How ambient AI is making its way into therapy sessions

AI continues to evolve quickly. Large language models (LLMs) and chatbots had their moment; now “ambient AI” grabs the spotlight. Many therapists feel anxious that this kind of technology might devalue or even replace their essential role. So let’s unpack what ambient AI is, and how it could effectively support you, without replacing you.

What is ambient AI?

Ambient AI refers to artificial intelligence that runs quietly in the background without needing constant input from the user. It listens, watches, or analyzes what’s happening around it, with no need for you to type commands or fill out forms.

Think of smart assistants that turn off lights when you say “good night,” or phone apps that summarize your meetings after they happen. These systems process language, sound, or behavior in real time and respond without disrupting your flow.

In therapy, it listens to (and transcribes) sessions, flags key details, and drafts notes so you don’t have to start from scratch. But it’s not a chatbot that you prompt, and it won’t give advice or replace your clinical judgment.

How ambient AI works in therapy

Right now, ambient AI for therapists typically fall into two camps:

1. Audio-based tools that record and analyze session audio
2. Natural language processing (NLP) tools that extract key themes, emotions, or topics from conversations

Some systems transcribe sessions in real time. Others generate brief summaries or highlight moments of high emotion. A few even track changes in tone or pacing across multiple sessions.

If LLMs are like Grammarly, ambient AI is like Teams or Zoom’s meeting summary functions.

Here’s what that might look like in practice:

• After a session ends, you get a short summary that outlines major discussion points.
• You notice a recurring theme your client hasn’t voiced directly, which shows up in the AI-generated insights.
• Session notes are partially pre-filled to save time.

Why do some therapists use ambient AI?

Notes are the bane of most therapists. Studies show therapists spend 20–30% of their week on documentation. That’s time you could use to prep for sessions, connect with colleagues, or even take a walk.

Ambient AI reduces that time substantially. It lets you keep your focus where it belongs: on the person across from you. No more splitting your attention between a client and a screen. No more leaving notes until 10 PM because the day got away from you. Some studies have found that clinicians that adopt ambient AI tools could improve experience and time doing notes, but not across all specialties.

Current AI tools don’t fully adapt to specialty-specific needs documenting detailed physical exam findings or complex test results that medical subspecialists require. That means specialists have to manually add these sections to AI-generated notes, which takes time and makes their notes longer. Different specialists also use different note formats (think BIRP, SOAP, operative notes), and AI isn’t always optimized to use highly specialized formats.

It also helps with consistency. Ever had a session where you swore you’d remember a key detail and then forgot that detail after five back-to-back clients? AI doesn’t forget. It flags follow-up topics, tracks progress over time and keeps your notes thorough without you breaking a sweat. Some tools even offer rough drafts of session notes or treatment plans based on session content.

Some concerns about ambient AI are valid

Not all ambient AI tools are created equal. And not every shiny new feature will serve your clients, or your ethical standards.

Data breaches and cyberattacks are happening more often across healthcare and digital services. That means privacy can’t be an afterthought. Even if you trust your tool, you’re responsible for protecting your clients’ information. That’s why the best ambient AI tools are HIPAA-compliant. They encrypt sessions, let you control access, and delete recordings once notes are drafted. They also clearly explain what happens to your audio files: where they’re stored, who can view them, and whether they can be deleted or turned off. Before committing to any platform, read the fine print and ask hard questions.

Many therapists worry that session recordings could be used to train AI chatbots. That’s a valid concern. But even if you’re not worried about that scenario, you still need ironclad safeguards against leaks and misuse. Clients deserve to know what’s captured and how it’s used. Some therapists add the tool to consent forms; others explain it in session. Do what fits your style, but don’t skip this. Your clients’ trust matters more than convenience.

Clinical judgment remains irreplaceable. AI might suggest a theme or flag a risk, but it doesn’t possess your expertise, or the human qualities essential for therapy. Your empathy, intuition, and personal insights, developed through the therapeutic relationship, are what truly matter and can’t be replicated by an algorithm. If something feels off, trust your gut. No algorithm knows your client the way you do. And as Dr. Steven Lin explains in this article, the quality of ambient AI documentation compared to other documentation methods (whether manual or by using direct transcription tools) has not been proven.

Ambient AI can still hallucinate, so human review remains essential. It may seem surprising to have hallucinated content based on a transcript. So far, researchers have found two potential culprits. First, the AI models themselves don’t actually understand content; they recognize patterns in language and make educated guesses, which can lead to mistakes. Second, speech patterns like long pauses, hesitations, or background noise can confuse the AI, especially during moments of silence, which are common in clinical conversations. Since AI struggles to interpret these gaps, it might fill them with incorrect information, leading to unreliable summaries.

Which brings us to another concern brought on by AI: cognitive offloading. Cognitive offloading is when we rely on tools or devices to reduce mental effort. It’s helpful in some situations (like writing something down so you don’t have to memorize it or using a GPS), but risky in others. If you use ambient AI to draft session notes, you still need to review, revise, and verify everything it produces. Don’t just skim and approve. Mistakes can creep in when we stop actively thinking through the details.

Licensed psychotherapist Amanda Marks writes in her blog that over-relying on AI can lead to clinical deskilling. New therapists, especially, should consider writing notes by hand for a while. It helps you learn what to notice. Like learning math, you need to master the basics before relying on a calculator. Skipping that step might save time in the short-term, but it can limit your growth and your ability to catch important nuances.

How to know if ambient AI is right for you

If you’re curious but cautious (which is a healthy place to be), here’s how to explore ambient AI in your practice.

First, start small. Look for tools that let you test with a few sessions. Ask other therapists what they use, and why. Look for platforms built specifically for mental and behavioral health.

Then, test the tool outside of sessions. Try using it with mock sessions or recorded examples. Get comfortable with how it works and the details it misses.

If you find a tool you like, bring it into sessions cautiously. Let your client know what you’re using and why (be sure to give them a chance to opt out). Watch how it affects the dynamic. Adjust as needed.

After a few weeks, ask yourself: Is this helping me with the way I like to practice? Am I still connecting with my clients effectively? This Medical Economics article points out that, among other things, proper AI implementation should be reflected in improved metrics.

The best tools feel invisible, like they’ve been part of your practice all along. You shouldn’t have to learn a whole new system. You shouldn’t have to fight with the technology. It should work for you. As Dr. Eric Bose pointed out in the Advancing Health podcast, you want to make sure that “it’s really helping the physicians and not being a hindrance to their day or some new technology that’s being imposed on them.”
When you find a solution that clicks, you’ll notice the difference. Less frustration. More room to breathe. More time to do the work you love.

Ready to make the leap?

Change can feel uncomfortable. But tools like ambient AI aren’t going away. They’re already here, quietly reshaping parts of the work we do.

The key is to stay grounded. Know your values. Know your clients. And use technology in ways that align with both.

If you approach ambient AI with curiosity, clear boundaries, and a critical eye, it can become a helpful part of your toolkit. Give it a try, but always keep the relationship with your client at the center of your work.

Because at the end of the day, the person sitting across from you and how you show up for them is what matters most.