AI In Therapy Without Losing Your Clinical Brain

AI is creeping into therapy work in a way that feels helpful and risky at the same time. I’m talking about what happens when we start using AI to write our reports, our notes, and even our thinking, especially when we’re overloaded and just trying to get through the week. I love AI for the right jobs, but I’m seeing a pattern: when the cognitive load is high, we reach for shortcuts, and the quality of our clinical reasoning can quietly slide.

We dig into why AI can’t truly formulate a clinical opinion, and why that matters when you’re writing for real humans and for funding bodies like the NDIS. A report needs a clear line from functional impairment to disability to recommendation. If the output is generic, vague, or just “words on a page”, it can create more work, not less, and it can leave you unable to stand behind what’s written. I also cover privacy and professional integrity, including the very real issue of AI generating fake references and the need to keep client information protected.

Then we get practical. I share where AI is genuinely useful for therapists: structuring case notes from your own voice memos, holding information outside your working memory, helping with content ideas, transcription, and even supporting scheduling systems when you set them up intentionally. I also talk about the specific risk for early career therapists, because using AI before you learn to think can delay the exact skills you need to grow into a confident clinician.

If this hits home, subscribe, share it with a therapist friend, and leave a review so more clinicians can find it. What’s one task you think AI should never touch in therapy practice?

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Transcript

Welcome And Podcast Purpose

SPEAKER_00 0:00

Welcome to Cognitive Capacity Chat. This is the podcast for the therapist ready to think beyond the therapy room. I talk about our cognition as our foundation, not just for our clients, but for ourselves. Because the way we think, organise and live directly shapes our clinical work, our capacity, and longevity in this profession. I'm Imogen, an OT, here to bring you practical conversations that fit into real life. This podcast is for the therapist who wants more depth, more clarity, and more life. Welcome.

A Temporary Home And New Routine

SPEAKER_00 0:40

Hello, welcome to episode three of the Cognitive Capacity Chat. Thank you so much for being here. I am currently recording this from my mother-in-law's house. We've moved in as we're having renovations done to our house. We will be here for 8 to 12 weeks, which is very kind of her to offer up her house and hopefully a new kitchen and living room roof and windows await for me at the house when we return. But definitely trying to settle into a new routine and our new normal because we've only been here for one night. So this is my first time sitting down and doing work in a couple of days after a big few days of packing up the house and moving things across. Today

Why AI Is Flooding Therapy

SPEAKER_00 1:25

I really wanted to talk about something that's really prevalent at the moment in our world and also new in the therapy space. And that is AI. Because I think that just like every other podcast, it's a really important topic to talk about. But particularly in the therapy space, because what I find is a lot of people lean into AI when they might not actually have the skills to use the AI in the way that it's intended to. And what I have noticed is a tendency for therapists to, when they're really overwhelmed, when they have additional cognitive load, they lean in on AI for everything. And I love AI. I use it for a handful of my systems, but I don't think it's everything. And I'm going to talk about it today. And I'd love to hear your thoughts on it because it's definitely something that's new in the space. It's something that everyone's starting to work out how they want to utilize it. And it's something that I think we should be mindful of, particularly as therapists.

AI Reports Without Real Opinions

SPEAKER_00 2:56

You don't use it, you lose it. But two, AI can't formulate opinions. So when I read reports that are written primarily by AI, it is honestly just words on a page. It's just a lot of descriptive words, over-explanation words, but there's no clear opinion. And I'm really big on the fact that we are writing, well, at the moment, we're definitely writing to humans that read this report. And we need to keep in mind that the humans that are reading these reports aren't always well educated in what we are well educated in. And that's fine. That's our job as a therapist to articulate and explain our clinical reasoning in a way that meets the funding body's needs. So for NDIS, that's understanding how the functional impairment is related to their disability and why it's their responsibility to pay for it. And the reports that I've read that have used AI or when I felt a little bit lazy and lent into AI, it actually makes more work than is necessary because it actually just writes words on a page with no clear structure and way that makes sense. So I feel like reports, AI, when writing reports, should only be utilized if we are enhancing or concising or trying to articulate it in a way that's more straight to the point, whilst also making sure that it's getting what we want out of it. Now, I also think you need to be very wary of the AI system that you're using and the privacy information. I would hope and trust that no one is utilizing AI to put clients' private information in. I would also be very wary there was a court case where the physiotherapist had written a report using AI and didn't even check the references that the AI had linked in. And there were fake references. So there's the professional integrity that we need to maintain as well. And I truly believe you don't need AI to write your reports. You need capacity to write your reports. You need capacity to be able to lean into that higher level thinking of problem solving, decision making, the clinical reasoning, the critical analysis, putting all those pieces of the puzzle together in a way that can articulate it. And I think therapists will lean into AI too much when their cognitive load is too high. But what we could actually do is we can use AI as a system to help your

Privacy Risks And Professional Integrity

SPEAKER_00 5:56

capacity. So you do still have the space to write your reports and to get those complex ideas out on paper so that someone's reading it in a way. I also think there's discussions that NDIS might start using AI to read reports and formulate decisions, which is concerning in itself. But the consideration of writing it in the way that you formulate a really clear opinion, you write it where you have clearly outlined the functional impairment, the symptom, and how that symptom is related to their disability, that is going to do great in an AI bot. It's going to clearly show your opinion and what you're recommending. Whereas if you are writing with AI, it's words on a page, like I said before. It doesn't formulate opinions. It might look good, but it doesn't mean that it is good. And I think this comes through with early career therapists as well, that unfortunately what you don't know looks good when AI writes it. But what you do know, it's very when you do know things, you note how generic vague. And really, there's no clear clinical opinion outlined in AI. And so where I think we can use AI as therapists is with managing our small tasks or our systematic tasks or the start and the end, not the big, juicy, meaty middle that is required to articulate what we need to do. So I use it. Some clinicians choose to do this within appointments, which is good for them. I like to primarily do that when I am, I like to primarily use Heidi AI when I jump in my car because then I can articulate my clinical reasoning that comes as well, not just what was recorded. And so some clients I do it with, but typically I'm jumping in the car, brain dumping, just voice memoing my case note. So I can articulate everything that I observed, what they said, and then my assessment, and then my clinical justification reasoning or plan of attack. And that's where I think AI is really good because it then structures it in a way that enables me to just get back to my desk, copy and paste it, and edit it. That so it makes sense. And it's definitely my words. But the reason this is good is because you are providing the AI with your clinical reasoning. It's not generating the new information, it's structuring the information. Also, really integral for managing cognitive load because all of a sudden, if you have back-to-back appointments, you've been able to get that out of your working memory into your system. It's able to hold that information and structure it in a way that when you get to it at the end of the day, if you do have back-to-back appointments, that is easy to review and read through. So AI is just helping you hold the information, which is going to give you more capacity to provide those clinical reasoning and justification skills that we need, that higher-level thinking.

Using AI To Reduce Cognitive Load

SPEAKER_00 9:36

I also use it personally for content ideas and expansion. So I'll often come up with one idea, and it's really good at prompting me to expand that into other areas or provide me with some prompting questions to help me get three posts out of what I had one idea. So I enjoy it from that sense. I also enjoy it that it is able to transcribe my podcast right now, and I'm able to just select the words and delete. Amazing. I also know AI can also be integrated into calendar and scheduling tools, which is really cool. I think that's great if you spend the time with setting it up in a way that works for you. So we need to make sure we're critically analyzing the system that we want to set up and then we're utilizing it in a way that works for us. We don't want to mold to the new system. We want the new system to mold to us. So with the likes of motion calendar, which often comes up in my feed, where it says it auto-reschedules things and it plans out your day, it's amazing. But I think we need the human behind that. We need a little bit of our own oversight into how we want to manage our calendar. And I think if you don't set it up well, it's not going to work well. So we've used FlowSavvy here. I've used it before. And it's also an auto-scheduler to help with rescheduling things if you miss something, or it say you take a phone call when you've got report writing time in your Flow Savvy, it will reschedule your report writing time to another time. Now, this works really well if you're intentional with the structure and intentional with the prioritization of these reports. So I find that the generic setup is what do you have to do for work? And then you write a report, an email. But what you need to do is you need to say my Thursday afternoons, 12 p.m. to 6 p.m. are my report writing time. So I'm going to, in my flow savvy, put report writing time specifically for that calendar. For my business development time, I'm going to do that on a Wednesday morning, 9 a.m. to 12 p.m. And you brain dump your hearts that belong in business development in there. So this way you've got more control over your organization, but you still have the benefits of AI. So it's enabling you to have structure because otherwise AI will optimize the wrong thing. The more information you give AI, the more structure you give it, the more likely it's going to be utilized for

Scheduling Tools Need Human Oversight

SPEAKER_00 12:37

you. The other consideration that we need to think about is what are we risking if we're utilizing AI or leaning too much into AI? Particularly, I really feel for early career therapists at the moment because I think if AI was established when I was a new grad, I would have a really difficult time actually creating information in my brain. I would lean so heavily on AI because I didn't have the right support. I would have just asked chat everything, and I would have stepped away from actually learning, looking at evidence, talking to people, observing. And I think it reduces our ability to justify reason, articulate in a way that we need to, as experienced therapists, we're able to plug things into AI and then come back and be able to review it and say, oh no, that doesn't sound very good. So if we are dependent on AI or if we use AI before we actually learn to think, we're only going to delay learning how to think. So we need to consider do we want to build our capacity and step away from AI, or do we want to be very heavy on AI? So I think, in summary, AI is here and is powerful, but it's not you. It's your value is not just putting words on a page. Your value is providing that clinical justification to articulate to a funding body or to a support worker or to a care manager that this person with a disability, this injury needs this intervention to reduce their functional impairment. You need to have your own clinical justification. You can't replace your clinical reasoning. You need to be able to be confident enough to stand in court and read your report and know that you wrote

Early Career Risks And Weekly Reflection

SPEAKER_00 14:34

it. And if you can't do that, then you're leaning much too heavily on AI and you need to manage your cognitive load in a different way so that you have capacity to lean into writing those comprehensive reports that we need to provide. And so I would love for you to think about this week, have a reflection time. When you are leaning in on AI, why are you asking chat to write a sentence about a wheelchair or regulation? Do you are you actually overloaded and you actually more so need a break, you need to go for a walk, or you need to think about how you can manage your systems better so that you have capacity for this? How can you change the way you practice so that we can actually read what's in your brain? So that is it from me this week. If you like what you heard, I would love for you to message me on Instagram and give me your opinions on AI. Obviously, it's a very big topic, and I only just scrape the surface here. I'm also soon to release my private podcast to my newsletter. So if you're not in my newsletter, then make sure you jump on that and I'll put all the links in the show notes. Have a lovely week.