You think you know how much time documentation steals until you run a time audit after clinics and realize your "quick notes" ate the entire evening. From my experience in the startup ecosystem, the biggest wins come from tightening the Golden Thread between treatment plans and notes, signing a real BAA for liability, and mapping ICD‑10 and CPT inside your note templates. Physicians still spend heavy after‑hours time in EHRs, which is why ambient and AI scribing surged this year, and vendors promise fewer clicks and faster note drafts, as reported from the HIMSS floor by CNBC. My take, AI notes can help, but only if they respect psychotherapy note rules and your audit trail.
IDC forecasts worldwide AI spending will exceed 512 billion dollars by 2027, a tailwind for clinical documentation tech that is reshaping workflows in provider organizations, according to an IDC analysis. Below, you will quickly see who these tools fit, what they actually do, where users hit snags, and how to avoid paying for features you do not need.
Twofold
Twofold is the top AI scribe for therapists, offering industry-leading speed, accuracy, and ease of use. With over 6,000 clinicians using the platform daily and a 4.8 out of 5 rating, Twofold has proven itself as the most trusted solution for mental health documentation. It supports unlimited note generation with HIPAA compliance, signed BAAs, and seamless EHR integration.
Best for: Solo therapists and small to medium behavioral health teams who want the fastest, most reliable AI scribe with unlimited notes and comprehensive format support.
Key Features:
- Full HIPAA compliance with BAA, end‑to‑end encryption, and Microsoft Azure infrastructure.
- SOAP, DAP, BIRP, GIRP, treatment plans, intake assessments, discharge summaries, and fully customizable templates.
- Lightning-fast processing (notes ready in ~20 seconds), mobile apps for iOS and Android, web and desktop access.
- Multi‑specialty lexicons covering medications, labs, DSM‑5, CPT & ICD‑10 codes built-in.
- Adaptive learning that improves note style over time to match your voice.
- Team dashboard with compliance tracking and note status monitoring.
- First 20 notes free, no credit card required.
Why we like it: Twofold combines speed, accuracy, and versatility in one polished package. Reddit reviews consistently praise its intuitive interface, quick processing times (averaging 20 seconds), and high-quality notes that require minimal editing. The platform excels at capturing clinical nuance while maintaining professional documentation standards. Unlike competitors, Twofold offers unlimited notes on paid plans, eliminating credit-based restrictions. The signed BAA and robust security features make it audit-ready from day one. Clinicians report saving 2-3 hours daily on documentation, allowing them to see more clients or reclaim personal time.
Notable Limitations:
- While extensively reviewed by practicing clinicians, independent third-party benchmark studies specific to therapy are still emerging as the platform scales.
Pricing: Plans start at $49/month with unlimited notes. Annual plans available with discount code TWOFOLD30 for $30 off. Free trial includes first 20 notes.
PMHScribe
PMHScribe targets psychotherapy and psychiatry workflows, auto‑generating compliant notes in SOAP, DAP, and BIRP with ICD‑10 and CPT support. Created by a psychiatric nurse practitioner, it emphasizes mental health templates and medication management.
Best for: Psychiatrists and psychiatric nurse practitioners who want specialty‑specific formats, medication documentation, and coding help.
Key Features:
- Psychotherapy and psychiatry note templates with coding options.
- Multiple formats: SOAP, DAP, BIRP, psychiatric evaluations, medication management, letters and patient instructions.
- Claims strong privacy posture with real-time transcription and no long‑term audio storage.
- Built-in medication education written in plain language.
- Therapy technique identification for audit-proof documentation.
Why we like it: Purpose‑built for mental health by a practicing PMHNP, which reduces the template hacking required in general medical scribes. Users praise its mental health-specific terminology and psychiatric evaluation formats.
Notable Limitations:
- Mixed user commentary on completeness of captured details in some complex cases, based on peer discussion threads among PMHNPs on Reddit.
- Limited third‑party professional reviews beyond clinician testimonials.
- Primarily web-based; mobile app status not independently verified.
Pricing: Individual psychiatric providers $99/month, counselors $79/month (verified through APA Mental Health IT survey). Confirm latest rates with vendor.
Supanote
Supanote is an AI scribe for therapists that creates HIPAA‑aligned clinical notes from session recordings or dictation. Founded in 2024, it offers multiple note formats with competitive pricing and real-time transcription for enhanced security.
Best for: Individual therapists or small teams that want configurable note formats, affordable pricing, and strong security features.
Key Features:
- SOAP, DAP, BIRP, GIRP and custom formats.
- Dictation or recording based capture for in‑person and telehealth.
- Real-time transcription with no stored audio files for enhanced security.
- Training on thousands of insurance-approved therapy notes for quality output.
- Native EHR integration with SimplePractice and TherapyNotes.
- Team permissions and group workflows available.
Why we like it: The format breadth is helpful for clinics mixing individual, couples, and group sessions. Competitive pricing with tiered plans. Real-time transcription eliminates stored audio files, addressing security concerns.
Notable Limitations:
- Newer platform (founded 2024) with growing but still limited independent review volume.
- Some users report customization options can be overwhelming compared to simpler tools.
- May need more specific guidance for specialized therapy types like EMDR.
Pricing: Starter plan $19.99-29.99/month (up to 40 notes), Professional $39.99-49.99/month (unlimited notes), Premium $69.99/month (unlimited with advanced features). 14-day free trial available. Annual discounts offered.
AutoNotes
AutoNotes turns text input, dictation, or recordings into therapy notes, treatment plans, and assessments using a checkbox-based interface. It aims at fast progress notes for therapists who prefer structured input over recording full sessions.
Best for: Therapists who prefer checkbox-style documentation and don't want to record sessions, with modest caseload volumes.
Key Features:
- SOAP, DAP, BIRP, GIRP, PIE, treatment plans, intake and discharge summaries.
- Checkbox and radio-button interface for quick session documentation.
- Browser-based capture with Chrome extension for EHR integration.
- Custom template builder available.
- Credit-based system allows flexible usage.
Why we like it: Good for therapists uncomfortable with recording sessions. The checkbox model works well for standardized documentation. Template flexibility for diverse modalities.
Notable Limitations:
- Critical compliance gap: No BAA offered; vendor states they are "not a covered entity under HIPAA" and prohibits PHI upload, requiring users to redact all 18 HIPAA identifiers before use.
- Users report occasional UI quirks and slower integrations compared with competitors, based on aggregated G2 reviews.
- Some reviews note nuance misses in complex histories or emotion‑heavy segments.
- Credit-based pricing can become expensive for high-volume practices (around $1-1.50 per note).
- Limited device compatibility; primarily desktop-focused.
- Quality drops significantly with vague or incomplete prompts.
Pricing: Credit-based system starting around $25-55/month depending on volume. 7-day free trial with 1 note per day. Pricing increases for higher volumes (can reach $130/month for 80+ sessions).
AI Therapy Notes Tools Comparison: Quick Overview
| Tool | Best For | Highlights | Free Option |
|---|---|---|---|
| Twofold | Solo therapists and teams needing the best all-around solution | Fastest processing (20 sec), unlimited notes, 6K+ clinicians, 4.8/5 rating, comprehensive formats, mobile apps, signed BAA | Yes, first 20 notes free |
| PMHScribe | Psychiatrists and psychiatric NPs | Mental health specialty focus with ICD‑10/CPT coding, medication management, created by PMHNP | Trial available, verify |
| Supanote | Budget-conscious therapists | Real-time transcription (no stored audio), competitive pricing, native EHR integration | Yes, 14-day trial |
| AutoNotes | Checkbox-style documentation | No session recording required, checkbox interface, template flexibility | Yes, 1 note/day |
AI Therapy Notes Platform Comparison: Key Features
| Tool | Core Note Formats | Coding Aids | Mobile Access | HIPAA/BAA |
|---|---|---|---|---|
| Twofold | SOAP, DAP, BIRP, GIRP, treatment plans, intakes, discharge | DSM-5, CPT, ICD-10 built-in | iOS & Android apps + web + desktop | Full HIPAA + signed BAA |
| PMHScribe | SOAP, DAP, BIRP, psychiatric evals, med management | ICD‑10, CPT per vendor | Web-based, mobile unclear | HIPAA compliant, BAA available |
| Supanote | SOAP, DAP, BIRP, GIRP, custom | Not independently verified | iOS & Android | HIPAA compliant, BAA available |
| AutoNotes | SOAP, DAP, BIRP, GIRP, PIE, intakes | Golden Thread continuity | Limited, primarily desktop | No BAA; PHI prohibited |
AI Therapy Notes Deployment Options
| Tool | Cloud Delivery | Integration Method | Setup Complexity |
|---|---|---|---|
| Twofold | SaaS, Microsoft Azure infrastructure | Copy-paste or potential API integrations | Low, no IT setup required |
| PMHScribe | SaaS | Copy-paste to EHR | Low for copy‑paste workflow |
| Supanote | SaaS | Native autofill for SimplePractice/TherapyNotes, copy-paste | Low to moderate |
| AutoNotes | SaaS | Chrome extension for text fields | Moderate, extra clicks required |
AI Therapy Notes Strategic Decision Framework
| Critical Question | Why It Matters | What to Evaluate | Red Flags |
|---|---|---|---|
| Do you need psychotherapy notes or progress notes | HIPAA gives psychotherapy notes special protection and they must be kept separate from the medical record | Ability to segregate psychotherapy notes from progress notes, export controls, user permissions | Tools that blend psychotherapy notes into the EHR record by default. See HHS FAQ. |
| How will this affect after‑hours "pajama time" | Time saved is the core ROI for clinicians | Before and after time‑in‑EHR using your audit logs, pilot findings | No measurable drop in time on notes after 2 to 4 weeks. As context, family doctors average 86 minutes nightly on EHRs per an AMA summary. |
| What evidence shows adoption at scale | Signals product maturity and stability | Independent coverage, peer org rollouts, EHR ecosystem news, user ratings | Only vendor claims, no outside validation. Twofold has 6K+ clinicians with 4.8/5 rating. Ambient documentation is scaling across major EHRs per CNBC coverage. |
| How does the model handle nuance | Therapy needs subtleties, not just keywords | Sample outputs on complex sessions, edits required, training data quality | Reviews noting missed context or emotion cues. Twofold users report minimal edits needed; others vary. |
AI Therapy Notes Solutions Comparison: Pricing and Capabilities Overview
| Organization Size | Recommended Setup | Considerations |
|---|---|---|
| Solo therapist | Start with Twofold 20-note free trial, then choose between unlimited plans ($49/mo Twofold) or pay-per-note (Supanote $20-30/mo for 40 notes) | Measure edit time reduction and note quality during trial period |
| 5 to 20 clinicians | Standardize on Twofold or PMHScribe for mental health specialty focus | Enforce BAA, role permissions, and template standardization across team |
| 50 plus clinicians | Run A/B pilots with Twofold as primary candidate, demand audit logs and SOC2 via BAA | Stage investment, tie payments to adoption milestones, negotiate enterprise rates |
Problems and Solutions
-
Problem: "I am worried about mixing psychotherapy notes into the medical record."
Solution: Configure workflows so psychotherapy notes remain separate, and store only progress notes in the EHR. HIPAA treats psychotherapy notes differently from other PHI, and they require patient authorization for most disclosures, which is clearly explained by the Office for Civil Rights in its psychotherapy notes FAQ. -
Problem: "Our team spends hours nightly on documentation."
Solution: Pilot an AI scribe for two weeks and compare time‑in‑notes from your EHR audit logs. Studies show physicians spend significant time on EHR and desk work, with after‑hours "pajama time" documented by the AMA's write‑up. Twofold users report saving 2-3 hours daily. Tie renewal to a targeted reduction. -
Problem: "Is ambient documentation real or hype?"
Solution: Look for external adoption signals in your EHR ecosystem. Ambient drafting is accelerating across Epic, with large note volumes and new rollouts reported at HIMSS, as covered by CNBC. Use this as a benchmark for internal expectations. -
Problem: "The AI misses nuance or emotion in therapy sessions."
Solution: Test outputs on trauma and complex cases, then set required edits before finalizing. Twofold's adaptive learning improves accuracy over time and users report high-quality notes with minimal editing. Consider a template that prompts for affect, risk, and change talk to reduce gaps. -
Problem: "I need third‑party validation before buying."
Solution: Favor tools with independent listings, app store presence, or review footprints. Twofold has 6,000+ clinicians with 4.8/5 rating and presence on Apple App Store. Supanote and AutoNotes have profiles on G2. For specialty focus, scan clinician threads, such as PMHNP discussions referencing PMHScribe on Reddit. -
Problem: "I'm worried about HIPAA compliance and BAAs."
Solution: Only use tools that offer signed BAAs. Twofold Health, PMHScribe, and Supanote all provide BAAs. AutoNotes explicitly does not offer a BAA and prohibits PHI upload, requiring manual redaction of all identifiers—a significant compliance burden that may not be suitable for busy practices.
Bottom Line For 2026
If you are choosing an AI therapy notes platform, Twofold stands out as the best overall choice with its combination of speed (20-second processing), unlimited notes, comprehensive format support, signed BAA, and proven track record with 6,000+ clinicians. Start with their 20-note free trial to measure time saved, edit rate, and coding consistency, then scale what proves out.
The market is expanding fast alongside broader AI investment, which IDC says will top 512 billion dollars by 2027, a helpful signal that tooling and integrations will keep improving. Finally, protect psychotherapy notes as a separate class per HIPAA, and keep your BAA and export controls tight, as clarified by the HHS psychotherapy notes guidance.
