A Statement Regarding AI and Therapy
As a therapist, one of my most deeply held beliefs is in the healing power and value of authentic human relationships, and I also acknowledge that we live in a world in which Artificial Intelligence, or AI, is becoming more and more prevalent in almost all realms of our lives. Time will tell if the impact is positive or negative, but currently there are many reasons for caution. Information generated by AI systems is sometimes inaccurate, misleading, or unethical, and the professional organizations that regulate the provision of therapy have issued limited guidance to mental health professionals regarding the use of AI in the context of therapy. In the meantime, while we learn together how AI may benefit or harm the field of mental health, I believe that all people have the right to understand clearly if and how AI is being used in their treatment.
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In alignment with this value, I have elected to issue a statement on the use of AI in my practice. In short, to the extent possible given the proliferation of AI in today's world, I do not use AI for any purpose in my practice. To be even more specific: I do not use AI-powered systems for process of assessment or diagnosis, education or research, provision of treatment or clinical interventions with clients, communication, note-writing or documentation, or to generate content for this website. I believe that your rights to privacy, as protected by laws such as HIPAA, are fundamentally at odds with many of the ways private health data may be used by AI-powered systems, and I have serious concerns with the use of AI in therapy before professional organizations have time to offer guidance on safe, effective, and ethical use of this technology.
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I believe that in order to be able to give your informed consent for therapy, you must be informed of all potential risks and benefits. In my eyes, this includes being informed of the risks and benefits of any AI-powered technology your therapist may be using. Whether you choose to work with me or chose to keep looking for another therapist, I encourage you to ask therapists you are considering working with if or how they use AI in their practice, with the knowledge that emerging ethical guidance suggests clients must be allowed to opt-out of the use of AI in the course of their treatment.
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Some examples of early attempts by the mental health profession to address the use of AI through professional Code of Ethics include the following:
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"CMHCs [Clinical Mental Health Counselors] clearly disclose to clients when clinical services are provided by any modality other than direct person-to-person contact. In order to support client autonomy, CMHCs must disclose the extent, if any, to which clinical services are provided through, or in conjunction with, the use of artificial intelligence, machine learning, deep learning, or any other human simulation modality. CMHCs must obtain client consent before initiating these clinical services. CMHCs remain ultimately responsible for all clinical services they provide including their choices about client evaluations, treatment planning, interventions, and assessments. When CMHCs use technology to support clinical services, they are also responsible for ensuring that such technology is sufficiently safe, appropriate, and effective."
- The American Mental Health Counselors Association
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Regarding the responsibility of therapists to be competent in the tools and interventions they use, the National Board for Certified Counselors (NBCC) states that:
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"Prior to integrating AI in their services, counselors must possess a foundational knowledge of how the technology works, its capabilities and limitations, and the ethical use of client data. This is consistent with the need to demonstrate competence with any assessment tool or intervention. AI must not be used as a replacement for professional judgment or the counselor–client relationship. Counselor competence in assessment, diagnosis, and treatment is still essential. Consideration must be given to multicultural issues and carefully considered to ensure unbiased and competent delivery of services."
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Regarding transparency and consent, the NBCC further states that counselors must "Obtain informed consent specifically regarding AI use, allow client choice to opt out of AI tools, and exercise transparency about data access and sharing and retention policies." It is worth informing yourself as a client the responsibilities of your clinician if they choose to use AI. Of note - though all therapists are bound by both law and guidelines of ethical practice to generally protect your privacy and wellbeing, not all therapists are currently bound by a code of ethics that specifically addresses the use of AI in therapy.
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As a clinical social worker and an addiction counselor, the ethical codes that govern my practice (the National Association of Social Workers, or NASW, Code of Ethics and the National Association for Alcoholism and Drug Abuse Counselors, or NAADAC, Code of Ethics) have not yet been updated to specifically address AI. In the face of this quickly evolving technology that promises, for better or for worse, to transform the world of mental health, I have taken responsibility to inform myself about the emerging guidance in relevant ethical codes and to provide this information to you in the name of informed consent.