The Use of Artificial Intelligence in Psychotherapy
AI has officially entered the consulting room. Clients are using it between sessions. Clinicians are using it for documentation and business administration. Platforms are being built to deliver scaled versions of therapy outright. The question is no longer whether this technology will shape the field. It already has. The question now is whether those of us who take the relational dimensions of this work seriously will be the ones shaping how it does.
This page brings together the writing, resources, and services I have developed at that intersection. My interest is not in AI as a productivity tool or a clinical shortcut. It is in what happens when a rigorously trained relational clinician engages these technologies with the same theoretical seriousness brought to the consulting room and what we stand to lose if we don't.
The most consequential problem with AI in clinical practice is not that it fails dramatically. It is that it succeeds in ways that quietly foreclose what therapy actually requires.
This book makes a philosophical and psychoanalytic argument for why that matters — drawing on Heidegger, Kierkegaard, Winnicott, Kohut, Bromberg, Levenson, and Ghent — and then gets specific about what to do with it. How to use these tools to sharpen clinical thinking without ceding the ground that makes relational work worth doing. How to orient AI toward the work of staying with what is unresolved rather than resolving it prematurely. How to bring a genuinely critical sensibility to a technology that will otherwise default to efficiency, coherence, and the reduction of ambiguity.
Holding and Holding Back moves from the conceptual to the practical to the applied: a philosophical chapter, a practical orientation to AI and large language models, and a clinical applications chapter with extended examples, case tracking, and consultation vignettes. It is written for clinicians working from a relational, interpersonal psychoanalytic, or existential-phenomenological orientation — and for anyone who wants to think more carefully about what these tools can and cannot hold.
130 pages. $20.
(Coming April 6th)
Where This Thinking Began
The book grew out of a three-part series published here over the course of the last several months. If you're coming to this work for the first time, the posts are worth reading in order. They trace the arc from initial skepticism through practical engagement to the philosophical stakes that ultimately drove the longer project.
→ Practical Considerations for the Use of AI in Clinical PracticeThe case for engagement. Why clinicians who care about relational work can't afford to look away.
→ Against My Instincts: AI as a Clinical CompanionSpecific, practical uses: supervision support, pattern tracking, literature comprehension, clinical vocabulary development.
→ What AI Cannot HoldThe philosophical reckoning. Heidegger, Kierkegaard, and what relational work requires that AI structurally cannot provide.
AI Consultation for Clinicians
You've been thinking about this. How to use these tools responsibly. What it means for your orientation. Whether the efficiency gains are worth what they might cost relationally: in your work, in your development as a clinician, in the field more broadly. What you probably don't have is a colleague who can think it through with you rigorously, from within a relational framework, without defaulting to either uncritical enthusiasm or reflexive dismissal.
That's what this consultation is for.
I offer individual and small group consultation for clinicians navigating AI integration in their practice. Sessions are oriented around your specific clinical questions. Those could be how to use these tools for supervision support, how to think about disclosure with clients, how to evaluate a particular platform or workflow, or simply how to develop a position on all of this that you can stand behind.
Individual consultation: $165 / 50 minutes Small group (up to 6 participants): $85 per person / 50 minutes
Email bretschermerhornlmhc@gmail.com to schedule consultation.
Presentations and Group Training
Holding and Holding Back is also available as a structured 45-minute presentation for group practices, training programs, and continuing education contexts. The presentation covers the book's central argument—what AI can and cannot hold clinically—alongside practical guidance for thoughtful integration, and is designed to generate genuine discussion rather than deliver a predetermined answer.
Suited for graduate and post-graduate training programs, as well as other professional development settings.
Email bretschermerhornlmhc@gmail.com to schedule training.