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Generative artificial intelligence (AI) systems designed to automate clinical documentation have rapidly proliferated in mental health practice, yet the field lacks established frameworks for their responsible adoption. This work examines how mental health clinicians navigate this technological landscape through two complementary qualitative studies. The first study investigates folk theories, the informal, experience-based models that clinicians develop to make sense of AI-enabled documentation tools in the absence of formal guidance, revealing how varying levels of AI literacy shape practitioners' ethical practices around data privacy and confidentiality. The second study uncovers an unexpected benefit of these same tools: their capacity to function as digital supervisors, supporting reflective practice by offering alternative clinical interpretations, clarifying practitioners' existing approaches, and enabling greater presence during sessions. Together, these findings illuminate a critical tension in contemporary psychotherapy: while AI platforms can enhance reflective capacity and reduce documentation burden, clinicians must simultaneously develop critical discernment to evaluate algorithmic output against their professional judgment. These findings point to how AI integration in mental health requires neither wholesale adoption nor rejection, but rather a dual investment in AI literacy and regulatory frameworks including governance structures, enabling clinicians to utilize AI's reflective potential while maintaining the critical stance essential to ethical, client-centered care.

Lauri Goldkind is a professor at Fordham’s Graduate School of Social Service and the Editor in Chief of the Journal of Technology in Human Services. She is the founder of the Participatory AI Research, Education and Development (PAIRED) Lab. Goldkind’s current research has two threads: data justice and artificial intelligence in human services and nonprofits, and artificial intelligence in social work practice. She has a robust network of community partners in New York City and internationally, including the International Federation of Settlement Houses, United Neighborhood Houses, and Caritas Macau. She holds an MSW from SUNY Stony Brook with a concentration in planning, administration, and research, and a PhD from the Wurzweiler School of Social Work at Yeshiva University.