Why I’m fighting for Ethical AI Tools in Psychotherapy

I’m way too old to fight, but I train with world-class fighters. One thing I learned quickly is that your guard is everything. Lose it for even a split second and it’s lights out.

And there’s no substitute for training hard. The daily struggle is the fight. The fight itself is just the display of all the skills and mindset acquired during years of training and culminating in a grueling fight camp that lasts weeks. It’s how one acquires an unstoppable mindset that one cannot and will not lose. 

What would a fight look like between two people, one of whom showed up each day to the gym, took the hits, suffered injuries, and sweated gallons, and the other who had someone else do all the hard work and just showed up to the fight?

We’re in that place now in the field of psychotherapy.  Because of burnout and fears of audits, therapists are being seduced by the allure of AI-powered notes and treatment plans. This is a problem since the extensive research on how therapists get better is by reflecting deeply on each session and making sense of what happened. 

Do a thought experiment. 

Take two therapists, one reflects on their past experience and struggles to make sense of human behavior and subjective experience. They deliberately think about each session, including the transference, countertransference, which interventions worked, which didn't, and so on. The other therapist had an AI tool write the DA, the treatment plan, and each session’s note from transcripts.

After five years, which one would you rather see if you were suffering from a psychological problem of significant seriousness?

Today, the market is being flooded with the tools that will undoubtedly create many more of the second type of therapist. The result will be less experienced clinicians who will become ever more reliant on tools to perform their job than on their own skills as a psychotherapist. 

I’m fighting for patients who need quality care. I’ve been a patient many times. I’m fighting for new therapists who are trying to find their way and want to be helpful. I was one of them as well. I don’t want to have wasted years of my life walking away from a successful career to do something meaningful only to become a shell of what I could have been because I outsourced the struggle to AI and subsequently became little more than a dilettante. 

But I fear the field is losing the fight. 

Every transcript uploaded to an AI service drops our collective guard. Each time an opportunity for struggle is outsourced to AI, the entire field takes a punch. While there are some fighters that can take a lot of hits, most understand that taking repeated damage adds up quickly.

I want to keep fighting for the art that I love so much and for my own dream of becoming an expert psychotherapist. It will not happen without struggle, including the struggle against taking the easy way out.

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These reflections express my personal opinions on systemic issues in psychotherapy and technology, not on any specific organization or individual.