{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/clinical-and-counseling-psychologists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Clinical and Counseling Psychologists",
    "soc_code": "19-3033",
    "category": "Science",
    "us_employment": 75990,
    "median_annual_wage": 100580
  },
  "verdict": "SAFE",
  "risk_resistance": 71,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 13,
    "embodiment": 7,
    "liability_shield": 16,
    "trust_premium": 19,
    "judgment_accountability": 16
  },
  "reasoning": {
    "task_resistance": "At 13 rather than 17, the hour-long session and the case formulation behind it resist automation, but the surrounding workload — PHQ-9/GAD-7 administration and scoring, MMPI-2-RF and WAIS scale computation, SOAP-note generation from session audio, insurance treatment-plan templates, and CPT/ICD-10 coding — is already handled by software, and manualized CBT protocols for uncomplicated anxiety or insomnia are the most scriptable part of your caseload.",
    "embodiment": "A 7 reflects that you work from a chair in an office or over telehealth, with physical presence mattering only in specific contexts — reading agitation and posture during a mental status exam, being in the room during an in-person crisis, administering timed performance subtests with blocks and stimulus books, or working an inpatient unit or forensic facility — none of which involve uncontrolled field conditions.",
    "liability_shield": "State licensure through a psychology board, a doctoral degree plus supervised hours plus the EPPP, and personal exposure under duty-to-warn statutes (Tarasoff and its state codifications) and mandatory child-abuse reporting law mean your name and licence number sit on the diagnosis, the risk note, and the court-ordered evaluation — a 16 rather than 20 only because bachelor's- and master's-level counselors legally do overlapping talk-therapy work under different credentials.",
    "trust_premium": "19 is near the ceiling because the therapeutic alliance is not the delivery mechanism for the treatment, it is the largest single predictor of outcome in the outcome literature; clients wait months for a specific clinician, disclose abuse or suicidal ideation only after years of rapport, and terminate when transferred.",
    "judgment_accountability": "A 16 belongs to the person deciding, with incomplete information and no algorithm to hide behind, whether a client is safe to leave the office tonight, whether to initiate an involuntary hold, whether personality pathology or trauma or a medical cause explains the presentation, and whether custody-evaluation findings favor one parent — each defended afterward in a board complaint, deposition, or malpractice suit."
  },
  "rationale": "The core product — a sustained therapeutic relationship where a client discloses things they wouldn't type into a chatbot, and a licensed clinician owns the risk assessment — is exactly what AI can't hold. The exposed edges are real: intake questionnaires, progress-note drafting, treatment-plan boilerplate, symptom screening, and scoring of standardized instruments are already largely automatable, and low-acuity supportive counseling faces genuine substitution pressure from AI companion apps. Diagnostic formulation for complex or comorbid presentations, suicide and violence risk calls, and psychological testing interpretation that gets signed and defended remain human.",
  "outlook": "Demand keeps outpacing supply through the 2030s while AI absorbs the paperwork and the mildest cases, pushing psychologists toward higher-acuity caseloads, assessment, and supervision of larger care teams.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State laws restricting AI mental-health services are already in motion — Illinois HB1806 (2025) bars AI from providing therapy or therapeutic decision-making without licensed-professional oversight, Nevada AB406 similar, Utah HB452 imposes disclosure duties. If more states adopt the Illinois model and boards require a licensed psychologist to be the named responsible party for any AI-assisted assessment, formulation, or risk determination, the shield tightens near ceiling.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "liability_shield",
        "change": "Malpractice carriers (e.g. The Trust, APAIT) adding policy conditions that AI-generated notes, risk screens, or test interpretations must be reviewed and countersigned by the insured clinician, with coverage voided otherwise — a de facto human-signature requirement enforced by insurers rather than boards.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "Already near ceiling at 19. Marginal residual route: court and forensic contexts (Daubert/Frye admissibility, custody evaluations, competency and disability determinations) where the retaining party specifically needs a human examiner who can be deposed and cross-examined — if federal or state evidence rules explicitly exclude AI-generated psychological opinion, the forensic segment's premium is locked in.",
        "plausibility": "plausible",
        "would_add": 1
      },
      {
        "dimension": "task_resistance",
        "change": "Genuine two-tier occupation. If intake, screening, scoring, note-drafting and low-acuity supportive contact are absorbed by tools and companion apps, the surviving caseload skews to comorbid, personality-disordered, treatment-resistant, and acute-risk presentations plus supervision of lower-credentialed and AI-assisted providers — the remaining task mix is denser in judgment and measures as more resistant even with no new law. Watch payer carve-outs that route mild anxiety/depression to digital-first care while reserving psychologists for high-acuity tiers.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "judgment_accountability",
        "change": "If AI triage becomes the front door, psychologists increasingly own the escalated calls the model flagged and refused — involuntary hold decisions, duty-to-warn (Tarasoff) determinations, and clinical override of algorithmic risk scores. Formal protocols naming the psychologist as the override authority for AI risk flags, as some health systems already do for sepsis alerts, would push this toward ceiling.",
        "plausibility": "plausible",
        "would_add": 3
      }
    ],
    "ceiling_note": "trust_premium (19) and liability_shield (16) are already high; realistic headroom is a few points, not a transformation. Embodiment has no plausible upward route — telehealth parity rules have moved this occupation away from physical presence, not toward it. The larger risk to this occupation is volume and price at the low-acuity end rather than displacement of the licensed role itself: if payers and consumers route mild presentations to apps, headcount can fall even as every remaining dimension score rises."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2021,
        "emp": 58100,
        "wage": 82510
      },
      {
        "y": 2022,
        "emp": 62880,
        "wage": 90130
      },
      {
        "y": 2023,
        "emp": 71730,
        "wage": 96100
      },
      {
        "y": 2024,
        "emp": 72190,
        "wage": 95830
      },
      {
        "y": 2025,
        "emp": 75990,
        "wage": 100580
      }
    ],
    "from": 2021,
    "to": 2025,
    "change_pct": 30.8,
    "comparable_from": 2021,
    "spans_soc_revision": false
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}