The Problem with "Ambient Listening"

"Ambient listening" is a misleading term for recording client sessions, and therapists (and clients!) should think carefully about the privacy and ethical implications. (Quill does not listen to or record sessions at all, unlike other AI note writing tools.)

I've seen a few therapy EHR and AI companies use the term "ambient listening" lately when describing their note-writing software for therapists.

Ugh. I do not like how they're trying to sugarcoat what they're doing.

Yes, this is an ear. Just 'ambient listening' to a very private therapy session between client and therapist. "Ambient listening" is just a softer way of saying "recording client sessions". It's an attempt to make it sound passive, almost human -- like the software is just quietly sitting in the background, helpfully taking notes, typing away at a typewriter.

But that's not what's happening. It’s not some neutral presence that fades into the background. It’s a piece of software actively capturing every word, running it through additional processes, and converting it into data. And once that data is captured (even if just temporarily stored -- for now), it introduces questions about where it goes, how it’s handled, and who ultimately has access to it.

It's a balancing act for both client and therapist, deciding on whether recording sessions is responsible and ethical for their situation. Choosing to allow software to "listen" to every word in a session is a serious privacy and ethical consideration, and both the therapist and client need to think long and hard about it. Therapy is one of the most private, vulnerable spaces a person can enter. The idea that software is quietly collecting that raw, unfiltered conversation should not be taken lightly. Even if companies promise encryption or deletion, once a session is recorded, the risk of exposure, misuse, or future policy changes exists. (And that risk is zero if you simply do not record your session at all.)

Quill keeps therapy session conversations private by never even recording them in the first place. That’s exactly why Quill does not listen (ambient or otherwise) to client sessions. Quill only relies on the therapist’s own summary, written or recorded after the session is over. The therapist -- not an AI -- is in full control of what information is included in the note. This approach ensures that sensitive client conversations stay private, without introducing unnecessary risks.

Words matter! If AI or EHR companies want to introduce session recording into the therapy space, they should be transparent about it -- no euphemisms or marketing spin. They should be honest about what their new software or feature does.

Okay, that's it for my thoughts on this Monday! Have a great week!

Jon

PS -- I originally posted my thoughts on this topic on LinkedIn, if you want to join the conversation!

Published on Feb. 24, 2025.

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