{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/therapists-all-other/",
  "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": "Therapists, All Other",
    "soc_code": "29-1129",
    "category": "Healthcare",
    "us_employment": 22640,
    "median_annual_wage": 77930
  },
  "verdict": "SAFE",
  "risk_resistance": 72,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 15,
    "liability_shield": 11,
    "trust_premium": 17,
    "judgment_accountability": 14
  },
  "reasoning": {
    "task_resistance": "A drum circle with six psychiatric inpatients, a hemiparetic patient's hand physically guided through a clay-forming task, or a recreational therapist's community-reentry outing to a grocery store are improvised minute-by-minute from what the patient does next — only the notes, MDS/FIM scoring, and treatment-plan boilerplate sit in the automatable 5 points.",
    "embodiment": "You are in the room, often supporting weight, positioning instruments, spotting a patient on an adaptive bike, or being physically adjacent to someone who may become agitated — but it's a treatment room, day room, or facility grounds rather than a roadside or a rooftop, which is what keeps this at 15 rather than 19.",
    "liability_shield": "Board credentials (ATR-BC, MT-BC, CTRS, BC-DMT) plus state licensure in a growing number of jurisdictions gate reimbursement and your own name is on the note, but many of these titles are certifications rather than a practice act, so no statute makes it illegal for an uncredentialed person to run the activity — that gap holds this at 11 instead of 16.",
    "trust_premium": "A trauma client who won't speak works through your material because it's you holding the space, and a dementia patient's family requests the specific therapist whose songs their mother responds to — the therapeutic alliance is not a delivery channel for the intervention, it is the intervention.",
    "judgment_accountability": "You decide in the moment whether a patient's flat affect means disengagement or an emerging medical change, whether to stop a session escalating toward self-harm, and whether a resident is safe for an unsupervised community outing — calls you make alone and defend to the interdisciplinary team afterward."
  },
  "rationale": "This residual category holds art, music, dance/movement, recreational and similar therapists who work body-to-body and instrument-in-hand with patients — stroke survivors relearning gait to rhythm, dementia patients reached through song, trauma clients who can't yet talk about it. The automatable slice is the paperwork: progress notes, treatment plan drafting, insurance documentation, outcome-scale scoring. The core session — reading a nonverbal patient's affect in real time and adjusting the intervention on the spot — has no screen equivalent, and most states or national boards require credentialed practitioners for reimbursement.",
  "outlook": "Demand grows with aging and pediatric behavioral-health caseloads, and the session work stays human; expect documentation time to shrink sharply and reimbursement fights, not AI, to be the main pressure on this field.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State-level licensure (not just national board certification) for creative arts therapists spreading beyond the ~10 states that have it — e.g. more states adopting NY-style licensed creative arts therapist (LCAT) titles, or music therapy licensure bills of the kind AMTA/CBMT's State Recognition Operational Plan has been filing yearly. Licensure makes a named practitioner the legally accountable signer on treatment plans and makes Medicaid/private reimbursement contingent on that signature.",
        "plausibility": "already happening",
        "would_add": 4
      },
      {
        "dimension": "liability_shield",
        "change": "CMS or Medicare Advantage plans adding recreational/creative arts therapy as a separately billable service with a supervising-credentialed-provider attestation requirement (analogous to the qualified therapeutic recreation specialist requirement already in the SNF Conditions of Participation, 42 CFR 483.24 activities provision) extended to more settings.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift: this job genuinely has two tiers. If AI documentation tools absorb progress notes, treatment-plan drafting, insurance authorization letters and outcome-scale scoring, the residual day is almost entirely in-room clinical improvisation, which raises the share of the day AI cannot do. Watch for EHR vendors (Epic, WebPT) shipping arts/rec-therapy note templates with ambient scribing.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "Formal inclusion of arts/rec therapists on hospital interdisciplinary care teams with charting authority over risk decisions — e.g. documenting suicidality disclosures surfaced in a nonverbal session, or clearing a stroke patient for weight-bearing gait-to-rhythm work. Joint Commission behavioral health accreditation standards that name these disciplines in the treatment team would formalize the call.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "trust_premium",
        "change": "Already near ceiling at 17 — buyers of dance/movement and trauma-focused arts therapy are explicitly purchasing embodied human presence, and the modality's theory of change is the relationship itself. The realistic lever is not raising the premium but preserving the payer channel: if insurers keep covering these as skilled therapy rather than pushing them to unreimbursed 'wellness activity', the premium holds.",
        "plausibility": "plausible",
        "would_add": 1
      }
    ],
    "ceiling_note": "Embodiment and trust are effectively maxed for the in-session core; nearly all remaining headroom is in liability_shield, which is unusually low (11) only because most of these disciplines rely on national board certification rather than state licensure. Full 50-state licensure plus explicit CMS billing status is the realistic upper bound, and even then the occupation's exposure is less to AI than to being cut as a non-mandated service line in hospital budget rounds."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 12020,
        "wage": 53850
      },
      {
        "y": 2018,
        "emp": 11950,
        "wage": 50980
      },
      {
        "y": 2019,
        "emp": 12170,
        "wage": 52650
      },
      {
        "y": 2020,
        "emp": 11710,
        "wage": 57310
      },
      {
        "y": 2021,
        "emp": 13490,
        "wage": 59500
      },
      {
        "y": 2022,
        "emp": 16920,
        "wage": 60800
      },
      {
        "y": 2023,
        "emp": 16490,
        "wage": 63650
      },
      {
        "y": 2024,
        "emp": 19320,
        "wage": 65010
      },
      {
        "y": 2025,
        "emp": 22640,
        "wage": 77930
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 88.4,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}