Artificial Intelligence: Implications for the Counseling Room

Written by Kelsie Goller, MA, LPC-S, RPT

Clinical Director, KPS

With much recent conversation centering around AI (artificial intelligence), it is valuable to take a look at implications for the counseling profession, as well. IBM, an American multinational technology company, defines Artificial Intelligence as “technology that enables computers and machines to simulate human intelligence and problem-solving capabilities” (What is artificial intelligence (AI)?) As AI expands in scope, many professionals are finding that it can have diverse uses. For counselors, the therapeutic relationship remains a key element behind change, so it is unlikely that AI will replace counselors, though there are certainly some organizations experimenting with creating AI therapists. There are already some AI therapy platforms available (see this article for an evaluation of four of them), which allow people to track their moods, anxiety levels, energy, and/or sleep, as well as offering some suggestions or information for how to respond (i.e. engaging in self-case exercises, calling crisis phone lines, doing breathing exercises, etc.)

A second use for artificial intelligence for counselors is that AI can be used to study vast amounts of information, such as a recent study that used AI to evaluate 20 million text-based messages between counselors and clients. While it would be extremely laborious for a group of researchers to go through 20 million messages to highlight, underline, and classify the data, AI was able to analyze this data to come to the conclusion that "It's the human element and the ability of the therapist to convey that warmth, empathy, genuine curiosity, and insight on the part of the therapist to help the patients move forward, that are most important” (Landi, 2024).

Finally, a third use for AI is as a “supercharged secretary. Done right, AI can help clinicians with intake interviews, documentation, notes, and other basic tasks; it is a tool to make their lives easier” (Walsh, 2023). Elizabeth Stade, an incoming postdoc at Stanford University notes that “Important parts of the diagnosis and treatment pipeline can be cumbersome for both the therapist and the client, like symptom-tracking questionnaires or progress notes… Handing these lower-level tasks and processes to automated systems could free up clinicians to do what they do best: careful differential diagnosis, treatment conceptualization, and big-picture insights” (Walsh, 2023). Apart from face-to-face time with clients, counselors spend a good amount of time creating charts that are compliant with Board regulations- the Texas Behavioral Health Executive Council is the Board that regulates the practice of professional counseling in Texas. Counselors are required to include certain information in client charts, such as progress notes for every session, initial assessments, and treatment plans. Additionally, insurances have their own requirements for record-keeping that counselors must follow in order to be paid for sessions. Because counselors must create progress notes after every session, several AI platforms have been created to assist counselors with this, so that counselors can spend less time writing notes and more time focusing on client care. These AI assistants generally “listen” to the session and generate a note which the therapist must then read for accuracy and enter into the client’s chart. It is important to note that ethical use of any such AI assistant requires that the program is HIPAA compliant, meaning that they must maintain the same confidentiality guidelines that govern all of our interactions with clients. This requires the program to be confidential, protected by multiple layers of security, so that no client information is ever inadvertently released to any third party. Another ethical consideration is that clients should always be asked for their consent so that they are aware that an AI assistant is being used to create the progress notes. This generally takes the form of a conversation with the therapist and a form signed to indicate consent.

These are three current uses for artificial intelligence as applied to the profession of counseling, and more uses will likely develop as technology advances, but what is unlikely to change is that the most important element in achieving client success, apart from extra-therapeutic factors (for example, client support system, personality, genetics, environment) is the relationship between counselor and therapist. See my article here for a more in-depth look at that! Just as the AI identified in the study mentioned above, which is crucial enough to quote twice: "It's the human element and the ability of the therapist to convey that warmth, empathy, genuine curiosity, and insight on the part of the therapist to help the patients move forward, that are most important” (Landi, 2024).

For more information:

Landi, H. (2024, January 26). AI can crack open the “black box” of effective mental health therapy at scale, study finds. Fierce Healthcare. https://www.fiercehealthcare.com/ai-and-machine-learning/ai-can-crack-open-black-box-effective-mental-health-counseling-scale-study

Silva, L. (2023, December 6). 4 AI Therapy Options Reviewed: Do They Work?. Forbes Health. https://www.forbes.com/health/mind/ai-therapy/

Walsh, D. (2023, June 21). A Blueprint for Using AI in Psychotherapy. Stanford University: Human-Centered Artificial Intelligence. https://hai.stanford.edu/news/blueprint-using-ai-psychotherapy

What is artificial intelligence (AI)?. IBM. (n.d.). https://www.ibm.com/topics/artificial-intelligence