WP111 | How to Ethically Use AI in your Practice with Dr. Maelisa McCaffrey
Are you curious about how AI can simplify your life as a mental health professional? In this episode of The Wise Practice Podcast, Dr. McCaffrey dives into the practical, ethical, and downright fascinating ways AI is transforming therapy workflows! From speeding up documentation to generating personalized pep talks (yes, really!), she shares real-world examples of how AI can save time and spark creativity—without compromising ethics or client trust.
How Artificial Intelligence Transforms Daily Life and Private Practice
Dr. McCaffrey emphasizes the pervasive yet often unnoticed role of AI in our daily lives and professional practices. From predictive text on phones to more advanced applications, AI offers practical solutions for tasks that can be time-consuming or tedious. In a therapeutic context, AI can assist with creating templates for progress notes, treatment plans, emails, and worksheets, as well as gathering and synthesizing data efficiently.
For example, Dr. McCaffrey shared how AI streamlined the process of creating quiz questions for continuing education trainings, cutting the time spent by generating initial drafts, which were then edited for accuracy and relevance. Similarly, AI can simplify resource collection, particularly in telehealth settings, where practitioners may need information about distant counties’ emergency services.
However, she stresses the importance of reviewing AI-generated outputs, as AI can sometimes provide incorrect or overly generalized information. This need for oversight ensures that outputs are accurate and align with the user’s voice and context.
Dr. McCaffrey also highlights AI’s potential for synthesizing complex information, such as summarizing responses from team feedback forms, and even providing emotional support, like generating personalized pep talks. For her, the possibilities with AI are vast, and its ability to save time and spark creativity makes it an invaluable tool in both personal and professional spheres.
Ethical AI Integration in Private Practice
Dr. McCaffrey highlights the importance of informed consent and security when incorporating AI into clinical practices, especially as technology evolves rapidly. While AI can be incredibly useful for creating templates or simplifying workflows, its application in client records, such as progress notes and treatment plans, requires careful consideration.
She stresses the need for transparency with clients, emphasizing that clinicians should inform them about the use of AI, its experimental nature, and their option to opt-out. Ethical guidelines, such as those from AMH and APA, recommend making these practices optional and clearly communicating the evolving nature of AI. For instance, clinicians should update clients about potential changes and acknowledge any limitations in their understanding of the technology.
Regarding security, Dr. McCaffrey notes that tools used for client data must comply with standards like HIPAA in the U.S. Clinicians can ensure this by securing a Business Associate Agreement (BAA) with the AI provider, which guarantees the platform’s security measures. She reassures practitioners that it’s okay not to have all the technical answers. Instead, they can rely on the agreements in place or seek clarifications from the AI company when needed.
Dr. McCaffrey likens current apprehensions about AI to the early adoption of EHRs, urging clinicians not to let anxiety over technical details overshadow the benefits of these tools. By focusing on ethical practices and clear communication, practitioners can integrate AI effectively while maintaining trust with their clients.
Choosing the Right AI Tools for Progress Notes: Ensuring Security, Compliance, and Ethical Practices
Dr. McCaffrey discusses various options for using AI-powered progress note generators while emphasizing the importance of HIPAA compliance and ethical practices. She strongly advises against using platforms like ChatGPT or Google Gemini for client data, as they are not HIPAA compliant, lack Business Associate Agreements (BAAs), and explicitly warn against such uses. Instead, clinicians should choose specialized platforms designed for mental health professionals that are secure, ethical, and built to improve workflows.
She outlines several ways AI platforms process data to generate notes:
Real-Time Listening During Telehealth Sessions: These platforms can analyze live sessions, create progress notes, and often provide full transcripts.
Listening in Office Settings: Some tools capture conversations through microphones during in-person sessions.
Uploading Recordings: Clinicians can record sessions on their own devices and upload them to the platform for analysis.
Typed Summaries: Clinicians type session summaries, and the AI generates corresponding progress notes.
Verbal Summaries: Dictating a session summary allows the platform to create a note.
While these options vary in terms of accuracy and invasiveness, they all require clinicians to share session data with the platform. Dr. McCaffrey stresses the importance of choosing secure platforms, noting that many of these companies are driven by a genuine desire to support mental health providers and reduce administrative burdens like documentation.
She also reminds clinicians that the AI process may take time, especially for platforms analyzing full-session recordings, unlike the instant interactions common with general AI tools like ChatGPT. However, as these technologies evolve, processing times and features are likely to improve.
Her final advice: trial multiple HIPAA-compliant platforms to find one that aligns with your workflow and needs, ensuring both security and practicality in documentation practices.
Show Sponsor Mastermind Groups
Are you a small group practice owner who wants to level up your practice, but you’re terrified of making mistakes, or are just uncertain of the next steps to take? If you're ready to go from feeling overwhelmed to owning your role as a confident, organized boss, then it's time to join an exclusive mastermind group, beginning in January 2025.
Imagine being able to communicate seamlessly with your team, having a process in place to hire and onboard with ease, and finally finding smart solutions for managing your office space needs. You'll learn how to balance seeing therapy clients while building systems, and, most importantly, step into the role of a true leader.
In this 6-month mastermind, you can expect live Zoom meetings every other week, access to the Wise Practice Membership Community, and access to Amy Dover between meetings as well as discounts on individual consultation calls while in the group.
Whether you’ve just made your first hire or are already managing a team, this group will give you the tools, guidance, and support to build a practice that thrives.
Head on over to wisepracticeconsulting.com/masterminds to schedule a call and sign up for the group. Wise Practice community members will receive $100 off per month for the mastermind group. This group is limited to only 8 participants and you must sign up by January 3rd, so don’t delay.
Start the new year off with like-minded practice owners who want to grow and make 2025 the best year yet for your practice!
Dr. Maelisa McCaffrey’s Resources
"AI for Progress Notes" playlist available for free on YouTube
Stress-Free Documentation for Mental Health Therapists
Links and Resources
Looking for support and connection: Join the Wise Practice Community
Learn More about Wise Practice Consulting
Connect with Wise Practice on Instagram
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[00:00:00] Amy Dover: Hey guys, I'm Amy Dover, Group Practice Owner and WISe Practice Consultant. Are you a small group practice owner who wants to level up your practice, but you're terrified of making mistakes, or you're just uncertain of the next steps to take? If you're ready to go from feeling overwhelmed to owning your role as a confident, organized boss, then it's time to join my exclusive Mastermind Group beginning in January of 2025.
Imagine being able to communicate seamlessly with your team, having a process in place to hire and onboard with ease, and finally finding smart solutions for managing your office space needs. You're also going to learn how to balance seeing therapy clients while building systems. But most importantly, you'll learn to step into the role of a true leader in the six month mastermind.
You can expect live zoom meetings every other week access to the wise practice membership community and access to me between meetings as well as discounts on individual consultation calls while in the group, whether you just made your first hire or you're a new hire. We're already managing a team.
This group will give you the tools, guidance, and support to build a practice that thrives. Head on over to wisepracticeconsulting. com backslash masterminds to schedule a call with me and sign up for the group. WisePractice community members will receive a hundred dollars off per month for the mastermind group.
That's an awesome deal. This group is limited to only eight participants, and you must sign up by January 3rd, so don't delay. Start the new year off with like minded practice owners who want to grow, and let's make 2025 the best year yet for your practice.
[00:01:36] Whitney Owens: Hi, I'm Whitney Owens. I'm a group practice owner and faith based practice consultant, and I'm here to tell you that you can have it all.
Want to grow your practice? Want to grow your faith? Want to enjoy your life outside of work? You've come to the right place. Each week on the Wise Practice Podcast, I will give you the action steps to have a successful faith based practice while also having a good time. Now let's get started.
[00:02:02] Jingle: Where she grows your practice and she don't play.
She does business with a twist of faith. It's Whitney Owens and the Wise Practice Podcast, Whitney Owens and the Wise Practice Podcast
[00:02:21] Whitney Owens: for today's episode of The Wise Practice Podcast, we are talking about AI in your private practice. This is the topic that I have wanted to find an expert in for quite some time to bring on the show, and I did. So Dr. Melissa McCaffrey, who, she's an AI expert, she's also a documentation expert, brings tons of value to the table today.
So you're in for a treat with this episode for sure, but before we do that, I want to spend a few minutes talking about our mastermind groups that we're launching in wise practice. So going into 2025, starting in January, we'll be running 2 mastermind groups for 2 different phases of practice. One is for those that are solo practice centers wanting to grow their solo practice or potentially start it.
So this would be for someone who maybe just started and has a couple of clients, but thinking to themselves, Look, I've got to make more revenue for my family to have the lifestyle I want to do the things that need to be done, even just to care for basic needs. I need to grow my caseload. If that is something that you're asking yourself, this mastermind is a great fit for you.
Or maybe you're a solo practice owner trying to figure out what systems do I need to use in my practice? How can I work less and make more? Or I have this other really cool side hustle thought, how do I get that going? That would also be a perfect fit for this mastermind group. So we're running one mastermind group specifically for solo practice centers wanting to grow their private practice.
That's going to be led by WISe Practice Consultant, David Sturgis. And then we have another mastermind group. That's for group practice owners, those that have their first few therapists, really trying to figure out how do I run this thing? You know, what do I not know that I need to know? What do I need to know about streamlining my practice?
About delegating, about creating policies, having a handbook, so that this whole thing can function a lot more smoothly. And how do I have the marketing in place? For my therapist that I've hired so that it runs seamlessly and I'm not having to constantly get involved in that. So if you're thinking I have a few therapists, I want to get my group practice running more smoothly and having higher revenue Consider joining that mastermind group led by Amy Dover.
So if you are interested And taking your practice to the next level in 2025, I want you to head to wisepractisconsulting. com slash masterminds. I also want you to know it's very important to me that people don't work with us that don't find benefit. I want every single person to find benefit. To grow their practice and it be worth the investment.
I want everyone to walk away saying that was totally worth every bit of my energy and time and money that I put into this. So if you're thinking about a mastermind group, you're reading through it on the website and you're still not sure, let's jump on a phone call. Let's talk about where you are in your practice to make sure it's good fit for you to do that.
Head to that website. Fill out an application that will alert me and either myself or one of the consultants will jump on a call with you to make sure that the mastermind is a good fit for you. If you have other questions, please email me, Whitney at wisepractisconsulting. com. I totally enjoy the work I do and want to make sure that your practice It's serving your community, but also serving you.
So mastermind groups, I love them. All right. So we are going to move in to the episode here. This is with Melissa McCaffrey, and we're going to talk about using AI in your practice, what to be considering, what to maybe not be doing and how to do this in an effective confidential way. So I'm excited to have her on the show.
Welcome
back to the Wise Practice Podcast. And today on the show, I have Dr. Melissa McCaffrey, who's a licensed psychologist, nail design enthusiast, and multi passionate entrepreneur. Through her business, QA Prep, she empowers therapists with training and consultation on clinical documentation. As someone with ADHD who's had to figure out what works through trial and error, Melissa aims to make sure her trainings are both practical and fun.
Let's get started. Thank you so much for coming on the show today. Yeah. Thank you so much for having me. I'm excited to be here. Yay. Well, we are going to be talking about all things AI because this is just a hot topic, getting lots of questions about it. But before we jump into that, would you like to just kind of share with the audience, anything that went in your bio, kind of where you're from, how you got into this line of work?
[00:06:49] Dr. Maelisa McCaffrey: Yeah. I mean, that's kind of a longish story, so we won't get into all of it, but I basically fell into doing QA, quality assurance. at agencies and really, you know, kept getting the same response over and again in trainings, which was, we never learned any of this in grad school. This was so helpful. The agency that I worked at at the time really invested in training on documentation.
And so we had a really good training. And so the clinicians really valued it and found it so helpful. And I had a lot of friends in private practice and started talking to them and realized, They had nobody to call, right? They didn't have a QA department. Like, they just pick up a phone and, or send an email to.
And as I talked with people, I thought, Oh, this could actually maybe be a thing, you know, and it's now been 10 years since I started QA prep. And it is my full time job, just doing this, talking about documentation. I've been doing that for over 10 years now, and it's really, really fun. And It's been exciting over the last year and a half or so as AI has kind of changed some things with, with documentation and what I do.
So it, it's a field that doesn't actually stay stagnant, even though it seems like it might, you know. So it's actually been a lot of fun to help people figure out this topic.
[00:08:13] Whitney Owens: Yeah, and of course, I can see you. I can see your passion. Yeah, yeah. I love it. I love it. I'm thinking about my clinical director.
She's, she's like that too. She just loves to research and do documentation. If I got y'all together for coffee, it'd be so fabulous.
[00:08:27] Dr. Maelisa McCaffrey: Well, the funny thing is, the funny thing is, I am not passionate about documentation. Like, I like to tell people, you know, like I have ADHD. I am not naturally organized. Like I, I pay a lot of money every month to have other people manage me in order to have my own business, you know?
And so like, I do want people to know, if you're listening to this, you know, you can do it too. Cause I had to figure a lot of it out. And as I figured out these different strategies and realized different things work for different people, I will say one thing that I am really passionate about is clinical assessment and And thinking outside the box, you know, using ethics to guide what we do.
And I think that is really at the heart of a lot of the documentation questions I get and why it does mesh so well and why it keeps things interesting for me, because there is no like one way to write a progress note or a treatment plan, for example. And yet that's what we all want. And so we have to navigate these really vague.
Guidelines and waters and I really enjoy doing that and I really enjoy training and I enjoy training and making something that is typically really boring and stressful, more interesting.
[00:09:42] Whitney Owens: Yes, I love that. I love that. Alright, so we're going to talk about AI. And how AI impacts our practice and the work we do.
So maybe let's kind of start in a broad stroke, big picture of how does AI impact the way we run our private practice. And then we can kind of narrow it down into documentation into writing.
[00:09:59] Dr. Maelisa McCaffrey: Yeah, so obviously, you know, it can get as specific as using it to write notes, which we'll definitely talk about.
But in general, using AI is everything from using predictive text on your phone when you're texting people. I mean, that, that is AI. So a lot of us are using AI unknowingly or not realizing how pervasive it might already be in, in our life and in our practice. So you're probably using AI. Throughout your life, just not as aware of it, and it's not so in your face.
But then as far as using it for a practice, it can be really useful for things like creating templates and gathering resources, gathering data, synthesizing data. One thing that I, I love doing trainings. I hate creating quiz questions. for continuing education requirements, right? And I don't know what it is, but that particular thing is always like the bane of my existence.
And I'm like, it's the last thing I do every time I do a training. And ironically, I was doing a training on AI and then I realized, Oh, I could actually use AI to help me do this, right? Put in the outline, put in all the things that I've written down for this training and have AI give me 10 quiz questions.
And so that is something that it's really, really helpful for saving time. And it's across the board, no matter what you use AI for every single time I've used AI, I have never been able to just ask AI to do something. And then it gives me the perfect answer. So it is not yet replacing us and it's not yet replacing the things you don't like doing.
You always have to check it. So like with those quiz questions that I create. It will sometimes give me the wrong answer or it will sometimes give two answers that could be correct and a multiple choice option, right? And so I'll always have to edit the things, but it saves me probably an hour of time just inventing everything.
And so in that way, AI is super useful for things like creating templates, whether that's a progress note template, a treatment plan template or email template. Like, especially if you're starting out and you want to have some templates for, you know, no shows for new appointments for all these things. You can give AI a bunch of information about you and your practice and it will give you these nice templated statements and then you can just tweak them a little bit to make them more like you.
But that template idea is kind of endless. You can do that for worksheets, for all kinds of things, for collecting resources, especially if you do telehealth. Like, I used to do telehealth in California, which means sometimes I had clients that lived eight hours away from me. where I had no idea, you know, what the emergency resources were in their county.
And so it took time for me to go and I would, I wouldn't do, honestly, I wouldn't do like extensive research, but I would at least go and look up, okay, what's their county, you know, what number can I refer them to if I need to, if something happens, et cetera. And now you could use AI to collect a lot of that information more easily.
Now you always have to check it for accuracy because. We can get into this more, but it does lie to you. It wants to please you and it will lie in order to please you and give you an answer sometimes rather than just say, I can't give you that answer. So you always have to check it for accuracy as well as to make sure it sounds like you.
But you know, when you start to think about this type of thing, the possibilities are really endless. You've got my mind churning. Yeah. Yeah. Is there anything you're, you're thinking of
[00:13:43] Whitney Owens: like, Oh, I haven't used it for this, or I might want to use it for that. Well, definitely the idea of templates is really helpful, but yeah, the questions.
That you were talking about in quizzes. I, I hate that too. So that's like, I'm like, yeah, I can do that for all my quizzes. In fact, the other day, I'd never done this before, but we have a group practice here in Savannah. And so we were doing, like, aligning our mission and values and just getting feedback from the team.
Like, what do you, where do you see us going? What are we all about? What are our values? And it was all 17 of us filled out the Google form, and then we found a way to stick it all in to AI. And it summarized all of it. So instead of having to read through every single form, it summarized it. And then if I saw an outlier, I was like, Oh, let me go see who said that.
And I could research that some more, but I was, I mean, I about fell out of my chair.
[00:14:30] Dr. Maelisa McCaffrey: Yeah, exactly. So it, it, it's really useful for things like that. Saving time, synthesizing data, providing data, and some people like it. You can either use it, for example, to create a template or an outline and then you fill it out, or you can do more like my example with, like, I give it all the workshop material, and then it kind of gives me You know, some quiz questions from a bunch of work that I've already created.
So you know, but either way, it's really useful to have something to, to bounce ideas off of it. I was in a meeting last week and someone even said that you can, you can use chat GPT specifically to give you a pep talk. And they said that it was, this is a therapist and they were saying it was actually really nice because They just needed a little bit of encouragement, and so they just typed into chat GPT what they needed to hear, and it was really a really nice interaction.
So it's endless.
[00:15:27] Whitney Owens: I might be doing that tonight. All right. Well, this is great. Okay. I have so many things we could talk about, but I know we got to talk about notes because that is like your jam and that is what I get the most questions about. So let's chat about how, how do we do this? How do we use AI for our progress notes?
[00:15:44] Dr. Maelisa McCaffrey: Yeah. Yeah. So that is a whole training. And so this is like, we're gonna, you know, give them the surface and talk about the things, but I think it will give listening to this will give people an idea of whether or not you want to dig in more or whether or not you're like, okay, I heard enough. And I'm not ready for it yet.
And so that's my goal from listening to this is that you can kind of make that decision based on this information. So for me, the, the two things that come up with AI, regardless of what we're talking about, but that do really specifically relate to progress notes are not the things that everyone thinks of initially.
So the first thing is informed consent and secure, and then second is security. So these are always the two things that we need to be mindful of, and that are very much in flux and being developed. Because AI, the first, excuse me, the first YouTube video I did on AI was about a year and a half ago. And the information available then was so different.
Just like every six months, I feel like my information that I have previously given out is not obsolete, but absolutely has an asterisk on it. It needs to be updated. So it's important to recognize that, you know, that it's, it is constantly adjusting. And We have very few guidelines ethically that relate to AI specifically.
So one professional association has provided some very specific guidelines on AI and the rest of them have not. So that, so, uh, AMH specifically updated their, their ethics code. So they basically say you need to get informed consent from clients. And I think for the rest of us who, like I'm a psychologist, so I can't use that ethics code, but I can use that to say that's probably an indication of the clinical standard at this point.
And then I can couple that with the APA ethics code. Which tells me that anytime I'm using something new or emerging that I need to inform clients that this is new and emerging things might change. I may not know exactly what I'm doing and I need to make it optional. So that's another big thing is that part of this informed consent is if you are using AI for not for templates like we were talking about, that's more like your business practices.
But when you start using it for anything that's going to go on a client record, so anything that's got a treatment plan, create a progress note, anything like that, then you need to look at these informed consent issues. And so talk with your clients and actually get their informed consent and then make it optional.
So I do work with some clinicians who have been loving AI and really like using it. And no matter how useful it is for you, I would say it's still not. Um, the standard enough that you could say, Oh, well, if, if you don't want me to use a I, I can't see you, you know, most of our ethics would, would tell us no, your clients have the right to opt out and you have to be like, okay, even though a eyes made my life so much easier over here, I can't use it with this client, you know, so that's, that's one thing to consider is the informed consent piece and as part of that.
With the security, I think a lot of people, the questions I get are, how do I know how to even bring this up with my clients? How do I talk to them about it? Because I don't understand all of the technology with it. I, and I think people are worried that clients are going to start asking all these technical questions about how AI is used, et cetera.
And we had those same concern about 10 years ago, when EHRs started to become. A lot more popular. So I don't know if you remember that or had any of those fears yourself, but the same questions I hear people asking about AI are almost exactly the same questions people had about EHRs back in the day. So that wasn't even that long ago.
So I say that to hopefully dispel some of the anxiety around it and also to give people the reminder that you don't actually have to have all those answers. It's okay, you don't have to understand all of the technology. You do have to understand that if you're using any technology, anything, an EHR or AI for client records or client data, then it needs to be, in the US, HIPAA compliant.
Right. It needs to be HIPAA secure. And so as long as you have a business associate agreement, a BAA with the company that you are using for the AI company that you're using, then that company is guaranteeing that they are secure. You don't need to know everything that they're doing to be secure. As long as you have that agreement, you know, that that's the point of these agreements is that us as clinicians, we can just, okay.
You have agreed to this part. Now I can do my part and I can just let my clients know, Hey, I am using this. It's HIPAA secure. I would like to use it. I find it helpful. Are you okay with that? And if clients have questions, then that get really technical that you can't answer. I would recommend saying, you know, I can either ask these questions of the company I'm working with and see what they say.
Or if it gets too technical, just let your clients know, you know, actually, that's beyond what I know. All I know is that they, they guarantee being secure. And if you're not comfortable with me using it, that's, that's totally fine. We don't need to, to use it. So don't get too much in the weeds with all the technical stuff and worry about that part of it.
[00:21:28] Whitney Owens: Yeah, this is super informative. I love it. So tell me, do you have any companies that you specifically recommend that therapists look into for AI help?
[00:21:38] Dr. Maelisa McCaffrey: Well, I don't kind of similar to EHRs. A lot of them do the same thing, or almost all of them do the same thing. And some of them do it differently. And. So I recommend that you look into them, and just like I would recommend with an EHR, that you try a few of them out.
Because they are all a little different, and you might, and different people have told me, I love this one, versus I love this one, versus I love that one. So I would say pick, you know, two or three to try, and many of them offer free trials. Try it out and see if it works for you. If you are looking at, well, you know, and let's kind of break down what that looks like as far as using one of these platforms for writing notes, because I think that will let people know which options you might want to look at.
So, and actually I do want to like put a pin in that and make sure that we highlight that when I'm talking about all these platforms, I'm not talking about chat, GPT. So chat, GPT does not give you a business associate agreement. Is not HIPAA compliant or HIPAA secure and is not okay to use for anything that will go in a client record.
And, and that is, I very rarely have black and white statements like that, and I want to be really, really clear about that one. Same thing with Gemini, which is Google's version, um, which I actually like using a lot. But we cannot use those. And if you do actually type in information and say, give me a progress note because I've done this to create samples or to test things, it will tell you, do not use this platform for, for personal health, like they will give you that notice now.
So it is very, very clear that it is not a secure place. And I also want to say there is no such thing as de identifying information. enough that you write a quality progress note that is also individualized to a person. So that reiterates like, just do not use chat GPT or Gemini for any client data. Do not write progress notes or treatment plans with it.
Create your templates. And then if you want to check out AI, and there are a ton of these platforms. These AI progress node generators that you can use that are HIPAA secure, that have really good people behind them, and are really genuinely wanting to improve mental health access and mental health services, and A lot of these, these tech people are seeing this as their way of being able to do that.
So I've talked with a lot of these companies and the founders will tell me things like, yeah, we started out, you know, working with cancer patients and wanted to do this. And then we found, Oh, a lot of the issues were mental health related. And then they find, actually, we learned we could be a lot more useful creating a platform for the providers to save them time because they consistently told us documentation was one of their biggest stressors.
So that's just one example of a lot of these companies are really like good people have good people behind them and are trying to do something good for our profession and for the world in general. So pay them the money for a HIPAA secure platform. I will step off that soapbox for now, but I do want to make sure everybody has that message really clear because it is a little confusing.
Yeah. Yeah. So for these progress, no generators, You know, these different companies, they have various ways where you give it the data and then it gives you a progress note as an example. Some of them will also do intakes or treatment plans, but we'll just use progress notes as an example. The most I think what is perceived as invasive, but also what is likely to give you the most accurate.
Information is if you log in like through a telehealth session on this platform and it listens to the session and then it literally creates a progress note after the session is over and it analyzes the data and it will often give a transcript as well. So that's like the most detailed option that you can have.
You are literally going to have a full transcript of your session. So, so that's one way. Another way is a lot of them now can listen in if you're on your computer, even if you're in your office. And so it can hear the conversation that way. Other ones can, you can upload a recording. So maybe you take a recording with your phone or on your computer and then upload the recording after the fact.
So you're not like logged in, but you're still giving it a full recording of the session. Another option is to go in and type a summary of the note or of the session, sorry, and then have it give you a note. And then the last thing would be to dictate. So some of them you can either through your phone or through your computer, log in and give it a verbal summary instead.
So those are a lot of different ways to give it the data. But the thing is, you do have to provide this company with the data, right? With the session information so that it can then. Do the work of translating whatever it has into a progress note. Um, and I will say if you have used GPT, chat, GPT or Gemini, that is truly like having a text conversation.
It's, it's very quick, the interaction. And most of these companies are not like that at all. They will literally tell you like, okay, now go grab a coffee and, you know, you hit submit and it's 15 minutes later that you get your summary. So that's probably the type of thing that will improve over time. But as of right now, you know, the process takes a long time for it to synthesize all the information if it's synthesizing a recording.
Um, of like a full. Oh, yeah. Session.
[00:27:31] Whitney Owens: Yeah. Okay. Help me with this part here because I'm, I'm thinking about some different things. So what would be the benefit for using AI when I dictate instead of just dictating the note?
[00:27:44] Dr. Maelisa McCaffrey: Yes. So in some circumstances, there isn't. Okay. So that's been my experience is that for most people, and I've tested all of these out and I always, I upload a session to each of these platforms.
I have a whole YouTube series where I'm doing reviews of all the individual platforms. And, and I use the same Carl Rogers and Gloria therapy session that a lot of people are familiar with to have it write a note. So you can see all the different progress notes that these different platforms are creating from the exact same session.
And for a lot of them, you're not really saving time for you to go in and have to give it the information and then, you know, hit submit and then wait for it to produce the information. And then you always have to edit it. Because every single one of these platforms has given me inaccurate information in the progress notes, um, including making up client quotes.
So, if things that you would think it would actually do well or be able to, to suss out, you just can never rely on it to give you a perfect note. You always have to edit it. So by the time you go through that whole process, you've probably spent about the same amount of time as you would writing the progress note yourself.
So when could that be useful? Well, if the process of writing progress notes is really stressful for you, It might just be less effort. A lot of people tell me that having the AI produce the note and then editing it feels like so much less work. And they'll say, it doesn't really save me any time, but I'm not avoiding writing the note because I don't feel like I need to sit down and produce this information.
So, for me, if, if you experience that, that I think is still useful, right? So, especially if, if you're someone who spends a long time writing progress notes, or constantly rewrites things in your notes, or is constantly doubting what's in them, this might be a really good solution for you. Because it might actually be less time for you to just edit, it's kind of like editing somebody else's note instead of writing your own.
And then obviously if you're using a platform where it's recording you and the client and you don't have to write any type of summary or dictate any type of summary, then you're waiting a little bit for it to synthesize the information, but it's, it's really not much work at all. You just have to go and log in.
A lot of people in my community have ADHD or are, you know, neurodivergent. And so it's, A lot of people have told me that the fact that the AI starts the note is actually what really helps because they have that avoidance. And so just knowing the note is already started is what gets them to get the note done in general.
So there can be a lot of benefits. But that's why I think it's a really personal thing on whether or not it's actually useful. And it's something you have to play around with and find the right platform and then also see if it is useful for you and evaluate if it's worth investing the time and money in it.
[00:30:59] Whitney Owens: Yeah, well, your point right there about it, just getting it started for you made so much sense to me because I feel that way about a lot of other things. Like, if I have to do a presentation, it's just getting it started that I can't do. But once it's started, I'm rolling, you know, so you stay after that.
Just Hey, can you give me an outline of this? Okay, now I can get started. Okay, so this may be it's just ignorance on my part and how this works. But like, so I use therapy notes. Okay. For my progress notes, it doesn't sync with your EHR somehow and like check all the boxes for you too. No, it's just
[00:31:35] Dr. Maelisa McCaffrey: doing that one paragraph.
Yeah. So it's just doing, you know, whatever note. And for some of them you can create your own template for some of them you can't. So you, you know, depending on what platform you're using, you have more or less flexibility for what the product it is giving you, you know, the actual note that it's giving you.
And if you work with something like TherapyNotes, you know, if you use a platform where you can tell it the template you want to use, you could, for example, put in the TherapyNotes template and prompts, and then it would at least give you things that correlate to those different sections. But you would have to do that extra work and kind of train that system into it.
Obviously, I mean, the obvious answer to all of this is that these AI companies are going to pair up with these different EHR companies, and that is already happening, that they're starting to, you know, have, you know, You know, pair up with a company and have AI be something you can basically turn on in your EHR.
And so that I think is, is the future and, and most likely the most useful thing to use AI.
[00:32:46] Whitney Owens: Definitely. Some of the feedback I've gotten from clinicians was having AI when you have a very specific type of therapy you're doing, you know, like week one, week two, week three, and go ahead. And like you were saying, having that template, having it all pre created, that AI is super helpful in situations like that.
[00:33:03] Dr. Maelisa McCaffrey: Yeah, yeah. And for people who need to remember to include, Um, like one of the things I often recommend is include a progress statement. So some type of statement for insurance purposes that has both speaks to clients progress each week but also speaks to their ongoing need or impairment. And so that's really, really important.
If you are contracted with insurance companies to have that in your progress notes and it can be very difficult for people to remember or to pick out in from the information that they gathered during the session. That's potentially a really huge benefit if an AI platform can create that statement for you or pull out that information.
But again, if you tell the platform, I need this statement in every note, it might make something up. I've had it do that. So, you know, there's always that balance of like, you always have to, to watch, watch it and make sure that it's giving you accurate and good information. So that's one thing is that if you're not feeling confident about writing progress notes, it can help, for example, with starting the note with giving you some clinical language to use, but you will have to be the, the ultimate decision maker on whether or not that progress note is good.
And so you do still need to know what goes in a progress note, how you should be writing these things, what you want to have in your progress notes so that you can feel good about making those decisions as you're editing. Yeah,
[00:34:38] Whitney Owens: that's super helpful sitting here while you were talking and looking at zoom.
Right? And I was like, oh, a companion. Yeah, I know. I was like, I should talk to my podcast producer because that what you just said about being on a virtual call and doing the whole thing. I'm like, well, no, duh. Like, why haven't I thought of this? Like, this could do the whole podcast for us and the show notes would be done.
You need just have it all summarize. Yeah. Yeah, and imagine
[00:35:06] Dr. Maelisa McCaffrey: it could do like staff meetings, you know, if you have supervision meetings, you know, I think it can be really helpful. I think AI could be really awesome for a lot of supervision. because there are often times where you're relying on the supervisee that the clinician to give you information about what questions they have or what might be going on.
Whereas if you could actually look at a transcript of Mm-hmm the session. As a supervisor, you might actually pick out something very different than what the supervisee chooses to bring to you. And that's not always the case. But I think it could be really, really helpful. And I also see that AI in the future will likely do things like help us.
Identify trends within client records. So, you know, noticing like this topic tends to come up quite frequently for this person. Or among clinicians, I could see that being really useful to like, are there interventions that I use a lot more than a different clinician, for example. So I think there's a lot of potential for using it to, to analyze and synthesize all of this data that would be extremely time consuming for us to do on a human level.
Oh,
[00:36:19] Whitney Owens: I love this. Well, as a group practice center, like what we're focusing on right now is, um, uh, How can we consistently keep our clients coming back in and not just for the money? I mean, this is good for client care. And so I'm trying to figure out what's, what's making some therapists have great retention and other ones not.
So just you saying that sometimes I wonder if the language that they put in at the end of their session the way they talk about money. You know, the types of clients who work with right. I see you smiling. You're like, yeah, that's it. Yeah, that would make a big difference. So I wanted to bring up 1 more thing about insurance because I interviewed an insurance expert on the podcast about AI while we were seeing more audits.
And she was bringing up that AI was potentially creating more audits with insurance companies. I was just curious if you agree or had anything to say about that.
[00:37:06] Dr. Maelisa McCaffrey: Right now they're denying that, but obviously, I mean, they already use similar things. I think the thing to remember there is that insurance, you're never being audited because of the content in your progress notes.
You're not sending your progress notes to the insurance company, right? You're being audited pretty much always based on billing type of information. So what's the diagnosis, what diagnose, what billing codes are you using and how often are you billing? Those are the things really that create those red flags.
And insurance companies have had algorithms set up for years already to catch those things and look at trends there. And so I would not be surprised if they're using AI to improve. That system that they've already had in place.
[00:37:55] Whitney Owens: Yeah, it's good to know. Well, you have lots of great stuff to give away today, so I want to jump into that.
But is there anything else you want to make sure to say that we didn't include about Progress Notes?
[00:38:06] Dr. Maelisa McCaffrey: Yeah, I think the other thing that has come up for me more recently is remember that if you are logging into one of these AI platforms and creating your Progress Notes there, It is likely saving your information, your client's information there and then you are copying and pasting it into your EHR.
So now you have client progress notes in two separate locations and There's no saying, Oh, well, those I'm going to call those psychotherapy notes or process notes and just say they're not progress notes. No, those are clearly progress notes because you created them to be in the client record. So what does that mean?
And if you are using one of these platforms that's giving you a transcript, or if you're, you know, going online, most of them give you a transcript. If you're recording the session, are you deleting those transcripts? Because there are certain things clients say that we know require some interpretation.
And while you may still document that same information, having a transcript of it is very different. And so I would recommend that most people go in and delete that information from the AI platform. I also know as someone with ADHD, if back when I had my practice, I was doing this. I would probably not forget, I would probably forget about that, right?
Or I would not be doing it on a regular basis. And then it would build up and then I'd have to go in and delete 500 of these notes all at once, right? So, think about that process and ask about that and look at that when you're considering which of these platforms to use. Because some of them do let you have settings to delete things at specific time frames or, you know, every day, etc.
So think about what's useful for what couples also, you know, being useful for you, because if it's taking 20 minutes to create the note, you're not going in and doing all of these notes right after the sessions. You're doing them at the end of the day, because that's when you're going to have access to all these created progress notes.
So if you're not actually going in and saving all of those notes at the end of the day, you probably don't want those notes being deleted every single day. So you've got to kind of find a balance with how often do I want to delete these notes, but also like, when can I realistically get them done at the same time?
So thinking through those things, because I just see that being a big issue in the future. You wouldn't want someone to come back to you and say, well, where are the, where are the transcripts, you know, for my session? Because If someone requests that and you have that information, in most cases, they have the right to it because it is their client information and it is part of their record.
And so you want to be really clear about what you're deleting and when you're deleting it, and I would default to deleting things from the AI platform and keeping everything just in your EHR.
[00:41:13] Whitney Owens: Yeah. Uh, so, so important to think about. Thank you for bringing that back up. Yeah. Yeah. All right. Well, I have got some great leaks and things here that we're going to throw in the show notes.
So you have a free private practice paperwork crash course. Could you tell us a little bit about that? And we're going to have that in the show notes.
[00:41:29] Dr. Maelisa McCaffrey: Yeah. So the crash course is just a little sample of the clinical documentation course. I have stress free documentation for mental health clinicians, and it's a sample from each of the modules.
in that fuller, it's like 15 hours of lessons there. So you get a lesson on diagnosis. We talk about progress notes, treatment plans, intake assessment, medical necessity, creating your forms and policies, all those, all those things. And then, so, you know, that is free. So sign up for that course. You get lots of access to lots of great free stuff there.
And then it also gives you a good sense of, If you did want to buy one of my courses or check out my new book, Stress Free Documentation for Mental Health Therapists, checking that free course out first lets you know, okay, yeah, I want more of this or like, no, I'm good there. So I always recommend everybody start out with the free course.
[00:42:24] Whitney Owens: Great. Great. And then for you, since you're mentioning the book, we're going to throw that also in the show notes, anything else to say about your book? It just came
[00:42:33] Dr. Maelisa McCaffrey: out two weeks ago, so I'm still really excited about it and have gotten amazing feedback on it. So I will own that and say, I think it is really, really the culmination of 10 years.
of doing this, tweaking templates and, and doing all of that work. And if, if you're someone in private practice, I hear this a lot. People kind of feel guilty about not feeling like they don't have a good template or have good things set up documentation wise. I've literally been doing this full time for 10 years.
and feel like I have something good enough to put in a book. So, like, if this is the, has not been your full time job, creating templates for 10 years, you know, you're, you're doing other things, more important things. And so, so let me do that part for you. And, uh, so the book does give access to my full paperwork packet and templates, and you can access everything online as well as in, in the physical copy of the book.
[00:43:27] Whitney Owens: Perfect. Love it. Okay. And then you also have a YouTube kind of course on AI and progress notes. Yeah. So I
[00:43:34] Dr. Maelisa McCaffrey: have, I'm doing a bunch of reviews of all these different AI progress note generators, all these different platforms. So I have a lot more to do. I took a little break over the last few months as I finished up getting this book launched, but in November, we're starting those up again.
So check those out. and, you know, type in whatever progress note generator you've been looking at into YouTube and, and see if I've done a review. And then I also have other videos that walk you through similar to the things we've talked about here. And I have a rubric that you can download when you go to those videos that that gives you guidance on, okay, is this, is this, useful for me, this platform?
Is it actually benefiting me and gives you some, some guidelines for making those decisions?
[00:44:19] Whitney Owens: Well, if your stuff is anything like this interview, it's fantastic. Thank you. Yes. So much good information. And I, I think that speaks very highly of you and how you care about the field and you have a lot of good stuff.
Stuff that you're putting out. So I really appreciate you taking the time to share so much wealth with us and you got my mind spinning. I'm going to be calling my therapist in a few minutes like, Hey, you want to try this? You know, cause this is awesome. Thank you so much. Yeah. Thank you so much for having me.
[00:44:47] Dr. Maelisa McCaffrey: So
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[00:45:08] Whitney Owens: Special thanks to Marty Altman for the music in this podcast. The wise practice podcast is part of the site craft podcast network, a collaboration of independent podcasters focused on helping people live more meaningful and productive lives to learn more about the other amazing podcasts in the network head on over to site craft network dot com wise practice podcast represents the opinions of Whitney Owens and her guests.
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