You don't have to be anti-AI or anti-technology to be firmly against recording therapy sessions. But here's the thing -- the risk is easy to underestimate because these AI tools often create a false sense of security.
Let's talk about how.
Terminology
Some tools avoid using the word "recording" altogether. Instead, they rely on softer terms like "ambient listening" or "transcribing" or "processing"... or even just "AI scribe" to describe what they do during the therapy session.
But here's what matters:
If documentation is automatically written following the session, the session was recorded and then transcribed. Regardless of the wording on their website or in their consent form.
Encryption
"Your data is encrypted" sounds reassuring. And encryption is important -- but the term is often used without explaining what it actually guarantees (and what it doesn't).
For example, therapy session data may be encrypted in transit (when traveling from your computer to their server) and at rest (when stored on their server). Great! But to generate documentation from an LLM, the transcript must be processed as readable text at some point. That's simply how LLMs work.
Is this detail mentioned on their marketing website? Or do they just say "your data is encrypted" and leave it at that? It's not the full picture.
HIPAA
Another reassuring term: "HIPAA compliant"
Here's what HIPAA compliance actually means: it's largely a framework for safeguards and for a responsible response when data breaches happen. Notice the word "when" -- not "if". Because breaches definitely do happen to HIPAA compliant companies.
HIPAA compliance is not a guarantee of security and privacy, although marketing language certainly makes it sound like it is.
Client Responsibility
Lastly, there's sometimes an attempt to shift the burden onto client consent. The client signed the form, so it's their responsibility now.
But a checkbox on intake paperwork does not change the power dynamics, and it does not transfer responsibility to the client. The decision to create a recording and transcript of the therapy session is still a clinical and ethical choice -- and it remains the therapist's duty to weigh the risks and to make the decision that does no harm to the client.
At Quill, we've always believed that you can get excellent AI-assisted documentation without recording the full session. That's not just a technical position -- it's an ethical one.
