Why Therapists Should Consider Using an AI Note-Taking App, Even If They Are Worried About Privacy

And It’s Not Because It Will Save Them Time

Photo by Julia Joppien on Unsplash

If you visit the websites for various AI note-taking apps for therapists, you will see that the advertising largely focuses on how these apps will save therapists time. One app claims it will save a therapist 8 hours each week. Another states that normally each note takes a therapist 15 minutes to write, but this software can reduce that time to just one minute per note. For me, this just isn’t all that compelling.

I don’t spend a ton of time on progress notes. I’m pretty good about staying on top of my notes, either entering them right after the session ends and before the next one starts or jotting down a few keywords on a notepad and then turning them into official progress notes at the end of the day. When I enter a new note into my Electronic Health Record software, I keep most of the previous note intact, only updating the sections that need it, adding a couple of sentences about the content for that day, and checking various boxes for the interventions I used. This process takes about two or three minutes per note, and at most five. That, along with the effort required to learn and integrate new software, not to mention the cost, meant I wasn’t particularly interested in the new AI note-taking apps that began emerging following the introduction of LLMs in the past couple of years.

But then my husband recommended trying a note-taking app for personal use. So I downloaded Granola and used it for a virtual doctor’s appointment. I couldn’t believe the results. It was incredible. The entire meeting was transcribed, summarized, and organized into sections, each of which contained a link to a part of the transcript. The last section was titled “Action Plan,” detailing the next steps outlined from various points in the meeting. I immediately began using it for all of my virtual meetings, and even started to feel sort of naked at in-person appointments because I didn’t have it (luckily, they just launched a mobile version for this purpose). Then I began to use it for my personal therapy sessions. Once more, it amazed me.

It summarized the little bit of chit-chat at the beginning of the session, the situation that prompted the content I wanted to focus on, and even recognized that the therapy model my therapist uses was Internal Family Systems. Amazingly, it summarized the content of my session in the language of that model, using specific terms like “unblending,” “burden,” and “direct contact” in a way only those trained in the model would do. As always, it concluded with the “plan for the next session,” summarizing the potential directions we had discussed for our next meeting.

That was the moment I realized that therapy note-taking apps are probably worth using. And it has nothing to do with the time-saving aspect. The real benefit is that using a note-taking app would make therapy notes much better, leading to a better ability to remember the salient details that emerge from the work, improved continuity between sessions, and ultimately, more effective therapy.

Because the truth is that while I was “pretty good about my notes,” my notes were not nearly as good as the Granola notes. I tended to rush through them, feeling fatigued at the end of the session or the day, hurrying to get to the next client or to leave to pick up my kids. I remembered best and was most likely to record what happened toward the end of the session, sometimes forgetting the twists and turns along the way that held kernels of important information about the client.

And I think this speaks to an important point about the emerging technology and products, which is that one of the things they do best is act as additional stored memory. It’s not so much that we have to remember less, it’s that we can remember so much more, and in this case more about each session with a client.

And because of this extra memory, the Granola notes from my personal therapy sessions came alive. They have a fullness to them. They paint a picture with all the necessary details to revisit the session and remember what actually transpired. It may sound cheesy, but using the Granola notes felt like the future.

I’m just going to pause here to note that Granola is not a note-taking app for therapists and is not HIPAA compliant. So while I use it for my own personal therapy, sadly, it is not an option for me to use with my clients. With that said, clients can use it for their own sessions with the permission of the therapist if they would like. So I will have to find a note-taking app specifically designed for therapists, and lucky for you, I plan to share my research and conclusions in an upcoming post.

Okay, that all sounds good, you might be thinking, but what about the privacy concerns? While I’m not too worried about my own sessions (maybe I’ll do a post on why someday), I take the privacy of my clients’ sessions very seriously as an essential part of the therapeutic alliance, not to mention for other ethical and legal reasons. So when I explore the options for note-taking software for therapists in a future post, I’ll be taking note of how each one handles privacy. For now, it generally appears that most of these apps don’t store the transcripts they record, deleting them as soon as they have been synthesized into a note. They use encryption to protect the notes, similar to how electronic health record platforms like SimplePractice operate. Additionally, they are HIPAA compliant and sometimes have added security credentials like SOC-2.

Does that make me feel completely at ease about the security risks? No, it doesn’t. But if I can find an app that demonstrates a serious commitment to client privacy (something I’ll be exploring in a future post), that would probably make me feel comfortable enough for the risks to seem worthwhile. And of course, I would always explain the risks to my clients and do my best to make them feel at ease opting out of using the app if they wish. But for the clients who would consent, I’d probably have much better notes.