Colorado Mandates Real-Time Therapist Oversight of AI Therapy

Colorado's controversial AI therapy law

Colorado has enacted legislation requiring therapists to maintain active, real-time oversight whenever clients use AI tools during psychotherapy sessions. House Bill 1195 mandates that mental health professionals be "synchronously, real-time" logged into AI systems and prepared to intervene instantly throughout client interactions.

According to AI researcher Lance Eliot, who first reported the details of the law, the requirement represents a well-intentioned but potentially problematic approach to regulating AI in mental health care.

Under the new law, therapists cannot simply recommend or configure AI tools for client use between sessions. Instead, they must be actively present and monitoring throughout every AI-assisted interaction, creating what critics describe as a significant operational burden.

Three major concerns

Eliot identifies several adverse consequences that lawmakers may not have adequately considered. First, the real-time monitoring requirement creates a substantial time burden for therapists, raising questions about efficient use of professional expertise and whether insurance will reimburse for extended monitoring sessions.

Second, the stringent oversight mandate is likely to discourage therapists from incorporating AI into their practice altogether. Rather than navigate the complex requirements and liability concerns, mental health professionals may simply avoid AI tools entirely, potentially stagnating innovation in the field.

Third, and perhaps most paradoxically, the law may push clients toward completely unsupervised AI use. Faced with paying therapists for extended monitoring time, clients may opt to use AI mental health tools independently rather than under professional guidance—the opposite of the law's intended protective effect.

Why it matters

This legislation sets a precedent for how states regulate AI in healthcare settings, with implications extending beyond Colorado and mental health. The law exemplifies a growing tension in AI governance: policymakers attempting to ensure safety through restrictive oversight requirements that may ultimately produce counterproductive outcomes. As AI tools become more prevalent in therapeutic settings, the Colorado approach could either serve as a cautionary tale or be replicated by other states—making the real-world impact of HB1195 particularly significant for the broader healthcare AI landscape.

A pattern of hasty AI regulation

Eliot argues the Colorado law reflects a broader pattern in AI legislation, where policymakers draft regulations without sufficient analysis of potential downsides. While acknowledging that lawmakers' intentions are typically sound, he contends that inadequate due diligence leads to laws with significant legal gaps and unintended consequences.

The requirement also raises practical liability questions for practitioners who must now maintain constant vigilance during AI sessions, potentially increasing their professional risk rather than reducing it.

The details of Colorado's HB1195 and its implications were first reported by Lance Eliot in Forbes.