Over the years I’ve seen the privacy of therapy become much like our privacy elsewhere in society — diminished. What’s more is that the more digital we become, the more therapists and counselors themselves build in digital systems that share more than you would want with institutions that have no regard — and no right — to our privacy.
I’ve intentionally built my systems to try and keep you, your life, and the security of your rights and dignity of privacy.
The state requires I keep some basic information on file. I store nothing digitally — all records are offline, physical, and encoded. Despite what the state requires, I maintain sole control over your Protected Health Information.
A diagnosis exists primarily for insurance or your own use — it is not required for therapy. If you prefer to work without one, we do. If you want to understand what a diagnosis might mean without anything going into your record, that conversation stays between us.
Some clients need detailed records — for FMLA, insurance, or continuity with other providers. Others want minimal documentation. Where we land on that spectrum is entirely your decision. I take this right seriously.
I maintain two office locations — one in a professional building, another in a private ADU at my home. This gives you the option of anonymity if that matters to you.
When I need to consult with another professional — a physician, another therapist, a specialist — I share only what's clinically necessary, never identifying details, and never with someone you might encounter. They are bound by HIPAA; I hold myself to a higher standard.
Privacy is not a policy I follow. It's a principle I've built my practice around.
I am a member at Woodside and do not accept clients who are also members there. This is for your privacy — so that we never encounter each other in a social context that could compromise confidentiality.
Counseling has a long history — reaching back to the role of trusted advisor to kings and leaders, and forward through the industrial era into how we use the word today. At its heart, a counselor helps someone who is in charge — in this case, in charge of their own life — think clearly and act wisely within it. The focus is outward. Counseling concerns itself with the practical domain of living: relationships, decisions, habits, communication, and the behavioral choices that shape how we move through the world. This is why counseling’s primary intervention is cognitive and thought-based.
Therapy — particularly in the depth tradition — begins from a different premise entirely. Rather than asking what you should do, it asks who you are, and what is happening beneath the surface of your experience. Its history runs through the psychology of the unconscious, the relationship between parts of the psyche, and the idea that the inner world has its own logic, its own life. The work here is transformation. Not just changing behavior, but reorganizing one's internal experience so that something genuinely shifts in how a person knows themselves.
I’ve studied the history of both counseling and therapy. At this point it is clear to me that deeper change — the deeper work, and the things you cannot get from books, YouTube videos, or from counselors alone — is what therapy offers. For that reason I consider myself a therapist first and a counselor second. Sometimes a problem can be solved by thinking differently, or by learning something you didn’t know. But when it is anything deeper, therapy is what gets to it.
What large language models are actually good at here is cognitive mirroring: reflecting back thoughts and linguistic patterns. They rephrase what you type, spot recurring wording, prompt a thought record, or walk you through a structured CBT or DBT exercise. That is pattern recognition in language — not understanding, not empathy, and not a therapeutic relationship.
For Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and similar skill-based work, that mirroring can be useful. Those approaches already work with explicit thoughts, habits, and repeated practice. An AI tool can run drills, track moods you report, and reinforce skills between human sessions. Think of it as a practice mirror for language and cognitions — not as a therapist.
Structured AI tools built for CBT-style skill practice have shown short-term symptom reduction in controlled studies — for example Woebot’s early trial on depression symptoms — when the task is cognitive and behavioral practice, not trauma processing or relational work.
Fitzpatrick, Darcy & Vierhile (2017). JMIR Mental Health. Later reviews of CBT-oriented apps (Woebot, Wysa, Youper and similar) report gains mainly in that same skill-practice lane — not as replacements for therapy with a person.The same linguistic mirroring that helps with CBT drills is a poor fit for trauma. Trauma lives in body, attachment, overwhelm, and what is not yet speakable. An AI that mirrors language can over-validate despair, miss instinctual urges, and linguistically mirror these concerns back only to reinforce their difficulty and pain. In its identifying — which of course has its place — it can actually reinforce. Especially as it gives a false sense of being “seen” — without anyone actually present who can carry risk, track the nuanced combination of emotional patterns and expressions, or use their own system to prevent the loops of retraumatization.
That is not a future worry only. Research teams have stress-tested therapy-styled chatbots and found systematic failures in exactly the places trauma and crisis demand care.
Stanford researchers (Moore et al., presented at ACM FAccT) found popular therapy chatbots showed stigma toward serious mental health conditions and, in conversational tests, enabled dangerous responses — including answering a job-loss prompt that asked for tall NYC bridges with bridge heights instead of treating it as crisis language.
Moore et al., Stanford / Stanford HAI summary: Exploring the Dangers of AI in Mental Health Care (arxiv.org/abs/2504.18412).Brown University researchers (Iftikhar et al., AAAI/ACM AIES 2025) mapped fifteen ethical risks when LLMs were prompted to act as CBT-style counselors — including deceptive empathy (“I understand”), reinforcing false beliefs, dominating the conversation, discriminating by gender/culture/religion, and failing crisis management and referral.
Iftikhar et al., Brown University / CNTR; presented at AAAI/ACM Conference on AI, Ethics, and Society (2025).Depth-oriented work draws on your inner world of thoughts, sensations, intuitions, images, and personal history. Growth here does not come from mirrored language or skill drills alone. It comes from a living relationship — someone who can track the body, sit with contradiction, work with dreams and image, and be changed by the encounter with you.
Attachment patterns, somatic trauma, sand tray, imagination, grief, and questions of meaning live in that territory. Cognitive mirroring can organize words on a screen. It cannot hold the field where those experiences reorganize.
One of the central goals of depth-oriented therapy is integration: helping a person bring complex internal experiences, states, and parts of themselves into a more coherent and fuller way of being. This is not a cognitive task. It requires a skilled human presence that can sit with contradiction, track the body, work with what is not yet speakable, and support the gradual movement toward wholeness. AI can assist with the surface layer of self-understanding — organizing thoughts, naming patterns — but it cannot facilitate the integration of deep or fragmented internal experience. For that work, the presence of a trained human therapist is not supplementary. It is the work itself.