A Facebook post recently surfaced where a therapist asked:
"For those of you that use AI Note Taker: How do you keep track of which clients have agreed, declined and has not even signed the release yet?"
What followed was a series of responses that, while well intentioned, should give anyone pause.
The suggested solutions included:
- Adding "yes to AI" or "no to AI" in a memo field.
- Using a spreadsheet.
- Using all caps for the last name of the client if they opt out.
- Putting an asterisk in front of their name if they opt in or opt out.
These are not safeguards. They are workarounds.
Each of these approaches relies on human memory, manual processes, and visual cues that are easy to miss in the middle of a busy clinical day. A missed asterisk. A spreadsheet that is not updated. A memo field that is overlooked. A name that does not immediately stand out. Any one of these small failures could result in a therapy session being recorded without a client’s consent.
Just imagine -- your therapy session could be recorded without your consent if just one of these minor details are accidentally overlooked!
This is not a hypothetical edge case. These are real folks and real strategies, and they fall short.
This is not acceptable -- and therapists and therapy clients alike should be concerned.
Privacy in the therapy session is foundational to ethical care, client trust, and legal responsibility. Any tool that introduces recording into the therapy room must treat consent as a hard requirement, not a soft reminder. If a system allows recording to proceed unless someone remembers to flag otherwise, that system is fundamentally flawed.
(As background, AI Note Taker is a service provided by Simple Practice... But similar "workarounds" are likely being used in other EHRs as well.)
When it comes to therapy, consent to record a session cannot live in spreadsheets, naming hacks, or memory tricks. It must be explicit, enforced, and impossible to overlook. It should also be reconfirmed every session. Anything less puts both clients and clinicians at unnecessary risk.
And speaking of unnecessary risks, if the session is being recorded purely for help with writing progress notes, there are better and more private ways to gain efficiency in that area! (Quill happens to be one of them... We do not record sessions, and yet thousands of therapists save time on their notes using our note-writing tools!)
