AI and Therapy Notes: Is the Art of Case Conceptualization at Risk?
The Future of Clinical Documentation
What's the first thing AI is coming for in mental health practice? No, not our jobs. Our notes. But what does AI-generated documentation mean for therapy, therapists, and the future of clinical practice?
Clinical documentation is the low-hanging fruit of AI automation in healthcare. AI promises efficiency where progress notes, intakes, and reports consume hours of a therapist’s week. But as we hand over this task, we must ask: What do we lose when we outsource our clinical note-writing to AI?
The Role of Note-Writing in Case Conceptualization
As a clinical psychologist with nearly two decades of experience, I’ve trained students in case conceptualization and observed firsthand how documentation shapes clinical thinking.
When I meet a new therapy client, I take handwritten notes during the session—capturing their story, history, and my own initial impressions. I listen not just to what is said but also to what remains unsaid—the moments they gloss over, the hesitations, and the subtle shifts in tone or body language.
Later, as I type up the intake note, something essential happens: I revisit the session in my mind, reconstructing the conversation, filling in details, and making connections I might have missed in the moment. I recall the family and life history they shared, but I also notice what they didn’t share. This act of transcribing and reflecting isn’t just documentation—it’s an integral part of my thinking process and case conceptualization.
What Happens When AI Writes the Notes?
Let’s consider what happens if I rely on AI to generate my intake notes.
AI can transcribe my voice dictation, structure the session details, and produce a comprehensive document—saving me time, no doubt. But would I engage with the client’s history in the same way? Would I still go through that reflective process of synthesizing information, identifying key themes, and forming clinical hypotheses? Or would I simply review the AI’s output, make a few edits, and move on?
I’m not arguing against using AI for documentation. In fact, I already incorporate AI into my progress notes, as do many colleagues. The benefits are clear—it alleviates the paperwork burden, reduces clinician burnout, and enhances accuracy. AI can free up time for client-focused work, ongoing education, and even creating thoughtful out-of-session assignments.
But here’s the question I keep coming back to: If I stop writing my own notes, will it change the way I conceptualize cases? Will it affect the depth of my clinical thinking?
A Shift in Clinical Practice?
For me, note-writing has always been a twofold process: first, the session itself, and second, the reflective act of writing. If I remove the latter, am I unintentionally eliminating a step that makes me a better therapist?
Writing isn’t just about record-keeping—it’s a cognitive tool. It forces us to slow down, reflect, and make connections. If we begin outsourcing this task to AI, do we risk outsourcing the thinking itself?
For newer clinicians, this is an even bigger concern. Case conceptualization is a skill that requires practice, and documentation is part of that learning process. If early-career therapists never engage in this deep reflection because AI does the heavy lifting, will they develop the same clinical intuition?
Using AI Without Losing the Art of Therapy
AI doesn’t have to be an all-or-nothing tool. We could potentially use it to assist rather than replace. Instead of generating full notes, AI could:
Organize key themes from the session
Offer prompts that encourage deeper clinical thinking (e.g., “What stood out in today’s session that could inform case conceptualization?”)
Assist with structuring notes while still requiring manual reflection and synthesis
The challenge is ensuring that AI enhances clinical work rather than diluting it. As we integrate AI-powered documentation tools, we must remain mindful of how they shape our cognitive engagement with clients’ narratives.
Final Thoughts: The Future of AI in Mental Health Documentation
AI will undoubtedly change our field, but we must be intentional about how we integrate it. If writing therapy notes is more than just an administrative task—if it’s a cognitive process that shapes our understanding of clients—then we should consider how automation might impact clinical depth.
What do you think? Will using AI for documentation change the way we conceptualize cases? If you’ve experimented with AI-generated notes, have you noticed shifts in your own clinical thinking? Let’s start a conversation.
