How To Use AI Tools Like ChatGPT In Your Practice

Uriah
Hello, and welcome back to the Productive Therapist podcast. Thank you so much for listening. I really appreciate it. If you have been enjoying this podcast, I would love for you to leave us a rating and a review on Apple Podcasts or Spotify. If you leave a review, I will give you a shout out in a future episode. Today, I want to shout out DFK MFT. Says, Essential Listening for Therapists. Listening to this podcast has really helped fill in the gaps on the business aspects of running a practice that weren't covered in grad school. The information and insights from this podcast helped me from when I was a solo practitioner to running a group practice. Thanks to Uriah and all your guests for the help with running a successful practice as a psychotherapist. That's amazing. Thank you so much, DFK MFT. Today, I had a really short but super fun and valuable conversation with my good friend, Kim Tolson. If you haven't heard of Kim, she is the mastermind behind the Traveling Therapist podcast, Bill Like a Boss, and the Clinical AI Club. Today, we're talking about how to choose and use AI notewriting tools for your clinical sessions. I hope you enjoy this awesome episode with Kim Tolson. Have a good one. Hello, Kim! Welcome to the podcast.

Kym Tolson
Hi. Thanks for having me.

Uriah
I'm excited to be a guest. Yeah, absolutely. I can't believe it's taken us this long to have these conversations. I know.

Kym Tolson
How is that? That we have not recorded a podcast yet.

Uriah
But we are here. We are here today. I'm honestly glad that we're doing this and that we're recording it because this is a conversation I've wanted to have with you for a while because I'll give you some props. When I think about or hear about therapists using artificial intelligence tools, I immediately think about you. You're my go-to person. Yeah, good job on that.

Kym Tolson
Thank you. I feel like I was one of the first to really embrace it and try to then just start bringing it to the therapist community. Really introducing them to it.

Uriah
You really did. We'll give you a chance to tell people about how they can take advantage of that, too.

Kym Tolson
Okay, cool.

Uriah
Thanks. Good stuff. We're talking about AI note-taking tools. If somebody's listening to this and they're like, What is that? On the off-chance, somebody has not ever heard of this. Please tell us, what are these tools and how do they function?

Kym Tolson
There's different tools. There's one called ChatGPT, which is my favorite. When we say note-taking tools, there's different ways to do this. Chatgpt would be one where you just type in a quick little summary of what happened in the session. You could even dictate it down to ChatGPT, but it's not HIPAA compliant. You would not want to put any PHI or anything like that into ChatGPT, but it can generate really good notes. You can say, I'm a therapist. I specialize in CBT. Quickly, turn this into a soap note for me that meets medical necessity. You could put that prompt into ChatGPT and have a note in two seconds, which is amazing. And then there's a whole new breed of AI programs that are coming out. And one I'm partnered with, and I'm actually the clinical consultant for is Berries, B-E-R-R-I-E-S. They're amazing. They're HIPAA compliant. You record the session and then click on a button, it turns it into an amazing progress note for you, and you're done. You copy paste it into your EHR, and that's it. It erases the recording, and then it keeps just the note for you for 30 days, and then it even deletes that after 30 days to keep it super HIPAA compliant.

Uriah
So these tools are solving one of therapists' biggest pain points, which is clinical documentation. Well, almost nobody loves to take notes. We love to do therapy, but we don't necessarily love to do the note. So this solves that in one way or another, right? That's fantastic.

Kym Tolson
And Barry's, I think next week, they're coming out with a treatment plan solution. So now it's going to take the progress note it just wrote. It's going to turn it into a treatment plan. It's going to store the treatment plan under the client's initials or however you want to keep it. And then every time you write a progress note, it's going to update your treatment plan for you with AI, so you don't even have to do that.

Uriah
What? This almost makes me jealous.

Kym Tolson
Why did Why did they have this? I know.

Uriah
It's like, Why did they have this? Yeah, exactly. That's what I was going to say. This makes me jealous and want to start seeing clients again just so I can use all the cool tools.

Kym Tolson
Seriously, it's unbelievable. Being a clinical consultant on it is so cool because I'm just like, Here's what I wanted to do. Make it do that. They're like, Okay. They just create these different things. It's amazing. They even have a button where it's patient email. You click the button, it turns the session into an email that you directly send to the client client, and it summarizes what you talked about in the session and what the homework assignments were, what the plan is for the next week until you see the client again, basically.

Uriah
I like that very much.

Kym Tolson
It's so easy.

Uriah
Okay, so a couple A couple of quick questions for you. Is there a distinction between AI note writing tools that record the session and ones that do not? Is that a distinction worth making?

Kym Tolson
My opinion, it is because why wouldn't just want it to record it? Then you don't even have to input the information. Some of them you can dictate, but most of them that don't have the recording option, you have to literally still type in the note into the system, and then it turns it into a note. To me, that doesn't save a lot of time, is my thought. So the recording, to me, is so much easier. You don't even... When you used to write notes, it was pretty stressful. There's vicarious trauma, even from having to rewrite about a traumatic session or something like With berries and all these other note writing platforms, you don't even really have to think about it again. I mean, you go over the note, you read it, it's like, Yeah, does that make sense? What they said? Yeah, cool. Done. Instead of even having to retype it or even think about a short blurb to put into something that's then going to use AI to turn it into a note. In my opinion, it's a huge distinction, and I would never not want to use it ever again for recording my sessions.

Uriah
I would agree with you on that one. If I was to come back and have a second life as a working therapist, I would for sure do that 100%. But I know that, even I think about this, and I'm sure you have, but a lot of therapists are concerned about the safety and security of that. What do you recommend to overcome that or how to just consider that?

Kym Tolson
If you're going to use ChatGPT or Claude or Gemini, those are some free AIs out there. Just review what is PHI. There's 18 18 PHI points that you should be paying attention to. Go review that. Make sure basically whatever you put in that you would not be able to identify who that client is. If they were your neighbor and you read this, would you know? That thing. Ask yourself that question a little bit. Then for these note writing tools, just check, do a little research. Is it HIPAA compliant? Why is it HIPAA compliant? What type of security are they using on the back-end? Berries is getting ready to get their SOC 2 security certification, which is even higher than HIPAA. They're also getting the Canadian Privacy. I can't think of the name of the Canadian HIPAA. It's like HIPAA. They've got that going on. Meet with these companies and say, explain to me why this is HIPAA compliant. How can you guarantee it's HIPAA compliant? Because most of them use ChatGPT or an open language model in the background, but they've got a lot of security measures built in. So it's not going back out then training the AI because that's what ChatGPT does.

Kym Tolson
Anything you put in, it goes back out and the AI is learning from our input. Technically, it's like if you put in too much PHI or something, maybe it might come up in somebody else's search about something. If it's an open AI source like that that doesn't have HIPAA complaints in the background.

Uriah
Do your research and find a company you can trust. Okay, that makes sense. Are there any other downsides besides the possibility of safety and security issues? Are there any downsides to using these tools?

Kym Tolson
Not that I have found, really. I mean, of course, everything's biased, right? So even ChatGPT or even an open AI model is somewhat biased because it's giving you information based on its own training And of course, it's sourced from the internet. So the internet is biased. So you might want to just read through it and make sure it reflects your values and that thing in your practice, because it might say something you're like, No, I'm not. No, that's not even what I'm talking about, because it does have this thing where it will hallucinate information, is what they call it. It'll just come up. So if it's writing a progress note and you didn't say anything about the objective in your little blurb, it'll make stuff up. It'll interpret just what you put. It'll say, Well, this person's probably super tangential, too. It'll add stuff in like that. You have to pay attention to that. Even with berries and the other AI programs I've tried, there's a blank where something's supposed to go in the mental status exam. It's going to make something up sometimes. You have to just go back over it. You have to always read back over this stuff, I guess, would be the precaution there.

Uriah
That makes sense. It's not foolproof to be left alone. That makes sense. I watched your video recently where you were showing in Barry's how to set or create a favorite note and then reuse that and tweak it from session to session. I thought that was pretty clever.

Kym Tolson
It's amazing. You can literally... We all have bought progress note templates from somebody. I think most therapists have. They've got their favorite therapist that writes a really good note, and they have a template, and they bought the template. You can take that template and just go edit your last session and change everything to reflect how you want the template to be, and you save it. Then every time you go back in to do a session, you just make sure you're using that format, and it changes it to that format. It fills in all the boxes and everything in your favorite note, which is amazing to me.

Uriah
I think that's so cool. I've been around long enough. I started my My private practice. Well, I started seeing clients in 2001, and started my private practice in 2008. In the early days, I definitely did all my notes on paper. I did have a template that I printed out over and over and over again to write notes.

Kym Tolson
Yes, photocopy.

Uriah
It's just amazing to come from that. Yes, right.

Kym Tolson
I used to have a clipboard and I'd have photocopy.

Uriah
Oh my gosh. Yeah. It's just amazing how far things have come. I'm just astounded by it. It's really cool. Okay, so I have to ask you this, and I know you're a clinical consultant for Berries, and that's your favorite one, but I did a little bit of research, and I just find things on the internet and I compile lists for myself, and then sometimes I share them. I've been tracking down all the AI note writing tools that I can find. Then I did a little bit more research recently, and I found up to 16. I'm sure that's not All of them by any means. Some of these are primarily meant for medical scrabbing, but then they say it works for mental health as well. Some of them are behavioral health-specific. There's a lot of options, like there always is. How is How do therapists choose the best one for them when a lot of them do something similar? What's your thoughts?

Kym Tolson
I would say sign up for the free trials, see which one feels the most intuitive to you because they all have different interfaces. I've tried a lot of them, too. They all have different interfaces, so I just go in and play around with it. Of course, if you're going to actually try it with a client, make sure you have informed consent with your client. I should have said that earlier, but Beers, for example, all of them have some consent that you can download and give to your clients and explain this will be recording in the background. Here's how I'm going to use your information, AI is involved in all that stuff. I would just say, do the free trials. Barry has 20 free sessions, and they give you 10 free sessions every single month, and you never even have to put a credit card in. Just make sure you get that consent. But you can even in Barry's, I don't know about the other ones, but you can dictate, so you can just pretend that you're having a session. In that video you're talking about, I pretend I had session, and I just dictated with the record button. I was like, met with Susie, and we talked about her anxiety and how to resolve it. And she did deep breathing, and it worked, something like that. I just stopped recording, and it turns it into a note that way. So you could even practice in some of these free ones and just see which one you like the best.

Uriah
That's great. What do you think are the odds that, for example, SimplePractice buys one of these companies or makes their own?

Kym Tolson
It's going to happen, right? Yeah. This is my Yeah, I'm waiting for it. I already saw that Alma... Alma is another one of my partners, by the way. Alma has connected with Uphill, and I saw that they were releasing a beta feature. So I think it's just a matter of time before all of them have got this built in the background. Really, I do. Now, how good it's going to be? I don't know. I mean, I feel like it might be simplistic, but eventually I would hope that they'd be able to pull in the PHQ-9 measures that you did and your old treatment plan and be able to pull that in and just have it do a really sophisticated analysis of all of that for you. Even predictive analysis in the future is what I'm seeing people talk a lot about, that we've got all this data now and it's in a HIPAA-compliant environment. Now, let's do some predictive analysis. How likely is it if they do deep breathing three times a week, that they're going to decrease their anxiety levels? Or behavior I'm seeing reported in these notes is looking like they're getting ready to have a relapse because of everything. There's a relapse coming. We've got to put some measures in place that can stop this. Having the AI doing all that in the background. But I couldn't imagine an EHR not figuring out how to put this in there.

Uriah
They're all planning. They're all trying to figure it out right now. They've got to be.

Kym Tolson
I think it's going to be great. If I had one, I would.

Uriah
If you're already doing your Telehealth sessions in your EHR, whatever that might be, it just makes sense that you would want to have that note writing and AI-assisted note writing built in there. I know it's probably somewhat controversial in 2024, but I'm all for the AI-assisted therapist. I think if artificial intelligence can help a therapist do better work, get better outcomes, and also streamline their operations so that they can enjoy their life, let's go.

Kym Tolson
Sign me up. Exactly. You avoid burnout, and you're going to be healthy for your clients. The trickle-down effect of this is going to be amazing.

Uriah
Two things to know, we don't need to get into this today, but I'm guessing that these notes are going to be more audit proof for insurance because they're just better, right? Right. Makes sense. Then also, this would be like if I was going to start my group practice over again today, or if I was... Actually, I'm winding my group practice down. I don't know if you know that. No, I didn't know. But if that wasn't the case, I would be for sure implementing one of these tools to save time for my clinicians on note writing and specifically helping train associate therapists to write better notes. But then my mind goes like, Well, if associate therapists or pre-licensed folks start using these tools, will they not get the skills of manually writing good clinical notes? I don't know. That might be a trade-off.

Kym Tolson
Exactly. So two group practices have contacted me about berries, and I followed up with them and I was like, Did you decide to sign up? One said, Heck, yes. We signed up. The other said, I'm not ready to bring it in for the exact same reason that you said, because she has a lot of really young therapists in her group practice, and she doesn't want them to not understand what goes into writing a progress note. So I was like, I get that. Yeah.

Uriah
You know what I would do?

Kym Tolson
I'm just thinking off the top of my head here.

Uriah
I would probably go. I would have them do six months of supervision with manual note writing and then turn on AI-assisted note writing. I think that would be nice. That's smart.

Kym Tolson
I think that would be amazing. Could you imagine if your employer just paid for your AI and you're like, Finish your notes in two seconds. You don't even have to do it on the weekends or in the evenings? I used to have to do it.

Uriah
Then if your notes are not up to date, then what's your excuse?

Kym Tolson
Exactly.

Uriah
There are no excuses. Oh, my goodness. Well, this was so fun. I know this is a super fast conversation, but I know you have a lot more resources and ways for people to get more tips and wisdom from you on this topic. Where can they go to find that?

Kym Tolson
I have a free Facebook group called Run Your Private Practice with AI. Then I started something called the Clinical AI Club. It's super affordable. It's $9 a month, but every single month, I drop a new module about different things you can do with AI to run your private practice. We have a monthly implementation session for 90 minutes. We get together, we just really geek out about AI and private practice. People be like, I'm trying to do this. How do we do it? We'll problem-solve and figure it out together. That's a really fun session. Then every other month, I have an intro to AI class that I do for people that are brand new to AI. People really like that, too. Then the opposite month, we have a co-working session. Just to get in the modules and do the work and ask me questions, I just hang out and people ask me, Well, how do I do this? I help them. It's a lot of fun.

Uriah
That's amazing. Okay, $9 a month. Go sign up now. Link is in the show notes. Just do it. Awesome. Thank you. Thank you, Kim. I appreciate it so much.

Kym Tolson
Oh, thank you.