AI scribe for therapists: an honest comparison for LPCs, LCSWs, LMFTs, and psychologists

By Selam Koch, PMHNP-BC, founder of OneStep Scribe and practicing psychiatric nurse practitioner. Published July 2026.

Let me name the elephant first. OneStep Scribe is my product, and I am a prescriber, not a therapist. Two of the tools below are therapist-first by their own descriptions: Upheal calls itself an AI-native EHR built specifically for therapists, and Mentalyc calls itself the AI platform for therapists, counselors, and mental health professionals. So why read a comparison from me? Because the criteria for judging any AI scribe do not change with the seller. A BAA either exists on your plan or it does not; drafts either contain your client's actual words or interchangeable paragraphs; pricing is either published or it is not. This article gives you that checklist and applies it to every option, including mine, with every competitor claim drawn from that vendor's own public website as of July 2026. Where another tool fits your practice better, I will say so.

What a therapy progress note has to survive

A therapist's note carries its own audit exposure. The organizing test is medical necessity: the diagnosis has to justify the treatment plan, the plan has to show up as the intervention documented in each session, and the intervention has to connect to progress toward a stated goal. Payer reviewers pull a run of notes, and the classic adverse finding is cloned documentation, paragraphs so interchangeable that nothing proves a distinct service happened at each visit. Session-specific content, anchored by the client's own words, is the defense.

Two more layers. Risk documentation: when suicidal ideation, self-harm, or safety concerns surface, the note has to show what you assessed and what you did. And intakes: therapists bill the 90791 diagnostic evaluation, which has its own required elements; I covered it in the 90791 vs 90792 guide. For a section-by-section model, including the therapist-structure walkthrough, see the psychiatric progress note example.

The checklist: what to demand from any AI scribe

• A BAA before any PHI moves. If your plan tier does not include a Business Associate Agreement, that tier is not an option, whatever the price.
• Session-specific drafts with the client's own words. Interchangeable paragraphs are the audit finding you are paying to avoid.
• A review-and-sign workflow. The AI drafts; you edit, sign, and own the final note.
• Transparent pricing and note limits. Caps and the real monthly cost should be published, not discovered on an invoice.
• Clarity on recordings. Is audio stored, for how long, and does anything train models? Published, not assumed.
• A real trial. Judge the note you would sign from a real session, not the demo.

The comparison

OneStep Scribe (our product)

OneStep Scribe is mine, so read this as the vendor's case, stated as fit rather than superiority. It is mental-health-only, proven in daily use at my psychiatric practice in Cranford, New Jersey, and designed prescriber-first, which produced a habit that transfers directly to therapy notes: documentation discipline. Drafts use session-specific language and your client's own quoted words rather than boilerplate, and the structure keeps the diagnosis, the goals, and the intervention you actually delivered connected, because that coherence is what a records request tests. It includes standardized scales, a DSM-5-TR criteria reference, custom note templates, and a review-and-sign workflow where the final note is yours. Accounts are NPI-verified, and a BAA is available where applicable.

The honest case for a therapist is three things: that documentation discipline; one tool across a mixed practice, because when therapists and prescribers share clients, notes written to the same standard keep the chart coherent; and simple pricing, $59 per month for Basic with up to 100 notes, $79 for Pro with unlimited notes, and a 14-day trial that never asks for a card.

The honest limitations for a solo therapist: OneStep is a scribe, not an all-in-one therapy EHR. No scheduling, no client portal, no treatment plan library. If you want the whole practice platform in one product, two tools below aim squarely at that, and I would rather you know it now than after a trial.

Mentalyc

Mentalyc describes itself as "the AI platform and tools for therapists, counselors, and mental health professionals," and its stated audience is the one reading this article: LMFTs, LPCs, LCSWs, psychologists, and social workers. Its site lists SOAP, DAP, and BIRP plus 100+ custom templates including PIRP and GIRP on its Pro plan, group therapy notes on its Super tier, free supervisee accounts, and a pre-licensed therapist discount. It names SimplePractice, TherapyNotes, and Jane App integrations and claims 30,000+ mental health professionals.

Pricing is published: from $14.99 per month billed annually for 40 notes up to $99.99 to $119.99 for 330 notes, with a 14-day, 15-note, no-card trial of Pro. The site claims HIPAA compliance and SOC 2 Type II certification and says a signed BAA can be downloaded from account settings. If you want a therapist-built tool with granular note formats at a low entry price, Mentalyc's own positioning says that is exactly what it sells.

Upheal

Upheal calls itself "the most loved AI notes for therapists" and, more tellingly, an "AI-native EHR built specifically for therapists," claiming 70,000+ providers. By its own description it is more than a scribe: AI notes, AI treatment plans, a compliance checker, scheduling, telehealth, a client portal, and secure messaging. Its support center lists SOAP, DAP, GIRP, BIRP, EMDR, mental status exam, and biopsychosocial intake templates among a lineup its homepage puts at 30+ formats.

Pricing is the simplest on this page: $1 per session capped at $69 per month on the individual plan, with a 30-day no-card trial and a money-back guarantee. The site states it provides a BAA for every account and claims HIPAA compliance and SOC 2 Type II certification. If you want a full therapy practice platform rather than a scribe feeding the EHR you already have, Upheal's own positioning says it is building precisely that.

Freed

Freed positions itself as "the AI scribe and Front Desk giving time back to independent clinics," serving 30+ specialties by its own count, with mental health listed among them. It is a deliberately broad generalist rather than a therapy-specific tool; its homepage claims 26,000+ clinicians and states that Freed does not store patient recordings.

Published pricing: $39 per month for Starter with a 40-note cap, $79 for Core with unlimited notes, $104 to $119 for Premier, and a 7-day no-card trial. The site claims HIPAA compliance and SOC 2 certification and says an organization-wide BAA is available on group plans; individual-plan BAA terms are not published on the pages I reviewed, worth asking before you upload a session. If your clinic spans non-behavioral specialties too, a generalist like this may be the practical pick.

Heidi Health

Heidi describes itself as "your AI care partner for modern clinical practice" and serves the broadest audience here by its own account, from primary care and nursing through dentistry and veterinary work. Its mental health page does speak to therapists directly, naming psychologists, counselors, psychotherapists, and social workers, saying Heidi is "trained on the language, context, and clinical complexity of behavioral health," and listing progress note, risk assessment, and PIRP templates.

Heidi's pricing page lists Free, Clinician, and Practice tiers with 14-day trials on the paid tiers, but current US dollar prices are not published in the page content I could review. The site claims HIPAA compliance with a dedicated safeguards page, SOC 2 Type 2 and ISO 27001 certifications, and states no audio recording is stored; a BAA section exists on its HIPAA page, though which accounts receive one is not published there.

Twofold Health

Twofold positions itself as a multi-specialty scribe with a heavy mental and behavioral health emphasis, claiming over 20,000 clinicians from psychiatry and therapy through pediatrics and veterinary medicine. For therapists, its site lists SOAP, DAP, BIRP, GIRP, and intake formats, telehealth support, iOS and Android apps, and a works-with-any-EHR claim naming SimplePractice among compatible systems.

Published pricing: a free tier with a 7-day full-access trial, and a Personal plan at $69 monthly or $49 billed annually. Its site states a BAA on every plan including the free tier, no raw audio storage, and no PHI used to train models, exactly the data-practice clarity the checklist asks for. The fit question is focus: mental health is prominent on Twofold's site, but the platform is multi-specialty by its own framing.

Side by side

Frequently asked questions

Is it HIPAA compliant to use an AI scribe in therapy?

It can be, and the burden is shared. On the vendor side you need a signed BAA before any PHI moves, plus published data practices: whether recordings are stored and whether sessions train models. On your side you need client consent and a defensible workflow. HIPAA compliance is a property of how you and the vendor operate together, not a badge on a homepage. None of this is legal advice; when in doubt, ask a health care attorney.

Do I need client consent to record sessions?

Treat it as yes. Recording consent is best practice everywhere, and in many states it is required by law. Statutes vary by state, and telehealth across state lines adds another layer, so check the rules where you and your client sit, and get consent in writing. This is not legal advice.

Will the notes sound like me?

That is the question a trial answers and a demo does not. Generate drafts from real sessions and check three things: does the note quote your client's actual words, does it capture what happened in this session rather than any session, and does it use your modality's language, whether CBT, EMDR, IFS, or psychodynamic work. Judge the note you would sign.

What about couples and group sessions?

Multiple voices are harder for any AI scribe: speaker attribution, separating individual from relational content, per-member documentation in groups. Some vendors publish support; Mentalyc, for instance, lists group therapy notes on its Super tier. For every vendor on this page, including mine, published support and a usable draft are different things, so verify with a real couples or group session during a trial.

Can one tool work for a practice with both therapists and prescribers?

Yes, and that is the setting OneStep Scribe was built inside: a working psychiatric clinic, wanting note quality that does not change with the credential behind the signature. The same engine that drafts a therapist's progress note drafts the prescriber's medication visit with its psychotherapy add-on; for that side, see the annotated 90833 note example. Other vendors above also state support for both audiences, so put your practice's actual mix through a trial.

This article is educational only and is not legal, billing, or purchasing advice. The comparison is based on each vendor's public website as of July 2026; features and pricing change, so verify current details with each vendor directly. All trademarks and product names are the property of their respective owners. No vendor named here endorsed, reviewed, or is affiliated with this article. OneStep Scribe is the author's product; weigh this comparison accordingly. CPT is a registered trademark of the American Medical Association.