survey, 13% of respondents said they used AI for generating notes.

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Contrast that with half of all respondents who said they used AI in some capacity on a daily basis (eg. for writing emails or managing their schedules).

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According to one statistic cited in a peer-reviewed paper, 30% of physicians use AI for note-taking.

Does AI note-taking save therapists time?

Generally speaking, using an AI scribe for notes does save time—but sources differ as to exactly how much time is saved:

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Industry reports by AI platforms suggest that AI note-taking reduces documentation time by 60% – 70%
Broader clinical documentation research suggest that healthcare clinicians reduce their documentation time 20% – 30% by using AI note-taking tools
One peer-reviewed study found that 73% of survey respondents in a controlled study agreed or strongly agreed that AI note-taking reduced the time they spent on documentation outside clinical hours

Which AI scribes are HIPAA-compliant?

We’ve selected the five best HIPAA-compliant AI scribes:

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Mentalyc, a comprehensive standalone tool
Quill, a standalone tool that prioritizes privacy
SimplePractice, a popular EHR platform with built-in AI notes
Upheal, an EHR whose free plan lets you experiment with AI notes
Blueprint, a free EHR with the option to add AI notes for a per-session fee

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For a full breakdown and comparison of these platforms, check out The Top 5 AI Scribes for Private Practice.

How does an AI scribe comply with HIPAA?

Most AI scribes use mainstream large language models (LLMs) to process data and generate notes. Examples include ChatGPT, Claude, and Gemini.

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These models are not themselves HIPAA-compliant. It’s the AI scribe’s job to remove all identifying data from PHI, making it anonymous and safe to pass on to the LLM.

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To do this, it needs to meet the requirements of the HIPAA Safe Harbor Method.

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Safe Harbor is formally outlined in 45 CFR § 164.514(b)(2)(i), which names 18 types of identifying data that need to be removed from PHI to de-identify it:

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Names
Geographic identifies smaller than a state (some exceptions apply for the initial three digits of zip codes)
All dates (except the year) directly related to an individual
Phone numbers
Fax numbers
Email addresses
Social Security numbers
Medical record numbers
Health plan beneficiary numbers
Account numbers
Certificate or license numbers
Vehicle identifiers (serial numbers, license plates)
Device identifiers and serial numbers
URLs
IP addressed
Biometric records (including fingerprints and voice prints)
Full-face photos or other identifying images
Any other unique identifying numbers, characteristics, or codes

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All of this should be specified in the AI scribe’s BAA.

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Once PHI is de-identified, an LLM may use it for training purposes. For insight into how anonymized client data is used, carefully review an AI scribe’s BAA and Terms of Service contract (TOS).

AI scribes and Business Associate Agreements (BAAs)

When an AI scribe provides note-taking services, they become a business associate under HIPAA. They must sign a Business Associate Agreement (BAA).

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A standard BAA includes:

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How and when clients’ personal health information (PHI) will be shared
What counts as PHI in the context of the tool’s use
Administrative, technical, and physical safeguards for protecting PHI
How data breaches will be avoided and detected
Info on any downstream subcontractors who may have access to PHI
Your responsibilities complying with HIPAA as a therapist
How and when PHI will be deleted when you end service with the platform
Indemnification and limited liability for the company providing the service

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Extra provisions for an AI tool should include:

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Training uses, which may specify that clients’ PHI will not be used to train AI
A transparent explanation of how the AI processes PHI and generates notes
Data residency, or where PHI will be stored and how storage methods conform with jurisdictional requirements
Requirements for AI uptime, accuracy, and error rates

Is client information safe with an AI scribe?

Provided you sign a complete and comprehensive BAA with an AI scribe platform, PHI is safe under the terms of HIPAA.

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However, keep in mind that any de-identified client data (including recordings, transcripts, and notes) may be used by the platform for purposes such as training AI, tracking user activity, and improving services.

Does an AI scribe use client recordings to train AI?

In order to conform with HIPAA, any client data an AI scribe platform or a third-party LLM uses to train AI must be de-identified. The platform may also use that de-identified data to track user behavior and make improvements to the product.

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So recordings, transcripts, and notes are private in the sense that their content, once de-identified, can’t be connected to you or your client. But that content may be put to other uses.

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If you’re concerned about how de-identified data may be used by an AI scribe, carefully review the BAA you sign as well as the product’s Terms of Service Agreement (TOS).

Do you need client consent to use an AI scribe?

If you’re using an AI scribe to record and transcribe sessions with clients, you should get informed, written consent from each client in writing:

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Informed consent means the client understands your purpose for recording the session, how the recording will be used, and the steps you will take to protect the data.
Written consent means a signed agreement that you keep as part of your patient’s records. You may need to provide this document in the event of legal proceedings.

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The consent document clients sign should include everything they need to make an informed decision. That includes the identity of the AI scribe platform you use.

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To get a better sense of what this document looks like, check out Mentalyc’s client consent template.

How to talk to clients about using an AI scribe

When disclosing the use of an AI scribe to a client:

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Use simple language, avoiding technical jargon
Specify that the client can opt out of AI recording and that it will not affect their quality of care
Explain that you will personally review and revise all notes prepared by AI
Invite dialogue, and be prepared to answer any questions or respond to any concerns your client may have

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It’s important to explain to a client why you’re using an AI scribe. You may want to highlight:

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Time savings. By spending less time on documentation, you can focus your energy on one-on-one treatment.
Focus during sessions. With a “hands-free” tool for taking notes, you can better connect with your client.
Accuracy and continuity. You can review session transcripts to make sure no important details slip through the cracks.

Best practices for using an AI scribe in therapy

If you plan to use an AI scribe for progress notes, here’s a checklist of best practices to follow:

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Get client consent. Remember: Written, informed consent is key.
Offer an opt-out. Clients should feel confident that, if they opt out of session recording, it won’t change their quality of care.
Hold up your end of HIPAA. Follow your own obligations as a therapist as outlined in the BAA you sign with an AI platform.
Educate yourself in data use. Carefully review both the BAA and TOS to ensure you understand how de-identified client data will be used.
Follow security best practices. This includes strong passwords, two-factor authentication, avoiding the use of shared devices, and using a secure network to transmit data.
Review and revise notes. AI is a helper, not your replacement. Make sure all notes are thorough and accurate before saving them to your clients’ files.

Should therapists use AI scribes?

Not all platforms are the same—you should take the time to review the best AI scribe platforms for therapists to find that one that’s a best fit for your practice.

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Whether you use an AI scribe at all will depend on your personal preferences and working style as a therapist. To help you make the right choice, here are some pros and cons:

Pros

Time saved. Even conservative numbers suggest a 20% to 30% reduction in time spent on documentation, freeing up more time to focus on other parts of your practice (or even to take a little time off).
Accuracy and recordkeeping. Transcripts are a valuable resource when you want to review a past session or check your notes against what was actually said.
Progress tracing. Some platforms offer AI features that can survey reams of past transcripts and notes, teasing out trends in client progress and the evolving therapeutic alliance.
In-session connection. When you’re freed from the task of taking notes and confident that you can review the conversation later, you may find it easier during sessions to connect with your clients and focus on what they’re saying.

Cons

Client pushback. Some clients may not be comfortable with having sessions recorded, or with having an AI play a role in their treatment.
Lack of hands-on approach. Despite sometimes finding it tedious, many therapists find working on progress notes gives them a chance to carefully review their clients’ cases and pick out important details.
Personal ethical dilemmas. Depending on your position on AI in general, you may not be comfortable providing LLMs with training data—which, considering the potential benefits, could be a dilemma.

Will AI replace therapists?

AI is currently in no position to replace real, human therapists. And given the importance of personal connection in psychotherapy, there’s a good chance it never will be.

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If you’re anxious about competition from AI, a couple points to keep in mind:

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Current AI therapy tools are limited. Most chatbots advertised as AI therapists provide some form of CBT or mindfulness exercises. These may threaten the sales of CBT workbooks and self-help journals, but not in-person therapy.
AI fails at nonverbal communication. According to some experts, 70% of communication is nonverbal. That’s 70% of the conversation that AI chatbots leave out during a session.
The effectiveness of AI therapy is unclear. While AI therapy may help to relieve some users’ distress, the long-term benefits—and potential drawbacks—are uncertain. Just because a treatment style is popular does not mean it is effective.
Some clients are already pushing back. Anecdotally, some therapy clients are explicitly seeking human therapists and avoiding AI solutions. One example: A volunteer on a crisis text line who often receives messages asking for confirmation that they’re not chatting with AI. (Reddit)
AI may give clients a chance to test the waters. Individuals anxious about seeing a therapist for the first time may experiment with AI first. It could serve as the first step towards seeking real therapy.

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For a closer look at this issue, check out Will AI Replace Therapists?

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Ready to start experimenting with an AI scribe? Check out The Top 5 AI Scribes for Private Practice.

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