Your clinic has a standard for its notes. It’s probably in a document. We’d like to put it in the notes.

When the regulator inspected suicide-prevention work in adult mental health services in 2023, the reports from Stavanger and Bergen said similar things: the evaluation of treatment was documented to a varying degree, diagnostic assessments were hard to find in the record, and it was the organisation’s job to go through its record-keeping and put it right. The clinician who wrote the note at ten past four with the next client waiting is not the one the letter is addressed to. It’s addressed to you, and the regulation behind it says a leader has to have an overview of where the work is at risk of failing. It doesn’t say how you get that overview when the work happens behind a closed door and reaches you as a note.¹²³

So the standard you’re responsible for is one you can only check afterwards, in samples, in notes about sessions you weren’t in, written by people whose days you didn’t have.

You have done this before, or it was done to you. When the patient-pathway reform came in, a survey in 2019 found nearly everyone spending more time on registration afterwards, half saying patients were getting less of their time, and nine in ten saying the workload had grown. At one child and adolescent outpatient clinic, staff told the evaluators that colleagues were resigning over the coding and that psychologists were leaving for the municipalities; seven posts stood open and nobody had applied. At another clinic, a clinician said the quality criteria coming out of the system didn’t show what was actually done in the service.⁴

That is what “data-driven” has come to mean in a lot of clinics: forms, codes, and an afternoon a week that used to go to patients, producing numbers about everything except the work. We understand why nobody wants more of it. We don’t either. If a standard costs the person writing the note their time, it won’t hold, and it shouldn’t.

Your clinic has a way of writing a note. It’s in a document on the intranet, in the heads of the two seniors who wrote it, and in the notes the new hire happens to read first. Then each note gets written at the end of a day that used up most of what it was about: six clients, ten minutes between them, and the note from whatever is left. What comes out follows the standard about as well as the writer remembered it and the day allowed. That variation is what inspections tend to find, because it’s the most ordinary thing that goes wrong.

It isn’t a question of effort. When structured notes and free-text notes have been compared side by side, the structured ones scored higher for quality and were judged clearer and more concise. Most people in your clinic would agree without needing the study. The structure has just never been in the place where the note actually gets written.⁵

psylab is built on one idea: a therapist should be able to look at what happened in the room, and nobody else should unless the therapist decides otherwise. For a clinic there’s a second part to that. The note is drafted from the session, and it’s drafted into the structure your clinic has published. Nobody has to remember the standard at the end of the day. It’s already there when the draft arrives.

A new clinician’s first note is drafted with your sections, your questions and your example already in front of the treatment model. The thing the inspection flagged last time can be a question at the end of every session, answered by the person who was in the room. When you change the standard, you publish a new version: before you publish it, you can see the note it would write for one of your own sessions, notes written from then on follow the new version, and the ones written before stay as they were. Clinicians who work in Norwegian see the Norwegian template. Nobody has to sit through a training on the new standard. They just write the next note.

When we say data-driven, we mean something fairly modest, and we don’t mean a dashboard. The data is what happened in the room, and the note that came out of it. Supervision starts from the session: the supervisee marks the moments, writes down what they saw next to each one, and chooses what their supervisor gets to see. Across the clinic, notes share one structure, so the record can be read, handed over and audited as one record rather than thirty different styles.

What we won’t build is a number about a person. In a single supervision hour, more than four in five trainees already keep something back. Put a score next to their name and the difficult session stops arriving at all, and from then on the data only describes the sessions people were willing to show. If you want to know how your clinicians are doing, we think the honest answer is better notes, and supervision that works from the real session.⁶

The therapists with the best results tend to be the ones who go back over their own sessions and work on specific things. A recent commentary from the University of Oslo notes that traditional supervision misses its chance to practise specific clinical skills. Neither of those needs more senior time. They need the material to exist, and an hour in the week to look at it. That’s the part a clinic can provide. Each clinician has their own sessions to look at, in the same place the note already is, and each supervisor has the session in front of them instead of a retelling of it. That is what scaling development looks like to us: everyone has something to practise on, and nobody is being watched.⁷⁸

A session is deleted the day after it’s ready unless the therapist keeps it. A case folder lasts three months at most, and every share goes with it. The one thing in psylab that’s built to last is the template: your clinic’s standard, every version of it, with a name and a date on each. The way your clinic writes is yours to keep. What your clinicians did in the room stays with them.

This is half a minute of a teaching session from 1965, published and shown in training ever since. The therapist asks one question, and the answer is about the client’s daughter. One track is the recording as it was made. The other is what a supervisor would hear if you kept the session for one: the same words at the same pace, in a voice that is not the one in the room, with the daughter’s name beeped. Switch between them while it plays.

The step runs on the way in, on every session, and there is no version of psylab without it. A name becomes language rather than a hole, so the note, the feedback and anything you ask about a session are written from a transcript that still reads like one. Keep a session for a supervisor and the voice is changed first. The original recording is deleted.

The reason almost nobody kept a recording is a good one, so it was the first thing we had to design for. psylab never asks who your client is. It doesn’t ask for a name, a date of birth or a personal number, because nothing in it needs them. A case has a title you choose, and we ask you to make it one that means something to you and nothing to anyone else.

What was said in the room is pseudonymised on its way in. Names, places, dates and the details that would point to a person are replaced, and the clinical meaning stays. It isn’t a setting, and there’s no version of psylab without it. The note, the feedback and anything you ask about a session are written from that text, so nothing after that step sees the original. We say pseudonymised rather than anonymised on purpose: it makes a client much harder to recognise, and we’d rather not claim more than that.

The recording itself isn’t kept. Audio is transcribed and then let go, and only the pseudonymised transcript stays. If you keep the audio so a supervisor can hear a session, the voice is changed first, and the original is deleted. That is what makes it safe to study your own work here, and to let AI help you with it: what’s on the page is the session, without the details that would identify a person.

We’d like this to be ordinary: the standard is in the note because that’s where it was written, changing it means publishing a new version, and the next inspection finds the evaluation of treatment in the record because a question put it there. Supervision that starts from what happened. Clinicians who get better at the work inside the week they already have. A clinic that can show its standard by pointing at any note.

A profession that improves the way surgery and sport learned to, without giving up what makes it therapy: that what is said in the room belongs to the two people who were in it.

psylab is for clinic leaders who would rather have the standard in the notes than in a memo, and who suspect that development you can monitor from your office isn’t development anyone will bring you. If what you want is a scoreboard of your clinicians, we’re not going to build one. It’s for your clinicians too: the standard costs them nothing, and their sessions stay theirs.

psylab is built by a small company in Oslo that hasn’t taken venture money. Raising tends to mean owing someone a rate of growth, and what a company owes shows up in the product: the price creeps up, and your data starts to look like an asset. We want to owe the people who use this.

So far psylab has been paid for out of our own pockets. From early access on, we want it paid for by the clinicians who use it, at one price for every therapist, held for the people already paying it. A few of them may come to own a small piece of the company. Nothing here depends on hitting a number by the end of a quarter.

We’re doing this because we think the quality of mental health care can go up, and that it starts with therapists being able to look at their own work. We also think AI can be used well here, on the clinician’s side, if the people building it are careful about what it’s for. psylab is our attempt to be careful.