Therapy Transcripts Are Being Subpoenaed in Court: What Every Therapist Needs to Know

So you have probably seen something about this floating around. A headline, a panicked thread in a Facebook group, a colleague who messaged you asking if it is true. A woman's private therapy messages, the ones she typed to her therapist through an app, pulled into a courtroom and used against her by her former employer.

It is true. And if you felt your stomach drop a little when you heard it, that response is worth paying attention to.

Pull up a chair, y'all. Because Kelly Higdon and Miranda Palmer spent a full episode of Starting a Counseling Practice Success Stories unpacking this, and the conversation goes a lot deeper than one app or one lawsuit. This is not about scaring you. It is about getting you informed, because that is where your power lives.

It Is Not Just a Talkspace Problem

When the story first broke, a lot of therapists had the same reaction: Well, I do not use Talkspace, so this does not apply to me. We understand the impulse. When something feels overwhelming, the mind reaches for the fastest exit. If it is a Talkspace thing, and I am not on Talkspace, then I am fine.

But that is not what this is. The case that brought it into the open involves Talkspace, yes. According to the Proof News investigation by Annie Gilbertson, Jennifer Kamrass was let go from her nursing role at AdventHealth in 2021 while she was nearly nine months pregnant. She started using Talkspace, a benefit her employer provided, to talk through her worries about money and finding work. When she later filed a pregnancy discrimination claim, her former employer's lawyers subpoenaed her Talkspace records, including the messages with her therapist, and used them in the case.

But the mechanism that made that possible is not unique to one platform. This is a transcript problem. As Miranda put it in the episode: "This is not a Talkspace thing. This is a transcript issue. This is a new legal and ethical concern that none of us were trained on in grad school."

Think about what that opens up. Every video session being recorded "for documentation." Every AI scribe generating a word-for-word transcript. Every chat-based platform storing the back-and-forth. The thing that made Kamrass vulnerable was not the brand name. It was the existence of a complete, written record of everything she said.

Takeaway: The lawsuit is the symptom. The transcript is the diagnosis.

Tip: Make an honest inventory of every tool in your practice that creates a recording or a transcript. Video platforms, AI note-takers, chat features. If it captures words verbatim, it belongs on the list.

What We Were Actually Taught About Privilege

Most of us learned about privilege at some point in training, even if it has gone fuzzy since. Privilege is one of the real protections a license gives us that coaches do not have. Coaches can offer confidentiality or an NDA, but they do not have legal privilege. We do. And it can only be waived in specific situations.

Here is one of those situations, and it matters enormously here. When a client sues for emotional damages, that can waive privilege. The reasoning, roughly, is that if you are claiming emotional harm, the other side gets to examine the evidence related to that harm. As Miranda described it, this is the pro-and-con conversation many of us remember: if a client is involved in a workers' comp issue, or there are attorneys involved, we know it can open the door to their full clinical record being accessed by a third party.

In the old world, that record was a few sentences of progress notes. A clinician sat down and summarized: client presented with anxiety, processed work stress, will follow up next week. Sparse by design.

Now sit with the difference. "We're not talking about progress notes," Miranda said. "We're talking about transcripts. Word by word." A complete transcript of every session is a fundamentally different object than a progress note. It is not a summary of the work. It is the raw, unedited interior of a person's worst week, available to be read aloud in a courtroom and twisted in ways no one in the room intended.

Takeaway: Privilege has always had limits. What has changed is the size and detail of what gets exposed when those limits are reached.

Tip: Revisit what you actually understand about when privilege is waived in your state. Not the vibe of it. The specifics. This is the foundation everything else rests on.

Where the Old Safeguards Used to Live

Here is a part of the conversation that is easy to miss, and it is one of the most important. In a traditional practice, there were humans in the chain who could slow things down.

Picture the old-school version. A records request comes in from an attorney. Most therapists, getting that request directly, would call the client first. As Miranda described her own practice: "I want to make sure you have informed consent and that you really understand what you're releasing. You can't put the genie back in the bottle." In some cases, she invited clients in to actually read their own record together, to have a clinical conversation about the impact before anything went anywhere.

Now add a layer. If you worked in a group practice, the owner was almost always a therapist too. That person would look at a request and ask: " Wait, is this actually within scope?” They might push back and say this goes beyond what was authorized. You had two layers of clinical judgment, plus a liability provider, plus maybe an attorney.

Replace all of that with a tech company. "Our group practice provider is a tech company that says, ' Oh, you want that? Here you go. That's just data. You said you wanted a file, I can give you a file." No clinical pause. No one is asking whether the release was even proper. Just a data export.

That is the quiet shift. It is not only that transcripts exist. It is the human beings who used to stand between a client's record and the outside world have been removed from the process.

Takeaway: The danger is not just more data. It is fewer people positioned to protect it.

Tip: If you contract with any platform, get clear on who actually responds to a subpoena or records request, and what clinical review, if any, happens before records go out the door.

"HIPAA Compliant" Is Doing Less Than You Think

We need to talk about a phrase that gets used like a security blanket. HIPAA compliant. It shows up in marketing copy everywhere, and it makes us feel covered. But it is worth understanding what HIPAA actually is and is not.

As Miranda put it bluntly in the episode, HIPAA was not designed to protect clients in the way we imagine. "It was created to make insurance billing easier. It was created to give insurance companies more access to your clinical records." In several states, including California, existing protections were already stronger than what HIPAA introduced.

And then there is the de-identification piece, which is where a lot of the false comfort lives. The reassuring story is that data gets anonymized, so even if it is shared, no one can trace it back to a person. But anonymized is not the same as anonymous. The Proof News reporting quotes a staff attorney at the Electronic Frontier Foundation making the point plainly: information that has been anonymized can be reidentified, and HIPAA is not enough protection on its own.

Miranda put it this way: a large share of supposedly anonymized data can be de-anonymized. Stripping a name out is not the same as making a person unfindable, especially when the transcript itself is full of identifying detail about their life, their job, their relationships.

Takeaway: "HIPAA compliant" is a marketing phrase, not a guarantee that your clients are safe.

Tip: Stop treating that label as the end of the inquiry. Ask the harder question: what specifically happens to session data, and who can it be shared with, under what conditions?

Read the Part About Affiliates and AI

Here is where the business model comes into focus. The reason these platforms want your clients' transcripts is not sentimental. According to the Proof News reporting, Talkspace's CEO told investors the company had compiled billions of words and well over a hundred million message exchanges, describing it as one of the largest mental health data banks in the world, with the explicit goal of training an AI therapy companion.

Sit with that. The intimate, vulnerable words your client typed in a hard moment are not a byproduct. For these companies, they are the product. As Miranda noted, these platforms are now being sold for hundreds of millions of dollars, sometimes with billion-dollar valuations, built substantially on the data of real therapy conversations.

And this is where it stops being only Talkspace's story. The same dynamic shows up across EHRs, AI scribes, and practice management tools that took venture capital and then quietly rewrote their terms of service. When a platform says it can use collected information for research and development, for itself, its affiliates, and its business partners, that clause is doing an enormous amount of work.

There is a version of AI documentation that Miranda actually finds genuinely useful, where you dictate a few sentences and it formats them into a clean progress note. That is a different thing entirely from a tool that keeps a full transcript of the session. "I would rather have that," she said, "than a whole transcript of the session. Especially given what we're seeing here now."

Takeaway: The transcript of your client's session may be worth far more to a tech company than the subscription fee you pay them.

Tip: When you read any terms of service, search specifically for "research and development," "affiliates," and "business partners." That is where the broadest permissions hide. And if a tool records sessions, ask in writing what happens to that recording and any transcript it generates.

Calling It Out Is Risky, and We Do It Anyway

There is a reason more therapists are not shouting about this from the rooftops, and it is not apathy. Speaking up against these companies can carry real cost.

The clearest example is in the Proof News piece itself. Linda Michaels, co-founder of the Psychotherapy Action Network (PsiAN), co-authored a 2019 letter to the APA raising concerns about Talkspace's business practices. Weeks later, Talkspace's lawyers filed a libel suit against her, her co-authors, and the organization. The case was eventually dismissed on jurisdictional grounds, but the message to the rest of the field was received. As Michaels described it, the suit functioned as a tactic to get critics to be quiet.

We have watched this pattern before. Therapists who spoke up about BetterHelp sometimes found themselves outmatched by corporate legal teams, simply unable to afford the time or money to fight back.

In fairness, and this matters, Talkspace has pushed back on how the Kamrass story is framed. The company's chief legal officer stated that Talkspace did not produce the transcripts and that the only person who had access to disclose the records at the time of the subpoena was Kamrass herself. That is the company's position, and it belongs in any honest telling of this. It also does not change the underlying reality for the rest of us: the transcript existed, and once it exists, it can be reached.

Takeaway: The risk of speaking up is real, which is exactly why community matters so much.

Tip: You do not have to name a single company to make a difference. You can blog about the situation, about informed consent, about what to look for in platform terms. Education is advocacy.

So What Do You Actually Do

Here is the part where the all-or-nothing response wants to take over. You either spiral into panic, or you go numb and file it away for later. Neither one helps your clients.

The practical floor is informed consent that actually informs. If a client truly understood that their session was being recorded, transcribed, and stored by a third party, how many would still consent? That question is worth asking honestly, because it tells you something about whether the consent you are currently getting is real or just a click.

From there, it is a series of doable steps. Get clear on which of your tools create transcripts. Read the terms with fresh eyes, specifically for the affiliate and research-and-development language. Have real conversations with clients about their data, including the parts that are out of your hands, like the chatbot or the AI app they might be using on the side. And keep the documentation you do control as lean and protective as the work allows.

This is also, as Kelly named in the episode, about guardianship. "We are the guardians of care. We are the guardians of our documentation. Because the corporations are not going to do that." When you build a practice that genuinely protects client privacy, that is not just risk management. It becomes part of what makes your care worth choosing.

Takeaway: You do not have to fix the whole system this week. You have to take the next informed step.

Tip: Notice what is happening in your body as you read this. Tightening, spacing out, getting fired up. That is data. It is telling you where you are and what you need next. Do not skip it.

This Is Your Invitation to Get Informed

You did not know what you did not know when you signed up for the tools you use. That is true, and it’s real, and beating yourself up about it is not the move. None of us were trained for this. The landscape shifted under our feet.

But now we know more. And knowing more means we can do more. Read your terms. Rethink your consent. Talk to your colleagues, the real ones, not just the comment sections. Keep building the kind of practice that lets you actually stand behind your work.

Because this field needs you in it. And it needs you informed, connected, and not alone.

Transcript

Miranda Palmer, LMFT She/her (00:02) We're so excited to talk about this. Maybe we're fired up. It's another one of our special starting a counseling practice, podcasts about the state of the profession with me, Miranda Palmer, LMFT and... Kelly Higdon (00:01) Welcome back. Kelly Higdon, LMFT. gosh. We were talking about what we could, you know, the different topics, so we decided to just focus on one huge topic that has come up. As of this month, there's been a lot of privacy concerns raised by Talkspace and private therapy chat logs and... Miranda Palmer, LMFT She/her (00:45) Okay, let's let's be clear. There has always been privacy. There's always been privacy concerns regarding talkspace. I think what we found this month is that what has been released is the actual legal impact to our clients. And it's not specific to talkspace. It is the specific how transcripts Kelly Higdon (00:50) Yes, sure. Miranda Palmer, LMFT She/her (01:12) can be used against our clients that basically the landscape for court subpoenas has completely shifted and changed. And I think there is so much for us to unravel. So anytime like right here right now, if you're thinking, this is a talkspace thing, this is not a talkspace thing, we're to talk about this particular aspect of it. But or a particular issue that happened with talkspace. This is a transcript issue. This is what happens or this is a risk or this is a reality. This is a new legal and ethical concern that none of us were trained on in grad school that a lot of therapists are catching up to. It's stuff that we have been talking about even on this podcast and we've been talking about the risks to our clients privacy in general. The risk to our prep our profession in general with these transcripts, but here is a tangible specific impact that it had on a real client in a real lawsuit and like how well the actual therapist was prepared for it. anywho, I get fired up about it. I was like, I want, I see people talking about reels. haven't even got, there's enough people talking about it. It's like, no, I want like, 40 minutes to talk about it. Like, there's so much to unpack here. It is wild Kelly Higdon (02:46) So for those of you that don't know, there is a recent pregnancy discrimination lawsuit between Jennifer Kamras and Advent Health. She was saying that she was let go because she was pregnant and it was discriminatory. They were saying that she was let go because of financial reasons and that had nothing to do with her pregnancy. And the transcripts. from Talkspace were used in court. So chat transcripts, where she talked about her employment, where she talked about her employer, where she talked about personal things, they were brought into court. Therapy messages used by the employer. The employer got to see these. So they subpoenaed the records and It's a technicality that those records were just sent over because they're not, they were saying that they're not protected in a traditional patient doctor or in this case, patient therapist privileged context. So that has led to open up so many things about privacy data and how it's used. And I, want to encourage as you listen here for you to suspend disbelief or suspend judgment and actually stay in a place of curiosity because this impacts us all. And we need to be really thoughtful and intentional about our use of technology in practice. And now this is signaling, which we've already had kind of known, but now we have hard evidence that this is signaling some significant disruption to what we thought was protected or whatever you may have thought before. So let's just suspend that disbelief like, oh, this could never happen to me. Oh, this doesn't apply to me. My clients just text me, or whatever. You might be thinking like, it's not going to happen to you. But this is impacting us as a field. And it's going to have very big implications. So I'm so curious. to see how this will continue to evolve with more companies. think this is just the beginning. Miranda Palmer, LMFT She/her (05:16) So I want us to like go back, I like I'm like back in my like professor days or whatever, like my faculty days. I want us go back to maybe if you recall it, what we were told about subpoenas and what we were taught about privilege. One of the things that most of us learned at some point in our process was that, hey, people have privilege. That's one of the things we get as a license that coaches don't have. Coaches may have confidentialities or NDAs, but they don't have legal privilege. We have legal privilege and that can only be waived in certain scenarios. When somebody goes to sue for emotional damages, one of the things that this opens up, it's a waiving of privilege, right? It's a waiving of privilege. That's part of the pro and con. It's something I remember being talked about in grad school, outside of grad school, all those things that if you have a client who's coming over for workers comp issue, if there's any attorneys involved, if the client wants to you may want to use this data, we know that it opens things up and the likelihood of their full clinical record being accessed by a third party or about the other attorney because part of the scenario is if you're going to enter in that there's some kind of harm or emotional damages, then they want to be able to look at the data regarding that, right? So some of us, it's the reason why in our informed consent, we'll do the silly thing of just saying, I don't go to court, right? I don't go to the court, which actually doesn't work. That's a side note. We teach about this in business school about like what an actual good court policy is, which is where you charge for it at the very least and that will detour way more things. But realistically, right, this person just goes and talks to an attorney, the attorney has this conversation, and then likely what happened is the attorney sent... a records request over to the therapist. Now again, I'm going based on my own clinical expertise and like by clinical experiences and what has happened long term. When that therapist got the information or got that request from the from the attorney, what most therapists do if they get the request directly is that they will reach out to the client and say, Hey, I got this request from your attorney. I understand there's a release of information, but I want to make sure that you have informed consent and that you really understand what you're releasing. You can't put the genie back in the bottle. You can't put the toothpaste back in the tube. Like, do you understand what's in here? In some cases, I have invited the person in to read their clinical record to say, here's what's in the progress notes. And so we have a longer clinical discussion and we talk about the clinical impact before that information is released to the attorney. And of course, right, there are sometimes spaces where like I've had the experience in clinical work, where I thought like, there's no way they could like, use this against my client. No, they still use it against the client. Like it's wild. the way that things can be twisted. So let's, I know I'm like making this long, but I think it's really important to like understand it. So part of what is in the article and we'll link it here is that the therapist had agreed to come and testify. Meaning the therapist knew that this was going on, right? Whether the therapist was still working for Talkspace or not, we're not sure. But the therapist had agreed to do this. And the quote from the therapist who said they didn't want to be named in the article, I haven't looked at the actual court record to see what the details are. But the therapist said, let me find the quote. They said basically like, was, when I came to understand how much information they had, I was shocked. Meaning that maybe if this therapist had gone through all of the right things, they talked to their, their liability provider, they got in consultation, like whenever we're gonna do things with court, like we usually get consultation. This therapist was shocked, right? They were shocked. The privilege had been waived. Hopefully there was a conversation with the client, but at what point have we been taught to think about things like transcripts? And while we could sit on this and just go, this is a Talk Space thing. Maybe this is a Rula of thing or a Grow thing. At this point with what is happening with AI and people doing video sessions and those video sessions being recorded for documentation purposes and transcripts being made. Every single video session that is recorded, this is an issue and a lot of therapists say, well, they say they're HIPAA compliant. That's not a thing. Do you understand like that is a marketing term? It's not actually a thing. You can be HIPAA consistent, but there's no like HIPAA compliance, like there's no actual like teeth to all of that. And what happens is all that HIPAA really requires is that you get permission. So in these terms of conditions of these big tech companies, right, all this information that's in there, somewhere in there is, hey, we can share this information for regulatory purposes, for legal purposes, with our affiliates, with all these other things, all these things have happened. Now, if we even put just one other layer, let's say, in this particular case that like, we were going to old school and you're working in a group practice, right, and you got this information, somebody said, hey, let's figure this out. The group practice owner would be a therapist in 99 % of cases. And that group therapist owner would be looking at like, let me look at the liability. Let me check all this out. Let me see what's in here. You would have maybe two layers of clinical oversight in addition to the liability provider or if you got your own attorney, whatever that looked like. In this case, our group practice provider is a tech company who says, oh, you want that? Here you go. Here you go. That's just data. You just said you wanted a file. I can give you a file. Here's this information. There was no, and maybe in another case, right? There might, maybe. Again, privilege was waived. So like there's some other pieces here that may or may not. But I think even in this particular case where privilege was was waived, if there's a group practice owner, they would be going in and going, wait, no, actually, you cannot have access to this. This is above and beyond what is here. This could be a simple mistake on one side of even the attorneys not being caught up in terms of what they, of how they did the release of information. But again, generally, privilege is waived. So are we, if we're doing video sessions, Are we legally putting our clients in positions that make it almost impossible for them to ever claim any kind of emotional damages without having their entire transcripts of every single therapy session? Transcripts, we're not talking about progress notes. We're talking about transcripts, like word by word. by word. Maybe the, again, some of these videos are deleted. Some of these transcripts are created and then they're anonymized, but we have already figured out that 90 % of them can be de-anonymized. And again, it's not clear legally whether the fact that if they're kept and they're anonymized, if there is a, if... somebody comes in and says, hey, I need that information. If they go, OK, and then they de-anonymize and they send it off to them. It's a frickin' mess. OK. Kelly Higdon (14:22) think what is also really salt in the wound is that the reason she was using Talkspace is through the HR department, right? It was a service that the HR department, the insurance company, whatever, I'm not sure which, what package it was through, but it was through her work. And I remember many years ago, Miranda, we were looking for a new payroll company. and to get our benefits and they would have like Talk Space or a Better Help better, Better Help And I would talk to the HR department and this is before we really knew the implications of AI even. And I would talk about like, do you know what these companies are doing to the therapist? Do you understand that you're not actually offering quality care? You know, all these kinds of things. And when HR departments didn't know. And now if you do some research, a lot of these HR websites and things are talking about like, we didn't understand that, the data could be used for training AI. Like it's all surprising to people now. So now it's not just the mental health field that's being impacted. Now, HR departments are having a lot of discussion about this as well. But it's just salt in the wound, right, that she's going to utilize the support given to her. And then that's used against her in court. Yeah, and I think that a lot of people, again, do not have the knowledge. And this is where we are trying to educate y'all so that you can also educate your clients about, OK, if you're using these platforms, here's the risks that come with them. This is what we don't. Nobody's being totally transparent about the training of these models. But you have to assume the same thing has happened with Headway. When anyone says we're training on the largest data set, that's not going to be journals and research libraries. No, we're talking about who is giving their session notes over to these AI models. It is people who work for these companies. Miranda Palmer, LMFT She/her (16:26) Yeah, there was, gosh, who was it? I have a quote here where they were like, we are trained on the largest direct mental health interactions. And it was something in the tens of millions or the billions of material that they were pulling in. And you're just like, what is happening here? This is... a wild scenario, right? And of course, these companies are now being sold for hundreds of millions of dollars. They have sometimes billion dollar valuations. OK, so back to here is the piece. And I just did a training for the American Counseling Association regarding AI and private practice. It's a training that we have done before. We can we have an older version of it on our on our website that you can get for free. Like police. Please, please watch it. Every ethical code that we have found in the mental health designation says, hey, therapists, if you're using technology, if you're using AI, you need to understand what it is and its implications and give your clients informed consent. I think as therapists, we don't understand how much trust our clients are placing in us when we go to work for somebody and we say, hey, here's my license, especially when we're 1099 employers or employees. I'm not sure if this person was 1099 for Talk Space, but usually people were primarily. As a 1099 employer, Kelly Higdon (18:10) I that is. Miranda Palmer, LMFT She/her (18:14) employer like there and they're not therapists. Talkspace isn't really worried about the clinical implications or about malpractice insurance, because they're not the provider. Talkspace so far, just like the insurance companies, they don't have malpractice insurance, because they're not practicing, you're practicing. And so this, this, this client comes to you. And they click on a, you know, they do a search and it says, hey, we can help you find somebody fast. People feel overwhelmed. We were watching the, how long does it actually take person, which I love her, but I don't know why Kelly knows I'm terrible with. Kelly Higdon (18:58) I think it's Christy. does, how long does it actually take? And she really talks about things she procrastinates, then she films herself doing the task and times it. And it's sort of this like, oh gosh, this thing I've been putting off only took a small amount of time. And I sent it to Miranda because she was helping a friend find a therapist. And I was like, oh, I'm so curious about this. And her friend had been putting it off for. Miranda Palmer, LMFT She/her (19:20) It wasn't a friend, it was a random person from Costco. No! She was like, I just met this stranger at Costco. And she was like, she was like, oh my god, you're the person. And she was like, do you, for a customer, she's like, trying to get therapists. I don't know, I think that's like a whole nother fun layer of that weirdness. Kelly Higdon (19:32) Okay. She's been putting it off for quite some time. But she sat down and they decided to go through Headway and I thought, gosh, this must be sponsored by Headway. I have to watch how this goes. And I was like, this is unusual. Like I'm surprised she would do a sponsorship like this. And then they got really frustrated. And it was a mess. And they ended up finding someone from a Facebook recommendation, like in a community referral. And they went that route. So I was like kind of, whew. You know, I was kind of on the edge of my seat waiting to see how it would turn out. Miranda Palmer, LMFT She/her (20:13) Yeah, but there is this space of like, when they go through these platforms, these platforms without your license mean nothing. They're nothing. They have no service. When you give them, like we talk about this when we have like the amount of clinical supervisors I've talked to, where they talk about their supervisees and they say, they're working under my license, like I'm responsible for their care. I'm putting my license at risk by this person doing that. And actually, there's parts of that that are are impactful, but it's not actually completely true that they are working under your license, like, or that like, if they do something unethical, as long as you're like keeping an eye on it, and you're, you're intervening, you're okay, right? In this particular case, when we talk about somebody exploiting your license, These companies are exploiting your license. They do not exist. cannot provide care without this scenario. And that also means the responsibility of the care ultimately comes back to you. But again, going back to our ethical requirements for using AI or anything that we touch that is touching AI is that we understand and that we do not engage with anything we do not understand. If you don't understand the implications of, if you don't really still understand HIPAA, if you don't like understand it in like a deep way, if you don't understand that HIPAA was not created to protect clients. It was not created to protect clients. It was created to make insurance billing easier. It was created to give insurance companies more access to your clinical records. In many states, the HIPAA regulations were actually less, what do call it? Like less stringent than what was already available, California being one of them. It opened up, it made it easier for people to access their records. There's pros and cons of that, there's things I love about that. But again, here's an example of where somebody's records have been used against them. So these tech companies have, what are we gonna sue them for? Hey, I told you and ultimately they were responsible, that therapist was responsible to let you know. And now this client maybe is in this frustrating experience and maybe feeling very triangulated in like, I didn't know. And they talked to their therapist and their therapist is like, I don't know either. But now I have this person that I'm bonded with that I don't want to sue this person maybe, but maybe I need to, maybe I need to sue this person to get therapists to like really understand the implications. And again, just as a, as a side note, So far, all we're talking about is the implications of a transcript or privilege communication. We're not even getting into AI chatbots, AI quote therapists. We're not getting into anything that actually doesn't even have privilege. What is gonna happen? What is gonna happen when your Claude or your fill in the blank of whatever. your woe bot or your wisa or your abby or your noah or your whatever the thing is what's going to happen when that gets you know subpoenaed or just requested there's there's nothing in there to to keep that private there is no privilege there's no privilege Kelly Higdon (24:14) It's interesting that APA has banned Talk Space from advertising at their conference. I find the system to be rather reactive. If we were really thoughtful, we could have prevented some of that, asking good questions. So before you utilize any kind of platform, like are you reading the policies? Do you understand? And I feel like organizations, often are the first to take the money, and then they'll figure it out later, to be honest, instead of really understanding who they are taking money from and what it is implying to us as a field and to our clients. And here now, APA is like, there's a lawsuit. You can't advertise here. Honestly, if you had looked into this way before this lawsuit, it would have hoped. And ask some questions. It's really, we've been saying this. Anonymized data can be de-anonymized. There's just no such thing anymore. And so what are we doing? our organizations, how are we talking about these things? And we've been quick to promote versus fully understand first. Miranda Palmer, LMFT She/her (25:29) So here's the other part. This is not like a new thing. There's actually, if we wanna go into it, which is kind of wild. So, Cyan, the Psychotherapy Action Network, has been on it. On it. Regarding these issues and regarding tech space from the beginning. Kelly Higdon (25:48) They have been, they're great. Miranda Palmer, LMFT She/her (25:54) And in fact, when they went to the APA with their concerns about Talk Space back into 2018, 2018 is when this started, they sent in a letter to the advertising managers of the American Psychological Association and to Michael Phelps, who was talking about Talk Space at the time. Kelly Higdon (26:20) Yeah, mm-hmm, I remember that. Miranda Palmer, LMFT She/her (26:22) So guess what happened? Talkspace then sued them for calling them out for multi, multi millions of dollars without like diving too much in but we'll put the link in the in the resources. But I remember talking with her about this and it was wild and part of if I recall correctly, I'm like do I have You know, sometimes you're like, wait, do I have information that's not public? But I'm really like 90 % sure that this is public information. Let me just see. Let's see. They file two motions. They sued us in Washington, DC, because that's the only jurisdiction nationwide where we could not immediately say that this was a slap suit for this lawsuit to silence criticism. The case was dismissed by the judge. But again, it went through it just continued going through this like whole process. Since the lawsuit. Yeah, I think there's something in here. I'm almost sure, I'm almost positive it's public that like they sued them for so much money, partially because they were getting ready to sign an agreement with one of these associations. And so they were wanting to say, hey, because you said these negative things, it cost us tens of millions of dollars because we were going to make a relationship with this association. And I think this is something that we've noticed over time. A lot of our associations are not actually therapist run. They are businesses. Some of them have really good leadership somewhere down the pike. But at the core of it, the things that they are recommending, it's like to me, it's like so clear. Why would you? Why would Talkspace have ever gotten in the room? Why would Rula have ever gotten in the room? Why would Grow have gotten in the room? Like if you were like sitting down to like really be thoughtful about this, if you were doing any like due diligence, I don't think you would ever take their money, but they have all this VC funding and they have all of this money. So of course they're going to invest $10,000 in every conference, right? They're gonna be on the bag and they're gonna be. putting the things and they're gonna be doing all the other pieces of that. And when we start to make decisions based primarily on what makes the most financial sense, like is this part of what happens, you know? It's just, ugh. Okay, but back to you. So if we, I know Kelly always likes to say like, let's take a breath. Everyone's, threatening to make a t-shirt. So if you want to send in your t-shirt design submissions. Let's see. What, when you look at what you are doing right now as a therapist, who you're working with, Kelly Higdon (29:38) Let's take a breath. Miranda Palmer, LMFT She/her (29:52) like where your clients are finding you touching you. Do you understand the implications? Are there questions you have that have not been answered? Do you even know the questions to ask? And our our AI training, we have a lot of specific questions that that we that we have you sit with. We also have one that's around platforms. that's very similar and we have another one on terms and conditions because of what's happened with EHRs because, or practice management systems, these practice management systems that were initially developed for therapists by therapists, venture capital went, there's all this data, we can make so much money with it. And so they came in and they started shifting things and they made these big changes to the terms and conditions. Like this was now. Over five years ago, I think when this started coming out and we're like, whoa, whoa, whoa, this is not okay. And again, this is like we're in the thick of just starting to see the impact, right? Like this is the difference between like all in one where you're putting all that data. Like we generally like that, like have your documentation in the same place where you're like putting your... you know, taking care of the financial pieces and you know how much money people are like, we don't want you to have these like crazy disconnected pieces. But when it comes to your clinical transcripts, or who's doing your video stuff, y'all we need to keep it separated. Like these AI companies that are coming in to do documentation, I actually like there's a core of me that I think it's really beautiful. Like it's been Such a frustration, we haven't been taught well, there is some room. If we have a little bit of space to not sort of be trying to do everything, maybe there's some room for us to get back into our place of thinking. Although some research around AI says no, the more that we outsource our thinking and decision making to AI, the worse it gets. It gets mushy up there. But I do think there could be some ways for us to use it well, but we need to... really pull back and get clear like one of the ones that I recommend often, the thing that I like about it is that you can type in a few sentences or you can like verbalize basically like dictate, hey, here's, here's what we did. And this is what the client said. And then it will put it into a well formatted session node, right. And I would rather have that than a whole transcript of the session. Sorry. Especially given what we're seeing here now. Kelly Higdon (32:41) Thank I also think that it's a good reminder that we are the guardians of care. We are the guardians of our documentation. We are the guardians of this work because the corporations are not going to do that. They are the exploiters. So the other thing I want to say here is that, like Miranda, you were talking about the abuse power and control wheel and those kinds of things and how it applies here. Right? How do we eradicate the exploitation is by talking about it. So sharing this podcast, talking about it with your peers, strategizing how are we going to make sure that our clients don't fall into this or that we don't partake in using platforms or software that puts us at risk and our clients at risk, and being vigilant about how we decide to run our businesses. And it is how companies will eventually get shut down. I'm not under any kind of delusion that we're going to get rid of hypercapitalism. But I do feel like, unfortunately, the way that things change is through legal action and that when, unfortunately, people sometimes are harmed in that process. But if we can start talking about this and being proactive, maybe. people will stop giving their labor to some of these companies and start speaking up and actually taking a stand. And those companies might weaken under our advocacy. And I know that some of you have different levels of privilege, and advocacy sounds like a huge word and exhausting, but just even sharing an article. and talking about it so we understand what's happening in the landscape can make a difference. It's a community effort for us to stay aware and to do this work and keep doing it well. And it is why I do feel that even as we talk about it with our clients, letting them know of like, hey, I saw this thing in Talkspace. Have you heard about it? Let me talk to you about what I'm doing. you know, in my practice to make sure that your data is safe, right? Educating, even like talking to our clients, if we, having these conversations and empowering our clients, because sometimes they could be seeing you and they're still using chat GPT for emotional support or these other places where their information can be subpoenaed. And I think that through that education, and when you have all these sectors, like I'm saying, HR is getting upset now. the therapists are upset, and maybe the clients are starting to think like, no. And then that is how we create this kind of groundswell to affect some change. Miranda Palmer, LMFT She/her (35:39) I do think, and I know this is going to be an uncomfortable take and it's going to feel like a lot of pressure, but I don't think with this information, ethically, if you are using any kind of recording software that is at all connected with any kind of venture capitals where they are keeping transcripts, and they are probably not telling you that they're keeping it. To be clear, every- therapists that we've worked with, or we've had them press, they will say it's D and Deanonymized or whatever, like they will go every different direction to be like, no, we're HIPAA consistent, we're HIPAA compliant. That's all in our terms of service. Just read our terms of service, like all the different pieces of that. Like, if you were to go in tomorrow and give your clients real informed consent about the impact of their session being recorded, how many of your clients would agree to their session being recorded? Now, if you as the 1099 contractor come in and you say, hey, Rula or Grow or Alma or fill in the blank, I withdraw consent for every single one of my clients, they will not have their stuff recorded. They're going to probably end your contract with them, right? if the clients come in as a groundswell and say, Hey, we do not consent, this is not okay. There is less of an issue of them like they're going to have to make a change, right? If therapists leave and then more therapists come in to fill the to fill the piece, right, which is what's been happening. The biggest complaint that clients have about using these platforms Kelly Higdon (37:16) Hmm. Miranda Palmer, LMFT She/her (37:24) is that like, hey, every time I find a good therapist, they leave, right? Like I can't get continuity of care. Like this doesn't really work for me, right? Which is a true statement. So if therapists do that, now here's the other part, because they are taking transcripts of sessions, they are flagging particular conversations that therapists are having with their clients. Things like, hey, Alma's not taking your insurance plan anymore. So we're gonna move you off of OMA, I can see you on headway for that. And we've seen therapists who've gotten their hands slapped or they have gotten a note, they've said, here's the thing, or in some cases, they've literally just cut their contract with them and said, hey, you are outside of the terms of service, you can't take this client with you. When the client is going, wait a minute, Kelly Higdon (38:02) Yeah. Miranda Palmer, LMFT She/her (38:20) I actually brought this client here because you took their insurance. They came for me. I brought them here. I thought you were just a helper for my insurance. When did you become the owner of this thing? When did you get to Big Brother into my session about the logistics of this? In some cases, again, I know I've talked about it before, but you these platforms are literally calling. Kelly Higdon (38:29) Yes. Miranda Palmer, LMFT She/her (38:44) the clients to say, how was your session? How are you doing this random, probably non therapist person, you know, I see you don't have another session scheduled. And they're like, I do have a session scheduled. They're like, well, therapists, why didn't you put the information in immediately? They're like, I put it in once a week. Like, that's my process. Like I know what my, you know, my schedule is. So there's a lot that's in there. And there is risk and There, I think long term there is more risk to us not standing up for our clients data, for us not being fully educated. Like there's only so long that we can be like, I didn't know, you know. You saw it, I didn't see it. We have you on camera, I didn't know. You know, and I know it's scary. I know what it feels like. I know it feels like, my gosh, there's a recession coming and the world is on fire and all the things and there's. No one's going to pay for therapy and all the things. And all of those things, if they all lead you down the path of doing work that is unethical, that you cannot stand behind, I don't think it's worth it. like, if that if that's where our profession is going, that you have to do things that are unethical and risk your patient, then like we need to be leaving this profession, we shouldn't be in it. I know that's harsh. Kelly Higdon (40:10) But my hope is that as communities are more educated, this is where I do find hope, is that the clinicians who are intentionally creating a business model that's reflective of high quality care, guardianship of records and privacy and data, the communities will value that. We are seeing more and more that clients are educated about the kinds of therapy they get. And then stuff like this comes out and clients are going to start asking more questions. That is my hope. Miranda Palmer, LMFT She/her (40:45) Okay, yes, Anne, I just have to, and I know this is, again, I know I'm like pushing hard right now, but the amount of therapists in Facebook groups who say, I don't understand why clients don't understand how problematic these places are while they're working for them. That's the part is like, it's the, like there's a, crap. Kelly Higdon (41:03) Yes. But if we're not having the conversation, if you don't understand why clients don't understand, first ask yourself, do you understand? Because if you did, then you would be able to explain to your clients how working for these companies and what it does for their data. Because if clients know, they will be better connoisseurs, I guess, or consumers of therapy. And so those of you who have actively chosen to be Miranda Palmer, LMFT She/her (41:14) Yeah. Yeah. Kelly Higdon (41:37) Not like I don't understand and I don't know and not read the contract, but really fully intentionally created something. I do think it's going to benefit you in the long run for sure. And that clients will value that. Especially because you can speak to it of like, let me explain to you why I'm not on the almond that way. You know, like why my fee is this? This is, I don't use your data. Those places are using, you know, like there's an education piece here that can really help you. when you're connecting with clients in those initial consults, all sorts of things. There's benefit to you if you are taking the time to understand and that you become an effective guardian of your practice and your client. Miranda Palmer, LMFT She/her (42:20) Yeah. I do think that's a, and I think sometimes we're scared to speak up in the public way too. It is hard. We saw that with BetterHelp when they came out and, we see it with Talkspace, right? They sued Dr. Linda Michaels, right? I'm so bad with names, Kelly knows it. I don't trust myself often. There were therapists, Kelly Higdon (42:39) Yeah. That's your name. Miranda Palmer, LMFT She/her (42:49) Who were talking about better help and then suddenly all their stuff was gone because better help went after them with their big attorneys and they knew that like Financially like I can't do this time-wise. I can't even navigate this so we know that all of that happens Right. So this space of going like I just totally lost my train of thought which is funny But like we we need to we need to stand up, like we need to say that it is not okay. And I think there are other pieces too, in terms of us being, blogging, this is why, blogging. That like, if you're scared to blog about a particular company, A, you can blog about this particular situation. Here's a great thing. Hey, when using online platforms or, chat bots or AI, here are some things here are some risks. You can make an informed consent blog regarding this. You can also talk about platforms in general. So instead of naming, I don't work for blank, blank or blank, you can say, I choose not to work with platforms. And anything that does this or takes venture capital funding. Here's some examples of terms of services that can be really risky for you. here are examples of impacts that have happened to clients. like, yes, if we can get those things in the New York Times, if we can get those things being published nationally and start the conversation, but those conversations start on your blog, on your website. They start in conversations at parties. They start with the person in Costco who sees a, you know, like, I wanna reach out and talk to the... the amazing content creator and like give her like the skinny like, hey, and here's all the background stuff that you may not know as you're considering it because it's not just a directory listing, which is how people are utilizing it. And what was interesting about that too was that she went to their insurance coverage, like she went to the insurance thing and the insurance thing was like, go and see Headway. And then they get to the end of it, Kelly Higdon (45:09) Mm-hmm. Miranda Palmer, LMFT She/her (45:11) And they're like, oh, let me look at the pictures. Oh, yeah, I think that's the person. And it was like, your share of costs will be $150. And she was like, wait, what? I thought I was using my insurance. Now, they didn't clarify. Is that because it's part of her deductible? Is share of insurance? that like, who's to know what the scenario is? Again, because our insurance situation is so convoluted. Kelly Higdon (45:28) Mm-hmm. Miranda Palmer, LMFT She/her (45:39) but all of those different pieces that she literally like is going in circles right this this space of this directory cup there she was already on a directory why would the directory for her insurance plan send her to another directory well because maybe that insurance invests in headspace and now they get to get another cut of the profits Kelly Higdon (45:50) Mm-hmm. Yeah. So one of the things just to, I know we're going long here, but one of the things we were talking about with some of our coaching clients last week in a call was about the initial consult, about when someone calls and inquires about services with you. And one of the things that I think is very basic but often forgotten is that when a client says, oh, I can't afford your fee, or I just want to use insurance if you're a cash pay, or you don't take the insurance that they have, instead of just saying, oh, OK, and let me. leaving them on their way, actually getting curious and engaging in a conversation to understand what their expectation was, because sometimes clients don't know how the mental health field works and what it means to go to a nonprofit versus user insurance. And this is an opportunity to educate a little bit about the platforms and then empower the client so you can provide really great referrals, because providing great referrals is a great way to give back. because we are shortening the duration of access points, right? Someone comes in and then they just start calling every therapist and you're like, okay, actually, this is somebody I think would be great for you. We kind of make access easier for them. And we empower them with knowledge and education. And this is one of the points you could say of like, I know you have your insurance. I wanna let you know about using some of the platforms versus finding a provider directly off of your insurance list. Here's someone I know who takes your insurance. Here's some questions to ask, making sure that they're not using a platform, and here's why. You you can use this opportunity even with clients that don't end up working with you. And we have found in business school, a lot of our business schoolers that do this, that take just a little extra time, a few, five, 10 minutes, those clients sometimes will come back. Like one of them said last week, they had a client come back after two other therapists. And they said, I would have saved a lot of time and a lot of money if I had just come to you. So you just never know how giving back can come back to you. But this is one area where you can have some advocacy with ease and empower people who are looking for therapy. All right. Miranda Palmer, LMFT She/her (48:13) I know, I think our next conversation needs to be all about consultations because yeah, I could say so much more but thank you all for being here. We would love to hear about your feedback from this or even if you want to review us on Google, we'll put that in there if you want to review us on your podcast of choice but it is helpful. Did you take something away? Did it change Kelly Higdon (48:21) Yeah. Mm-hmm. Miranda Palmer, LMFT She/her (48:40) behavior? Did it motivate you? Did it overwhelm you? Like we want to hear like, is this helpful, harmful? Let us know. And of course we have resources for you. You are not alone in this. You are not alone in this. You are not alone in this. You're not alone in this. Kelly Higdon (48:59) Until next time.

Resources:

Woman's Talkspace Therapy App Sessions Exposed in Court (Proof News): https://www.proofnews.org/womans-talkspace-therapy-app-sessions-exposed-in-court/

Psychotherapy Action Network (PsiAN): https://www.psian.org/

Starting a Counseling Practice Success Stories podcast: find it wherever you listen to podcasts

Questions? Reach us at help@zynnyme.com

About the Authors: Kelly Higdon and Miranda Palmer are the co-founders of ZynnyMe and creators of Business School for Therapists. Since 2010, they've helped tens of thousands of therapists build sustainable practices through organic digital marketing strategies that actually work—without wasting money on ads or time on tactics that don't convert. Because your practice deserves to be found by the people who need you most. Learn more here.