# Brauni
> The clinical copilot for psychologists.
Brauni is a clinical practice management platform for psychologists. It combines AI-assisted session notes, electronic health records, scheduling, WhatsApp reminders, Argentine electronic invoicing through AFIP/ARCA, and verifiable reports. Clinical data is encrypted and never used to train AI models.
## Features and safeguards
- Session notes from audio, images or text, always reviewed by the professional.
- Electronic health records aligned with the Argentine framework, including Law 26,529.
- Scheduling with Google Calendar and automatic WhatsApp reminders.
- Invoices C and B through Argentina's official AFIP/ARCA services.
- Clinical-data encryption, audit trails and a contractual ban on AI training.
## Main pages
- [Home](https://brauni.io/en)
- [Features](https://brauni.io/en/funcionalidades)
- [Clinical AI](https://brauni.io/en/ia-clinica)
- [Pricing](https://brauni.io/en/precios)
- [Security](https://brauni.io/en/seguridad)
- [About](https://brauni.io/en/nosotros)
- [Mission](https://brauni.io/en/mision)
- [Vision](https://brauni.io/en/vision)
- [Privacy](https://brauni.io/en/privacidad)
- [Terms](https://brauni.io/en/terminos)
- [Cookies](https://brauni.io/en/cookies)
## Blog and resources
- [Blog](https://brauni.io/en/blog)
## How many sessions do you need? Evidence of dose and frequency in therapy
- **URL**: https://brauni.io/en/blog/cuantas-sesiones-terapia-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-31
- **Tags**: duration therapy, dose response, frequency of meetings, evidence, psychotherapy, treatment plan
Dose-response research shows improvement curves, optimal session ranges, and an uncomfortable finding of weekly frequency. What does it mean when planning treatments.
"How long is this going to last?" is probably the most frequent question of a first interview and one of the worst we answer. The honest answer ("depends") is true and at the same time useless for someone who needs to organize their time and budget.
It turns out that the research has enough to say about it. Not a magic figure, but replicated patterns about how the improvement is distributed throughout a treatment and, above all, a pretty strong finding about something that we hardly ever discussed: frequency.
## TL;DR
- The ratio between number of sessions and improvement is **curvilinear**: much progress is made at the beginning and each additional session contributes less and less.
- A systematic review of 26 studies in real services placed the optimal range between **4-26 sessions**, according to severity and context: between 4 and 6 in mild to moderate malaise with low intensity interventions, and up to 26 in high discomfort.
- The **frequency** seems to weigh as much as the total amount: a randomized trial with 200 patients with depression showed that **two sessions per week** exceeded one, with **d = 0.55** at 6 months.
- In the same study, the higher frequency **reduced abandonment by half** (16 abandoned versus 32).
- There are documented exceptions to the typical curve, including eating disorders and severe psychiatric populations.
## Why it Matters
In Argentina there is a strong tradition of long treatments, often without explicit review of objectives. And there is an economic reality in which a large part of patients sustain therapy with effort and decide to follow or not depending on whether they perceive progress.
Understanding the dose-response curve serves two very concrete decisions: when to seriously review a treatment that does not progress, and how to pose the initial framing without promising more or less.
## What the evidence says
### The Curve
Robinson, Delgadillo and Kellett (2020) systematically reviewed 26 dose-response studies in psychological therapies **delivered in real services** (not in controlled trials), and published the results in *Psychotherapy Research*.
The central finding, consistently replicated, is that the relationship between treatment duration and outcome is **curvilinear** (log-linear or cubic): the improvement is concentrated in the first sessions and then the rhythm is flattened. It is not to stop improving, it is that more and more treatment is needed to achieve the same increase.
On optimal doses, the review found ranges that vary according to context, population, and measurement:
| Level of discomfort | Optimal approximate dose |
| --- | --- |
| Low to moderate (low intensity interventions, guided self-help) | 4 to 6 meetings |
| Stop | to 26 meetings |
The reported global range ranges from **4 to 26 sessions**. and there is an additional fact that often goes unnoticed: **weekly** therapy accelerates the rate of improvement compared to less frequent schemes.
These numbers describe averages in health services, mostly British, with populations of depression and anxiety. They are not a prescription for your patient, nor a roof. Describe where is the point at which, on average, most patients already obtained most of the benefit.
### Frequency
Bruijniks et al. (2020) published in *British Journal of Psychiatry* a randomized multicenter trial with **200 adults with depression** in nine specialized centers in the Netherlands, with factorial design 2 × 2: CCT or interpersonal therapy, and one or two sessions per week, during 16 to 24 weeks, with a maximum of 20 sessions.
That is: **same total number of meetings, different frequency**.
The results consistently favoured the two weekly sessions:
- Average difference of **3.85 points** in BDI-II at 6 months, with **d = 0.55**.
- Higher response rate (hazard ratio 1,48; CI 95% [1.00; 2,18]).
- **Less abandonment**: 16 abandoned in the group of two weekly sessions versus 32 in that of one.
That last point connects directly with what we know about [why patients leave therapy](/blog/desercion-abandono-terapia-evidencia): the slower the perceived progress, the more likely the treatment will fall.
## What does it mean in your clinical practice
- **Plan the frame in ranges, not in indefining**. "We will work and in about eight sessions we review together how we come" is more honest and more sustainable than "that cannot be known." It does not compromise you to a discharge and gives the patient a horizon.
- **I put an explicit review point**. If there is no movement at 8 or 10 sessions, that is clinical information, no lack of time. It may indicate that objectives, formulation, framing or referral need to be reviewed.
- **Consider increasing frequency in depressive pictures**, especially at the beginning. Evidence suggests that two weekly sessions during the first weeks accelerate the improvement without increasing the total. It is a distributional adjustment, not total cost.
- **Eye with fortnightly session by default**. Much is used as an economic solution, and the evidence suggests that it may slow the process to the point of compromising it. If it is the only viable option for the patient, it is worth knowing that you are working against the curve.
- **The curve flattens, does not fall**. That the rhythm drops does not mean that sustaining a long treatment is useless: it means that from a certain point it is appropriate to explain what is being sought at that stage. There a [written treatment plan](/blog/plan-de-tratamiento-psicologico) prevents the therapy from becoming inertia.
A simple way to apply this without becoming rigid: when the first interview is closed, a review date is agreed (e.g., the 8 session). At that point, 15 minutes are spent looking together at what changed, what did not and what follows. That ritual reduces silent abandonments and makes visible the progress that the patient often fails to record.
## Killings and limitations
- **Correlation in naturalistic data**. In real service studies, patients who need more sessions are different from those who need less. Part of the curve reflects who stays, not just how much it serves to stay.
- **The "optimal dose" depends on the criterion of success**. It is not the same to define it by reliable change, by remission or by satisfaction.
- **Documented exceptions**. The review found that the curvilinear pattern does not sustain the same in eating disorders or in severe psychiatric populations.
- **Frequency trial is on depression**, with CCT and PTI, in a specialized health system. It is not automatically extrapolated to other tables or other models.
- **None of this replaces individual evaluation**. They are population averages useful to guide decisions, not to take them for you.
## In summary
The evidence does not say how many sessions your patient needs. It says three useful things: that most of the improvement is concentrated at first, that the range where it is usually obtained goes from a few to about two dozen sessions according to severity, and that **how you distribute those sessions over time matters as much as how many sessions are**.
To be able to see this evolution requires registration. An orderly medical records, with consistent session-to-session notes, is what turns an impression ("I think it's better") into a clinical reading. [Brauni](https://app.brauni.io/register) takes care of the draft of each note so that reviewing the evolution of a treatment does not depend on your memory or loose papers.
## References
- Robinson, L., Delgadillo, J., & Kellett, S. (2020). The dose-response effect in routinely delivered psychological therapies: A systematic review. *Psychotherapy Research, 30*(1), 79-96. [doi.org/10.1080/10503307.2019.1566676](https://doi.org/10.1080/10503307.2019.1566676)
- Bruijniks, S. J. E., Lemmens, L. H. J. M., Hollon, S. D., Peeters, F. P. M. L., Cuijpers, P., Arntz, A., ... Huibers, M. J. H. (2020). The effects of once- versus twice-weekly sessions on psychotherapy outcomes in depressed patients. *British Journal of Psychiatry, 216*(4), 222-230. [doi.org/10.1192/bjp.2019.265](https://doi.org/10.1192/bjp.2019.265)
---
## Treatment of Trauma: What the Evidence Says About EMDR and Trauma-Focused TCC
- **URL**: https://brauni.io/en/blog/tratamiento-trauma-ptsd-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-30
- **Tags**: trauma, ptsd, post-trauma stress, emdr, tcc, evidence, psychotherapy
A network of 90 trials and 6.560 patients compared 22 treatments for post-traumatic stress. What EMDR and trauma-centered CCT show, and what it means when choosing approach.
Few topics generate discussions as heated among colleagues as the treatment of trauma. Some consider the EMDR little less than pseudoscience and those who have it as the approach of choice. Some argue that exposing the patient to traumatic memory is retraumatizing and those who show that avoiding it is just what keeps the picture.
The evidence gathered today allows much of that discussion to be answered, and the result leaves several positions uncomfortable at the same time.
## TL;DR
- The most comprehensive network meta-analysis (**90 trials, 6.560 people, 22 interventions**) identified **DREM** and **trauma-centered CCT (TF-CBT)** as the most effective treatments for post-traumatic stress in adults.
- Faced with the waiting list, EMDR showed SMD **-2,07** and TF-CBT **-1,46** at the end of treatment; both **sustained** the effect on 1 follow-up to 4 months.
- The Cochrane review (70 studies) coincides: Individual TF-CBT and EMDR are effective and exceed **non** trauma-centered therapies in follow-up.
- The overall quality of the evidence is described as **moderate to low**, especially by the size and design of many trials.
- The common denominator of what works is not the specific technique, it is **working on traumatic material**, not around it.
## Why it Matters
In Argentina, much of the postgraduate trauma training is organized around schools and not by comparative evidence. That makes the choice of approach often follow the training available in the city rather than the state of research.
Knowing what the data show does not force you to change your model. It allows you to derive better when appropriate, explain to the patient why you propose what you propose, and recognize when a treatment is not having the expected effect.
## What the evidence says
### The network meta-analysis
Mavranezouli et al. (2020) published in *Psychological Medicine* a systematic review with network meta-analysis designed to inform a clinical guide. It included **90 trials**, **6.560 people** and **22 interventions** different, with outcomes at the end of treatment, in follow-up of 1 to 4 months and remission rates.
The most effective treatments against the waiting list at the end of the treatment:
| Intervention | SMD (vs. waiting list) |
| --- | --- |
| EMDR | -2,07 (ICr 95% -2,70 to -1,44) |
| Somatic-cognitive combination therapies | -1,69 |
| Trauma-centered CCT (TF-CBT) | -1,46 |
| Self-help with support | -1,46 |
Other interventions also showed effects: non-trauma-centered CCT, TF-CBT combined with SSRI, medication alone, self-help without support, and counseling.
The data that weighs most clinically is not in the table: **EMDR and TF-CBT were the two that maintained the effect** on 1 follow-up to 4 months and improved remission rates. The authors concluded that both appear as the most effective for reducing symptoms and achieving remission in adults with post-traumatic stress.
A -2,07 SMD is a huge number and should be distrusted. In meta-network analysis, comparisons against waiting list inflate effect sizes, and EMDR trials tend to be smaller, increasing variability. Authors themselves rate the evidence as moderate to low quality. The correct reading is not "EMDR is a 40% better than TF-CBT", but "both are in the head group and both hold the effect".
### The Cochrane Review
The Cochrane review by Bison et al. (2013), with 70 studies, reached convergent conclusions: there is support for the efficacy of individual TF-CBT, EMDR, non-trauma-centered CCT and group TF-CBT in chronic posttraumatic stress in adults.
And he added an important nuance on follow-up: while the first three were equally effective immediately after treatment, there was evidence that **TF-CBT and EMDR were superior to non-trauma-centered CCT between one and four months later**. That is, the difference does not appear at the end, appears when time passes.
### What they have in common
This is the background finding, more useful than any ranking: the interventions that work best are those that **directly address traumatic material**, with different procedures. The ones that work around (generic stress management, nonspecific support) help, but less and with less support.
## What does it mean in your clinical practice
- **If you work with trauma, train on a trauma-centered approach**. The choice between EMDR and TF-CBT can be guided by your training, availability of supervision, and patient preference: evidence does not require choosing one.
- **Patient preference is not a detail**. In trauma, adherence is fragile and [early abandonment](/blog/desercion-abandono-terapia-evidencia) is high. A somewhat less "optimal" treatment that the patient sustains yields more than the optimal that he leaves in the third session.
- **Stabilize before processing**. The evidence compares complete treatments, which generally include stages of preparation. It does not say that you can go to traumatic memory in the first interview.
- **Medium. In trauma more than anywhere**. A periodically applied validated scale allows you to see if the processing is progressing or if the patient is deregulating, something that clinical impression alone can take long to detect. It is the logic of [result monitoring](/blog/monitoreo-resultados-terapia-evidencia).
- **Document with special care**. The medical records of trauma cases usually contain the most sensitive material that you are going to record in your professional life, often with legal implications. It is worth checking how you handle [professional secrecy](/blog/secreto-profesional-psicologia) and where you keep those records.
When a patient asks, "Am I going to have to count everything again?", the honest answer helps adherence: yes, let's work on what happened, gradually, with a method and with the possibility of stopping. Promise that you won't have to touch the memory usually ends up in a treatment that doesn't progress.
## Killings and limitations
- **Moderate to low quality**. Many trials have small samples, high risk of bias and comparisons against weak conditions.
- **The researcher's alliance weighs**. In the field of trauma it is common for those who develop a method to evaluate it, in all schools.
- **The debate on eye movements is still open**. There is active discussion about how much this specific component of EMDR contributes above the rest of the protocol. The whole package does not prove that each ingredient is needed.
- **Complex trauma is another conversation**. Most trials include post-traumatic stress stress from single or limited events. Evidence of complex developmental trauma, with comorbidity and chronic deregulation, is much scarcer.
- **Few research in Latin American population**, with the exception that these protocols have been implemented in very different contexts.
## In summary
If there is a field where the evidence is reasonably ordered, it is this: for post-traumatic stress in adults, **EMDR and trauma-centered CCT are the best-backed approaches**, and their advantage becomes more visible in follow-up than at the end of treatment. Choosing between them is a clinical decision; that of working on trauma rather than surrounding it, less and less.
Working with trauma requires your full attention in the session, and leaves long and delicate notes for later. [Brauni](https://app.brauni.io/register) Prepare the draft for you to review and decide what is settled, with your encrypted records and under your control.
## References
- Mavranezouli, I., Megnin-Viggars, O., Daly, C., Dias, S., Welton, N. J., Stockton, S., ... Pilling, S. (2020). Psychological treatments for post-traumatic stress disorder in adults: A network meta-analysis. *Psychological Medicine, 50*(4), 542-555. [doi.org/10.1017/S0033291720000070](https://doi.org/10.1017/S0033291720000070)
- Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. *Cochrane Database of Systematic Reviews*, (12), CD003388. [doi.org/10.1002/14651858.CD003388.pub4](https://doi.org/10.1002/14651858.CD003388.pub4)
---
## AI in mental health: what the evidence shows and where the boundaries are
- **URL**: https://brauni.io/en/blog/ia-salud-mental-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-29
- **Tags**: artificial intelligence, ia, chatbots, mental health, evidence, psychotherapy, clinical technology
The first randomized trial of a generational AI chatbot for mental health gave promising results, but other studies show serious failures. What research says today.
On artificial intelligence and mental health there are two equally simplified accounts circulating. One says that AI therapy is just around the corner and will replace psychologists. The other says that it is all dangerous smoke and that there is nothing to discuss.
The research of recent years does not support either. There is evidence of efficacy in confined contexts and, at the same time, solid evidence of serious failures in critical clinical situations. It is worth looking at the studies in particular, because the practical conclusion for those exercising is quite clear and is not "all or nothing".
## TL;DR
- The **first randomized trial** of a generational AI chatbot for mental health treatment (Therabot, 210 participants) showed symptomatic reductions from the waiting list: **51% in depression**, **31% in generalized anxiety**, 19% in body image concerns.
- The authors themselves conclude that **no generative AI agent is ready to operate autonomously** in mental health, and the trial had human clinical supervision.
- A meta-analysis of conversational agents (35 studies, 15 randomized trials) found moderate effects on depressive symptoms (**g = 0.64**) and discomfort (g = 0,70).
- In contrast, a 2025 study showed that language models **express stigma** towards pictures such as schizophrenia and alcohol dependence, and **failed to recognize crises**, even encouraging delusional ideation.
- The place where evidence and common sense coincide today: AI as a **professional support tool**, not as a substitute for treatment.
## Why it Matters
Your patients are already using AI. They tell things to a chatbot at 3:00 in the morning, ask for interpretations of dreams, consult if what they feel is "normal" before or after talking to you. It's not a future possibility, it's current behavior.
Knowing what the research shows allows you two things: to respond with judgment when a patient asks you, and to decide with your own judgment what tools you will incorporate into your practice and which ones you will not.
## What the evidence says
### The First Randomized Trial
In March of 2025, Heinz et al. published in *NEJM AI* the first randomized controlled trial of a generational AI chatbot designed for mental health treatment (Therabot, developed in Dartmouth).
The design: 210 adults with clinically significant symptoms of major depression, generalized anxiety or high risk of eating disorder. 106 received access to the app for four weeks, with four additional weeks of optional use; 104 remained on the waiting list.
Results vs. control:
- Depression: average reduction in symptoms of **51%**.
- Generalised anxiety: **31%**.
- Weight and body image concerns: **19%**.
Participants used the app for a total of about six hours throughout the trial, approximately the equivalent of eight sessions.
The comparator was waiting list, not therapy with a professional. That means the study shows that the chatbot is better than receiving nothing, not comparable to psychological treatment. It is a central distinction and is usually lost in headlines.
In addition, the trial was conducted with clinical supervision: there were people reviewing the interactions and ability to intervene. The researchers themselves stressed that no generative AI agent is currently in a position to operate completely autonomously in mental health.
### The accumulated evidence of chatbots
Prior to Therabot there was already a research body on conversational agents, mostly based on rules or scripts (not generative AI). The meta-analysis of Li et al. (2023), in *npj Digital Medicine*, reviewed 35 studies and included 15 randomized trials.
It found significant reductions in:
- Depressive symptoms: **g = 0.64** (IC 95% [0.17; 1.12]).
- Psychological distress: **g = 0.70** (IC 95% [0.18; 1.22]).
They are moderate effects, with broad confidence intervals, in typically short interventions and low access threshold.
### The other side: failures in critical situations
Moore et al. (2025) presented a study at the ACM FAccT conference that evaluated five language models and five commercial "therapy" bots against clinical scenarios.
The findings are worrying:
- Models **expressed more stigma** toward alcohol dependence and schizophrenia than to depression, and that stigma **did not improve** in newer or larger models.
- Faced with crisis scenarios, the models **failed to recognize the risk**.
- In several cases **they accompanied delusional thinking** rather than contrasting it with reality, which contradicts established clinical practice.
The authors' conclusion is explicit: these flaws prevent language models from safely replacing mental health professionals.
## What does it mean in your clinical practice
- **I distinguished two completely different uses**. One thing is patient-oriented AI as a substitute for treatment (where evidence is incipient and risks are documented) and another is AI as a professional support tool: transcription, draft notes, organization of clinical information. They are separate debates and should not be mixed.
- **Ask actively for the use of AI**. If a patient consults a chatbot between sessions, that is clinical material: what he seeks there, what he finds, what he cannot tell you.
- **Be clear about crisis limits**. If you work with patients at risk, it is worth explaining that a chatbot is not an emergency resource and writing down which ones are.
- **Apply the same confidentiality criteria as any other tool**. To dump identifiable clinical material into a general-purpose chatbot involves sharing health data with a third party, with specific legal consequences. We develop it in [ChatGPT and clinical data](/blog/ia-chatgpt-datos-clinicos-psicologia).
- **No AI replaces your judgment**. A draft note is a draft: you review it, correct it and sign it you, who was in the session.
When a patient says "I asked the AI," there's usually something more interesting behind it: why it was easier to ask a machine. That's the conversation it's worth, much more than evaluating whether the answer it received was correct.
## Killings and limitations
- **A trial does not make a body of evidence**. The study by Therabot is a methodological milestone, but it is only one, brief, with waiting list control and in population that for the most part did not receive another treatment.
- **Follow-up is short**. Four to eight weeks say nothing about sustaining medium-term results.
- **The systems evaluated are not the commercial systems**. Therabot was developed and supervised by an academic team; most available apps have neither that design nor that supervision.
- **Technology changes faster than research**. Any findings about specific models age in months, although Moore et al.'s study suggests that certain failures are not solved alone with newer models.
- **There is almost no evidence in Spanish or Latin American population**.
## In summary
The evidence available draws a reasonably sharp line. There are signs that well-designed and supervised conversational tools can help people who today do not have access to anything. And there is hard evidence that current models fail just where the most expensive fail: crisis, risk, severe pictures.
Therefore our position on clinical AI is the same from day one: the therapeutic work is yours and is not delegated. What can be delegated is the administrative burden that steals time and attention. [Brauni](https://app.brauni.io/register) prepares the draft of the note from the session, with your data [accommodated safely and not used to train models](/blog/tus-datos-no-entrenan-ia), so that you decide what is registered.
## References
- Heinz, M. V., Mackin, D. M., Trudeau, B. M., Bhattacharya, S., Wang, Y., Banta, H. A., ... Jacobson, N. C. (2025). Randomized trial of a generative AI chatbot for mental health treatment. *NEJM AI, 2*(4). [doi.org/10.1056/AIoa2400802](https://doi.org/10.1056/AIoa2400802)
- Li, H., Zhang, R., Lee, Y. C., Kraut, R. E., & Mohr, D. C. (2023). Systematic review and meta-analysis of AI-based conversational agents for promoting mental health and well-being. *npj Digital Medicine, 6*, 236. [doi.org/10.1038/s41746-023-00979-5](https://doi.org/10.1038/s41746-023-00979-5)
- Moore, J., Grabb, D., Agnew, W., Klyman, K., Chancellor, S., Ong, D. C., & Haber, N. (2025). Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers. *Proceedings of the 2025 ACM Conference on Fairness, Accountability, and Transparency (FAccT '25)*. [doi.org/10.1145/3715275.3732039](https://doi.org/10.1145/3715275.3732039)
---
## Does online therapy work just like face-to-face therapy? What does the evidence say
- **URL**: https://brauni.io/en/blog/terapia-online-vs-presencial-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-28
- **Tags**: online therapy, telepsychology, video call, evidence, psychotherapy, therapeutic alliance
Meta-analysis with thousands of patients compare video and face-to-face psychotherapy: equivalent results and therapeutic alliance without differences. What does it imply for your clinical practice.
The pandemic forced an entire profession to move to the screen in a matter of days, and several years later the map was mixed: hybrid clinical practices, patients in another province or in another country, agendas that combine face-to-face and video call according to the week.
What was left open is the fundamental question, which many colleagues continue to ask with guilt: is something lost? Is it the same? The answer no longer depends on the intuition of each one. There is enough research accumulated.
## TL;DR
- The most cited meta-analysis (103 studies, more than 5.000 participants) found that video therapy produces **big** improvements (g ≈ 0,99 pre-post) and that the difference against face-to-face is **insignificant**.
- Video call **therapeutic alliance** does not differ from the face-to-face, either by patients (MDS = -0,09) or by therapists (MDS = 0,04), in a review of 18 studies.
- The effect is more marked with **TCC** and in **anxiety, depression, and post-traumatic stress**.
- Adjusting by publication bias, the low pre-post effect of g = 0,99 to g = 0,54 remains real, but the literature is somewhat inflated.
- Equivalence is well established in common tables; **not** is equally established in severe tables, crises or specific populations.
## Why it Matters
In Argentina, online therapy stopped being a plan B. It enables patients in the interior, supports treatments when someone moves, allows working with Argentines abroad and makes a schedule viable without two hours of travel between sessions. But if at the same time it compromises the quality of the treatment, it would be an expensive comfort.
And there's a second, more practical reason: if you're going to offer online, you should be able to explain to the patient, with data, why it's not a devalued version of therapy. See also our [online therapy guide in Argentina](/blog/terapia-online-argentina-guia) for the operational and legal side.
## What the evidence says
### Clinical results
The reference work is the meta-analysis of Fernandez et al. (2021), published in *Clinical Psychology & Psychotherapy*. It collected 56 studies from a single group (N = 1.681) and 47 comparative studies (N = 3.564).
The central findings:
- Video psychotherapy produced a **big** improvement between initiation and end of treatment: **g = 0.99**.
- Compared to waiting list, it was clearly superior (g = 0,77).
- Compared to face-to-face therapy, the difference was **insignificant**.
- By model: TCC yielded more (g = 1,34) than non-TCC interventions (g = 0,66).
- By picture: anxiety, depression, and post-traumatic stress showed effects close to 1,00.
The authors also corrected by publication bias, and there the pre-post effect low to **g = 0.54**. It is an important fact and is usually omitted when this study is cited: the effect still exists, but the published literature exaggerates its size.
### The therapeutic alliance
The most frequent objection is not about symptoms, it is about the link: "the same is not built on the screen." Seoul et al. (2024) reviewed 18 studies comparing alliance in video call and face-to-face, and published the results in *Journal of Telemedicine and Telecare*.
No significant differences were found:
- Patient alliance: MDS = -0,09 (IC 95% [-0.26; 0.07]).
- Alliance according to therapist: SMD = 0,04 (IC 95% [-0.17; 0.25]).
That contrast is interesting: therapists often perceive video call as a loss to link more than patients report it. The evidence does not show the fall of alliance that many clinicians fear, something relevant if we consider that [the alliance is one of the strongest predictors of the outcome](/blog/alianza-terapeutica-evidencia).
### Non-inferiority tests
Beyond the meta-analysis, there are randomized trials designed specifically to test non-inferiority. In generalised anxiety disorder, for example, videoconferencing CCT was not statistically inferior to in-person CCT in primary, secondary and tertiary measurements at all times of evaluation. It is a more demanding design than the simple "no differences".
## What does it mean in your clinical practice
- **You can offer online without feeling that you offer less**, especially in anxiety, depression and trauma work in structured formats.
- **The frame weighs more than the channel**. On camera, private place on both ends, protected schedule, without driving or walking down the street. What degrades online therapy is not the screen, it is the informality that the screen enables.
- **Explicit the agreement from the beginning**: what happens if the connection is cut, what platform, whether it can be recorded or not (spoiler: [record has concrete legal implications](/blog/grabar-sesiones-terapia-legalidad)), and how to proceed to an emergency.
- **I have a crisis protocol with local data**. It is the weakest point in the format: if the patient is 800 km away, you need in advance his address, a reference contact and the emergency resources of his area.
- **Take care of technical confidentiality**. Encrypted video calling, without third parties listening, and clinical registration in a secure system, not in a chat. About this we write in detail in [data security and clinical practice](/blog/ciberseguridad-consultorio-psicologico).
A question that should be asked in the first online session: "Where are you going to connect and who else will be in the house?" Many early abandonments online are not clinical, they are logistical: the patient has no place to talk calmly.
## Killings and limitations
- **Equivalence is proven where there are studies**. Anxiety, depression, PTSD and TCC concentrate most of the evidence. Severe symptoms, active suicidal risk, psychosis or severe eating disorders have much less comparative research.
- **The publication bias exists and is measurable** in this literature, as shown by the correction of Fernandez et al.
- **Average noninferiority is not individual equivalence**. There are patients who clearly perform better in face to face, and detecting it is part of your clinical work.
- **The evidence is mostly from high-income countries**. Connectivity, devices and privacy in the home are not distributed the same here.
- **Almost all studies evaluate video calls**, not chat, audio or apps. It cannot be extrapolated from one format to the other.
## In summary
The question "online therapy works?" is quite well answered: yes, and in the most studied tables the results are comparable to the face-to-face, with a therapeutic alliance that does not suffer. The question that remains alive, and that is still clinical, is *for whom and at what time* each format fits.
Whether online or face-to-face, the record of what happened in the session is the same work, and it is the one usually left for the end of the day. [Brauni](https://app.brauni.io/register) prepares the draft of the note for you to review and sign it, in either of the two formats.
## References
- Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. *Clinical Psychology & Psychotherapy, 28*(6), 1535-1549. [doi.org/10.1002/cpp.2594](https://doi.org/10.1002/cpp.2594)
- Seuling, P. D., Fendel, J. C., Spille, L., Göritz, A. S., & Schmidt, S. (2024). Therapeutic alliance in videoconferencing psychotherapy compared to psychotherapy in person: A systematic review and meta-analysis. *Journal of Telemedicine and Telecare, 30*(10), 1521-1531. [doi.org/10.1177/1357633X231161774](https://doi.org/10.1177/1357633X231161774)
---
## Ask the patient for feedback: what the evidence about FIT says
- **URL**: https://brauni.io/en/blog/feedback-informed-treatment-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-27
- **Tags**: feedback reported treatment, fit, ors, srs, pcoms, evidence, psychotherapy, monitoring of results
The feedback reported treatment (FIT) and the ORS/SRS scales promise to improve results by asking for feedback in each session. What meta-analysis shows and where the evidence is weaker than is said.
There is a practice that sounds so sensible that it is difficult to discuss it: ask the patient, session-to-session, how he is doing and how he is feeling the work with you. Two scales of four items, two minutes, and a brief conversation about what the scale shows. That is, in essence, the *feedback-reported treatment* (FIT) and its most widespread system, the PCOMS (Partners for Change Outcome Management System), with its two instruments: the ORS (Outcome Rating Scale, how next week) and the SRS (Session Rating Scale, how the session comes).
The promise is attractive: better results, less abandonment and less deterioration, without changing the theoretical model. The honest question is how much evidence that promise holds. And the answer is more nuanced than is usually told in training courses.
## TL;DR
- The most complete meta-analysis of the PCOMS found a **small** effect on general symptoms (**g = 0.27**), but that effect **disappears in psychiatric contexts** (g = 0,10, not significant).
- Another independent meta-analysis, with outcome measures outside the system itself, **found no effect** on well-being (g = 0,03) or on the number of sessions (g = 0,13).
- Much of the positive effect appears when the outcome measure is **the same scale of the intervention** (the ORS) and when the authors have a link to the system.
- The evidence about the **feedback of progress in general** (not only PCOMS) is more solid than that of PCOMS in particular: there are consistent improvements in results and abandonment.
- Practical conclusion: asking feedback is still a good clinic, but it should be done because of what it contributes to the conversation, not because it relies on a large effect that the evidence does not support.
## Why it Matters
In Argentina the FIT circulates mainly through formations and workshops, almost always presented as a practice "based on evidence" without further clarification. And there is something true there: the underlying logic (measure, return, adjust) is the same of the [monitoring of results](/blog/monitoreo-resultados-terapia-evidencia), which does have support.
But "logic has support" is not the same as "this specific system has support." And the difference matters when you're deciding if you're going to spend five minutes of each session, with each patient, for years.
## What the evidence says
### The favorable meta-analysis (and its asterisks)
Østergård, Randa and Hougaard (2020) reviewed 18 studies (14 randomised) with 2.910 participants. They found a small but significant effect of the PCOMS on general symptoms: **g = 0.27**.
The detail is in the moderators when they separated by context:
- On **counseling**: g = 0,45 devices (moderate effect).
- On **psychiatric**: devices g = 0,10, without statistical significance.
The authors themselves point out why the large number should be read carefully: almost all studies of the favorable group had **the researcher's alliance** with the system (the authors were promoters of PCOMS) and used **the ORS as the only result measure**. That is, the scale that is part of the intervention was also the rod with which success was measured.
### Unfavorable meta-analysis
That same year, Pejtersen, Viinholt and Hansen (2020) published in *Journal of Counseling Psychology* a systematic review of 14 randomized trials, designed specifically to look at independent measures.
The results:
- **Quantity of sessions**: g = 0,13 (IC 95% [0.001, 0.26]), which amounts to a difference of less than one session.
- **Patient welfare**, measured with scales outside the PCOMS: g = 0,03 (IC 95% [-0.18, 0.23]), i.e. nothing.
The authors' conclusion is direct: they found no evidence that PCOMS would improve the well-being of patients or the number of sessions they attend.
The two meta-analyses do not contradict as much as they seem. They measure different things. When the result is measured with the system's own scale, the effect appears. When measured with independent instruments, it dilutes. That does not prove that the FIT does not work, but the effect is much smaller than its marketing promises.
### The replica
Duncan and Sparks (2023), central figures of the development of the PCOMS, responded publicly questioning the inclusion of studies they consider confused and defending the validity of the ORS against independent measures. The discussion remains open and worth knowing: it is a legitimate methodological debate, not a closed case in either direction.
### The broader context
Here comes the nuance that changes the reading. The meta-level analysis of Jong et al. (2021), on overall progress feedback (several systems, not just PCOMS), did find consistent effects: better results, less abandonment and less deterioration, with the greatest benefit in cases that were bad ("not-on-track").
That is: **the practice of measuring and returning has backup; the specific brand is not what makes the difference**.
## What does it mean in your clinical practice
- **I asked for feedback, but for the right reason**. The main value of asking "how did you feel this session?, was there anything that didn't close you?" isn't statistical, it's relational. It opens a conversation about the link that many patients don't start alone, and that connects directly with what is well established about [the therapeutic alliance](/blog/alianza-terapeutica-evidencia).
- **Don't delegate clinical judgment to a number**. An ORS from 26 doesn't tell you what to do. It tells you it's worth asking.
- **If you are going to measure result, consider an independent measure**. A validated scale of the picture you are dealing with (PHQ-9, GAD-7, BDI) gives you less self-referential information than a scale that is part of the feedback ritual itself.
- **Pay special attention to cases that do not improve**. It is where the feedback shows its highest performance and where the [treatment abandonment](/blog/desercion-abandono-terapia-evidencia) is most played.
- **Eye with Social Desire**. Many patients score high on SRS to avoid discomfort. If all your SRSs are close to maximum, the instrument is probably not capturing anything: there the useful data is that uniformity, not the score.
A way out of the automatic "all right": instead of asking if the session was okay, he asks what he missed. "What would you have wanted us to work today and not get there?" he gets answers much more informative than any scale of satisfaction.
## Killings and limitations
- **Small effects are not null effects**. A g of 0,27 at population level may be clinically relevant if the cost of the intervention is low, and here the cost is a few minutes per session.
- **The quality of the studies is uneven**. Much of the favorable evidence comes from team with an interest in the system, and much of the unfavorable evidence comes from studies in contexts very different from Argentina's private clinical practice.
- **How it is implemented matters more than if it is implemented**. Applying the scale without talking about the result makes feedback an administrative procedure. In studies where it works, return is a real clinical conversation.
- **Almost none of this evidence is Latin American**. The cultural transfer of short self-reporting instruments is not automatic.
## In summary
The informed feedback is not the revolution that is sometimes sold, but it is not smoke either. The honest reading of the evidence is this: **to systematically ask the patient how it is doing and how we are going is a reasonable, low cost and probably beneficial practice, especially when things are not working**. What is not supported is the idea that a one-time system, with two scales of four items, improves outcomes substantially by itself.
None of this replaces your clinical reading: the scale opens the door, the conversation is yours. And if what you're looking for is to be able to look at a patient's evolution without relying on memory or loose sheets, having the clinical record sorted and queryable is the basis on which any feedback system works. That's exactly what it does [Brauni](https://app.brauni.io/register) with your session notes.
## References
- Østergård, O. K., Randa, H., & Hougaard, E. (2020). The effect of using the Partners for Change Outcome Management System as feedback tool in psychotherapy: A systematic review and meta-analysis. *Psychotherapy Research, 30*(2), 195-212. [doi.org/10.1080/10503307.2018.1517949](https://doi.org/10.1080/10503307.2018.1517949)
- Pejtersen, J. H., Viinholt, B. C. A., & Hansen, H. (2020). Feedback-informed treatment: A systematic review and meta-analysis of the Partners for Change Outcome Management System. *Journal of Counseling Psychology, 67*(6), 723-735. [doi.org/10.1037/cou0000420](https://doi.org/10.1037/cou0000420)
- Duncan, B. L., & Sparks, J. A. (2023). When meta-analysis continues to mislead: A reply to Østergård and Hougaard (2020). *Psychological Services, 20*(Suppl 2), 238-240. [doi.org/10.1037/ser0000666](https://doi.org/10.1037/ser0000666)
- de Jong, K., Conijn, J. M., Gallagher, R. A. V., Reshetnikova, A. S., Heij, M., & Lutz, M. C. (2021). Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. *Clinical Psychology Review, 85*, 102002. [doi.org/10.1016/j.cpr.2021.102002](https://doi.org/10.1016/j.cpr.2021.102002)
---
## ADHD in Adults: What the Evidence Says and What Myths Down
- **URL**: https://brauni.io/en/blog/tdah-adultos-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-13
- **Tags**: tdah, adult tdah, evidence, psychotherapy, diagnosis, tcc
On the International Day of ADHD we reviewed the evidence on ADHD in adults: real prevalence, subdiagnosis, fluctuating course and what therapy provides.
Every 13 of July is commemorated on the International Day of ADHD, and it is a good excuse to do something that the date usually deserves less than it receives: to separate what the evidence says from the disorder from what is repeated about it. Because few conditions accumulate so many myths in opposite directions: that "it does not exist", that "it is an invention of the industry", that "heals only by growing" or, at the other end, that any daily distraction confirms it.
For psychologists working with adolescents and adults, ADHD poses a specific clinical challenge: it is frequent, it is subdiagnosed in adults, it rarely comes alone and its course is less linear than the manuals suggested. Let’s see what the research says.
## TL;DR
- ADHD affects about **5.9% of children and adolescents** and **2.5-2.8% of adults** globally.
- In adults, the gap between symptoms present and clinical diagnosis is strongly **underdiagnosed**:, especially after 50 years.
- The idea that "half overcomes it as they grow" became old: the typical course is **fluctuating**, with remission and recurrence periods. Only ~9% shows sustained recovery.
- Adult ADHD CCT shows **moderate effects** on symptoms and functioning compared to control conditions.
## Why it Matters
If you care for adults, it is almost certain that patients with undiagnosed ADHD have already gone through your clinical practice. Many come for something else: depression, anxiety, partner problems, "chronic disorganization", erratic performance history. Adult ADHD rarely presents itself as such; it is presented as its consequences.
And the cost of not seeing it is real: years of treatments that point to comorbidity without touching the base factor, and patients who carry narratives of "vagance" or "lack of will" that a correct diagnosis could have disarmed long before.
## What the evidence says
### It is common, also in adults
The reference document today is the International Consensus of the World Federation of ADHD (Faraone et al., 2021): 208 evidence-based conclusions, signed by 80 authors from 27 countries, built only on large studies (more than 2.000 participants) or meta-analysis. According to consensus, **5.9% of young people** and **2.5-2.8% of adults** meet diagnostic criteria.
The overall meta-analysis of Song et al. (2021) adds an important nuance: the prevalence of **persistent ADHD** in adults (with a documented onset in childhood) was **2.58%**, but that of **symptomatic ADHD** (symptoms present in adulthood, without requiring confirmation of childhood onset) was **6,76%**. Translated: hundreds of millions of adults in the world with clinically relevant symptoms, most without diagnosis.
### Subdiagnosis in adults is massive
The consensus itself quantifies it in its most extreme range: in people over 50 years, the clinical diagnosis rate recorded is just **0.2%**, against a much greater symptomatic prevalence measured with scales. The gap between what exists and what is diagnosed is widening with age.
Part of the explanation is historical: many adults today were children in times when ADHD was poorly diagnosed, with more restrictive criteria, or directly not considered in girls. It is not that the disorder "appears" in adulthood; it is that it is only now sought.
### "It heals when it grows" is more myth than fact
For years it was repeated that about half of the children with ADHD "surpassed" when they reached adulthood. Following the MTA study (Sibley et al., 2022), published in the *American Journal of Psychiatry*, complicated that image: the most frequent pattern was neither stable persistence nor recovery, but **fluctuation**. **63.8%** of the participants alternated periods of remission and recurrence over time. Only **9.1%** showed sustained recovery until the end of the study, and about **90%** continued to present residual symptoms in young adulthood.
The clinical implication is direct: that a patient is "well" today does not close the chapter. ADHD is more like a condition that fluctuates with the context and demands of each life stage than with something that has or is no longer present.
### Psychological therapy provides, and is measurable
Treatment of adult ADHD is not only pharmacological. The meta-analysis of Knouse, Teller and Brooks (2017), about 32 cognitive-behavioral treatment studies for adult ADHD, found effects compared to control conditions of **g = 0.65** for self-reported symptoms and **g = 0.51** for functioning. They are moderate effects, in line with what psychotherapy achieves in other tables, on very specific skills: organization, planning, time management, emotional regulation.
## What the evidence DOES NOT say
- **It does not say that any distraction is ADHD**. The diagnosis requires a persistent pattern, with functional deterioration, in more than one context. The popularization of the term (and its viralization in networks) does not change the criteria.
- **It does not say it is an invention**. The conclusion of the international consensus is exactly the opposite: few psychological conditions have such a broad and replicated empirical basis on their existence, course and treatment.
- **Does not say adult diagnosis is trivial**. Evaluating adult ADHD is genuinely difficult: it requires evolutionary history, discarding and weighting comorbidities (depression, anxiety, consumption, bipolarity, according to consensus the most frequent) and distinguishing ADHD symptoms from those of those same tables.
## What does it mean in your clinical practice
- **I included ADHD in your adult differential radar**. When you consult for chronic disorganization, erratic academic or work history, persistent "procrastination" or anxiety/depression treatments that progress less than expected, ask if there is an unevaluated basic ADHD.
- **Ask for history, not just for the present**. Adult ADHD is evaluated backwards: school performance, newsletters, what teachers said, what it was like to organize 10 years. Documenting well that timeline is half the evaluation.
- **Waits for fluctuation, not linearity**. If the typical course alternates referrals and recurrences, setbacks in times of higher demand (ascent, parenthood, a move) are expected part of the picture, not a failure of the treatment. Anticipating it with the patient protects the [alliance](/blog/alianza-terapeutica-evidencia) and reduces the risk of [abandoning](/blog/desercion-abandono-terapia-evidencia).
- **Work with concrete and measurable objectives**. Treatments that show effect are those that point to specific abilities. This lends itself especially well to [monitoring results](/blog/monitoreo-resultados-terapia-evidencia): define with the patient what they will consider improvement and review it systematically.
With ADHD patients, the structure of the session is also intervention: explicit agenda, closures with summary of agreements and reminders between sessions are not "extra administrative", they are clinical scaffolding for a patient whose central difficulty is to sustain the organization on his or her own.
## Killings and limitations
- **Prevalence figures depend on method**. The difference between 2,58% and 6,76% in Song et al. is not a contradiction: it reflects different definitions (persistent vs. symptomatic). Any number of adult ADHD you read comes with that small letter.
- **The MTA followed children diagnosed in the 1990s**. Their findings on the fluctuating course are solid, but describe a specific cohort, treated in a specific health system.
- **The effects of CCT are mainly based on self-reporting**. The effect sizes of Knouse et al. are smaller when reporting external observers, a common pattern in psychotherapy that should be borne in mind.
- **None of this replaces individual clinical evaluation**. Population evidence guides; diagnosis is done by a professional on a case-by-case basis.
## In summary
The evidence about adult ADHD draws a clear picture: it is common, it is subdiagnosed, almost never comes alone, fluctuates throughout life and responds to structured psychological treatment. For the clinical psychologist, the International Day of ADHD is less an event than a reminder: behind many consultations for "other thing" there is a basic attention pattern that no one has yet looked at.
And if something asks for the work with these patients is orderly documentation: the evolutionary history, the concrete objectives, the agreements of each session. In that a tool like [Brauni](https://app.brauni.io/register) can help you keep the record structured and up-to-date; the clinical look that detects the pattern, that is still yours.
## References
- Faraone, S. V., Banaschewski, T., Coghill, D., et al. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. *Neuroscience & Biobehavioral Reviews*, 128, 789-818. [https://doi.org/10.1016/j.neubiorev.2021.01.022](https://doi.org/10.1016/j.neubiorev.2021.01.022)
- Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. *Journal of Global Health*, 11, 04009. [https://doi.org/10.7189/jogh.11.04009](https://doi.org/10.7189/jogh.11.04009)
- Sibley, M. H., Arnold, L. E., Swanson, J. M., et al. (2022). Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD. *American Journal of Psychiatry*, 179(2), 142-151. [https://doi.org/10.1176/appi.ajp.2021.21010032](https://doi.org/10.1176/appi.ajp.2021.21010032)
- Knouse, L. E., Teller, J., & Brooks, M. A. (2017). Meta-analysis of cognitive-behavioral treatments for adult ADHD. *Journal of Consulting and Clinical Psychology*, 85(7), 737-750. [https://doi.org/10.1037/ccp0000216](https://doi.org/10.1037/ccp0000216)
---
## Why patients quit therapy (and what the evidence says)
- **URL**: https://brauni.io/en/blog/desercion-abandono-terapia-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-11
- **Tags**: Abandon therapy, desertion, dropout, evidence, psychotherapy, adhesion, withheld patients
About 1 in 5 patients drop out of therapy prematurely. What predicts abandonment according to Swift and Greenberg meta-analysis and what strategies with support reduce it.
A patient begins to work, advances, and from one day to the next stops coming. He does not warn, does not respond to the message of reprogramming, does not return. Early abandonment of treatment is one of the most frequent and most frustrating experiences of clinical practice, and also one of the least talked about, because it is easy to live it as a personal failure.
The evidence helps to put it in perspective: abandonment is common, it has identifiable predictors and, in part, it is preventable. Not everything depends on you, but some things do, and they are precisely what research points out.
## TL;DR
- About **1 in 5 patients** leaves psychotherapy prematurely (average rate of **19.7%** according to the largest meta-analysis).
- Abandonment is more common in **young patients**, in some cadres (personality and eating behavior disorders) and when the therapist is **in training**.
- The theoretical orientation and format (individual or group) **no** showed significant differences.
- There are strategies supported to reduce it: align expectations, monitor progress, and take care of the alliance.
## What the evidence says
The reference study is the meta-analysis of Swift and Greenberg (2012), published in the *Journal of Consulting and Clinical Psychology*. It is enormous: **669 studies** and **83.834 patients**.
The central data: the weighted average dropout rate was **19.7%** (IC 95%: 18,7% to 20,7%). That is, about one in five patients leaves treatment early.
That number, moreover, is good news relative. A previous review of two decades ago had estimated a rate close to 47%. Abandonment fell, probably due to changes in the way you work and understand adherence, but it remains a large-scale phenomenon.
### What Abandonment Predicts
The meta-analysis identified several moderators, factors associated with increased risk of abandonment:
- **Patient age**: younger patients leave more.
- **Diagnosis**: personality and eating behavior disorders were associated with higher rates.
- **Therapist's experience**: treatments conducted by trained professionals showed more abandonment than those of more experienced clinicians.
- **Context and definition**: the scope of attention and even how "abandoning" is defined in each study influence the figures.
And just as important, which **not** predicted abandonment:
- The **theoretical orientation** of the treatment.
- The individual or group **format**,.
- Several **demographic** variables of the patient.
That theoretical orientation does not predict abandonment is a liberating finding: there is no school "that retains better." What makes the difference is not your theoretical framework, but transversal factors such as alliance and the management of expectations, that any orientation can take care of.
## What does it mean in your clinical practice
Abandonment is never entirely eliminated, but several strategies with empirical support help reduce it. The most consistent:
- **Align expectations from the beginning**. Much of early abandonment comes from a mismatch between what the patient expected and what he finds: how long it will last, how the process is, what is expected of him, when changes tend to appear. Discussing it explicitly in the first sessions prevents avoidable desertions. The [first interview](/blog/primera-entrevista-psicologica) is the key moment for that.
- **Work the alliance actively**. Abandonment is often the final symptom of a [damaged alliance](/blog/alianza-terapeutica-evidencia) that was never named. Detecting and repairing the ruptures of the bond is one of the most direct ways to retain patients.
- **Monitor progress**. [systematic follow-up of results](/blog/monitoreo-resultados-terapia-evidencia) reduces abandonment precisely because it detects patients who are unhooking in time, when there is still room to intervene.
- **Take care of the first contacts and absences**. A warm reprogramming message after an absence, a reminder that doesn't feel bureaucratic, a space to talk about the doubt of continuing: the details of the link around the session also support the treatment.
When a patient misses without warning, the reaction matters. A message that leaves the door open without pressing ("your schedule is left free, let me know if you want to pick it up when you can") communicates availability, I do not claim. Many definitive desertions are, in fact, absences that no one resumed in time.
## Killings and limitations
- **Not all abandonment is clinical failure**. Some patients leave because they achieved what they were looking for, others because framing was not adequate, others for external reasons that have nothing to do with treatment. "Abandonment" is a broad category that mixes very different situations.
- **Definition of abandonment varies**. Studies do not agree on what counts as desertion (do not complete a number of sessions, go against the therapist's criteria, stop attending without notice), which introduces noise in any comparison.
- **Predictors are averages**. That young patients abandon more at the population level does not say anything about a particular young patient. They are signs to be attentive, not labels to prejudge.
- **To reduce abandonment is not to retain at all costs**. The goal is that those who would benefit from following will not go away for avoidable reasons, not convince someone to sustain a treatment that does not serve them.
## In summary
Premature abandonment affects about one in five patients, and although it is never completely eliminated, it has known predictors and prevention strategies with support. The constant that goes through all the evidence is that what it retains is not the technique or the school, but the management of expectations, the care of the alliance and the ability to detect the patient who is unhooking in time.
In order to detect in time, it is necessary to see the patterns: who is missing, who is not reprogramming, how each treatment evolves. When the [agenda management](/blog/gestion-citas-psicologos) and the history of each patient are ordered and in sight, those signals stop passing unnoticed. In [Brauni](https://app.brauni.io/register) we seek that follow-up is part of the workflow, so that no empty chair is a surprise.
## References
- Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. *Journal of Consulting and Clinical Psychology, 80*(4), 547-559. [doi.org/10.1037/a0028226](https://doi.org/10.1037/a0028226)
- Swift, J. K., Greenberg, R. P., Whipple, J. L., & Kominiak, N. (2012). Practice recommendations for reducing premature termination in therapy. *Professional Psychology: Research and Practice, 43*(4), 379-387. [doi.org/10.1037/a0028291](https://doi.org/10.1037/a0028291)
---
## The therapeutic alliance according to the evidence: how much it really weighs
- **URL**: https://brauni.io/en/blog/alianza-terapeutica-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-10
- **Tags**: therapeutic alliance, therapeutic link, evidence, psychotherapy, therapeutic relationship, common factors
The therapeutic link is one of the most robust predictors of the outcome in psychotherapy. What Flückiger's meta-analysis shows (295 studies) and how it translates into your clinical practice.
There is a question that goes through decades of research into psychotherapy: what really makes a treatment work? Technique, theoretical orientation, diagnosis, relationship. Above all, there is debate. But on one factor there is a remarkably solid empirical consensus: the therapeutic alliance.
The alliance (or therapeutic bond, or working relationship) is not "feeling good." In Edward Bordin's classic definition it has three components: the **emotional bond** between patient and therapist, the **agreement on the objectives** of treatment, and the **agreement on tasks** to achieve them. It is a collaboration with leadership, not just a good chemistry.
The interesting question is not whether the alliance matters, that hardly anyone disputes it, but how much it matters and what the quantitative evidence says about it.
## TL;DR
- The therapeutic alliance is one of the most **consisting** predictors of the outcome in psychotherapy.
- The largest meta-analysis to date (295 studies, more than 30.000 patients) found an association of **r ≈ 0.28** between alliance and outcome.
- The effect is **robust**: sustained through different orientations, measurement types, disorders and countries.
- It's an association, not a pure causality test, but it's one of the most replicated findings in the whole field.
## What the evidence says
The reference study is the meta-analysis of Flückiger, Del Re, Wampold and Horvath (2018), published in *Psychotherapy*. It is the most ambitious synthesis carried out on the subject: it gathered **295 independent studies** and more than **30.000 patients**, covering face-to-face and online psychotherapy, from 1978 to 2017.
The central result: the aggregate correlation between alliance quality and treatment outcome was **r ≈ 0.28**.
This number deserves context. In psychotherapy research, where the results depend on dozens of intertwined factors, a correlation of this magnitude, replicated in hundreds of studies, is one of the most stable findings that exist. The alliance explains a modest but very consistent portion of why some patients are doing better than others.
An R of 0,28 does not mean that the alliance "makes" the 28% of work. It is a measure of association between the force of the labor bond and the outcome. The remarkable thing is not the magnitude but the consistency: hundreds of studies, with different methods, pointing in the same direction.
And perhaps the most important thing for practice: the effect remained **table through moderators**. It did not depend substantially on the therapist's theoretical orientation, the type of instrument used to measure the alliance, the treated disorder or the country. Whatever your framework, the quality of the working relationship is associated with how treatment ends.
## What the evidence DOES NOT say
Here it is necessary to be precise, because the alliance is sometimes cited as settling all the debates:
- **No experimental causality test**. No patients can be randomly assigned to a "strong" or "weak" alliance, so the evidence is correlated and longitudinal, not experimental. That said, the meta-analysis itself tested whether the association was just a reflection of early improvement (adjusted by initial severity and previous changes) and found that it held almost the same (r went from 0,25 to 0,22), which supports that the alliance functions as a facilitating factor and not as a mere byproduct of progress.
- **It does not say that the technique does not matter**. That the alliance is robust does not make specific interventions irrelevant. Much of a strong alliance is precisely the agreement on tasks that make sense to the patient.
- **It is not a permission to neglect the method**. "Total, what heals is the bond" is a lazy reading. The evidence says that the bond weighs, not that it is the only thing that weighs.
## What does it mean in your clinical practice
The good news is that the alliance is not a fixed trait of the therapist: it is something that is built, monitored and, when damaged, repaired.
- **Work the agreement, not just the weather**. The emotional bond is a three-legged one. Check explicitly that patient and therapist share where they are going (objectives) and how they are going to get (tasks) is central to building alliance, not an initial process.
- **Pay attention to ruptures**. Moments of tension, disagreement or distance in the relationship are frequent and are not a failure: they are opportunities. The literature on repair of ruptures shows that addressing them openly can strengthen the bond more than if they had never appeared.
- **Ask for the relationship directly**. Many patients will not spontaneously say that something about the bond does not work. Open the door ("How do you come feeling these sessions?, is there anything you would like us to work differently?") makes visible what otherwise goes silent, many times in the form of [abandonment](/blog/desercion-abandono-terapia-evidencia).
- **Consider measuring the alliance**. As with the [monitoring of results](/blog/monitoreo-resultados-terapia-evidencia), a short scale of alliance applied from time to time can detect a deterioration of the bond before it is translated into an empty chair.
A rupture of alliance is rarely announced. It is noticed in subtle signs: the patient who participates less, who arrives late, who "is all right" when clearly not. Name what you see, without accusing, usually reopens the conversation: "I noticed you a little quieter today, do we talk about it?"
## Killings and limitations
- **Association is average**. That the alliance despite population level does not mean that it is the decisive factor in each individual case. In some treatments other elements will weigh more.
- **Measuring the alliance has its own biases**. Most measurements are based on the patient's report, which may be influenced by his or her state of mind of the day or the desire to please the therapist.
- **Correlation is not a recipe**. Knowing that the alliance matters doesn't automatically tell you how to build a better one in a specific case. That's where your training, your supervision and your clinical experience keep coming in.
## In summary
Of all the factors studied in psychotherapy, the therapeutic alliance is one of those that best resists the passage of the years and the accumulation of studies. Not because it is magical, but because a patient who trusts, who understands where he is going and who agrees with how to get there, is a patient who sustains the treatment and works in it.
None of this is done by a machine. The link is, by definition, human. That is why the role of a tool like [Brauni](https://app.brauni.io/register) is exactly the reverse to which is sometimes feared: when dealing with the record and documentation, it releases your attention for the only thing that cannot be delegated, which is to be present with the patient. AI prepares the draft of the note; the link is built by you.
## References
- Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. *Psychotherapy, 55*(4), 316-340. [doi.org/10.1037/pst0000172](https://doi.org/10.1037/pst0000172)
- Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. *Psychotherapy: Theory, Research & Practice, 16*(3), 252-260. [doi.org/10.1037/h0085885](https://doi.org/10.1037/h0085885)
---
## Library with AI: upload your manuals and your assistant reads them for you
- **URL**: https://brauni.io/en/blog/biblioteca-ia-manuales-psicologia
- **Category**: Artificial Intelligence
- **Date**: 2026-07-10
- **Tags**: artificial intelligence, library, manuals, psychological tests, RAG, wizard, psychologists
Upload your test manuals, notebooks from your reference authors, and notes to Brauni. Your AI assistant answers your questions by quoting the exact document and page.
If you are a psychologist, your knowledge does not live only in your head: live in the manual of the test that you will manage, in the emphasized volumes of your head author, in the clinical guides and in the notes that you accumulated during years of training. The problem is that all that material is in PDFs that you have to open, remember and search by hand — usually at the worst moment: in the middle of a session or preparing a report.
Since today, Brauni has a **Library**: subdue your documents once, and your AI assistant reads them, understands them, and uses them as a source to respond to you — **quoting exact document and page** so you can always verify it.
## What is the Library?
It's a personal space within Brauni where you upload your reference documents:
- **Test manuals** with their criteria, scales and correction guidelines
- **Works of your reference authors** — even scanned volumes of hundreds of pages
- **Clinical guides and protocols** of administration
- **Your own notes** of training, papers and teaching materials
Brauni accepts **PDF, Word (.docx) and plain text (.txt)**, with documents up to 50 MB and 1.500 pages. And here comes the important thing: **it doesn't matter if the PDF is text or an old photocopy scan** — if the pages are image, Brauni applies optical character recognition (OCR) automatically.
Do you have the 24 volumes of your favorite author's complete works scanned? Uploads. Brauni processes them, indexa and leaves them searchable page by page.
## How it works: from dead PDF to colleague who read it all
When you upload a document, Brauni does three things in the background:
1. **Extracts the text** — if the PDF already has text, it reads it directly; if they are scanned pages, it applies professional-grade OCR (the same engine used by large-scale document scanning systems)
2. **Indexes it by meaning** — the content is divided into fragments and is semantically indexed: the search understands concepts, not just exact words. "Rumination" finds passages on repetitive thinking even if the book never uses that word.
3. **Makes it available to your assistant** — from that moment on, the AI wizard can consult your library when responding
The result feels like this:
> **You:** "What diagnostic criteria does the manual use for generalized anxiety?"
>
> **Your assistant:** "According to your manual, the criteria are... The key point is the minimum duration of 6 months... 📖 *Manual Diagnosis — p. 272*"
That page quote is not decorative: it is the difference between an AI that "sounds convincing" and a clinical tool that you can trust. **Each response based on your library includes the document and the source page**, so you can go to the source and verify it yourself.
{/* screenshot: chat del asistente respondiendo con cita de documento y página */}
## All Gemini power, enriched with TUS sources
The Brauni wizard always had the power of the latest generation AI models. But generic AI responds with generic knowledge. The difference now is the **context**: your assistant responds with **your** theoretical framework, **your** manuals, **your** authors — the criterion with which you work.
Ask him about psychoanalysis and he answers you from your volumes of Freud. Ask him about a test and he answers you from the manual you will manage, not from an internet summary.
## What you're going to use it for (real cases)
### During administration of a test
"How does the X scale score when the patient omits an item?" — manual response, with the scale page. Without cutting the session to browse.
### Preparing a Session
"What does my author say about this type of resistance in teenagers?" — the assistant searches in the volumes you uploaded and brings you the relevant passages with volume and page.
### Basing a report
Accurate quotes from your sources, ready to check and reference. "I know I read it somewhere."
## Upload a document, step by step
From **→ Library Upload document**:
1. **Choose the file** (PDF, DOCX or TXT)
2. **Put a title and description** — optional but highly recommended: "Cognitive Therapy Manual with Children and Adolescents — Bunge, Gomar and Mandil" gives the wizard much more context than the file name
3. **Ready** — the document queues and is processed only
{/* screenshot: pantalla de subida con campos de título y descripción */}
### How long does it take?
Depends on the size and whether the document is scanned:
| Document | Approximate time |
|-----------|-------------------|
| Notes or paper (ten pages, with text) | less than 1 minute |
| 400 text pages manual | 3 to 6 minutes |
| 400 scanned page manual (OCR) | 10 to 20 minutes |
| Taken from 1.000 scanned pages | 20 to 30 minutes |
You can close the quiet screen: the processing is still in the background and the document appears as **Ready** in your Library when it ends.
The description you carry is also indexed. If you write "Rorschach test manual that I use in evaluations", then you can tell the assistant "seek in my Rorschach manual" and he will know exactly which document you refer to.
## How much do you consume from my plan?
Processing uses the **A. I. tokens of your plan** — the same budget that uses the — wizard chat with a fee intended for indexing to come out cheap:
- **Text documents**: ~62 tokens per page. A 400 page manual ≈ 25.000 tokens (a minimum fraction of your monthly budget)
- **Scanned documents (OCR)**: add up 1.000 tokens per scanned page, because optical recognition has a real processing cost
The cost is discounted once, when indexing. Then, consulting your library in the chat costs the same as any conversation with the wizard. In the detail of each document you see exactly how many tokens it consumed.
## Privacy and security: your library is yours only
We know trust is all about a clinical platform, so we apply the same standards to your library as to medical records:
- **Living**: your files and extracted text are stored encrypted (AES-128, Fernet encryption) — the same scheme with which we protect your patients' data
- **Full isolation**: Your library is yours and nobody else's; no other professional can see your documents or your searches
- **No model is trained with your material**: Your documents are used only to respond to you, in your account
- **Verified integrity**: each file saves its SHA-256 fingerprint to detect any alteration
## Frequently Asked Questions
### Does it work with scan PDFs of poor quality?
Yes. The OCR Brauni is professional and handles well old scans, digitized photocopies and editorial fonts. If any page is unreadable, the same document is indexed with the rest and we let you know which pages remain pending.
### What if a document fails in the middle of processing?
Nothing is lost: what has already been processed is indexed and searchable, and the **Retry** button completes only what was missing — without re-eating tokens for what has already been processed.
### Can I ask the assistant to look for a specific document?
Yes. If you say "seek in the volume 16" or "according to Bunge's manual...", the wizard identifies the document in your library and restricts the search to that material.
### Is the library per patient?
No — is yours, by the professional. The same manuals and authors accompany you in the chat of any patient. What is for patient (and always was) are the session notes and clinical material.
### How many documents can I upload?
Depends on your plan: 10 documents active in the Initial plan and 50 in the Expert, in addition to the token limit of your plan for processing. If you delete a document, you release the quota.
### Can I download my documents?
Always. Your original files are saved and you can download them whenever you want, with integrity check included.
## Summary
| Action | Time | Frequency |
|--------|--------|------------|
| Upload a document with title and description | 1 minute | By document |
| Processing and indexing | 1 to 30 min according to size and scan | Automatic |
| Check it from the wizard chat | Instant | Every time you want |
## Conclusion
Your training is your biggest clinical tool — but only if you can access it at the right time. With the [Brauni Library](/funcionalidades/biblioteca-ia), your manuals, authors and notes stop being PDFs asleep in a folder and become an available colleague 24/7 that read everything, responds in seconds and always tells you what page it says. Upload your first manual today and ask him what you want.
---
## Does measuring results improve therapy? What does the evidence say
- **URL**: https://brauni.io/en/blog/monitoreo-resultados-terapia-evidencia
- **Category**: Based on Evidence
- **Date**: 2026-07-09
- **Tags**: monitoring of results, ROM, evidence, psychotherapy, feedback, measurement-based care, clinical results
Systematic monitoring of results (ROM) and feedback to the therapist improve outcomes, especially in cases that go wrong. What meta-analysis says and how to apply it.
Most treatments end well. The problem is that we don’t, and above all, often don’t realize it on time. Research is consistent with an awkward point: therapists tend to be optimistic about how a patient evolves, and we detect those who are getting worse late. That’s where systematic monitoring of results comes in.
The monitoring of results (in English *routine outcomes monitoring* or ROM, part of what is called *measurement-based care*) consists of something simple: to measure briefly and repeatedly how the patient is session-to-session, and to return that information to the therapist in time to adjust. It is not a school or a therapeutic technique. It is a measuring layer that is mounted above what you already do.
The question that matters is whether this really changes the outcomes or whether it's just red tape with a cute name. There's meta-analysis that answers it.
## TL;DR
- Measuring results systematically and returning that information to the therapist improves outcomes, with a **small but consistent** effect on the average.
- The effect is **much larger in cases that go wrong** ("not-on-track"), which are precisely the ones that matter most to detect.
- Feedback also **reduces abandonment** of treatment.
- It doesn't replace your clinical judgment: it's an early warning system that tells you where to look.
## What the evidence says
The most complete and recent meta-analysis on the subject is that of Jong et al (2021), published in *Clinical Psychology Review*. He collected 58 studies, more than 21.000 patients and 110 effect sizes, comparing treatments with feedback of progress against treatments without it.
The central findings:
- **Symptom reduction**: feedback produced a small but significant improvement against control groups (d = 0,15). In practical terms, it is a modest push applied to all patients equally.
- **Cases going wrong**: in patients "not-on-track" (those who are not evolving as expected), the benefit is sustained and is where the tool shows its real value.
- **Abandonment**: feedback had a favorable effect on dropout rates, helping to retain patients who would otherwise have left.
The key that goes through this entire line of research, which starts with the work of Michael Lambert and his team on alert systems and short result questionnaires, is this: **the biggest revenue is not in the average patient, but in detecting the one that is getting worse early**. When a case deviates from its expected trajectory and the therapist sees it in time, he can intervene before the patient leaves or deteriorates.
The average effect size is small on purpose: most patients were going to improve the same. Monitoring does not seek to change those cases, but to rescue the minority that was going down a bad path without anyone noticing it. That subgroup is where most of the benefit is concentrated.
## Why it works: the problem it solves
Without a systematic measurement, the evaluation of how a patient is doing depends on the clinical impression session by session. And clinical impression has a well-documented bias towards optimism: we tend to see progress where there is sometimes stagnation, and to underestimate the risk of abandonment.
Monitoring does not correct your judgment, it complements it with an external data. A short scale completed before each session gives you a curve. When that curve flattens or falls, you have an objective signal to ask yourself what is going on: did the alliance break?, did the focus of treatment stop being the right one?, is there anything that the patient is not bringing?
It is the difference between navigating by memory and navigating with instruments. The instrument does not handle the plane: it warns you when to look outside.
## What does it mean in your clinical practice
You don't need to set up a complex system to start capturing most of the benefit.
- **Choose a short measure and hold it**. A short, validated scale, completed consistently before each session or every few sessions, is worth more than a long instrument that you leave a month. Consistency is what builds the curve.
- **Look at the path, not the isolated number**. A loose score says little. What reports is the direction: improvement, plateau or deterioration throughout the sessions.
- **Pay special attention to the "not-on-track" cases**. If a patient is not improving as you expected, that is the most valuable signal in the whole system. Don't let it go: it's exactly the case that monitoring exists to rescue.
- **Use the data as an opening, not as a verdict**. "I see that the last few weeks you have scored lower, how do you see it?" turns measurement into clinical material and, many times, into a conversation that would not have appeared alone.
If you never measured results, it starts simple: a single short scale, always the same, always at the same time. Hold it three months before evaluating if you add up anything else. As with [session note formats](/blog/notas-soap-dap-birp-psicologia), the value is in consistency, not in the sophistication of the instrument.
## Killings and limitations
Methodological honesty is part of taking the evidence seriously:
- **The average effect is small**. Those who expect to measure results transform all their treatments will be disappointed. The benefit is real but concentrated, especially in cases that go wrong.
- **It depends on what is measured and how much**. Meta-analysis points out that the instrument used, the frequency and intensity of the treatment moderate the effect. Not any measurement made in any way yields the same.
- **Feedback has to come in time and be translated into action**. Measuring and not looking at the result, or looking at it late, does not work. The value appears when the warning signal actually changes something you do.
- **Does not replace the relationship**. Measurement is a complement to the link and clinical judgment, never a replacement. [The therapeutic alliance weight](/blog/alianza-terapeutica-evidencia) remains one of the most robust factors in the whole process.
## In summary
Systematic monitoring of results is neither a fashion nor a bureaucratic requirement: it is one of the few interventions at the process level with meta-analytical support. Its strength is not to improve the average patient, but to give you an early warning about the cases that are going astray, which are the ones that benefit most from an adjustment in time.
Measuring systematically requires, first, systematic documentation. When each session is recorded with the same structure, the evolution of the patient becomes visible and comparable. In [Brauni](https://app.brauni.io/register) structured documentation and [digital medical records](/blog/historia-clinica-psicologia) make following the path of a case over time part of the flow, not an extra task. Clinical measurement and reading remain yours.
## References
- de Jong, K., Conijn, J. M., Gallagher, R. A. V., Reshetnikova, A. S., Heij, M., & Lutz, M. C. (2021). Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. *Clinical Psychology Review, 85*, 102002. [doi.org/10.1016/j.cpr.2021.102002](https://doi.org/10.1016/j.cpr.2021.102002)
- Lambert, M. J., Whipple, J. L., & Kleinstäuber, M. (2018). Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring. *Psychotherapy, 55*(4), 520-537. [doi.org/10.1037/pst0000167](https://doi.org/10.1037/pst0000167)
---
## What is Patient Privacy Monitoring and why any health app should have it
- **URL**: https://brauni.io/en/blog/patient-privacy-monitoring-brauni
- **Category**: Privacy and Security
- **Date**: 2026-06-26
- **Tags**: HIPAA, UEBA, Patient Privacy Monitoring, security, patient data, audit, insider threats
Encrypting clinical data is not enough. We explain what Patient Privacy Monitoring is (UEBA applied to health), why HIPAA demands it, and how Brauni detects suspicious access to medical records in real time.
When you talk about security in medical applications, almost everyone thinks about the same thing: encryption, MFA, HTTPS, [BAA with the infrastructure provider](/blog/baa-hipaa-google-cloud-brauni). All that is necessary. But there is a layer that almost no one publicly discusses and that, however, is the one that most real gaps stops in the day to day.
The awkward question is not *"Are the data encrypted?"*. It is:
**If we call you right now and ask you who agreed to Juan Pérez's medical records in the last 30 days, can you answer us in less than a minute?**
To answer that question there is a category of systems with their own name in the industry: **Patient Privacy Monitoring**, a specific application of **UEBA** (*Use & Entity Behavior Analytics*) to the health context. In this article we tell you what it is, why HIPAA requires it, how it works technically and how we implement it in Brauni.
## The real health threat profile
When you imagine a medical data breach, think of a hooded hacker typing commands on a dark keyboard. Reality is much less cinematic.
According to the annual reports of **OCR** (Office for Civil Rights, U. S. regulator HIPAA) and **Verizon DBIR**, most incidents of PHI do not come from an external attacker breaking encryption. They come from **legitimate accounts asking questions they should not**:
- A curious employee reviewing the file of a known or famous patient
- An engaged account exporting 200 tokens to 3 in the morning
- A former active-session worker who no one revoked upon discharge
- Someone trying to change IDs in the URL to see what is returned (which is called a **IDOR**, *Insecure Direct Object Reference*)
- A therapist accessing files that aren't from his assigned patients
The industry calls this pattern "insider threats."It does not necessarily imply bad faith: a phishing-stealed account is also, in practice, an "insider" because it has valid credentials.
None of these threats stop with encryption. Encryption protects against someone who gets in by force. It does not protect against someone who has the key.
## What is Patient Privacy Monitoring?
It is a category of systems dedicated to **observing how clinical data are used from within the application** and detecting patterns that are far from normal. In the technical literature it is known by several names according to the angle:
- **UEBA** (*Use & Entity Behavior Analytics*): The large umbrella, used by Gartner and suppliers such as Splunk, Exabeam or Microsoft Sentinel
- **Patient Privacy Monitoring** or **Patient Privacy Intelligence (PPI)**: the name used by health providers (Protenus, Imprivata FairWarning, Maize Analytics)
- **Insider Threat Detection & Response (ITDR)**: name from the pure cybersecurity angle
- **Audit log monitoring**: the oldest and technical name, without a marketing flavour
In the HIPAA language, this type of system covers three formal requirements:
| Requirement HIPAA | Article | What it demands |
|---|---|---|
| Audit Controls | 45 CFR §164.312(b) | Record and review activity on PHI-containing systems |
| Information System Activity Review | §164.308(a)(1)(ii)(D) | Regularly review activity records |
| Security Incident Procedures | §164.308(a)(6) | Identify and respond to security incidents |
It's not optional, it's law.
## How it works: the nine questions the system is asked
In Brauni, each access to protected health information (PHI) is recorded in an unchangeable audit log. On that log, a detection engine executes nine rules in parallel, each answering a specific question:
### 1. Is someone trying to change IDs in the URL? (`IDOR_ATTEMPT`)
Severity: **HIGH**
If an account accumulates multiple events `ACCESS_DENIED` in a short window, it is probably manually testing to change patient IDs to see which ones answer it. It is the classic pattern of discovery of **IDOR** (*Insecure Direct Object Reference*). The rule groups the denied by `user_id` and triggers when it crosses a threshold.
### 2. Is someone opening too many stories in a short time? (`BULK_ACCESS`)
Severity: **HIGH**
A normal therapist checks between 5 and 20 files per day, yours. If an account opens 30+ different medical records in a short window, something is not right. It can be a scraper, a committed account, or an employee curiosating. The rule counts **different patients** (not repeated accesses to the same patient, that is normal use).
### 3. Is anyone exporting massively? (`BULK_EXPORT`)
Severity: **Critical**
Exporting is the most dangerous operation: it takes PHI out of the app's controlled perimeter and turns it into a file that can live on any disk. A single legitimate export is normal. Ten in an hour is a red alarm signal. That's why this rule is the only one with CRITICAL severity.
### 4. Is there a brute force attack? (`LOGIN_BURST`)
Severity: **MEDIUM**
It detects when a single IP accumulates many login failures. The important technical subtlety: this rule **is not indexed per user** but by **original IP**, because an attack of brute force or of *credential suffing* triggers many different attempts: sometimes against emails that do not exist, sometimes with the incorrect password of a user that does exist. That is why it groups failed attempts by IP **regardless of whether the email corresponds to a real user or not**, and is the only rule of the engine that does not need a valid `user_id` to shoot.
### 5. Did the account make "teleport"? (`IMPOSSIBLE_TRAVEL`)
Severity: **HIGH**
If the same account enters Buenos Aires at 14:00 and ten minutes later in Madrid, there is a physical problem: nobody travels to 60.000 km/h. The system calculates the implied speed between two consecutive sessions and shoots when it exceeds a configurable threshold. It is one of the strongest indicators of compromised account.
VPNs can generate false positives in this rule. That is why it is not CRITICAL: it is a HIGH that an administrator must triage, not an automatic action.
### 6. Did the account enter from a new country? (`NEW_GEO`)
Severity: **MEDIUM**
An account that historically only entered from Argentina and suddenly logins from Romania deserves a review. It is not always an attack (it may be a trip), but it deserves attention.
### 7. Is it a new device? (`NEW_DEVICE`)
Severity: **MEDIUM**
Brauni assigns a stable identifier to each device (signed cookie + minimum footprint). If an account uses a device it has never seen before, it is registered as an event. Useful for detecting shared accounts or hijacked sessions.
### 8. Was there access out of schedule? (`OFF_HOURS`)
Severity: **LOW**
A reading of PHI at 3 in the morning is not necessarily suspicious, but it is useful information to correlate. If you also cross with `IMPOSSIBLE_TRAVEL` or `BULK_ACCESS`, the total score goes up.
### 9. Is the account in the process of decommissioning? (`AFTER_TERMINATION`)
Severity: **LOW**
If a user has a scheduled low date and continues to access PHI, it is flagged. It is one of the most common and worst covered threats: the ex-employee with live session.
### How they combine: added scoring
Each rule adds points to a score by time window. A single Low rule does not scale. Three Low + a MEDIUM in the same window can cross the global alert threshold and mark the event as `alerted=true`, which is what triggers notification to the admin panel and CloudWatch.
This avoids two bad extremes: **alert fatigue** (everything is urgent, then nothing is) and **subdetection** (each rule separately does not alarm, but the sum should).
## Break-glass auditing: the other half of the problem
Detecting the suspect is only half the job. The other half is **to rebuild the story after**.
In any health institution there are times when it is necessary to break the normal rule of access: an emergency, an internal investigation, a court order. This is called **break-glass access**, "break the glass." HIPAA allows it, but demands that it be registered who did it and when.
Brauni displays a break-glass view per patient. Given a `patient_id`, it returns who accessed its medical records, on what date and time, from which IP, from which device, and what operation it performed (READ, EXPORT, UPDATE...).
### The problem of the observed observer
There is an easy technical detail to overlook that we learned quickly: **the system you look at also has to be looked at**.
When an administrator consults a patient's timeline, that query is itself an access to PHI. If it is not audited, the admin panel becomes the only place where data can be accessed without leaving a trace. That is exactly the hole that the system comes to plug.
In Brauni, each break-glass query:
1. It is recorded as an audit log of its own (`READ` over `audit_timeline`)
2. It is excluded from its own detection statistics, so that an administrator investigating 30 different timelines does not self-incriminate with a `BULK_ACCESS`
3. Validate the patient's existence before writing, to avoid "ghost" logs on patients who do not exist
It's a pattern that seems obvious when it's stated, but that we broke up and arranged during internal review rounds. If you never saw it, it's because few providers tell it publicly.
## Immediate response: four actions from the panel
Detecting is necessary but not sufficient. If the administrator sees a CRITICAL alert at 2 in the morning, he needs to act **now**, not to open three different tabs.
That is why four response actions can be fired from the event itself:
1. **Revocation of all user sessions** - invalidates the active JWT (bump of the `token_version`) and deletes all refresh tokens. The next request from the attacker receives a 401.
2. **Reset 2FA** - deletes TOTP, WebAuthn and backup codes. The legitimate user will have to reconfigure; the attacker with the stolen physical key is left out.
3. **Unlock account** - useful in the reverse scenario: after an accidental `LOGIN_BURST` on the account of a legitimate user.
4. **Force password reset** - triggers email flow with mandatory change link.
Each action requires explicit confirmation (`confirm: true`), CSRF token and leaves a trace at the event. An administrator cannot act on its own `user_id` (self-defense against committed admin accounts).
### Event Lifecycle
An event goes through states: `OPEN` → `ACKNOWLEDGED` → `RESOLVED` or `FALSE_POSITIVE`. The first successful action automatically moves it to `ACKNOWLEDGED` (so the team sees that someone is working it). A closed event rejects new actions until an admin reopens it. This avoids "reopening the wound" unintentionally after the incident was formally closed.
## How it fits in the Brauni architecture
The system runs on two levels:
- **Capture plan**: each operation on PHI writes a `AuditLog` in an append-only table. This happens in a synchronic manner with the user request, in the same transaction: it is a deliberate decision to ensure **atomicity** (if access is not recorded, the change on PHI is not concrete) and zero loss of events by worker drop. Cost is an extra write on the critical path of each request; if the volume comes to justify it, the natural step is to derive that record to an intermediate persistent tail, without resigning durability or immutability.
- **Detection plan**: An APScheduler job runs the detection engine over configurable time windows. It is executed by the **worker process** (separate from the API), with PostgreSQL leader choice by advisor lock, so that only one instance runs it at a time even if there are multiple replicas.
Each detected event also emits a metric to **CloudWatch** via metric filter, which triggers SNS alarms to the guard team. Thus a CRITICAL event does not depend on someone looking at the panel at 3 in the morning: the panel notifies the phone, not the other way around.
Monitoring system data **does not contain PHI**: only internal IDs, IPs, geolocation, device identifiers and counting. The rule is strict: the system that monitors access to sensitive data **cannot itself be a second copy of that data**.
## How to choose a clinical software provider by looking at this
If you are evaluating a platform for your clinical or practice, ask this before signing:
1. **Do they keep an unchangeable audit log of each access to clinical data?** If the answer is "logs are in CloudWatch", it's not enough: CloudWatch is operational, it's not an audit log retained six years as HIPAA requires.
2. **Do you have active detection rules on that log or just keep it?** Saving without looking is like having security cameras off.
3. **Can you show me whose timeline accessed a particular patient's file?** If the answer takes more than a minute, they don't have actual break-glass.
4. **What if an employee of mine resigns today? How do I know that no data was taken before leaving?** The rule `BULK_EXPORT` and the answer `revoke-sessions` should be part of the answer.
5. **Does the monitoring system audit itself?** If the question takes them by surprise, I assumed not.
These questions are what a serious HIPAA auditor would ask you. Better to prepare the answers before, choosing the tool well, than improvise them later during a review.
## What does this mean to you?
It means that when you keep a session note in Brauni, that act is permanently recorded. If tomorrow you suspect that a data leaked, there is a way to reconstruct exactly what happened, who saw it and from where. If a computer account behaves strangely, the system detects it before someone checks the logs by hand. And if an incident is confirmed, access can be cut in seconds.
Encryption, [BAA with infrastructure provider](/blog/baa-hipaa-google-cloud-brauni), [do not use data to train AI](/blog/tus-datos-no-entrenan-ia), [field-by-field encryption](/blog/seguridad-privacidad-brauni). All these are necessary conditions. Patient Privacy Monitoring is the layer that **makes trust verifiable**.
Because in the end, in health, the right question is not *"Are the data safe?"*. It is *"How do you know they are?"* And that question is only answered with evidence.
Do you have any doubts about how we protect privacy or do you want to delve into some technical aspect of this system? Write to [soporte@brauni.io](mailto:soporte@brauni.io). We are here to give you peace of mind.
---
*Brauni complies with the principles of Argentina's Personal Data Protection Act 25.326 and is aligned with the international standards of HIPAA for the management of protected health information (PHI). The Patient Privacy Monitoring system covers the requirements of Audit Controls (45 CFR §164.312(b)), Information System Activity Review (§164.308(a)(1)(ii)(D)) and Security Incident Procedures (§164.308(a)(6)). Brauni provides the infrastructure and monitoring tools compatible with these standards; responsibility for data processing and activation of response protocols rests with each professional or institution, in its role as controller.*
---
## How to get patients by being a psychologist: 10 real strategies
- **URL**: https://brauni.io/en/blog/como-conseguir-pacientes-psicologia
- **Category**: Management of clinical practice
- **Date**: 2026-06-24
- **Tags**: patient uptake, marketing for psychologists, directory, clinical practice, psychologists
Practical guide to getting patients by being a psychologist: referrals, Google, directories, online reservations and clear niche. Real strategies, no smoke.
In the faculty you were taught to attend: theory, technique, ethics, supervision. What no one taught you is to be found. That’s why, when a psychologist wonders how to get patients, he often lives it as a personal failure. It’s not: an empty agenda doesn’t mean you’re bad professional. It means that people who need what you offer don’t yet know you exist.
Getting patients by being a psychologist does not depend on a marketing trick or becoming an influencer. It depends on building, with constancy, the channels by which people come to therapy: the referral of another professional, the Google search, the recommendation of an acquaintance.
In this guide we review 10 concrete strategies, ordered from major to minor return by effort: what is each, how to implement it and what to realistically expect. There are no promises of full agenda in three months, because no one serious can promise that. There is cumulative work that, well done, is noted.
## 1. I built a network of professional referrals
The referral between professionals is historically the most solid way to get patients in psychology. A patient referred by a psychiatrist, a doctor or a colleague arrives with a confidence that no advertisement can buy.
How to implement it:
- Make a list of the professionals in your area who care for your population: psychiatrists, pediatricians, clinicians, obstetricians if you work in perinatal, school cabinets if you work with teenagers.
- Present yourself in a short and professional way: who you are, your tuition, what population you work with, your focus and your availability.
- Cultivate the link with fellow psychologists. Those who have waiting lists, another orientation or other specialty derive often, and need to know whom.
- Close the circuit: I thanked each referral received and, when a case is not for you, derive it well. We write a complete guide to [responsible referral in psychology](/blog/derivacion-responsable-psicologia).
What to Expect: It's the slowest starting strategy and the most stable one once it works. Five or six professionals who trust your work can sustain much of an agenda for years.
## 2. Be where you are wanted: Google and verified directories
Many of the people who decide to start therapy do the same as for almost everything: they search Google. "Psychologist in Rosario", "online therapy anxiety", "perinatal psychologist Córdoba". If you don't appear in those searches, for that universe of patients you don't exist.
How to implement it:
- If you have physical clinical practice, create a Google Business profile (the box with map, times and phone of local searches). It is free, set up in an afternoon and has an effort-result relationship that is difficult to overcome.
- Add to verified professional directories. A serious directory does for you the job of positioning that would only take years: optimized pages, structured data, indexing in Google.
- Complete your profile seriously: professional photo, visible registration, specific bio and clear specialties generate much more confidence than a half-filled profile.
Here comes something that we build: the [public directory of psychologists of Brauni](/blog/directorio-publico-psicologos). Each professional who uses the platform can activate a verified profile, with visible registration, indexed in Google, at no extra cost on his plan and without commissions for the queries he receives. It is not the only directory that exists, but it is one that you already have included if you use Brauni.
In any public profile, I wrote a specific bio. "I attend to various problems" does not position or convince. "I work with adults in anxiety, panic attacks and grief, with cognitive-behavioral focus, online modality" tells Google and the patient exactly what you offer.
What to expect: indexing and positioning take weeks or months, not days. But once your profile appears in the correct searches, work alone, every day.
## 3 Make booking a session easy
You can do all of the above well and lose patients in the last step. A person who gathers courage to write to a psychologist is at a fragile time of decision: if the answer takes three days, or if coordinating a schedule requires eight messages, often follow the next professional on the list.
How to implement it:
- I responded to the first consultation as soon as possible, ideally on the same day. I was able to confirm that you received the message, clarify modality and fees if applicable, and propose a specific schedule.
- I have a model answer prepared for first queries, so you don't write it down every time from scratch.
- Better still: I offered direct online booking. In the Brauni directory, patients can [book direct session from your profile](/blog/reserva-sesiones-directorio), choosing day, time and mode; you confirm each application and do not pay commission for any booking.
What to Expect: This strategy does not generate new demand, but it makes much better the one you already have. It is one of the fastest improvements to implement from the whole list.
## 4. I defined a specialization and a clear niche
"I take care of everything" seems to expand your possibilities and actually reduces them. Whoever seeks help finds someone who understands their specific problem: the couple in crisis is looking for a couple's therapist, the recent non-sleeping mother is looking for someone who works the perinatal.
How to implement it:
- Choose one or two spotlights where your training, experience and real demand cross: anxiety, couples, teenagers, perinatal, grief.
- Align everything to that focus: bio in directories, presentation to colleagues, content if you do content. Let it say the same thing everywhere.
- Specializing yourself does not force you to reject the rest: the niche is how you present yourself, not a restriction of your practice.
What to expect: at first it gives vertigo, because you feel that you leave patients outside. In practice the opposite happens: it is much easier for them to recommend you and find you for something concrete than for "psychologist in general".
## 5. Take care of the experience of the current patient: the mouth-to-mouth is built
Mouth-to-mouth is the favorite channel of all psychologists, but it is usually treated as if it were luck. It is not: it is the accumulated result of the experience of your current patients, from the first message to the end of treatment.
How to implement it:
- Timeliness and framing: start and end on schedule, warn changes with time, session reminders that work.
- Continuity between sessions: to resume in each encounter what was opened in the previous one demonstrates that the process matters to you.
- A first solid interview: this is the moment when the patient decides whether to stay. We have a complete guide on how to structure the [first psychological interview](/blog/primera-entrevista-psicologica).
- Close the treatments well. A patient who ends with a careful closure is the one who is most likely to recommend you for years.
What to expect: It is the slowest channel to build and the highest quality. Recommended patients arrive with prior confidence and usually better sustain treatment.
## 6. Network content, but with ethics
Social media can work for a psychologist, but not as usually shown. You don't need to dance trends or post every day. You need someone in your niche to see you, when someone in your niche finds you, a serious professional who understands your problem.
What works:
- Psychoeducation in your niche: what is a panic attack and what is not, how to know if a couple needs therapy, signs that a teenager is having a hard time.
- Moderate consistency before volume: better one publication managed per week than ten improvised.
- Direct traffic somewhere: your directory profile, your contact form. Untargeted content is entertainment, not strategy.
What does not work (or directly damages):
- Generic viral tips ("5 habits to be happy") that don't differentiate you from any self-help account.
- Expose recognizable cases or cartoons of patients, even if you change the names.
- Promise results or simplify clinical charts to gain reach.
What to Expect: Networks are a medium-term, high-effort channel. For most psychologists they yield less than referrals and Google, so they are in the 6 position and not the 1 position.
## 7. I woven local alliances: institutions, companies and talks
Outside the internet, you also get patients. The institutions in your area (schools, clubs, cultural centers, companies) bring together entire populations that may need what you offer, and almost no one comes to propose anything.
How to implement it:
- I offered short talks or workshops on your topic: management of anxiety in a company, boundaries and screens in a school, parenting in a neighborhood center.
- Don't go selling: go and contribute. A useful 40 minute talk positions you before dozens of people as a referent.
- Leave a clear contact path at the end: your profile, an email, an QR code.
What to expect: irregular return but of good quality. A single talk may bring nothing or bring several consultations and an institutional relationship that lasts for years.
## 8. Health insurance and card to get the first patients
Working with health insurance and private health plans divides water, and rightly so: tariffs are usually low and payments are slow. But for a clinical practice that starts from scratch, the booklet offers something unique: a flow of patients looking for you without you doing anything else to figure out.
How to implement it:
- Choose one or two private health insurances or health plans with a good presence in your area and find out about provider registration requirements.
- Use it as a stage strategy, not a destination: fill part of the agenda, gain experience and generate word of mouth while building the channels of particular patients.
- I put a limit on the proportion of your agenda that occupies the notebook, so that the low tariff doesn't define your full income.
We write in detail about the pros, cons and formalities in our guide to [private health insurance and health plans for psychologists](/blog/obras-sociales-prepagas-psicologos).
Cartilla and individuals are not exclusive: the booklet gives predictability and visibility, individuals give better tariff and more control over the frame. The ideal proportion changes according to the stage of your clinical practice.
What to expect: relatively fast patients, low tariffs, administrative procedures. As initial schedule filling works; as the only long-term strategy, it wears out.
## 9. Use waiting list and strategic schedules
When the agenda begins to move, how you manage your schedules becomes a catch-up tool in itself. Two concrete ideas:
- Active waiting list. If you don't have room for a new patient, don't fire him with a "I don't have schedules": I offered to write it down and let him know as soon as a space is released. A well-kept list gives you a mattress for the natural casualties of clinical practice.
- Strategic timetables for new patients. The most demanded schedules (after work, first hour of the morning) are filled by themselves. Reserve some of those blocks for first consultations: a patient who can start this week has many more chances of realizing than one you offer a gap in a month.
What to expect: does not generate new demand, but avoid wasting the one you have already generated with all the above. It is pure order, and order converts.
## 10. I measured where each query comes from.
The latest strategy makes the other nine work better: to know what is working. Of your last ten patients, how many arrived by referral, how many by Google, how many recommended? Most psychologists cannot answer it with data.
How to implement it:
- Always ask, in the first contact or in the first interview, "How did you get to me?" It's a natural question that no one takes wrong.
- Register the answer somewhere: a spreadsheet, your management system, wherever it is, but let it be written.
- Check the registry every two or three months and I decided accordingly: if referrals bring most patients, I spent more time on your network; if no one comes online after a year of publishing, that effort may yield more on another channel.
What to Expect: Clarity. Stop spreading effort by intuition and start investing it where your data shows that it works.
## WHAT NOT TO DO
The advertising of psychological services is not free: the Code of Ethics of FePRA and the regulations of the professional colleges of each jurisdiction set clear limits. Before applying any strategy, I kept in mind what is left out:
- Testimonies of patients for advertising purposes. Even if the patient accepts, exposing him to promote your practice compromises confidentiality and is at odds with professional ethics.
- Promises of healing or results: "overcome your anxiety in 8 sessions" is not marketing, it is an ethical infringement and a clinical lie.
- The format "before and after" applied to mental health, in any of its variants.
- Give you degrees or training that you do not have, or omit your tuition where it is appropriate to show it.
Also don't buy shortcuts: fake followers, paid reviews or inflated accounts. In addition to the ethical problem, they don't work: a profile with thousands of followers and zero real interaction is transparent for anyone. Trust is not purchased, and in mental health trust is the whole product.
Consult your school's code of ethics before launching any public material. Ten minutes of reading saves you serious problems.
## Frequently Asked Questions
### How long does it take to fill a psychologist's schedule?
There is no standard time frame and don’t trust anyone who gives you one. It depends on your area, your niche, your previous network and how many strategies you apply in parallel. The constant: fast channels (letter, online booking) move the needle in weeks; deep ones (derivations, mouth-to-mouth, Google) take months to mature but then they hold the agenda with less effort.
### Do I need social media yes or yes to get patients?
No. Networks are one more channel, and for many psychologists not even the best. There are full clinical practices built only on referrals, directories and mouth-to-mouth. If creating content is enjoyable, add it up; if you do it by sneer, that time pays more in your referral network.
### Should we lower the fees to attract patients?
As a general strategy, no: the low price attracts price-sensitive patients, who are usually the first to leave, and leaves you with no room to sustain the practice. A deliberate policy (some quotas with reduced tariff, letter in definite proportion) is different than lowering the general price for agenda anxiety. On this we write in the [psychologist fees](/blog/honorarios-psicologos-argentina) guide.
### Do psychologist directories serve, or is it silver thrown?
Depends on the directory. Those who charge for appearing or taking commission per patient usually perform little. One with registration check, good Google positioning and direct contact without intermediaries works for you passively. The Brauni is included in the plan of the platform, without extra cost or commissions.
### What do I do if I am newly received and have no experience to show?
Support yourself in what you do have: specific training, supervision, a clear niche and availability. The channels that work best without trajectory are the notebook, the referrals of colleagues with waiting list and a neat online presence. The experience is built by attending, and to attend first you have to be found.
## Summary
- An empty agenda speaks of visibility, not your clinical ability.
- Professional referrals are the most stable channel: I built a network with psychiatrists, doctors, schools and colleagues.
- Being in Google is unnegotiable: Google Business if you have physical clinical practice and verified directories like Brauni.
- The booking facility converts: I responded quickly and offered direct online booking.
- A clear niche positions; "I take care of everything" does not.
- The mouth to mouth is built: punctuality, follow-up and a first solid interview.
- Networks with ethics and only if you enjoy them; booklet as initial filling, not as destination.
- Ask "how did you get here?" and search it: it tells you where to invest.
- Respect the ethical limits of FePRA and your school: no testimonies of patients, no promises of cure, no reviews purchased.
---
## Burnout in psychologists: early signs and how to prevent it
- **URL**: https://brauni.io/en/blog/burnout-psicologos-prevencion
- **Category**: Mental Health of the Professional
- **Date**: 2026-06-17
- **Tags**: burnout, Compassion fatigue, Self-care, mental health of the professional, psychologists
Guide on burnout in psychologists: early signs of clinical role, factors of clinical practice that feed it and strategies of prevention with sustenance.
Psychologists listen to pain all day. Anxiety, grief, trauma, crisis. And yet, they are usually the last to look at themselves. Burnout in psychologists is one of those subjects that is rarely discussed among colleagues, is consulted late and suffers in silence, almost always with a dose of guilt: "If I work on this, it cannot be happening to me."
Yes it can happen to you. In fact, the very nature of clinical work makes it more likely, not less. To sustain the suffering of others for hours, alone, without anyone asking you how you are, is a working condition with cumulative costs.
In this article we review exactly what burnout is (and what it is not), why professional wear and tear in psychology is so frequent, what are the early signs specific to the clinical role and what prevention strategies have real support. No magic prescriptions or self-help manual: a serious topic, seriously addressed.
## Burnout, fatigue from compassion and vicarious trauma: three concepts that are confused
Before talking about prevention, it is important to distinguish three phenomena that are often used as synonyms and are not. Differentiating them matters because they have different causes and therefore different answers.
### Burnout: exhaustion due to sustained working conditions
The WHO included burnout in the CIE-11 as an occupational phenomenon: it is not a disease, but the result of chronic work stress that was not successfully managed. Maslach's classic description characterizes it in three dimensions: emotional exhaustion (the feeling of having no more to give), depersonalization or cynicism (distant from patients, treating them as cases and not as people) and low personal accomplishment (feeling that work no longer makes sense or impact).
The key detail is that burnout talks about working conditions, not a personal failure. It occurs when the sustained burden exceeds the available resources for too long.
### Compassion fatigue: the cost of empathizing
The concept, developed by Figley, describes the specific wear and tear of those who work by empathizing with the suffering of others. It is not the tiredness of having many tasks: it is the cost of opening one's own emotional apparatus, session after session, to resonate with the pain of another. Unlike burnout, which is gradually installed, compassion fatigue can appear relatively quickly, especially after periods of very demanding cases.
### Vicaric Trauma: When Stories Transform You
The vicarious trauma goes one step further: it is the therapist's internal transformation by repeated exposure to traumatic stories. It's not just about being tired, but the way the world looks begins to change. Whoever works with abuse, violence or catastrophes can notice that his confidence in people, his sense of security or his vision of the future is modified without having a traumatic experience of his own.
That WHO defines burnout as an occupational phenomenon has a practical consequence: prevention involves changing working conditions, not just by "better managing stress." If the agenda is unsustainable, no relaxation technique makes it sustainable.
## Why professional wear and tear in psychology is so common
Any worker can develop burnout, but the role of the clinical psychologist brings together several risk factors at the same time.
The first is invisible emotional work. A session is not just 50 minutes of conversation: it is sustained attention, regulation of one's own emotional response, tolerance to uncertainty, and sometimes very heavy material containment. None of that is seen from outside, and that is why it tends not to count as effort.
The second is the loneliness of clinical practice. Most psychologists work in private, without team, without a corridor where to comment on a difficult case, without a colleague who notices that today you arrived different. The isolation not only deprives of support: it also deprives of mirror. No one returns an image of how you are.
The third is the absence of a structure that protects. There is no schedule record, no agreement that limits the day, there are no scheduled licenses. The limit is you or no one puts it. And when income depends on the number of sessions, the economic incentive always pushes in the same direction: add one more patient.
The fourth is perhaps the quietest: the requirement to be "well" to be able to attend. There is an implicit mandate that those who help cannot need help, and that makes it time for many professionals to consult for their own discomfort. The stigma of mental health also operates among those who work in mental health.
## Early signs: how burnout looks in psychologists before the crisis
The burnout installed is easy to recognize. The difficult, and useful, is to detect early signs, which in the clinical role have very concrete forms:
- **Look at the clock wanting the patient to miss.** Not once: as a pattern. When the other's absence becomes the best news of the day, something is calling for attention.
- **Relief disproportionate to cancellations.** We all appreciate an unexpected gap at some point. The signal is when each cancellation feels like a pardon.
- **Irritability with patients who didn't bother you before.** The same story, the same resistance, the same silence that you tolerated a year ago without a problem, today gives you trouble.
- **Notes that accumulate without writing.** Clinical documentation is one of the first to fall when there is no energy left. Unregistered session weeks are usually a fairly accurate thermometer.
- **Isolation of colleagues.** Stop going to supervision, postulate the study group, don't tell colleagues chat. Just when more network you need, less search.
- **Physical symptoms.** Insomnia, contractures, headaches, getting sick more often. The body usually records wear before consciousness.
- **Incipient cynicism.** Thoughts of the "other with the same" type or "this is of no use" that previously did not appear.
None of these signals makes you a bad professional. They are information, not a sentence. The problem is not to have them: it is to ignore them until the only way out is to stop attending.
## Clinical practice factors that feed (and can be changed)
Not all the wear comes from the clinic itself. Much originates from how the practice is organized, and that, unlike the content of the sessions, can be modified.
### Intersessional agenda
Chaining patients behind each other, without ten minutes to write the note, drink water, or simply breathe, turns the day into a marathon without hydration stations. Intersessional breaks are not lost time: this is what allows you to close a meeting before opening the next one.
### More patients than you can sustain
There is no universal number, but there is a number of you: the number of processes that you can accompany with the head and body available. Overcoming it in a sustained way is not noticeable in week one; it is noticeable in month six.
### Low fees that force the agenda to overload
When the value of the session does not reach, the only adjustment variable seems to be to attend more. It is a familiar circle: low fees, saturated schedule, less energy per patient, more wear and tear. Reviewing how you set your [honoraries](/blog/honorarios-psicologos-argentina) is not just an economic decision: it is an occupational health decision.
### Administration out of time
The pending notes, the coordination of appointments, the invoices: all that usually resolves to the 11 of the night, at the only "free" moment of the day. It is unpaid work that eats the recovery time, and is one of the most modifiable factors on the list.
## Sustainable prevention strategies
There is no one-size-fits-all solution, but there is a set of practices supported by the literature on professional wear and tear and accumulated clinical experience.
### Regular clinical supervision
Supervision is not only for difficult cases or for the early years. It is the space where work is shared, where counter-transfer is thought rather than accumulated, and where another professional can see what you no longer see. Holding it in time, even when "no need" is one of the most consistent preventive measures.
### Personal therapy
Personal therapy is not a formal obligation in all contexts, but it works as an early detection network: your therapist is more likely to notice your wear and tear than you do.
### Specific agenda limits
Abstract limits ("I have to take care of myself more") do not work. Concretes, yes:
- A patient stopper per day, predefined and non-negotiable with yourself to those in a hurry.
- Real breaks between sessions, scheduled as if they were appointments.
- At least one day a week without clinical practice, with no exceptions "this time".
- Schedules of start and close that are respected, also the days on which you "could" add one more.
### Network of colleagues
Against the loneliness of clinical practice, structure: an intervision group, a study space, even if it is an active chat with two or three trusted colleagues. It does not need to be formal; it needs to be regular.
### Movement and sleep
It sounds basic and it is: clinical work is sedentary and mentally intense, a combination that the body pays for. Sleeping enough and moving regularly do not prevent burnout alone, but its absence speeds it up quite reliably.
### Reduce administrative burden
If notes, appointments, and reminders are eaten your nights, that is a concrete front where you can earn hours. Automating [appointment reminders](/blog/gestion-citas-psicologos) eliminates a repetitive task that no one misses, and using tools to [shorten notewriting time](/blog/ia-completar-notas-sesion) can reduce to minutes what takes you the last hour of the day today. It's part of what we're looking for with Brauni: that the administration takes less place in your week, so that that time goes back to where it has to be, which is your break.
No tool prevents burnout alone, and no technology replaces monitoring, therapy, or schedule limits. What it can do is to return hours: if the administration steals five hours a week, recovering them is a concrete, not cosmetic measure.
## When yours is no longer prevention
All of the above applies to incipient wear. But if when reading the early signs you recognized a picture installed months ago (exhaustion that does not yield with rest, persistent physical symptoms, marked disconnection with patients, significant discomfort), the time of prevention has already passed and the next step is another.
First, consult. With your therapist, with a doctor if there are physical symptoms, with whom it is appropriate. The same criterion you use with your patients is valid for you: sustained discomfort is not resolved with will alone.
Second, evaluate your schedule with clinical honesty. If you cannot support all your patients with the quality of care they deserve, reduce the schedule or derive some processes is not to abandon them: it is to take care of them. We already write about how to make a [responsible referral](/blog/derivacion-responsable-psicologia), and this is exactly one of the scenarios where it applies. Attending from emptying is not neutral for the patient, and codes of ethics recognize it: working in conditions that compromise your professional judgment is an ethical problem, not just personal.
Third, give yourself permission to pause. A period without clinical practice, or with a minimal schedule, may be the difference between recovering and chronicling the picture.
## Frequently Asked Questions
### Burnout is the same as depression?
No. Burnout is an occupational phenomenon, specifically linked to the work context: the WHO describes it in the CIE-11 as a result of unmanaged chronic work stress, and does not classify it as a medical condition. Depression is a clinical picture that goes through all areas of life. That said, it can coexist and be confused, and a sustained burnout can lead to a depressive picture. If you have doubts about your situation, that doubt already justifies a consultation.
### How many patients per day is too much?
There is no magic number, and don't trust the one who gives you one. The criterion is functional: it's too much when you can't be fully present in the last session of the day, when the notes accumulate because there's no energy left to write them, or when you need the whole weekend just to go back to zero. That threshold varies according to the type of patients, your vital moment, and your experience. The useful question is not "how many others attend" but "how many I can hold, today, with quality".
### Do vacations cure burnout?
They ease, but they don't cure. If the rest takes you back and you return well, it was probably accumulated tiredness. If two weeks after you return you are the same as before, the problem was not the lack of vacation but the working conditions you returned to. Burnout is approached by changing those conditions, not only interrupting them.
### Does compassion fatigue mean I have to leave the clinic?
Not necessarily. Compassion fatigue usually responds well to specific measures: to vary the composition of the agenda (not to concentrate all cases of trauma), to increase supervision, to strengthen the spaces of recovery. Many professionals go through it at some point and continue to exercise it for decades. The alarm signal is to ignore it and follow as if nothing.
### Having burnout signals disqualifies me from attending?
Having early signs, not: they are precisely the opportunity to intervene in time. What does compromise the practice is the picture installed and neglected, because it affects the emotional availability and clinical judgment. The responsible response is not to stop attending to the first signal, but to take it seriously: consult, adjust the agenda and, if necessary, derive the processes that you cannot sustain.
## Summary
- Burnout is an occupational phenomenon recognized by the WHO in the CIE-11: it speaks of sustained working conditions, not of personal weakness.
- It should be distinguished from compassion fatigue (the cost of empathizing session after session) and vicarial trauma (the internal transformation by exposure to traumatic narratives).
- Psychologists are at risk: invisible emotional work, loneliness of clinical practice, absence of structural limits and the mandate to "be well" to be able to attend.
- Early signs of clinical role include wanting the patient to miss, relief from cancellations, new irritability, accumulated notes, peer isolation, and physical symptoms.
- The modifiable factors of clinical practice: calendar without pauses, more patients than sustainable ones, low fees that force overload and administration out of time.
- The strategies with sustenance: regular supervision, personal therapy, specific agenda limits, network of colleagues, movement and sleep, and reduce the administrative burden to recover hours of rest.
- If the box is already installed, it is not time for prevention: consult, adjust the agenda and consider deriving processes that you cannot sustain with quality.
---
## health insurance, private or private health plans: guidance for psychologists
- **URL**: https://brauni.io/en/blog/obras-sociales-prepagas-psicologos
- **Category**: Management of clinical practice
- **Date**: 2026-06-10
- **Tags**: health insurance, private health plans, refunds, invoicing, clinical practice, psychologists
Letter, return or particular: guide for psychologists on health insurance and private health plans in Argentina. Pros, cons, invoicing and how to put together your mix.
One of the first economic decisions that psychologists face when opening clinical practice is also one of the least explained: do you work with health insurance per card, take care of personal reimbursement or cobras? The answer defines how much you gain per session, when you charge and how much bureaucracy you add to your week. And yet, in the faculty almost no one approaches it.
What usually circulates among colleagues are loose phrases: "health insurance pays little and late", "reimbursement is the best", "particular is never filled." They all have some truth and none is enough to decide, because the modality that suits you depends on the moment of your practice, your area, your patient population and how much administrative time you are willing to absorb.
In this guide we explain the legal framework of mental health coverage, the three modalities with their honest pros and cons, what a patient needs to manage the recovery of psychology with his private health plan, how to invoices without mistakes and how to put together a mix that you can review over time.
## The framework: mental health coverage is mandatory
Before comparing modalities it is important to understand why patients ask "do you care for health insurance?" It's not just a question of cost: it's a right.
The 26.657 Mental Health Act provides that health insurance and private health care companies must provide mental health coverage. In turn, the Compulsory Medical Program (PMO) includes psychological care within the benefits that every funder must guarantee, and provides a floor of annual sessions per member. The exact number of sessions, co-payments and conditions of access depend on the regulations in force and each funder, so before a timely consultation the correct thing is to refer the patient to his or her health insurance or private health plan.
The PMO defines a cover floor, not a roof. Many private health plan plans offer more sessions or better conditions than the mandatory minimum. Therefore, it is always advisable for the patient to see what covers his or her specific plan before assuming a limit.
For you, this means two things. First, that the demand for care with coverage exists and will continue to exist: it is structural. Second, that the obligation to cover is from the funder, not yours: you choose if you want to be part of that chain as a card provider, if you prefer that the patient manage a refund or if you work in a particular way.
## Letter, return or particular: the three modalities
### 1.
You will join as a provider of health insurance or private health plan, either directly or through the professional college of your jurisdiction. The patient places you in the card, pays a copay (or nothing, according to the plan) and the funder liquidates your sessions.
Pros:
- Constant flow of patients without effort of diffusion: the booklet brings you consultations.
- It's the fastest way to fill your schedule when you're starting.
- It allows people who could not pay a particular fee to attend.
Cons:
- The tariff is fixed by the financier, not you, and is usually well below the particular fee of the area.
- Payments are delayed: between 30 and 90 days is the usual, and in some cases more.
- Constant bureaucracy: prior authorizations, session caps, consolidated monthly invoicing and debits due to administrative errors that you have to claim.
### 2.
The patient pays your full fee in each session, you give him the invoices and he presents it to his private health plan, which returns him a part (or the total, according to the plan) of the value of the session.
Pros:
- Keep your fee: don't work on a tax.
- You'll pay in the moment, without waiting for liquidations.
- Your only administrative obligation is to deliver a proper invoice.
Cons:
- No invoices is refunded: you need to be formalized and invoices each session.
- The patient advances the money and does the procedure, and that discourages a part of the consultations.
- The amount he recovers depends on his plan, and you cannot guarantee or promise.
### 3.
The patient pays your fee and no funder intervenes. It is the simplest relationship: you agree a value, you attend, you will pay.
Pros:
- Free and up-to-date fee when you decide.
- Zero bureaucracy of third parties: no authorizations, no settlements, no debits.
- Direct and transparent economic relationship with the patient.
Cons:
- All patient uptake depends on you: recommendations, referrals, online presence.
- It is the most sensitive to the economic context: when the pocket tightens, the first thing that is cut is the expenditure that has no coverage.
A quick comparison:
| | Cartilla | Return | Particular |
|---|---|---|---|
| Who sets the fee? | The funder | You | You |
| When will you charge? | Upon liquidation (weeks or months) | In each session | In each session |
| Who does the procedure? | You | The patient | No one |
| Administrative burden | High | Low (only invoicing) | Minimum |
| Patient flow | Stop it, get the letter. | Medium | Depends on your broadcast. |
## What the patient needs for reintegration (and what he will ask of you)
Each private health plan has its own circuit, but the requirements are usually similar. The patient is usually asked to:
- The invoices for each session, issued in your name.
- Professional data: full name, CUIT and registration number.
- In some plans, a prescription or referral that indicates psychological treatment.
- In certain cases, a report or record with the diagnosis.
That translates into what they are going to ask of you: invoices in order with your data and your registration, and eventually some additional document. Here is a delicate point that should be handled well.
The diagnosis is a sensitive data protected by the 25.326 Personal Data Protection Act. Before reporting a diagnosis to a funder, talk to the patient and make sure you have his/her consent. He/she informs only the minimum necessary for the procedure: in many cases he/she can record "psychotherapy" or the concept that the funder requires, without clinical detail. We tell you more in our guide on the [law of protection of personal data for psychologists](/blog/ley-proteccion-datos-personales-psicologos).
The general recommendation: always deliver what the procedure requires, no more or less. A refund does not justify pouring clinical content into a paper that will circulate through administrative areas of a company.
## How to invoices well for refunds
The invoices is the centerpiece of the refund. If you have mistakes, the private health plan rejects it and the patient asks you again for a new one, with the discomfort that that creates for both of us. To make it right at the first:
- Issue valid electronic invoicing (Type C invoice if you are a monotributist). If you are not registered yet, in our guide to [monotribut for psychologists](/blog/monotributo-psicologos-argentina) we explain how to register and which category corresponds to you.
- It will be made in the name of the patient, with its DNI or CUIT. An anonymous "end user" invoices is usually rejected because the funder needs to identify the affiliate.
- It uses a clear concept: "session of psychotherapy" or "session of psychology" with the date of attention.
- I included your tuition if the private health plan requires it (many ask for it on the invoice or in a supplementary receipt).
- Emitila in date: invoices with long session delays can generate observations.
The full step of the tax circuit is in our [electronic invoicing for psychologists](/blog/facturacion-electronica-afip-psicologos) guide. And if you use Brauni, [invoicing is integrated into clinical management](/funcionalidades/facturacion-afip): you issue the invoices with CAE from the patient's file, with your data already loaded, without leaving the platform or copying information by hand.
## How to build your mix (and when to change it)
Few practices are 100% particular or 100% particular. The usual is a mix, and a very repeated path (although it is not a rule) is this: start with one or two notebooks to fill the schedule and, as demand grows by recommendation, gradually migrate to return and particular, who pay better per hour worked.
To decide with data and not with sensations, calculate the actual cost of each card session:
1. Take the rate paid by the funder.
2. Restor the proportional share of your monotribute and your fixed expenses.
3. Add administrative time: authorizations, monthly invoicing, debit claims.
4. It considers the delay in collection: a tariff that arrives two or three months later is worth less in real terms, especially with inflation.
With that number opposite, compare it to your particular fee and I decided how many hours of your week you want to assign to each modality. If you haven't defined your fee yet, in our [psychologist fees](/blog/honorarios-psicologos-argentina) guide we give you criteria to calculate it.
Check your mix once or twice a year. If your schedule is full and you have a waiting list, it's probably time to cut back on notebook hours. If you have holes, a notebook can be the fastest way to cover them. Mix is not a professional identity: it's a tool that fits.
## How to communicate "reimbursement"
The most frequent question you're going to receive for WhatsApp is "Do you attend to [health insurance]?" If you work for reinstatement, the difference between losing or winning that patient is usually in how you explain it. A brief, concrete message works better than a class on the health system:
> Hi, [name]. I don't work by letter with [private health plan], but by return: you pay the session and I give you the invoices so that it is present in your private health plan, which returns a part of the value according to your plan. I recommend you consult them how much you are reintegrated by psychology session so you know before you start. Any doubts with the procedure, I will gladly help you.
Three details that improve the conversion of that message:
- Clarify the mechanism before the first session, never after you collect it.
- Invite the patient to consult his plan: thus the expectation of the amount is set by the funder and not you.
- I offered help with the part that does belong to you (the correct invoice), without taking charge of the procedure.
## Collections and registration: don't let the silver slip away
Whatever your mix is, you need to know at all times who paid, who owes and how much each funder owes you. With a card, debits and settlement differences are current currency, and if you don't keep track of your own, you don't have what to claim. With return and particular, patients' debts accumulate in silence if you don't write them down at the time.
A minimum record per patient should include: sessions performed, value of each, payments received with date and a half, outstanding balance and invoices issued. In Brauni that record is part of the patient's file: each payment and each debt is associated with the person, and the invoice is issued from the same place, so that the session circuit at collection is closed without parallel sheets.
## Frequent errors
### Accept all cards without calculating the actual cost
Adding agreements gives a sense of security, but each card with low tariff and delayed payment may be costing you money per hour worked. Do the full account (arancel, taxes, administrative time, delay) before signing.
### Do not invoices
Working without invoicing leaves you outside the return circuit, exposes you fiscally and weakens your professional support. Formalization is the basis of any modality you choose.
### Inform diagnostics without need
Sending detailed clinical reports when the procedure only required an invoice is an error with legal and ethical implications. Sensitive data: always the minimum necessary and with the consent of the patient.
### Promise the refund amount
You will not control how much the private health plan returns. If you assure the patient "reintegrate everything" and the plan covers less, the anger you take. Let the amount always be confirmed by the funder.
### Never adjust the mix
The combination that served you to start may be holding you back three years later. Agenda filled with frozen card tariffs is the clearest sign that it is up to you to review.
## Frequently Asked Questions
### Am I obliged to take care of health insurance?
No. The obligation to provide mental health coverage is the obligation of private health insurance and health plans, not of each professional. You decide freely if you will join as a card provider, if you tend to return or if you work only in a particular way.
### Does the patient need medical referral for reimbursement?
It depends on the funder and the plan. Some private health plans ask for a prescription or referral that indicates psychological treatment; others accept the invoices alone. The most practical thing is for the patient to consult the requirements of their plan before the first session.
### Do I have to put the diagnosis on the invoices?
In general no. The concept "session of psychotherapy" or "session of psychology" is usually sufficient. If a funder requires a diagnosis in any document, it informs the minimum necessary and always with the consent of the patient, because it is sensitive data protected by the Law 25.326.
### What if the private health plan rejects reinstatement?
The procedure is between the patient and his funder, but you can help: check that the invoices has the correct data and, if there was a mistake of yours (wrongly written name, confusing concept), it issues a new one. If the rejection is unjustified, the patient can claim before his private health plan and, if he does not get an answer, before the Superintendency of Health Services.
### Can I combine card, refund and private?
Yes, and it's the most common thing. Many professionals reserve part of the notebook schedule and the rest for return and individual. The important thing is to know the actual performance of each modality and adjust the proportion according to the stage of your practice.
### Do I need to be a monotributist to attend for reinstatement?
You need to be able to issue invoices in order, and for most psychologists the path is the monotribute. Without valid invoices the patient cannot initiate the procedure, so formalization is a requirement of fact to work with this modality.
## Summary
- Mental health coverage is mandatory for private health insurance and health plans (Law 26.657 and PMO, which provides for an annual session floor according to current regulations and each funder).
- Cartilla: constant patients, but tax imposed, payments that take between one and three months or more, and high bureaucracy.
- Reimbursement: You will keep your fee and charge at the time; the procedure is the patient's and your obligation is the invoices in order.
- Particular: Free honorary and zero bureaucracy, but all patient acquisition depends on you.
- For reimbursement, the patient needs your invoices with his or her data, your CUIT and your tuition; the diagnosis only if the plan requires it, with consent and the minimum necessary (Law 25.326).
- A common path (not a rule): start with a notebook to fill agenda and migrate to return and particular as demand grows.
- Register payments, debts and invoices per patient: without your own registration there is no possible claim or real control of your economy.
- Check your mix once or twice a year instead of keeping it fixed forever.
---
## Cancellation policy for psychologists: how to charge absences
- **URL**: https://brauni.io/en/blog/politica-cancelacion-consultorio-psicologia
- **Category**: Management of clinical practice
- **Date**: 2026-06-03
- **Tags**: cancellations, absences, cancellation policy, frame, fees, psychologists, template
Cancellation policy guide for psychologists: when to charge for a cancelled session, how to communicate it without damaging the link and clause ready to copy.
A patient warns you at 9 in the morning that he does not arrive at the 10 session. The gap he leaves does not recover: that time can no longer be offered to anyone. The appointment of a psychologist is the only "marketing" that expires at the exact moment when it is not used: it is not kept, it is not sold tomorrow. And yet, most professionals are guilty of charging it.
A policy of cancellation in clinical practice of psychology is not a gesture of hardness or a disguised fine: it is part of the framing. It defines what happens when a patient cancels late or directly does not come, and defines it before it passes, when there is still no discomfort in the way. Without that previous rule, each absence becomes an uncomfortable negotiation.
In this guide we explain why it is legitimate to charge a cancelled session if it is agreed in advance, how to define your own policy, how to communicate it without damaging the therapeutic relationship and what to do the first time you apply it. It includes a model clause ready to copy.
## Why Absences Are a Double Problem
### The economic problem: the time reserved is the product
When a patient takes a fixed schedule, he is not just buying the 50 minutes of the session: he is buying the reservation of that space in your week. You organized the schedule around that commitment, you rejected other patients for that schedule, and you sustain clinical practice with that income.
An absence without notice is not a session that "was not done": it is an hour of work that was already assigned and that no one else could use. That is why the cancellation policy is a central chapter of any [fees guide](/blog/honorarios-psicologos-argentina): it is of little use to define how much your session is worth if a part evaporates into holes that nobody pays.
### Clinical problem: discontinuity affects treatment
The cost is not only economical. The regularity of the sessions is part of the therapeutic device: a patient who lacks followed cuts the thread, arrives at each session "starting again" and tends to stagnate. A clear cancellation policy also protects that: it tells the patient that the space has a value and that sustaining it is part of the treatment.
## Is it legitimate to charge for a cancelled session or non-attendance?
Yes, on one condition: that it be agreed in advance and in writing.
Collecting a late cancellation session or non-attendance is an accepted and extended professional practice. It is not a fine or punishment: it is the consideration for a space that was reserved exclusively and could not be reassigned.
The key is in the previous agreement. If the patient knows the rule from the beginning and has it in writing, to apply it is to comply with the agreement. If the issue was never discussed and appears for the first time when the patient is missing, there it is lived as arbitrariness, and rightly so.
The natural place to leave it agreed is the initial framing, documented in the [informed consent](/blog/consentimiento-informado-psicologia) or in a separate work agreement. In fact, a full informed consent already includes a fee and cancellation section.
The golden rule: never take an absence that was not agreed in writing in advance. Without prior agreement there is no policy, there is a unilateral decision taken hot. And that can damage the bond.
## How to define your own cancellation policy
There is no single right policy. There is one that you can consistently sustain. These are the points that you have to decide.
### The warning window: 24 or 48 hours?
It is the heart of politics: how much anticipation the patient has to warn so that the cancellation is not charged.
- **24 hours** is the most commonly used standard: easy to remember ("until the day before the same time") and with reasonable room for the patient.
- **48 hours** makes sense if your schedule is too full or you work with a waiting list and you need more time to reassign the appointment.
Less than 24 hours is difficult to defend and more than 48 starts to feel rigid. Choose a window, write it in specific hours and don’t change it according to the patient.
### Actual contingencies and exceptions
Life passes: an internment, an accident, a family emergency. A policy without any room for the unforeseeable becomes inhuman and ends up generating the conflict that I wanted to avoid.
Our recommendation: reserve the criterion explicitly. The policy is applied by default, and you keep the power to exempt it from situations of force majeure, case by case and with clinical criteria. That is very different from the exception being the rule: if you end up excluding each flu and each "I hung up", you no longer have politics. A practical stick: the exception is for what the patient could not foresee or solve, not for what he did not prioritize.
### Reprogram or collect?
I also defined what happens to reprogramming:
- **Notice inside the window**: the appointment is cancelled or rescheduled at no cost.
- **Notice outside the window**: the session is paid. Some professionals also offer to reschedule within the same week if they have a gap; if the patient takes it, the session is done and charged as a normal session.
- **Inattention without notice**: the session is paid in full. It is the clearest case, because there was not even a chance to reassign the schedule.
Courtesy reprogramming is a possibility you offer when you can, not a right to dodge politics.
### Holidays and holidays: politics runs for both of us
A serious frame is symmetrical. I also defined:
- **Your vacation**: advises in advance (one month is reasonable) and those weeks are not charged.
- **Patient's Holidays**: if you notify with the same anticipation, they are not charged.
- **Ferias**: I decided in advance if you attend, if the session is passed to another day of that week or if there is no session or charge.
- **If you cancel**: the session is not charged and offer to reschedule, warning as early as possible, as you ask the patient.
## Repeated Absence: Clinical Reading
So far we speak of absence as an administrative problem, but when absences are repeated, there is something else to look at.
A pattern of cancellations can be resistance to treatment, avoidance of a topic that is approaching, or a sign of something that happens in the therapeutic link: anger not said, stagnation, doubts about following. In such cases, invoicing for absence and not saying anything else is losing valuable clinical information.
The most useful behavior is usually to take it into session: "I noticed that in the last month you cancelled three times. I am interested that we can think together what is happening with this space." Sometimes the answer is purely logistical and the solution is to adjust the schedule. Other times a material opens that would not have appeared otherwise.
Beware of the opposite extreme: not all absence is a failed act. Overinterpreting each flu or every transit problem as resistance is as unhelpful as never reading the pattern. The clinical signal is in repetition, not in the isolated episode.
## How to communicate your cancellation policy without damaging the link
Politics communicates at the worst possible time or at the best: when the patient has just missed, or in the first interview, when nothing has happened yet and it is simply one more condition of work, such as the schedule or value of the session.
Three principles:
1. **From the beginning**: is explained together with fees, frequency and modality. Said at the beginning, it is information; said after a fault, it seems retaliation.
2. **In writing**: in the informed consent or in a work agreement that the patient signs or accepts. The writing avoids "no one told me".
3. **For the reason, not only the rule**: a phrase reaches. "I reserve this schedule exclusively for you; therefore, if you cannot come, I ask you to let me know with 24 hours in order to be able to reorganize."
### Model clause ready for copying
You can adapt this text and include it in your informed consent or work agreement:
> **Cancellations and absences.** The agreed schedule is reserved exclusively for the patient. Cancellations or reprogramming orders must be communicated at least [24/48] hours in advance. Sessions cancelled after that deadline, as well as absences without notice, are paid in full, since the schedule cannot be rescheduled. Except for duly justified situations of force majeure, at the discretion of the professional. If the cancellation comes from the professional, the session is not paid and the reprogramming is offered. Holiday periods on both sides, with reasonable advance notice, do not generate charge.
### Short message to remember when it happens
When a patient cancels outside the window, there is no need for a speech. A brief, cordial and unreproached message:
> Hello [name], thanks for warning. As cancellation is with less than [24/48] hours, the session is paid according to what we agreed at the beginning. If you want, I see if I have a space this week to reschedule it. See [day].
The order matters: first the recognition, then the rule (with reference to the agreement, not your decision), then an alternative if it exists. No justification in three paragraphs.
## The first time you have to apply it
The first application is the one that defines whether your policy exists or is decorative. A short script for the next session, if the topic appears:
> "As we spoke at the beginning, the schedule is reserved and therefore cancellations with less than 24 hours are paid. I know it can be uncomfortable, and at the same time it is what allows us to hold this space in a stable way. If the schedule stopped serving you, we review it together."
Three things to avoid:
- **Apologize to collect**: You can empathize with discomfort without asking forgiveness for fulfilling the agreement.
- **Convert it into sermon**: The rule applies once and goes ahead, without warning.
- **Decide at the moment**: If you doubt whether the exception is appropriate, I say, "Let me think about it and I confirm you tomorrow." Better a delayed response than an improvised rule.
## Automatic reminders: the best policy is the one that is hardly used
An important part of absences are not decisions: they are forgetfulness. The patient did not choose to miss; it was missed. And those are exactly the absences that a timely reminder avoids.
A notice 24 or 48 hours before the session serves a double function: it reminds the patient of the appointment and gives him the chance to reschedule inside the notice window, i.e. at no cost. It is not just a tool for reducing gaps: it is a courtesy to the patient, which can be reorganized in time rather than finding out late that the session is charged the same.
Doing it by hand is another administrative job. In Brauni [the reminders via WhatsApp](/funcionalidades/agenda-turnos) they are automatically sent before each session, with the anticipation that you set up, and the patient can confirm or warn that it does not arrive. In our [appointment management for psychologists](/blog/gestion-citas-psicologos) guide we count on how to set up that circuit.
Align the reminder with your warning window: If your policy is 24 hours, set the reminder to arrive before the window closes. Thus, the patient always receives the warning when it is still on time to cancel at no cost.
## Record absences in medical records
Absences are also recorded. A brief entry reaches: date, whether notice was given or not, how far in advance, and whether the policy was applied or an exception was made.
That record has two functions. The administrative one: if there is a disagreement about how many sessions are due or when it was notified, you have the history. And the clinic: the pattern of absences is seen in the record long before in the memory, and it is a concrete input for the clinical reading mentioned above. In our guide to [medical records in psychology](/blog/historia-clinica-psicologia) we explain what is best to record and how. If you use a clinical software, mark the appointment as absence and that is associated with the patient's file simplifies all this.
## Frequent errors
### Having no policy
The most common mistake. Without a previous rule, each absence is solved by improvising, with guilt and according to the mood of the day. The result is usually never to collect and accumulate silent discomfort.
### Having it and never applying it
A policy that is enunciated but never executed teaches that the rule is not serious, and patients register it quickly. If you wrote 24 hours, hold it; if you know that you will not be able, I wrote a softer but fulfilling rule.
### Apply it with anger
Politics exists just so you don't have to be angry: the rule works for you. If you communicate it with annoyance, the patient doesn't listen to the framing, listen to anger. Neutral tone, reference to agreement, and something else.
### To collect without having agreed
The only scenario in which to charge an absence is really a problem. If it was not agreed, do not charge it retroactively: present the policy forward, in writing, and apply it from there.
## Frequently Asked Questions
### Can I charge 100% of the session cancelled?
Yes, if so agreed. It is the most common and the simplest thing to manage: the cancelled session outside the window is paid in full. Some professionals prefer to charge a percentage (for example, half) as an intermediate formula. Both options are valid; what does not work is to decide on a case-by-case basis.
### What if it's me who cancels?
You do not charge and offer to reprogram, warning as early as possible. Symmetry is part of legitimacy: it is much easier to sustain the rule when you also fulfill it.
### What happens if the patient attends for health insurance or private health plan?
Health insurance and private health plans in general do not recognize sessions not performed, so absence is not invoiced by that way. It is customary to agree that late cancellations and absences are paid in a particular way. It has to be explicit in the initial agreement, because it is the case where it generates the most surprise.
### Does the policy apply to the first consultation?
You can apply it, but it is more difficult to sustain: there was still no framing or signed agreement. The most practical thing is to communicate the rule to the scheduler (a confirmation message with the summary policy) and, if the patient is missing without notice, decide whether or not you want to reschedule. The complete policy applies since the framing was agreed.
## Summary
- The quote is the only "goodery" that expires at the time: an absence without notice is an hour of work that no one could use.
- Collecting a late cancellation session or non-attendance is an accepted professional practice, provided it is agreed in advance and in writing.
- The policy is documented in the informed consent or working agreement: notice window (24 or 48 hours), what happens outside the window, force majeure exceptions, and symmetrical holiday rules and cancellations of yours.
- Exceptions are decided on a clinical basis, but if the exception becomes a rule, there is no longer policy.
- Repeated absences can be clinical material: they are taken into session, not just invoicing, without overinterpreting isolated episodes.
- The policy is communicated in the first interview, in writing and with the motive; it is applied in a neutral tone and without excessive apologies.
- Automatic reminders before the warning window closes avoid absences from oblivion and give the patient the chance to reprogram at no cost.
- The absences are recorded in the medical records: date, notice, application or exception of the policy.
---
## New: Patients can now book direct session from your profile - no commissions
- **URL**: https://brauni.io/en/blog/reserva-sesiones-directorio
- **Category**: Product
- **Date**: 2026-05-27
- **Tags**: directory, reservations, agenda, appointments, patient acquisition, no commissions, availability
Activate your availability in the Brauni directory and I received direct session reservations. Patients choose day and time, you confirm. No booking fee or session fee, included in your plan.
When we launched the [public directory of psychologists](/blog/directorio-publico-psicologos), patients could find you and contact you. That was fine, but one step was missing: that they could **schedule a session directly from your profile**, by choosing day, time and mode. Today that is already true.
## What changes
Before, a patient looked at your profile, texted you and expected you to respond to coordinate a schedule. Now see your **real availability** and book directly on an appointment that will serve you. You get the application and confirm it. No WhatsApp back and forth, no "do you have anything on Tuesday?"
The full flow:
1. **The patient searches** in the directory by specialty, modality or city
2. **Enter your profile** and see your calendar with the available times of the week
3. **Choose an appointment** and complete your data (name, email, query reason)
4. **You receive the reservation** and confirm it or reject it
The patient knows there's a real appointment waiting for him, and you know someone wrote to you who already saw your profile, your focus and your availability.
## How the availability looks in your profile
Each directory profile now has an availability section below your bio and specialties. Show:
- **Weekly calendar** with the next 7 days
- **Opening hours** per day, in the time zone of Argentina (GMT-3)
- **Movement selector**: online or face-to-face (if you offer both)
- **Season browsing** to see future availability
Patients see only appointments that you make available. If a schedule has already been booked, it disappears automatically. You don't have to update anything by hand.
## And on the list: "Next appointments"
Not only in the profile. On the **search page**, every psychologist card now shows the next available appointments. The patient sees something like:
> **Next appointments**: Today 14:00 · Mar 10:00 · Mié 11:00
This completely changes the dynamics: the patient no longer has to enter profile by profile to see who takes place. From the list you can identify who has availability soon and take action.
## No commissions - neither now nor ever
This is important and we will repeat it whenever necessary: **Brauni does not charge commission for reservations you receive through the directory**. Not a percentage, not a fixed fee, nor a "premium plan to unlock reservations".
The session reservation is a feature included in your Brauni plan. If you already pay for the plan, you already have access. If you are on the free 30 day trial, too.
Why? Because we are not a marketplace. We do not compete with you for the patient or keep a part of your work. The directory exists for more people to find a suitable psychologist, and the direct reservation exists for that to be translated into real sessions, not messages that are lost.
Quick comparison: Many medical appointment platforms charge between 10% and 30% of each consultation, or require a separate monthly fee only to appear. In Brauni, visibility in the directory and direct bookings are included in the same plan you already use to manage your clinical practice.
## The patient reserves, you confirm
Every booking you enter is a **request pending confirmation**. not automatically confirmed. You decide whether or not to accept each appointment. This gives you total control:
- If a patient book on a schedule that you already occupied by another channel, you can refuse the application.
- If you want to filter for query before accepting, you can do so.
- If you're on vacation and missed an open appointment, it's okay - the reservation awaits your confirmation
The patient receives a clear warning that his appointment **is pending confirmation**, is unconfirmed. There is no confusion.
## Cancellation from email
If a patient needs to cancel, they can do so from the same confirmation email with a single click. Without having to call or send a message to you. The cancellation is immediately reflected and the appointment is again available to other patients.
## How to set up your availability
If you already have an account in Brauni:
1. **Ingresses to** [app.brauni.io](https://app.brauni.io)
2. Go to **My Profile → Directory**
3. Find the section **Agenda Settings**
4. I defined your time blocks per day of the week and modality
Your availability is synchronized with the directory in real time. If you change a schedule, the change is reflected in minutes.
Tip: Set at least 3-4 blocks per week dedicated to new patients. A profile with visible availability generates many more reservations than one that only shows "Contact." Immediateness matters - if someone seeks psychologist, he wants to know that he can start this week.
## For psychologists who do not yet use Brauni
If you came to this article looking for ways to get more patients, here's what you get with Brauni:
- **Verified public profile** indexed in Google with SEO optimized
- **Direct session reservation** without commission, without intermediaries
- **Calendar with actual availability** visible to patients
- And also: appointment management, reminders via WhatsApp, AFIP invoicing, medical records, AI session notes
You can **try 30 days for free**, without a card. Your profile is published in the directory from day one and you start receiving bookings immediately.
## What's coming
This is just the beginning of the booking experience. In the coming months we will add:
- **WhatsApp automatic reminders** to the patient prior to the reserved session
- **Bidirectional Sync with Google Calendar** for directory appointments to be reflected in your personal calendar
- **Verified Reviews** of patients who had sessions, to strengthen confidence in your profile
If you have ideas or feedback, email us at **soporte@brauni.io**. Each functionality of the directory is being built with the direct input of the professionals who use it.
---
*Reservation of sessions is an opt-in functionality: it is only activated if you set your public availability. Patient data (name, email, reason) is shared exclusively with the professional receiving the reservation. Brauni does not access or use this information for any other purpose. All data is encrypted at rest and in transit.*
---
## WhatsApp with patients: limits, risks and good practices
- **URL**: https://brauni.io/en/blog/whatsapp-pacientes-psicologia
- **Category**: Privacy and Security
- **Date**: 2026-05-20
- **Tags**: whatsapp, confidentiality, limits, frame, privacy, psychologists
How to use WhatsApp with patients without breaking the frame or confidentiality: clear boundaries, crisis protocol and good practices for psychologists.
If you attend patients, you use WhatsApp with them. It is practically inevitable: in Argentina it is the default channel for everything, and the use of WhatsApp with patients in psychology is not the exception. You coordinate appointments around, let us know if you are late, confirm the session on Thursday. So far, all reasonable.
The problem is that almost no psychologist thought of WhatsApp as part of the frame. He went in alone: first an appointment, then a brief consultation, then a seven-minute audio on a Sunday night counting the week. And one day you find yourself making chat interventions from your personal phone, without schedules, without rules and without registration.
The conclusion of this article is not "stop using WhatsApp". The tool is not the problem. The problem is to use it without rules. Here we show you the concrete risks, what professional ethics says and how to put together a use of WhatsApp that protects your patients, your practice and your rest.
## What WhatsApp is for with patients (and why not)
The first decision is one of framing: to define what happens through that channel and what does not. Our recommendation is simple: WhatsApp is an administrative channel, not a clinical channel.
### WHAT IS SUPPOSED TO BE DEFINED via WhatsApp
- Coordinate, confirm or reschedule appointments
- Timely warnings: delays, absences, holidays, changes in clinical practice
- Sessional reminders
- Payment issues: send the alias, confirm a transfer
- Share practical information: address, video call link, timetable
### What's NOT going for WhatsApp
- Chat therapy: interpret, intervene, "work" a topic between sessions
- Clinical content of the patient: crisis reports, dreams, detailed family conflicts
- Long audios of the patient counting his week, waiting for return
- Reports, diagnoses or results of evaluations
- Discussion on the treatment of session space
The dividing line is easy to remember: if the content of the message should be left in the medical records, it is not a theme for WhatsApp. It is a topic for the session.
A practical criterion for answering messages: the administrative is resolved by chat, the clinical is appreciated and taken to session. "I read it, it is important, we work it on Thursday" is a complete answer and takes care of the framing.
## The risks of using WhatsApp with patients without rules
It is not about alarmism: these are concrete risks that we have already seen materialize in real clinical practices. We grouped them into three.
### 1 Confidentiality: Your personal phone is the weak link
WhatsApp encrypts end-to-end messages as they travel. The problem is not transit: it's all around your phone.
- **Backups without encryption.** By default, the backup of your chats can be uploaded to Google Drive or iCloud without end-to-end encryption. There are still years of patient conversations, accessible to anyone entering that account.
- **The screen that displays messages.** A notification that appears while you show something to another person, the phone supported on the table during a dinner, WhatsApp Web open on a shared computer. The patient's name and the start of the message are visible.
- **Phone stolen or lost.** If there is no strong and encrypted lock, whoever has access to all chats. And even if you do, the chip can be used to reactivate the account on another device if you did not activate the verification in two steps.
This is not just a technical problem: it is a legal problem. Mental health data are sensitive data according to [Act 25.326 on Personal Data Protection](/blog/ley-proteccion-datos-personales-psicologos), and you are responsible for protecting them with appropriate security measures. A clinical chat on a personal phone without encryption or blocking hardly qualifies as "appropriate measure".
### 2. Availability 24/7 and framing erosion
The second risk is not technological: it is clinical. WhatsApp generates an expectation of permanent availability that no treatment agreed.
The message of 2 AM. The double blue tilde that the patient interprets as "read me and does not answer me." Saturday's consultation that "is short." The feeling, for the patient, that the therapist is always there, and for you, that you never finish working.
When the channel has no rules, every quick response out of schedule reinforces the expectation of the next one. And each silence becomes interpretation material: are you angry? do you not care? What began as comfort ends up eroding the framing and, with it, part of the therapeutic work.
### 3 The dispersed clinical record
There are patients who tell important things by chat: a relapse, a decision, a weekend episode. If that is left alone in WhatsApp, your clinical record is incomplete.
The medical records is the document that the 26.529 law requires you to carry and keep. The relevant for the treatment has to be there, not distributed between a notebook, your memory and a chat that can be erased with a change of phone. If a patient communicates something clinically significant via WhatsApp, it is appropriate to record it in his medical records as any other data of the treatment.
## What Professional Ethics Says
Professional secrecy does not distinguish channels. What a patient entrusts to you by chat is as protected as what he says in the divan: the Code of Ethics of FePRA obliges to protect the confidentiality of everything known within the framework of the professional relationship, without exception by the means used.
That has practical consequences:
- You can't forward or show patient chats, not even "anonymized" in peer groups.
- If a relative writes to you asking about the patient, you can't even confirm that he's being treated.
- You are responsible for the security conditions of the channel you choose to communicate with
If you want to deepen the scope and exceptions of the duty of confidentiality, we develop it in our guide on [professional secret in psychology](/blog/secreto-profesional-psicologia).
Professional secrecy applies the same in digital. That the conversation happened via WhatsApp does not make it less confidential or exempt you from liability if it leaks through negligence in the care of the device.
## Good practices for using WhatsApp with patients
Ordered from the most structural to the most technical.
### 1. It will know the professional of the personal
Ideal is an exclusive line for practice: a separate chip or a second number with WhatsApp Business. Immediate benefits:
- Your personal number stops circulating between patients
- You can silence the professional phone outside your schedule without fault.
- WhatsApp Business allows you to configure visible schedules, absence messages and quick responses
- If you ever give up your schedule in a secretary or service, don't give up your personal life.
If you can't have two lines for now, at least use WhatsApp Business on the same phone for the professional profile and set the absence message with your schedules.
### 2. Express response schedules
Define and communicate when you respond to messages. For example: Monday to Friday from 9 to 18. There is no need to justify it: it is part of the frame, just like the session schedule.
Two details that help:
- Deactivate the blue tilde if the "view" generates more anxiety than information
- Use the WhatsApp Business automatic absence message to make the expectation clear without you having to hold it message to message
### 3 What you answer and what you take to the session
We already said it, but it deserves to be an explicit rule: administrative answer, clinical is taken to session. When clinical content arrives by chat, the answer takes care without intervening: you receive, value and re-frame. You do not interpret in writing, you do not open a therapeutic exchange at times.
### 4. Protocol to an off-time crisis message
This is the point that generates the most anguish and the one that can be improvised the least. If a patient writes in crisis to 2 AM and there is nothing agreed, whatever you do (respond, not respond, respond late) is left to chance.
The protocol is armed before, not during:
1. **Leave it agreed on informed consent**: WhatsApp is not an emergency channel, and in the event of a crisis the patient knows where to turn.
2. **Accords the emergency routes according to the patient's area**: the 911, the SAME (107 in CABA), the nearest mental health guard or the 135 line of suicidal assistance (CABA and GBA).
3. **Define what you are talking about** when you see the message: something short that recognizes gravity, remember the agreed resource and offer the nearest space. For example: "I received your message and I care what you're going through. If you're at risk now, call the [agreed resource]. Let's talk today at the [first available schedule]."
4. **Record the episode** in the medical records: what he wrote, what you answered, what was done next.
Having protocol doesn't make you less available as a therapist: it makes you predictable, which is exactly what a crisis person needs from their treatment.
### 5. Secure the phone and backup
The technical minimum, in four movements:
- **WhatsApp 2-step verification**: Settings → Account → Two-step verification. Prevent someone from activating your account on another phone by just having access to your line.
- **End-to-end encryption rackup**: Configuration → Chats → Backup → Copy encrypted end-to-end. Without this, your chats are readable in Google Drive or iCloud.
- **Phone block** with PIN or biometrics and automatic locking within a few minutes.
- **Notifications without content on the locked screen**: that a message came, not from whom or what it says.
### 6. Do not send reports or clinical material for WhatsApp
Psychological reports, certificates, evaluation results, and any clinical documents go through channels designed for that: hand-delivery, email with protected file, or a secure platform. A PDF with diagnosis circulating through WhatsApp can end up being forwarded, in an unencrypted backup, or on the wrong phone, and there you will no longer control anything.
## How to include it in the frame from the first session
All of this works if you talk at the first session, not when the problem has already appeared. Communication between sessions is part of the frame, as well as fees, schedules and cancellations, and its natural place is [informed consent](/blog/consentimiento-informado-psicologia).
A brief model that you can copy and adapt:
> **Intersessional communication.** The WhatsApp [professional number] is used only to coordinate appointments, warnings and administrative issues. It is not a channel for dealing with treatment issues or for emergencies. Messages are answered from Monday to Friday from [time]. Faced with an emergency or risk situation, communicate with [agreed resources: 911 / SAME 107 / reference mental health guard / line 135]. What arises between sessions and is important for treatment is discussed at the next meeting.
Two sentences when presented reach: "I tell you how I handle messages between sessions, so we both know what to expect." Presented like this, it is not a barrier: it is care of treatment.
Putting the use of WhatsApp in writing on consent is not defensive bureaucracy. It is what allows you, six months later, to resume the rule without living as a personal rejection: "Do you remember that this we had agreed upon at the beginning?"
## Automate the administrative to get it off your phone.
If you look at your professional WhatsApp, most messages are variations of the same: confirming the appointment, remembering the session, warning a change. All of this is automated, and automating it has a direct effect on the risks of this article: less administrative conversation on your personal phone is less exposed data and less out of schedule interruptions.
With Brauni, appointment reminders are automatically sent via WhatsApp from the platform, without exposing your personal number: the patient receives the reminder, confirms or warns that it does not arrive, and you see everything on the agenda without having touched the phone. In our guide on [appointment management for psychologists](/blog/gestion-citas-psicologos) we tell how this also reduces absenteeisms.
The practical result: your WhatsApp ceases to be an entry table and is what the frame says it is again, a channel limited to what really requires a message from you.
## Frequently Asked Questions
### Can I charge for answers for WhatsApp?
You can, as long as it is agreed in advance. Some professionals offer inter-session availability as part of their work mode, with scope and fees defined in the frame. What does not work is to charge it retroactively or implicitly: if they never spoke about it, the patient reasonably assumes that answering messages is free. Our suggestion: before monetizing the chat, ask yourself if that exchange should not be taking place in session.
### What do I do if a patient sends me long audios counting his week?
Don't chat them: that confirms that the channel is useful for therapy. I answered briefly and will reschedule: "I listened to your audio, there are important things there. We take it on Thursday in session." If the pattern is repeated, it is clinical material: take it to session as a topic, not as a challenge. Behind the audios there is usually something worth thinking about together, from the difficulty to wait to the need to feel that the therapist is.
### Should I use WhatsApp Business?
Yes, it is a concrete and free improvement: separate professional profile, visible schedules, automatic absence message and quick responses for the repetitive. It does not solve everything (the chats are still on your phone and the backup still needs encryption), but sort the channel and communicate professionalism. The ideal version remains an exclusive line for practice.
### Are WhatsApp conversations part of the medical records?
The chat itself is not a valid clinical record, but the clinically relevant thing that a patient communicates there does have to be recorded in the medical records, which is the document that the 26.529 law requires you to carry out. The recommended practice: when something meaningful comes by message, you enter it in the medical records with date, as you would do with something said in session.
### What do I do if a relative of the patient writes to me?
Professional secrecy also reaches you there: you can't confirm that the person is in treatment, nor comment on any of the work done, except for the usual legal exceptions (true and imminent risk, injunction). A possible answer: "For reasons of confidentiality I can't give you information. If there is a risk situation, I suggest you contact [emergency response]." And the episode, like everything relevant, is registered.
## Summary
- WhatsApp with patients is valid as an administrative channel: appointments, notices, reminders and payments. Clinical matters go to session and medical records.
- The three main risks: confidentiality (unencrypted backups, screen, phone theft), availability 24/7 that erodes framing, and dispersed clinical record.
- Mental health data are sensitive data under the 25.326 Law, and the professional secrecy of the FePRA Code of Ethics applies equally in digital.
- Good practices: separate line or professional profile, explicit response schedules, written agreed crisis protocol, two-step verification, encrypted backup and no chat reports.
- The use of WhatsApp is agreed in the first session and is written in the informed consent, including the emergency channels.
- Automate reminders and confirmations (for example, with the [WhatsApp reminders by Brauni](/funcionalidades/agenda-turnos)) remove the administrative from your personal phone and return the channel, and rest.
---
## Online therapy in Argentina: legal framework, framing and tools
- **URL**: https://brauni.io/en/blog/terapia-online-argentina-guia
- **Category**: Professional practice
- **Date**: 2026-05-13
- **Tags**: online therapy, teleconsultation, telepsychology, frame, psychologists, legal framework
Guide to online therapy for psychologists in Argentina: legal framework, informed consent, remote framing, safe tools and risk assessment.
Online therapy came to stay. What in 2020 started as an emergency solution today is part of the usual practice of thousands of professionals: online therapy in Argentina ceased to be the exception to become one more modality, which many patients choose by comfort or distance.
The problem is that most people still exercise it as in 2020: on the go. Emergency (platform, timetables, learning to silence the microphone) was resolved, but almost no one reviewed the legal frame again. What laws apply to teleconsultation? Can you care for a patient who is in another province? Does the consent you use in clinical practice serve for the video call? What do you do if the patient goes into crisis at 800 kilometers?
In this guide we review the normative framework of telepsychology in Argentina, the requirements of consent and distance framing, the necessary tools and the situations where the online modality does not reach.
## What the regulatory framework says about online therapy in Argentina
The first clarification is the most important: **there is no specific national law of telepsychology**. That does not mean that online therapy is in a legal vacuum. It means the exact opposite: the same laws that govern your face-to-face practice apply, with no distance discount.
### Act 26.529 (Patient's Rights)
Informed consent, medical records and confidentiality apply in an identical way. A video session is a care act like any other: the patient retains all his or her rights and you, all your obligations, including that of recording care in [medical records](/blog/historia-clinica-psicologia).
### Law 25.326 (Protection of Personal Data)
The health data are **sensitive data** with reinforced protection. In the online mode this law weighs even more: clinical information travels through the internet, passes through third party platforms and is stored on servers that are not in your clinical practice. Choosing the video call tool or the place where you keep your notes is not a minor oversight, is a normative breach.
### Law 26.657 (Mind Health)
The right to privacy, dignified treatment and care based on informed consent does not change through the channel. Teleconsultation does not enable more lax standards.
Practical rule: if something is mandatory in clinical practice (informed consent, medical records, professional secrecy), it is also mandatory in the session by video call. Change the channel, not obligations.
### professional license and jurisdiction: the grey area of telepsychology
The exercise of psychology in Argentina is regulated by jurisdiction: each province and CABA have their own law of professional exercise, and the professional license enables you to exercise in that jurisdiction. The uncomfortable question of online therapy is evident: if you are enrolled in Cordoba and the patient connects from Salta, where are you exercising?
The honest answer is that it is a **grey area**. The professional exercise laws are prior to the teleconsultation and were not intended for distance care, and there is no national norm that resolves the point expressly. Several professional colleges and FePRA itself published guidelines and recommendations on telepsychology; none replaces a law, but they set the standard of prudence that is expected of you.
From this perspective, the prudent approach is summarized as follows:
- I kept your license plate up to date in the jurisdiction where you reside and from where you attend.
- Ask your school about specific questions: many have their own recommendations about teleconsultation and it is the body that will evaluate your behavior if a problem arises.
- Leave it in the consent and medical records that care is at a distance, from where you attend and from where the patient connects.
- If the patient resides in another jurisdiction and the condition may require face-to-face interventions, evaluate whether it is appropriate to refer the patient to a local professional.
## Informed consent specific to the online modality
The consent that the patient signed thinking about a clinical practice does not automatically cover teleconsultation. The online modality introduces new conditions and risks that the patient has the right to know and accept. We have already published a complete guide on [informed consent in psychology](/blog/consentimiento-informado-psicologia); here we focus on what you have to add for distance care:
- **The channel**: which platform is used for sessions and by which means appointments are coordinated. Defining it prevents the clinical relationship from spilling into personal chat.
- **What happens if the connection is cut**: who calls who, why alternatively, how long is expected before reprogramming and how the session is computed.
- **Crisis plan**: physical address from which the patient connects, an emergency contact with telephone and the emergency services of his locality. This point is agreed at the beginning of the treatment, not in the middle of a decompensation.
- **Confidentiality of the environment**: the patient undertakes to connect from a private space, without third parties present or listening; you assume the same commitment on the other side of the screen.
- **Records**: make it explicit that the sessions are not recorded, by either party, unless expressly agreed and in writing.
I asked for the physical address and emergency contact in the first interview, even if the patient seems stable. The day you need them there won't be time to get them.
## The online framing: the same rules, another scenario
The frame does not relax because it is virtual. On the contrary: as the screen already introduces distance, the rest has to hold more firmly.
- **Private space on both sides.** You attend from a closed, orderly and uninterrupted place, as in clinical practice. The same is asked of the patient: a room with the door closed, not the living room with the family circulating.
- **Earphones, always.** On your side are innegotiable: no one who passes by you should listen to the patient's voice. Suggesting them to the patient also improves the privacy on your side.
- **Camera on.** The image is a large part of your clinical material at a distance: gestures, posture, general status. A "session" with camera off is an exception to working, not an equivalent option.
- **Timeliness and duration.** The online session starts and ends on schedule, lasts as long as the face-to-face session and does not fragment into messages during the week.
### What if the patient connects from the car or from work?
It spends all the time and deserves clinical reading, not just a rule. A patient who connects from the parked car may have found the only private space available to him: there the car is a solution of confidentiality, not a problem. Different is the one who attends the session from the desk of the work, between mails, "while it ends something": there the emerging one is the dehierarchization of the therapeutic space, and it is appropriate to point it out and work it like any other movement on the frame.
The criterion: a private environment without third parties is a minimum condition. How each patient achieves it, and what it says about its relationship with treatment, is session material.
## Distance Risk Assessment: When Online Therapy Is Not Enough
The screen shows you a rectangle. You don't see the whole body, you don't perceive the state of the house, you don't notice the smell of alcohol or the movements when you arrive and leave. Evaluating risk at a distance is possible, but with fewer signals: it forces you to ask more directly and to document in more detail.
There are situations where the online mode directly **does not reach**:
- **Active suicidal hazard**: ideation with plan, available means and intention. At a distance you cannot physically accompany or activate an immediate response with the same effectiveness.
- **A acute crisis**: psychomotor excitement, decompensated psychotic symptoms, poisoning.
- **Tables requiring face-to-face or interdisciplinary approach**: eating behavior disorders with clinical involvement, severe problem consumption, situations of domestic violence from which the patient connects.
In these cases the options are to refer to a local professional or device, combine the teleconsultation with face-to-face instances or, if the risk is imminent, activate the crisis plan: contact the emergency referent and the emergency services of the patient's locality. On how to deal with this process without leaving the patient we write in the [responsible referral](/blog/derivacion-responsable-psicologia) guide.
If in an online session you detect certain and imminent risk, your obligation to act is the same as in clinical practice. The difference is that at a distance you can only intervene through third parties: that is why the physical address and emergency contact are collected before, not during the crisis.
## Tools and safety: the technical requirements of the teleconsultation
You don't need to be a technology expert, but you do need to know what to demand from the tools you use.
- **Custration of communications**: the transmission has to travel encrypted from point to point or at least encrypted in transit.
- **No recording by default**: that the platform does not record or store sessions except for deliberate action, and that any recording is visible to both parties.
- **Private rooms**: Unique links per session or waiting room, so that no one enters a video called by an old link.
- **Minimum patient data**: that the patient does not have to create accounts or deliver unnecessary information to connect.
And a rule without nuances: **sessions never go through social networks**. Instagram, Facebook or Messenger are not health care platforms, they mix your personal profile with your practice and offer no guarantee about the treatment of that data. If you want to deepen the protection of your digital practice, we have a complete guide to [cybersecurity for clinical practice](/blog/ciberseguridad-consultorio-psicologico).
There is one point that almost no one plans: where you register the session after you cut. The note from a teleconsultation goes to the medical records like any other, not to a loose file on the desktop. If you use Brauni, you can register the note as soon as the video call ends, even from the cell phone, with the data encrypted in transit and at rest. AI helps you order the registration in minutes; the clinical reading of the session is still yours.
## Fees and online collection
Remote collection is the most determined part of the teleconsultation, but it should be ordered:
- **Defined payment method**: bank transfer or virtual wallet, agreed in advance, with time defined (before session or within 24 hours).
- **Invoice, as well as face-to-face**: the online mode does not change your tax situation. The session is invoiced as any provision.
- **Explicit cancellation policy**: What happens if the patient does not connect, if he/she calls two hours before or if the session falls due to technical problems. Writing it in consent avoids uncomfortable negotiations later.
## Documentation: The medical records does not change because it is online
The 26.529 Act does not distinguish modalities: all attention is recorded, and teleconsultation is not the exception. What should be added in the registration of an online session:
- The **modality and platform**: "video call session" and the medium used.
- **relevant technical incidents**: if the session was cut, reprogrammed or completed by an alternative channel.
- **The environment, when clinically relevant**: if the patient was connected from an unusual location or with third parties nearby, and how it was worked.
- The **risk assessment**, in more detail than in face-to-face, precisely because your sources of observation are more limited.
The rest (evolution, hypotheses, interventions, deadlines) is identical to what you already do. And remember that professional secrecy also covers messages, mails and video calls with the patient.
## Frequent errors in online therapy
1. **Making sessions through social networks** or through personal chat, mixing the clinical with the private.
2. **Do not have specific consent for the modality**: the document designed for clinical practice, without channel, crisis plan or environmental agreements, is still used.
3. **Do not record teleconsultations in the medical records**, as if the online session was an "informal" service.
4. **Do not have physical address or emergency contact** of the patient, and discover it on the day of the crisis.
5. **Naturalize any connection environment**: patients who attend from work, walking or with people next door, without that being worked.
6. **Record sessions "to review later"**, without express consent and without dimensioning that such recording is sensitive data.
7. **Assuming that the modality serves any patient**, without evaluating whether the picture or risk requires presence.
## Frequently Asked Questions
### Can I take care of patients living in another country?
It is the grey area raised squarely: in addition to the Argentine jurisdictional question, the regulation of the country where the patient resides comes into play, which may require local ratings. There is no single answer. The prudent criterion: consult your school, evaluate if you can put together a viable crisis plan with resources from the place where the patient lives and document everything. For prolonged treatments abroad, consider whether a local professional is not the best option.
### Can the online session be recorded?
By default, no. Neither you nor the patient record without the other accepting it in writing, for a definite purpose (e.g. supervision). That recording becomes clinical documentation with sensitive data: apply the 25.326 law and you have to store it encrypted and with controlled access. In practice, the recommendation is simple: do not record.
### Do I need a special license plate to do telepsychology?
There is no specific registration or qualification of telepsychology in Argentina. You need the same as to attend to your clinical practice: Enabling enrollment per day in your jurisdiction. It is advisable to check whether your school published recommendations on teleconsultation and adjust your practice to that standard.
### Can I do sessions for WhatsApp?
The WhatsApp video call is encrypted from end to end, so the problem is not technical but frame: the app mixes your personal life with the clinic, exposes your number and turns the chat into a diffuse extension of the session. A dedicated platform is preferable and book WhatsApp, at most, to coordinate appointments. What does not correspond in any case is "session" by text messages or loose audios.
### Is online therapy as effective as in-person therapy?
The available evidence supports a comparable efficacy for many common conditions, such as anxiety and mild to moderate depression. This does not make it universal: there are patients, moments of treatment and risk levels that ask for presence. The modality is a clinical decision of yours, not a preference of comfort that is accepted without evaluation.
## Summary
- Online therapy in Argentina is governed by the same laws as face-to-face care: 26.529 (patient rights and medical records), 25.326 (sensitive data) and 26.657 (mental health). There is no legal vacuum or more lax standards.
- The registration is jurisdictional and the teleconsultation between provinces is a grey area: registration per day where you exercise, consult the school and all documented.
- Informed consent should be specific to the modality: channel, protocol before cuts, crisis plan and confidentiality of the environment.
- The frame is not negotiated because it is virtual: private space on both sides, headphones, camera on and schedules respected.
- In the event of active suicidal risk or acute crisis, the online modality does not reach: deriva or combination with face-to-face.
- Platform with encryption and no recording by default; social networking sessions, never.
- The medical records does not change because it is online: it will register each teleconsultation, its modality and the relevant incidences.
---
## New: Public directory of verified psychologists, free for all Brauni professionals
- **URL**: https://brauni.io/en/blog/directorio-publico-psicologos
- **Category**: Product
- **Date**: 2026-05-07
- **Tags**: directory, psychologists, marketing for psychologists, SEO, patient acquisition, professional profile
We launched the public directory of psychologists: I appeared indexed on Google, received direct consultations from patients and showed your verified professional profile. No extra cost for Brauni users.
If you are a psychologist and use Brauni, you now have a new (and free) channel for patients to find you: the **public directory of psychologists** in [directorio.brauni.io](https://directorio.brauni.io). It is a new section of the website designed so that each professional has an indexable profile in Google and can receive direct inquiries, without intermediaries and without commissions.
In this article we tell you how it works, how a profile looks, what information is published and how to take advantage of it to get more patients.
## What is the directory of Brauni
The directory is a public page that lists psychologists who use Brauni and choose to display their profile. Anyone can enter, filter by specialty, modality (online, face-to-face or hybrid), city, country and language, and contact the professional that interests them.
Unlike marketplace platforms, **Brauni does not get into the middle**:
- We do not charge commission per consultation or per session.
- We do not mediate in contact: the patient writes directly to you.
- We don't charge you for showing up or highlighting your profile.
- The patient data and the clinical relationship are yours, not ours.
The directory is a feature **included in your Brauni plan**, at no additional cost. If you are already a user, you can activate it from your professional profile settings.
## What a profile looks like
Each profile in the directory shows:
- **Professional photo** and full name
- **National or provincial registry** (M. N. / M. P.)
- **City and country** where you exercise
- **Specialities** and therapeutic approach (TCC, psychoanalytic, systemic, integrative, etc.)
- **Modalities** available: online, face-to-face or both
- **Languages** you attend
- **Professional Bio** with your experience, training and areas of interest
- **Direct contact**: email or channel you set up
You choose which information is displayed. You can activate the public profile when you are ready and disable it when you want from the settings. Your patients' clinical data is never exposed: the directory only shows your professional information.
## Why it matters: SEO and patient uptake
One of the biggest advantages of the directory is that **each profile is an indexable page on Google**. That means that when someone looks for "cognitive behavioral psychologist in Mendoza" or "online therapy specialized in anxiety", your profile may appear in the results.
Under the surface, we did a strong technical job to make this work well:
- **Server side rendering (SSR)** so that Google can read the full content
- **Structural data** (Schema.org) type `Person` and `MedicalBusiness` for search engines to understand that you are a health professional
- **Clean URLs** of the type `/directorio/nombre-apellido`
- **optimized metadata** (title, description, OpenGraph) generated automatically by profile
- **dynamic sitemap** that is updated when new profiles are published
- **ISR cache** with periodic revalidation to keep everything updated without sacrificing speed
Translated: your profile is not just an internal page of the site. It is content intended for **you to find people who are looking for a psychologist right now**.
## Verification: Why Patients Can Trust
One of the most common problems in public directories is the lack of clarity about who is really professional. In Brauni we give patients a clear guide with a **verification badge**:
1. Any Brauni account can activate your profile in the public directory
2. Professionals who complete our identity and registration verification process receive a visible **Professional Check Badge** on their card and profile
3. professional license charged is shown publicly, so any patient can corroborate it directly at the relevant professional college
4. Patients can filter the directory to see only profiles with the check Badge
The badge does not replace the patient's diligence: what it does is facilitate it. Brauni indicates which profiles have already passed through our process, and visible enrollment allows anyone to check it in the school's official registry.
## How to activate your public profile
If you already have an account in Brauni, these are three steps:
1. **Initiate session** at [app.brauni.io](https://app.brauni.io)
2. Enter **Setup → Professional Profile**
3. Activate the option **"Show my profile in the public directory"** and complete the fields you want to show (photo, bio, specialties, modalities, languages)
As soon as you save the changes, your profile is published in the directory. Google indexing may take a few days to a couple of weeks, depending on how the search engine tracks the site.
To improve your positioning, I wrote a clear bio with natural keywords. Instead of "having different problems", try "working with adult patients in anxiety, depression and grief from a cognitive-behavioral approach." The more specific, the better people find you who are looking for exactly what you offer.
## What if I don't have a Brauni account yet?
If you get here and don't use Brauni, you can try the platform **30 days for free**, without a card. You will have access to:
- The entire clinical suite: AI session notes, medical records, schedule, AFIP invoicing, reminders via WhatsApp
- The **AI Assistant** who understands your therapeutic orientation and knows your patients
- The **public director** to start receiving consultations from day one
There is no permanent free plan, but yes 15 real days of full use for you to decide with information, not with a limited demo.
## Booking of sessions: already available
Since May 2026 patients can **book direct session from your profile**, by choosing day, time and mode. Your availability is shown in a weekly calendar and each booking goes through your confirmation before scheduling. No commissions, no intermediaries.
Read the full article: [Patients can now book direct session from your profile](/blog/reserva-sesiones-directorio).
## What's coming
- **Verified Reviews** of patients (with explicit consent and anti-spam process)
- **WhatsApp automatic reminders** to the patient prior to the reserved session
- **Bidirectional Google Calendar Sync** for directory appointments
If you have suggestions or feedback about the directory, write to **soporte@brauni.io**. We are building this with professionals who already use the platform, and every idea counts.
---
*The public directory of Brauni is an opt-in functionality: only professionals who explicitly activate the profile are listed. Clinical information and patient data are never exposed to the public. Brauni complies with Personal Data Protection Act 25.326 and maintains BAA contracts with its infrastructure providers.*
---
## Monotribute for psychologists: high, categories and invoicing
- **URL**: https://brauni.io/en/blog/monotributo-psicologos-argentina
- **Category**: Management of clinical practice
- **Date**: 2026-04-30
- **Tags**: monotribute, ARCA, AFIP, invoicing, taxes, psychologists
Monotribute guide for psychologists in Argentina: high step by step, how the categories work, the semi-annual recategorization and the C invoices per session.
You received to care for patients, not to interpret tax regimes. But proper invoicing is part of exercising: without an active tax registration you cannot issue invoices, and without invoices you cannot work with health insurance, rent a clinical practice in your name or justify your income to a bank.
For the vast majority of psychologists who start in Argentina, the answer is the monotribut. It is the simplified regime that unifies taxes, retirement and health insurance in a single monthly payment, with procedures that you can solve from your home. In this guide we explain to you what is the monotribut for psychologists, how to register, how the categories work and recategorization, and what obligations you have once in.
A clarification before you start: in Brauni we are not accountants. This is a general guide for you to understand how the regime works, but each situation has its particularities and it is advisable to review it with a reliable counter, especially before discharge and every recategorization.
## What is the monotribute and why is the natural regime of the psychologist who starts
The monotribut is the Simplified Small Contributors Scheme administered by ARCA (ex AFIP). Its logic is simple: instead of liquidating IVA and separate earnings, filing affidavits and keeping formal accounts, you pay a fixed monthly fee that already includes everything. The amount of that fee depends on the category you are in, which in turn depends mainly on how much you invoice per year.
For a psychologist who begins to attend in clinical practice or online, the monotribute is usually the starting point for three reasons:
- **Simplicity**: There are no IVA monthly affidavits or balance sheets. You will make, pay the fee and you will reschedule twice a year if applicable.
- **Predictability**: You know in advance how much you will pay each month, which makes it easy to calculate your net fees.
- **Cover included**: the quota includes the pension contribution and health insurance you choose, something especially valuable if you come from working without contributions.
The regime is intended for human beings who provide services below certain annual invoicing caps. As long as your practice stays within those limits, it is usually the most convenient option compared to the general regime.
## Requirements and high step by step
Discharge is a digital procedure that does not require going to any dependency. You need to solve four things, in this order.
### 1. I got your CUIT
The CUIT (Single Tax Identification Key) is your tax identity. If you have never processed it, it is managed digitally from the ARCA site with your DNI and a photo or scan of it. If you have ever worked in a dependency relationship, you probably already have it assigned and only need to activate it.
### 2 Generate your tax key
The tax key is the password with which you operate all ARCA services. For monotribute and electronic invoicing you need tax key with security level 3, which is obtained by validating your identity from the app "My ARCA" (historical "My AFIP") with facial recognition. The procedure takes a few minutes.
### 3. Sign up for the regimen
With CUIT and tax key, you enter the ARCA Monotribute portal and complete the discharge: you declare your activity, you estimate your annual income, you indicate if you use a local (your clinical practice, if you rent one) and the system proposes a category. You also choose how you want to cover the health and welfare part, which we see below.
### 4. Declare the correct activity
When you are discharged, you have to select an activity code of the official gazetteer. For psychologists, the corresponding activity is within the group of services related to human health, in the specific branch of psychology services. Choosing the code well matters: define which tax treatment corresponds to you and avoid inconsistencies if you then work with health insurance or private health plans that verify your fiscal situation.
If in addition to taking care of patients you do another activity (docencia, supervisions, workshops), you can declare secondary activities in the same monotribute. All add up to the same annual invoicing for the purposes of the category.
With the confirmed discharge, ARCA assigns your initial category and you can issue invoices. The next practical step is to configure electronic invoicing: in our [electronic invoicing guide for psychologists](/blog/facturacion-electronica-afip-psicologos) we explain step by step how to generate the digital certificate and issue your first C invoice from Brauni.
## Monotribute for psychologists: how categories work
The categories of the monotribute are identified with letters, from A onwards, and form a progressive scale: higher annual turnover, higher category and higher monthly quota. The parameters that define your category are:
- **gross income** of the last 12 months (the main income for a psychologist).
- **Surface affected** to the activity, if you have your own or rented clinical practice.
- **Electric energy consumed** in that space.
- **Accumulated rents** in the year, if you rent the clinical practice.
For most psychologists who attend to shared clinical practices, rented by hour or online, the parameter that really defines the category is invoicing. The others are rarely limiting in an individual practice.
The amounts of each category are not fixed: the scales are updated periodically by law. That is why in this guide you will not find figures: any number we publish today is going to be old. The income caps and current quota values are always published in the Monotribute section of the official ARCA site, and that has to be your source.
### Semester recategorization
Twice a year, in January and July, you have to review your situation and recategorize yourself if appropriate. The mechanism is like this:
1. Add your invoicing for the last 12 months (not the semester, from 12 months back).
2. Compare that total with the current scale published by ARCA.
3. If the total places you in a category other than the current one (higher or lower), you make the recategorization from the portal of Monotributo.
4. If you're still in the same category, you don't have to do anything.
The new category applies from the following month. It is a process of minutes, but to forget it has cost: if ARCA detects by its crossings of information that you invoiced above your category, it can recategorize you ex officio, with retroactives and penalties.
Add two fixed reminders per year, in the first weeks of January and July, to review your accumulated invoicing and recategorize yourself if needed. It is the cheapest administrative habit you can incorporate.
## What includes the monthly payment
The quota of the monotribute has three components:
- **Tax component**: replaces the IVA and the Income Tax for your activity. It is the "tax" part itself.
- **Retirement component**: your contribution to the pension system. These paid months count as years of contribution for your future retirement.
- **Health insurance**: a contribution that gives you access to health insurance that you choose from among those who receive monotributists. You can add your family group to paying an additional fee for each member.
A relevant detail: in several provinces there are own pension funds for professionals, and according to your jurisdiction and your registration you may be obliged to contribute to that box, which modifies how to frame the retirement component of the monotribut. It is one of the points where consultation with an accountant who knows your province is best.
If you work in relation to dependency in addition to attending in clinical practice, your situation also changes: your contributions and health insurance are already covered by your employment, and the monotribute is limited to the tax component. We see it in the frequently asked questions.
## Type C invoice: what is and when to issue it
As a monotributist, the proof you issue is invoice C. It is a non-discriminatory invoice of IVA (the monotribut does not require it) and today is mandatory electronic: each voucher requires an CAE awarded by ARCA to have tax validity.
When do you have to issue it? For each session charged, without exception:
- To particular patients, even if they pay in cash or by transfer.
- Health insurance and private health plans, which also require it to liquidate you.
- By online sessions, they are services like any other.
- For paid absences, if your frame includes charging for the unannounced session: if there was a charge, a voucher corresponds.
Many psychologists see invoicing as a separate process that they accumulate by the end of the month. The problem is that invoicing late or less generates exactly the inconsistencies that ARCA detects with its bank data crossovers. The simplest way to sustain the habit is that invoicing is part of the same flow in which you register the charge: Brauni [issues C invoices with CAE in real time](/funcionalidades/facturacion-afip), integrated with ARCA web services, without leaving the platform where you will already manage your sessions and payments. The complete step-by-step is in the [electronic invoicing guide](/blog/facturacion-electronica-afip-psicologos).
If you are still defining how much to charge per session, we have a specific guide on [Honoraries for Psychologists in Argentina](/blog/honorarios-psicologos-argentina) that can serve as a reference before projecting your annual invoicing.
## Gross income: the tax that goes separately
A common mistake is to believe that the monotribut covers everything. The monotribut is a national regime: it unifies national taxes and contributions, but it does not include the tax on gross income, which is provincial.
Each jurisdiction administers it with its own agency: AGIP in the City of Buenos Aires, ARBA in the province of Buenos Aires, and its equivalents in the rest of the country. The treatment varies according to where you exercise: some jurisdictions have simplified regimes unified with the national monotribute, others provide exemptions for university professionals who exercise themselves, and others require registration and payment from the first invoiced weight.
There is no unique answer here: check your situation in the agency of your province or with your accountant at the time of discharge, not after the first intimation.
To be up to date with ARCA does not imply being up to date with your province. They are two different inscriptions, with different organisms and maturities.
## When to leave the monotribute?
The monotribute has a roof, and at some point a growing practice can overcome it. The most common scenarios:
- **Exclusion by scale**: if your invoicing of the last 12 months exceeds the last category, you are excluded from the regime and you pass the general regime (responsible inscribed), with IVA and Gains. The exclusion can be declared by you or detected ex officio by ARCA, and in the second case it usually arrives with retroactive.
- **Pass to responsible registered for convenience**: in some specific cases (for example, if your main clients are companies or institutions that need to compute IVA) can agree to the general regime even if you are not required. It is a planning decision that deserves specific numbers with your accountant.
- **Arrange a structure with colleagues**: the monotribut is only for human persons. If with other professionals they arm a society to manage a shared center or clinical practice, that society is taxed by the general regime, although each professional may continue to be monotributist for their individual fees.
The signal to start planning is not to exceed the limit: it is to get closer. If your annual turnover is growing and approaching the limit of the last category, anticipate the transition instead of finding you an ex officio exclusion.
## Frequent errors of monotributist psychologists
These are the ones that we see most repeating, and all are avoidable:
- **Do not recategorize.** It is the classic. Invoicing grew, the category became old and the difference appears later, with interest. Two reminders per year resolve it.
- **Invoice less than "not to rank."** Collecting sessions without invoicing is not only an infringement: it is increasingly detectable, because ARCA crosses bank accreditations, virtual wallets and consumptions with your invoicing declared. The gap between what you enter your account and what you invoices is exactly what you look at.
- **Do not invoices for absences charged.** If your frame includes charging for the unannounced session, that charge is also invoiced, like any other income from your activity.
- **Mix personal and professional accounts.** Using the same account for fees, supermarket and family transfers makes it impossible to rebuild your actual invoicing. An exclusive account or wallet for the activity simplifies your accounting and recategorization.
- **Forgot gross revenue.** As we saw, it is a separate tax. Registering at ARCA and not at the provincial agency is a very common boot error.
## Frequently Asked Questions
### Can I attend health insurance and private health plans by being a monotributist?
Yes, and it's the usual thing. Private health insurance and health plans require a invoices to pay your benefits, and the single-payer's invoices C is valid for that. Keep in mind that what you invoices for health insurance also adds to your annual invoicing for the purposes of the category. If you work or plan to work with funders, our guide on [private health insurance and health plans for psychologists](/blog/obras-sociales-prepagas-psicologos) will help you.
### What if I'm out of class?
If your invoicing for the last 12 months exceeds the limit of your current category, it is up to you to recategorize to what reflects your real income in the next six-month recategorization. If you exceed the limit of the last category of the regime, the consequence is the exclusion of the monotribut and the move to the general regime. Moving from the category itself is corrected by recategorizing; moving from the regime requires planning with an accountant.
### Do I have to invoices online sessions?
Yes. A session per video call is a service provision just like a face-to-face, and each charge requires your invoice C. The modality does not change the obligation.
### What if I don't charge anything for a month?
The flat rate is paid the same: it is fixed by category, not proportional to the invoiced in the month. A loose month does not reduce it, as well as an exceptional month does not increase it. What matters for your category is the accumulated 12 months you review in each recategorization.
### Can I be in relation to dependence and be a monotributist at the same time?
Yes, they are compatible. If you have a registered job (e.g. in a hospital) and also attend patients in a particular way, you can be a monotributist for your independent activity. Since your contributions and health insurance are already covered by your employment, your fee consists only of the tax portion.
## Summary
- The monotribute is the simplified regime of ARCA (ex AFIP) and the natural starting point of the starting psychologist: a fixed monthly fee that unifies taxes, retirement and health insurance.
- The discharge is 100% digital: CUIT, tax key level 3, high on the portal of Monotribute and declaration of the activity of psychology services within human health.
- The categories are by letter and are mainly defined by your invoicing of the last 12 months. The amounts of the scales are updated: always check them on the official ARCA site.
- The recategorization is semi-annual, in January and July. Not to do so when it is appropriate to enable recategorizations ex officio with retroactive.
- As a monotributist, you issue electronic C-invoice for each session charged: private individuals, health insurance, online sessions and absences included.
- Gross income is a separate provincial tax: register and verify your treatment at the agency of your jurisdiction (AGIP, ARBA or equivalent).
- Signs to rethink the regime: approach the top of the last category, customers who need IVA or build a partnership with colleagues.
- This guide is general: validate your framing, your category and your provincial situation with an accountant.
---
## How much to charge for the session: fee guide for psychologists
- **URL**: https://brauni.io/en/blog/honorarios-psicologos-argentina
- **Category**: Management of clinical practice
- **Date**: 2026-04-23
- **Tags**: fees, how much to collect, clinical practice, management, psychologists
Guide fees for psychologists in Argentina: the ethical floor of the school, the formula for calculating your actual cost per session and how to adjust without guilt.
"How much to charge for the psychology session?" is the question that most disturbs the profession and, at the same time, the one that is the worst answered. In the faculty it is not touched, in the groups of colleagues it is answered with evasive, and the most repeated advice ("collect what seems fair to you") is not an answer: it is an elegant way to leave you alone with the problem.
The result is seen every day: psychologists with a full schedule who arrive at the end of the month, fees frozen for a whole year in a country with inflation, and the diffuse feeling that talking about silver betrays something of vocation.
The fees of psychologists in Argentina are not defined by intuition or guilt. There is an objective floor (the one that publishes the school of your jurisdiction), there is a formula to know your real cost per session and there are concrete criteria to position you above that floor. That is what we are going to disarm, step by step.
## Why it costs so much to put a price on the session
Before the formula, it is appropriate to name what the formula does not resolve.
The first barrier is guilt. You chose this profession to help, and somewhere the idea was recorded that charging well contradicts that vocation. It is exactly the other way around: the fee is what makes the help sustainable. A professional who does not arrive at the end of the month attends tired, overloaded and with his head elsewhere. Collecting well is not a luxury, it is a condition of practice.
The second is the comparison. There is always a colleague who charges less, and the fantasy of "if I go up, they all go away" weighs more than any calculation. But competing for price in a bond-based profession is a race down that nobody wins.
The third is the framing. The fee is not an uncomfortable accessory to treatment: it is part of the therapeutic framing, as is the schedule and frequency. Defining it clearly and sustaining it is also an intervention.
## The floor: your school's minimum ethical fees
Most schools and councils of psychologists in the country publish minimum ethical fees (sometimes listed as "ethical rank" or "suggested minimum honorary"). They are a reference value below which the school considers that the professional exercise is de-hierarchized.
Two important things about these values:
- They are a flat, not a suggested price. Nothing forces you to charge exactly that: the reference exists so that you don’t charge less.
- They are updated periodically. With Argentine inflation, a value published a few months ago is probably already old.
That is why we will not put amounts here: they would be outdated before you finish reading. Search the current value on the school website of your jurisdiction or consult it directly by email or phone.
Each jurisdiction has its own school and its own values. The minimum fee of CABA is not the same as that of Cordoba or the province of Buenos Aires. Always consult the one that corresponds to your professional license.
In addition to the number, many provincial codes of ethics, in line with the Code of Ethics of FePRA, treat the issue as an ethical and not just economic issue: systematically charging below the minimum is considered a form of unfair competition that harms the entire profession.
## The actual calculation: how much it takes to attend a session
The school floor is generic: you don't know how much you pay for rent or how many sessions you give per month. Your personal apartment comes from the other side: from your numbers. The account is simple and takes four steps.
### Step 1: Add your monthly fixed costs
Write down everything you pay per month to be able to exercise, whether or not it is directly related to a specific session:
- Rental of clinical practice (if you rent per hour, the total of the month): A
- Share of [monotribut](/blog/monotributo-psicologos-argentina): M
- School professional license: C
- Monitoring: S
- Personal therapy: T
- Training (courses, postgraduate courses, congresses, assessed per month): F
- Other: management software, insurance, travel, video calling platform: O
Your monthly fixed cost is A + M + C + S + T + F + O.
### Step 2: put a price on your non-invoiceable hours
For every session hour there is invisible work: evolution notes, medical records, appointment coordination, invoicing, WhatsApp messages, reports. Consider how many hours per week all that takes you and assign them a value: it is professional working time, not free time. Call it H.
If that number scares you, there is room to reduce it: much of that burden is administrative and is simplified by an [orderly agenda](/blog/gestion-citas-psicologos) and clear processes. But as long as it exists, it has to be in the account.
### Step 3: tell your real sessions, not the ideals
Most calculations fall here. No matter how many gaps your schedule has: it matters how many sessions you actually charge per month, discounting holidays, holidays, cancellations and absences. Look at your last three months and get the average. Call it N.
If you register payments in Brauni, the payment module shows you how many sessions you charged and how much you invoiced each month, without drawing up sheets: that is exactly the number you need here.
### Step 4: apply the formula
Cost per session = (A + M + C + S + T + F + O + H) / N
That result is not your fee: it is your point of balance. All you charge below that value is to attend to loss, even if the agenda is full. Your real fee is that cost plus the income you want (and need) to take you for your work.
Saying with variables: if your fixed costs plus your non-invoiceable hours add up to X per month and give N actual sessions, your equilibrium point is X divided N. With constant X, the fewer actual sessions, the more expensive it costs you each. That's why two psychologists with the same clinical practice can have very different personal floors.
I re-calculated this every time I change a significant cost (increased rent, re-categorization of the monotribute, a new post-graduate) and at least a couple of times a year. It’s half an hour of work that defines all your income.
## How to position yourself above the floor
Between the school floor and your equilibrium point you already have a minimum range. To define where to stand above that, there are three factors that weigh:
- Experience and training. It is not the same for someone newly enrolled as for someone with fifteen years of clinical practice, completed postgraduates and specific training in a work model.
- Specialization. The niches with little offer justify higher fees: perinatal psychology, neuropsychology, forensic evaluation, eating behavior disorders, among others. The more specific the problem you solve, the less alternatives the one who consults you has.
- Demand. The most honest thermometer is your waiting list. If you haven’t had a free slot in months and you’re still getting inquiries, your fee is below what your practice is worth. Upgrading it isn’t abuse: it’s letting the price order the lawsuit.
## Inflation adjustments: how much and how to communicate them
In Argentina, not adjusting the fees is not keeping them: it is lowering them in silence, month by month.
How often to adjust? There is not a single rule, but criteria that work:
- I defined a review frequency in advance (e.g. every three or four months), so that the adjustment does not depend on your mood or on "the occasion".
- Use your school's minimum fee updates as a reference: if the school updated, it's a sign that the context asks for it.
- Check when your costs jump: rent increase, recategorization, tuition rise.
How to communicate? In advance (two to four weeks is fine), in writing, in neutral tone and without apologizing. There is no need to justify the adjustment with a speech about the economy: your patients also live here.
A brief model that you can adapt:
> Hello, [name]. I advise you that from the [date] the value of the session is updated to [new value]. Anything you want to talk about this, we talk about it in session. See you on [day]!
Anticipating adjustment is not just courtesy: the fee is part of the framing, and framing changes are anticipated and, if they generate something, they are worked in session.
## Social scale or differential rate: how to do it without messing up practice
Wanting to attend to people who cannot pay your full fee is legitimate and even desirable. The problem is not the differential rate: it is the lack of method.
To make it work without messing with you:
- I defined a fixed quota. For example, a limited number of places with a reduced rate on the total of your schedule. When the quota is full, it is full.
- I set clear criteria. Who agrees, for how long, under what conditions. "I don't know what to charge the full value" is not a criterion.
- Review it periodically. A patient's financial situation changes; the reduced rate does not have to be forever.
- Also adjust the reduced rate. Reduced does not mean frozen: if your fees are updated, the social rate is updated in the same proportion.
The differential rate is your decision, not an obligation. If most of your schedule pays reduced rate, you don't have a social scale: you have an unsolved fee problem.
## Frequent errors
### Collect less "while starting", forever
The classic. You start with a low fee "until the agenda is filled", the schedule is filled and the fee remains the same, because now raising it is guilty of the usual patients. The price of launch without expiration date becomes your price, and by the way it marks the ceiling for colleagues who have just started.
### Never adjust
Freezing fees in an inflationary context is a real income reduction that no one decided: it just happened. If you’ve been charging the same thing for more than a year now, the question is no longer whether to adjust, but how much you’ve been left behind.
### Adjust without warning
The other end. The patient arrives, pays and finds out the moment the session goes out the more. Besides uncomfortable, it erodes confidence: the fee is part of the work agreement and the changes are communicated before, not after.
### Do not collect absences
A reserved session is an hour that no one else could take. If the patient is missing without notice and nothing happens, your schedule ceases to be a compromise and becomes a suggestion. The solution is not to be angry on a case-by-case basis: it is to have a clear [cancellation policy](/blog/politica-cancelacion-consultorio-psicologia), communicated since the first interview and always applied the same.
An operational detail that helps: the simpler it is to collect, the less it is postponed. If you issue the [electronic invoice from the same platform where you register the payment](/blog/facturacion-electronica-afip-psicologos), the collection and the voucher are resolved at the moment, with no outstanding tasks that accumulate.
## Frequently Asked Questions
### Can I charge below the minimum fee of my school?
The ethical minimum is a reference, not a regulated price. But systematically charging below has two problems: several schools consider it an ethical fault due to unfair competition, and it almost always means that you are working below your own real cost. Before doing so, do the balance point account.
### How often do you want to adjust the fees?
There is no universal number. What works is to define a review frequency in advance (every three or four months is a reasonable pattern in high inflation contexts) and to use as triggers your school updates and your own cost jumps.
### Do I charge the same per online session as in-person?
It depends on your cost structure. If you attend online without physical clinical practice, your cost per low session, and you can move that difference or not. What does not change is the value of your time and your training: the online session is full clinical work, not a reduced version. I decide with numbers, not with guilt.
### What do I do if a patient tells me he can't afford the adjustment?
First, take it to session: the relationship with money is also clinical material. Then, evaluate concrete options: incorporate it into your differential rate quota if you have a place, space the frequency, or a responsible referral if there is no way to sustain the treatment. What is not appropriate is to freeze the fee indefinitely without criteria, because that silent arrangement ends up weighing on the link.
### Do I have to collect the first interview?
It is professional work: you prepare the meeting, you dedicate your time and apply your clinical judgment from the first minute. Our suggestion is to charge it, and if you decide not to, make it a conscious choice and not an apology. In any case, communicate the value before the meeting to avoid misunderstandings.
### Should we publish the fees?
There is not a single answer. Publishing them filters queries that are not going to materialize and saves uncomfortable conversations; not publishing them gives you room to differentiate according to the case. The important thing is that, published or not, the value is defined before you are asked: the doubt when responding also communicates.
## Summary
- "Coach what you think is right" is not an answer: fees are defined with a floor, a calculation and a positioning criterion.
- The floor is the minimum ethical fees published by the school of your jurisdiction. They are updated periodically: always consult the current value.
- Your balance point comes out of a formula: fixed monthly costs plus non-invoicing hours, divided by your actual sessions of the month. To charge below that is to attend to loss.
- To position you above the floor weigh experience, specialization and demand. The waiting list is the most honest thermometer.
- Adjust with a predefined frequency, notify in writing two to four weeks in advance and without apologizing.
- The differential rate works with quota, clear criteria and periodic review. Without that, it messes with practice.
- Absences are charged according to a cancellation policy communicated since the first interview.
---
## First psychological interview: complete guide and model to use
- **URL**: https://brauni.io/en/blog/primera-entrevista-psicologica
- **Category**: Professional practice
- **Date**: 2026-04-16
- **Tags**: first interview, admission, Initial evaluation, frame, psychologists, template
Complete guide to the first psychological interview: objectives, questions by area, framing, risk assessment and a model ready to copy and adapt.
The first psychological interview defines much of what comes next: if the patient returns, how he starts the therapeutic alliance and with what information you tell to start thinking about the case. In a single session the person decides if he or she felt listened to, if he or she understood how you work, and if he or she trusts you enough to come back the following week.
And yet, many professionals improvise it. They arrive without a minimal structure, ask what is coming up and end the session without basic data: they don’t know if there were previous treatments, they didn’t explore risk, they didn’t agree fees or cancellation policy. All of that after they have to solve it on the go, when it’s more uncomfortable to pose it.
It is not a question of turning the admission interview into an interrogation. It is a question of being clear what you want to get from that first encounter and to carry a flexible guide that will sort the conversation without rigidizing it. In this guide we review the objectives of the first interview, what to explore in each area with specific questions, what to leave agreed in the frame and how to register it. In the end we leave you a model ready to copy and adapt to your approach.
## What does the first psychological interview do?
The first interview has four objectives that should be kept in mind at the same time. None achieves on its own.
### Evaluate
You need a first understanding of the problem: what happens to the person, since when, with what intensity, how it affects his daily life and what resources he has to face it. You will not reach a closed diagnostic hypothesis in a session, and it is not the objective either. It reaches with an initial map that allows you to guide the next interviews.
### Generate Alliance
The evaluation is of no use if the patient does not return. The first interview is also the first therapeutic act: the person has to leave with the feeling that she was heard without trial and that you understood, even in part, what happens to her. If the interview is lived as a form, the alliance starts in deficit.
### Define Frame
Fees, frequency, duration of sessions, modality, cancellation policy, confidentiality. Everything that is not agreed on the first day becomes potential conflict later. The framing is not bureaucracy: it is what makes the treatment for both parties predictable.
### Decide whether to take the case
This goal is often overlooked. The first interview is also your assessment of whether the case is within your competence, your focus, and your availability. If the problem exceeds your training or your actual availability, to derive on time is a responsible clinical decision, not a failure.
## Before the interview: the first contact
The admission interview begins before the patient enters clinical practice. The first contact (a message, a call, a form) already gives you information and already builds expectations. It is useful to solve some practical questions there:
- Full name and contact phone
- Reason for consultation in one or two sentences, without deepening
- Who derives it, if applied (professional, health insurance, someone known)
- If you seek attention for yourself or another person (son, relative)
- Time availability and preferred mode (presential or online)
- Fees and method of payment, if asked
Reporting fees before the first interview avoids a double problem: patients who arrive and discover that they cannot afford treatment, and the discomfort of negotiating the price in the middle of the session. A brief message with value, duration and modality reaches.
The other problem of the first encounter is absenteeism: the first appointment is the one that is lost the most, because there is still no bond or compromise built. A reminder the day before reduces those absences. If you use Brauni, reminders via WhatsApp come out alone once you load the appointment, and you can see who confirmed without chasing anyone. About this we write in detail in our [appointment for psychologists](/blog/gestion-citas-psicologos) guide.
## What to Explore in the Admission Interview
These five areas cover the essentials of an initial assessment. You do not need to exhaust them in order or read the questions on a list: they are a mental guide to check, before closing the session, that nothing important remained untouched.
### Reason for consultation
It is the starting point and it should be recorded in two versions: what the person says textually and your clinical reformulation.
- What brings you here?
- Why now, did something in particular happen that decided to consult you?
- If this thing that happens to you improved, what would change in your life?
- What do you expect from psychological treatment?
The "why now" is usually more informative than the stated reason: the problem may be years old, but something pushed the consultation right now.
### History of the problem
- Since when does this happen to you?
- How did it start? Was there any triggers you can identify?
- Were there times when it was better or worse? What was happening at that time?
- What did you try so far to solve it, what worked, even partially?
- How does it affect your work, your ties, your dream, your daily life?
### Clinical history and previous treatments
- Did you do psychological treatment before, with what focus, how long did it last, how did it end?
- What served you and what did not of those experiences?
- Do you take any medication at present? Who directed it?
- Do you have any relevant medical conditions or are you being treated for something?
- Any history of mental health problems in your family?
How the previous treatments ended deserves special attention: a history of early abandonment anticipates a specific risk for this treatment and allows you to work on it from the start.
### Support network and context
- Who are you living with?
- Who are you telling when you're wrong? Is there anyone who knows you're coming to consult?
- How is your work or study situation?
- How are your close ties today?
The support network weighs on prognosis and clinical decisions: it is not the same to go through a crisis with family support as in total isolation.
### Risk assessment
It is the area that is most omitted because of discomfort, and the one that can least be omitted. If the reason for consultation includes depressive symptoms, vital seizures, problematic consumption, or history of self-injury, ask directly:
- Did you have any thoughts of hurting yourself or of not being here?
- Did you think of any concrete way you did anything about it?
- Did you have suicide attempts or self-harms in the past?
- Are there situations of violence in your home or in your ties?
Asking for suicidal ideation does not induce behavior: it enables you to talk about something that the person often does not encourage to say. And everything you evaluate in this area has to be recorded, along with the decisions you made. In the face of certain and imminent risk, the Law 26.657 and the Code of Ethics of FePRA enable to prioritize the protection of the person over confidentiality.
## The framing: what to leave agreed from day one
The last part of the first interview is for the frame. Explaining it takes five minutes and avoids months of misunderstanding.
- Fees: amount, form of payment, when paid and how they are updated. If you work with health insurance or private health plans, what covers and what does not.
- Cancellations: how much advance notice is given and what happens to off-term cancelled sessions. The rule that is not said on the first day is impossible to apply on the day you need.
- Frequency and duration: how long they will be seen, how long each session lasts, and, if your approach allows, an estimated treatment horizon.
- Modality: face-to-face, online or mixed, and what conditions the online modality needs (privacy, connection, camera on).
- Confidentiality and its limits: everything that is spoken in session is confidential, with exceptions that should be explained: certain and imminent risk to the patient or third parties, judicial request and clinical supervision with dissociated data. We develop it in our guide on the [professional secret in psychology](/blog/secreto-profesional-psicologia).
Much of the frame is formalized in the [informed consent](/blog/consentimiento-informado-psicologia), which the 26.529 Law requires and which should be signed at this first meeting or you just decide with the patient to start treatment.
## How to register the first interview
The first interview generates the first document of the case: the admission note, which opens the [medical records](/blog/historia-clinica-psicologia) of the patient. The 26.529 law requires that the medical records record all actions performed on the patient, and that includes this first encounter, even if the person does not continue the treatment.
A good admission note includes:
- Patient identification data and source of referral
- Reason for consultation (textual and reformulated)
- Summary of the history of the problem and relevant background
- Risk assessment: what was explored and what was found, even if the result is negative
- First clinical impression or initial hypothesis, presumptive in nature
- Agreed framework: fees, frequency, modality, cancellations
- Next steps: continuity, referral or interconsultation
Also register the risk assessment when the result is negative. "Suicide ideation has been explored, the patient denies current ideation and background" is a phrase that professionally supports you; the absence of registration does not say anything in your favor.
In Brauni you can leave this solved on the same day: you charge the patient, you register the admission note with a first interview template and the consent is attached to the file. The AI can help you structure the note from what you registered, but the clinical reading of the case is always yours: the copilot orders, you decide.
## Model of first psychological interview to copy
This is a base model of admission note, adaptable to your approach and jurisdiction. Use it as a guide during the interview and as a structure for subsequent registration.
---
### Admission note - first interview
**Date:** ___________________
**Professional:** Lic. [Name and Surname] - M. P. [Number]
#### PATIENT DATA
- **Full name:** [Name and Surname]
- **DNI:** [Number]
- **Date of birth and age:** [Date, age]
- **Telephone / Email:** [Contact]
- **Occupation:** [Occupation]
- **With whom he lives:** [Composition of the household]
- **Health insurance/private health plan:** [Name and Affiliate number]
- **Emergency contact:** [Name, link, telephone]
- **Derivated by:** [Professional/institution/spontaneous consultation]
#### GROUND FOR CONSULTATION
**In the words of the patient:**
[Textual record of what the person refers]
**Professional reformulation:**
[Your clinical reading of the reason for consultation]
**Why do you consult now?**
[Unchaining or context of the decision to consult]
#### HISTORY OF THE PROBLEM
- **Start and evolution:** [Since when, how it started, course]
- **Preliminary attempts at solution:** [What was tested, with what result]
- **Current impact:** [Work, links, dream, everyday life]
#### BACKGROUND
- **Previous psychological treatments:** [Period, focus, duration, how it ended]
- **psychiatry treatment/current medication:** [Professional, medication, dose]
- **relevant medical records:** [Conditions, ongoing treatments]
- **Family mental health records:** [If any]
#### SUPPORT AND CONTEXT NETWORK
[Significant links, available support, employment or educational situation]
#### RISK ASSESSMENT
- **Actual suicidal ideation:** [ ] Deny [ ] Present: [detail]
- **Plan or method:** [ ] Deny [ ] Present: [detail]
- **Preliminary attempts / self-injury:** [ ] Deny [ ] Present: [detail]
- **Situations of violence:** [ ] Deny [ ] Present: [detail]
- **Driver adopted:** [Record of decisions, if applicable]
#### First clinical impression
[Initial presumptive hypothesis, observations of mental state]
#### UNDERTAKING
- **Honors and method of payment:** [Mount, medium, update]
- **Frequency and duration of sessions:** [Week / fortnightly, minutes]
- **Modality:** [ ] Presence [ ] Online [ ] Mixed
- **Cancellation policy:** [Warning period, conditions]
- **Confidentiality and limits:** [ ] Explained
- **Informed consent:** [ ] Signed [ ] Pending
#### Decision and next steps
- [ ] It is agreed to initiate treatment. Next session: ________________
- [ ] A second evaluation interview is agreed upon
- [ ] It is derived from: [Professional/specialty, motive]
- [ ] Interconsultation is indicated with: [Speciality]
**Signature and seal of the professional:** _____________________
---
## Frequent errors in the first interview
### Turn it into a questionnaire
The opposite error to improvise. If the interview is reduced to completing fields, the person leaves with the feeling of having done a procedure. The guide is for your head, not to read it in front of the patient: the conversation commands and the structure accompanies.
### Do not explore risk
Skipping the risk questions for discomfort or for not "ruining the climate" is the mistake with the worst possible consequences. If there are indicators, ask directly and register what you found.
### Leave the frame for later
To collect without having agreed fees, to cancel without cancellation policy, to go online without having discussed it. Each element of the frame that is not explained on the first day is negotiated later in worse conditions.
### Do not register the interview
Staying with the feeling that "I remember the case" and not writing the admission note. Weeks later, the details are mixed, and if the person did not continue, there is no record of a performance that the law requires to document.
### Promise what you can't promise
Ensure results, exact deadlines of improvement or unlimited availability. The alliance is built on realistic expectations; what is promised too much in the first interview is charged expensive afterwards.
## Frequently Asked Questions
### Is the first psychological interview charged?
It is a decision of each professional, but the most widespread practice is to collect it: it is real clinical work, with preparation, evaluation and subsequent registration. Some professionals offer a first short contact free of charge (10 or 15 minutes by phone) to evaluate whether it makes sense to coordinate the interview, and charge for the full interview. The important thing is to inform it before, whatever your policy.
### How long is the first interview?
It usually lasts as long as a regular session or a little longer, depending on your way of work. Some professionals prefer to extend it to cover the full initial evaluation; others distribute admission to two or three meetings. The two options are valid if the patient knows in advance what to expect.
### Can you make it online?
Yes. The online admission interview is an established practice and allows to evaluate, generate alliance and agree to frame just like the face-to-face. It requires some extra care: verify that the person is in a private space, have a contact phone and localization data in case a situation of risk arises, and explain the conditions of the modality within the frame.
### Is the admission interview and the first session the same?
It depends on the device. In particular clinical practices they usually coincide: the first encounter is both admission and beginning of the therapeutic bond. In institutions, admission is usually a separate instance, sometimes in charge of another professional, that evaluates and leads the therapist who will carry the case. In both formats the objectives of evaluation, alliance and framing are the same.
### Should I sign the informed consent at the first interview?
It is the ideal moment, because consent formalizes just what you agreed in the frame: modality, fees, confidentiality and its limits. If the decision to start treatment is pending, you can sign it at the beginning of the second meeting. What is not appropriate is to start a sustained treatment without that support, which is also part of the medical records according to the 26.529 law.
## Summary
- The first psychological interview has four simultaneous objectives: to evaluate, generate alliance, define the frame and decide if you take the case.
- The first contact is already part of the admission: I solved fees, modality and expectations there, and used reminders to reduce the absenteeism of the first appointment.
- Areas to explore: reason for consultation (and why you are consulting now), problem history, background and previous treatments, support network and risk assessment.
- The risk is directly questioned and always recorded, even when the result is negative.
- The frame is agreed on day one: fees, cancellations, frequency, modality and confidentiality with its limits.
- The admission note opens the medical records and documents the performance required by the 26.529 Act, even if the patient does not continue.
- Deriving in time a case that exceeds your competence or availability is a responsible clinical decision.
---
## Notes SOAP, DAP and BIRP: what format to use in your session notes
- **URL**: https://brauni.io/en/blog/notas-soap-dap-birp-psicologia
- **Category**: Professional practice
- **Date**: 2026-04-09
- **Tags**: session notes, SOAP, DAP, BIRP, Clinical documentation, psychologists, template
Note Guide SOAP, DAP and BIRP for psychologists: each format explained field by field, with comparable examples, table and templates ready to copy.
If you ask ten psychologists to show you their session notes, you will find ten different systems: notebooks with their own abbreviations, Word documents without structure, notes from a line written to those in a hurry between patient and patient. The problem is not the variety, it is the inconsistency. That’s why there are session notes formats, and that’s why SOAP notes became the most widespread standard in health.
When each note follows a different criterion, comparing the evolution of a patient becomes difficult, retaking a case costs twice as much and, before a judicial request or an audit of the professional college, these loose notes are worth little as backup. A note without date, without structure and with mixed personal judgments does not defend you: exposes you.
A format does not change your way of working. Change the way you document what you already do. Here you will find SOAP, DAP and BIRP explained field by field, the same fictitious session written in the three ways and templates ready to copy.
## What is a session note format and why to use one
A note format is a fixed structure that defines what you register after each session and in which order. Instead of facing a blank sheet, you complete predefined fields: what the patient told, what you observed, what evaluation you did, what follows.
The notes of evolution are not a separate document: they are part of [medical records](/blog/historia-clinica-psicologia) and apply the same legal rules to them. 26.529 Law requires "clear and precise records of acts performed by professionals" (Art. 15.d), in chronological order and in a complete way. The law does not impose a specific format, but a standardized one makes it much easier to comply with that standard.
Using a format has specific benefits:
- **Consistency**: all your notes follow the same logic, session after session
- **Speed**: Do not waste time deciding what to write down or how to organize it
- **Visible evolution**: you can compare the 3 session with the 15 because the fields are the same
- **Legal backup**: a structured, dated and complete note has more probative value than a loose note
- **Interconsultation and referral**: another professional can understand the case without you translating your abbreviations
Session notes are part of the medical records according to the 26.529 law: they must be kept at least 10 years since the last performance, protected as sensitive data (the 25.326 law) and provided with a copy to the patient if requested. I wrote each note knowing that the patient has the right to read it.
## Notes SOAP in psychology: the most widespread format
The SOAP format is born in the medicine of the years 60, within Lawrence Weed's problem-oriented registration model, and over time it was adopted in almost all health disciplines. Its strength: it clearly separates what the patient says from what you observe, and both from your clinical interpretation.
### S: Subject
What the patient refers to in his own words: how he felt, what he worries about, how he describes his symptoms. Textual appointments are valuable here because they document without interpreting.
### OR: Objective
The observable and measurable: punctuality, general aspect, rhythm of speech, affection, conduct in session, results of scales, fulfillment of tasks. Everything a third party could verify if he had been present.
### A: Analysis
Your clinical evaluation: how you integrate the subjective and the objective, what progress is there with respect to objectives, whether the diagnostic hypothesis is sustained or adjusted. It is the field where your professional judgment is documented.
### Q: Plan
What follows: interventions for the next session, assigned tasks, frequency adjustments, referrals or interconsultations.
## Notes DAP: abbreviated version
The DAP format condenses SOAP into three fields: Data, Analysis and Plan. The central difference is that it merges the subjective and the objective into a single Data field.
- **D: Data**. Everything that happened in the session: what the patient told, what you observed, the topics worked. Without separating source or type of information.
- **A: Analysis**. As in SOAP: your clinical reading of those data.
- **P: Plan**. As in SOAP: the next steps.
DAP is the preferred option for many psychologists who find artificial the division between subjective and objective in psychotherapy, where the main material is the patient's speech. Fewer fields mean faster notes, at the cost of losing that explicit distinction between story and observation.
## Notes BIRP: the intervention in the center
The BIRP format organizes the note around what you did as a therapist and how the patient responded. Its four fields:
- **B: Behavior (Behavior)**. Presentation and behavior of the patient: what brought him into session, what symptoms he refers to, how he looks.
- **I: Intervention**. What did you do: applied techniques, markings, psychoeducation, work on specific objectives.
- **A: Answer**. How the patient reacted to these interventions: participation, insight, endurance, changes during the session.
- **P: Plan**. The next steps, as in the other formats.
BIRP is widely used in institutional contexts because it accurately documents the therapeutic activity: what intervention was made and what outcome it had. If you work with health insurance or institutions that audit treatments, that record is a strong backup.
## The same session written in all three formats
Nothing clarifies more than a comparable example. Let's take a fictitious session: M., 34 years, anxiety consultation, 8th session. A demanding week for a job presentation, a timely breathing technique and an exposure achieved with tolerable discomfort.
### In SOAP format
**S:** M. refers to a week "very loaded" for a presentation at work. It says: "I thought I was going to pass the usual, but this time I could stop before." It reports anticipated concern the days before and difficulty sleeping the night before the presentation.
**O:** It arrives punctually. Organized speech, with accelerated rhythm when reporting the work episode. Congruent affection. Moderate anxiety observable at the beginning, which decreases during the session. It completed the agreed thought record (5 of 7 days).
**A:** Progress on the objectives of anxiety management: identified anticipatory thoughts and applied diaphragmatic breathing before exposure. Avoidance persists in social situations outside the workplace. The working hypothesis remains.
**Q:** Continue with gradual exposure: attendance at the Saturday family meeting is agreed. Thought recording with reassessment column is assigned. Next session in one week.
### In DAP format
**D:** M. refers to a week "very loaded" by a work presentation, with anticipation concern and insomnia the previous night. He applied diaphragmatic breathing before exposing himself and said: "this time I could slow down before." He arrives on time, accelerated speech at the beginning, moderate anxiety that gives in during the session. He completed the thought record 5 of 7 days.
**A:** Progress in the objectives of anxiety management: identification of anticipated thoughts and spontaneous use of the technique worked. Social avoidance persists outside the workplace.
**Q:** Gradual exposure (Saturday family reunion), reassessment thinking record, next session in a week.
### In BIRP format
**B:** M. relates an episode of anticipation anxiety before a work presentation, with insomnia the previous night. It arrives punctually, speech accelerated at the beginning of the session, observable moderate anxiety.
**I:** Review the register of thoughts of the week. The use of diaphragmatic breathing is reinforced. The restructuring of the thought "is going to pass me the usual" and psychoeducation is performed on the curve of anxiety.
**R:** M. participates actively, identifies anticipatory thinking without help and proposes the next exercise of exposure on his own initiative. Anxiety decreases throughout the session.
**Q:** Agreed exhibition (Saturday family meeting), recording thoughts with reassessment column, next session in a week.
The session is the same, but each format illuminates something different: SOAP gives the most complete picture, DAP is the most agile, and BIRP leaves the clearest record of what you did and what effect it had.
## Comparative table of session note formats
| Criterion | SOAP | DAP | BIRP |
|----------|------|-----|------|
| Fields | 4 (Subjective, Objective, Analysis, Plan) | 3 (Data, Analysis, Plan) | 4 (Driving, Intervention, Response, Plan) |
| Separate patient account and self-observation | Yes, explicitly. | No | Partially |
| Document the intervention of the therapist | Implicitly | Implicitly | Yes, with its own field |
| Writing Time | Major | Minor | Intermediate |
| Strengths | Complete table, interdisciplinary standard | Agility, simplicity | Mapping of interventions and response |
| Context where it shines | Interconsultation, health teams | private clinical practice, high volume of patients | Institutions, audits, health insurance |
## Which format suits your theoretical orientation
None of the three formats belong to a school. They are containers, not theoretical frames, and anyone adapts to any orientation. That said, some natural affinities:
- **TCC and behavioral therapies**: SOAP and BIRP fit almost without friction. You work with measurable objectives, defined techniques and inter-session tasks, which is what these formats ask for.
- **Psychoanalysis and psychodynamics**: Many colleagues prefer DAP, because the division between subjective and objective can be forced when the central material is speech and transfer. The field of Analysis comfortably houses the reading of the material and the hypotheses.
- **Systemic**: in sessions with couples or families, the SOAP Objective field (or BIRP Conduct) serves to record interaction patterns: who speaks, who interrupts, how the system is reorganized before an intervention.
- **Integrative**: any of the three works. What matters is that you choose one and hold it, because the value of the format is in the comparability between sessions.
If you never used a format, start with DAP: it is the least frictional and you can migrate to SOAP or BIRP later. Hold it at least a month before evaluating a change: consistency is worth more than choice.
## Frequent errors when writing session notes
### Write note days later
Memory rebuilds, does not reproduce. A note written three days later mixes what happened with what you remember happened. Ideally it is to write it the same day, as soon as the session ends.
### Notes to a line
"Good session, anxiety was worked out" does not document anything: it does not say what was worked, how the patient responded or what follows. Faced with a requirement, such a note is worth almost the same as none.
### The opposite extreme: transcribing the session
A note is not a derecording. Registering each sentence takes time, exposes more intimate content than necessary and buryes the relevant in detail. The format exists just to force you to synthesize.
### Mixing personal judgements with clinical observations
"The patient was unbearable" is not an observation, it is a relief. The patient can read his or her medical records, and a judge too. He or she registers behaviors and clinical formulations, not opinions.
### Change format every two weeks
If the 4 session is in SOAP, the 5 in a notebook and the 6 in a message you sent yourself, you lost the comparability that makes the format useful.
### Save notes anywhere
Session notes are sensitive data protected by the 25.326 Law. A personal Google Drive folder without encryption or access control is not a place for clinical material. On this we write a comparison between [paper, Google Drive and clinical software](/blog/notas-sesion-papel-google-drive-vs-software-clinico).
Before a court order, what is not registered does not exist for evidentiary purposes, and what is misregistered can play against you. I wrote each note as if one day you had to back yourself in it, because that day can come.
## Ready-to-copy templates
Take the one that corresponds to your chosen format and adapt it to your practice.
### SOAP Template
```text
NOTA DE SESIÓN (SOAP)
Paciente: [Iniciales o N° de legajo]
Sesión N°: [Número] | Fecha: ____/____/________
Asistencia: [ ] Presente [ ] Ausente con aviso [ ] Ausente sin aviso
S (SUBJETIVO)
Lo que el paciente refiere: estado de la semana, síntomas,
preocupaciones. Incluir citas textuales relevantes.
O (OBJETIVO)
Lo observable: puntualidad, aspecto, discurso, afecto,
resultados de escalas, cumplimiento de tareas.
A (ANÁLISIS)
Evaluación clínica: integración de S y O, avance respecto
de los objetivos, estado de la hipótesis diagnóstica.
P (PLAN)
Próximos pasos: intervenciones previstas, tareas,
ajustes de frecuencia, derivaciones.
Firma y matrícula: _________________
```
### DAP Template
```text
NOTA DE SESIÓN (DAP)
Paciente: [Iniciales o N° de legajo]
Sesión N°: [Número] | Fecha: ____/____/________
Asistencia: [ ] Presente [ ] Ausente con aviso [ ] Ausente sin aviso
D (DATOS)
Qué pasó en la sesión: relato del paciente, observaciones,
temas trabajados, cumplimiento de tareas.
A (ANÁLISIS)
Lectura clínica de los datos: avance, hipótesis, cambios
respecto de sesiones anteriores.
P (PLAN)
Próximos pasos: tareas, foco de la próxima sesión, ajustes.
Firma y matrícula: _________________
```
### BIRP Template
```text
NOTA DE SESIÓN (BIRP)
Paciente: [Iniciales o N° de legajo]
Sesión N°: [Número] | Fecha: ____/____/________
Asistencia: [ ] Presente [ ] Ausente con aviso [ ] Ausente sin aviso
B (CONDUCTA)
Presentación del paciente: síntomas referidos, comportamiento
observable, material que trae a sesión.
I (INTERVENCIÓN)
Qué se hizo: técnicas aplicadas, señalamientos,
psicoeducación, objetivos trabajados.
R (RESPUESTA)
Reacción a las intervenciones: participación, insight,
resistencias, cambios durante la sesión.
P (PLAN)
Próximos pasos: acuerdos, tareas, foco de la próxima sesión.
Firma y matrícula: _________________
```
If you prefer not to put this together by hand, in Brauni the [dynamic templates](/blog/templates-dinamicos-documentacion-clinica) adapt to any of the three formats (or your own), and the [IA can draft the note from the session audio](/blog/ia-completar-notas-sesion), already organized in the fields of your format. The clinical judgment remains yours: the AI prepares the draft, you review each field and decide what is left. The full detail is in [session notes with AI](/funcionalidades/notas-de-sesion-ia).
## Frequently Asked Questions
### What does SOAP mean in session notes?
It is the acronym in English of Subjective, Objective, Assessment and Plan: Subjective (what the patient refers to), Objective (what you observe), Analysis (your clinical evaluation) and Plan (the next steps). It is the most widespread documentation format in health.
### Is it mandatory to use SOAP, DAP or BIRP in Argentina?
No. The 26.529 Act requires clear, accurate, chronological and complete records, but does not impose any format. SOAP, DAP and BIRP are professional conventions that help you meet that standard, not legal requirements.
### Can I modify the fields or combine formats?
Yes. Many professionals add fields of their own (risk, medication, coordination with other professionals) or build hybrids. The important thing is that the structure is stable over time: the value is in consistency, not in format orthodoxy.
### Which format is faster to write?
DAP, for having only three fields and not demanding the separation between subjective and objective. Anyway, real speed comes from habit: with practice, any of the three is completed in a few minutes.
### Are session notes the same as the medical records?
No. The notes of evolution are part of the medical records, which also includes the patient's data, initial evaluation, treatment plan, informed consents and closure. The notes inherit all their legal obligations: conservation, confidentiality and patient access.
### What about my personal notes or work hypotheses?
Unlike other countries, Argentine regulations do not formally distinguish between progress notes and personal notes of the therapist. Prudent posture: I assumed that everything you register can be read by the patient or required by a judge, and wrote accordingly, with well-founded clinical formulations and without loose speculations. Faced with doubt, consult your professional college; the Code of Ethics of FePRA is the reference in matters of professional secrecy and records.
## Summary
- A session note format is a fixed structure that orders what you register; the 26.529 Act does not impose any, but requires clear, accurate and chronological records
- **SOAP** (Subjective, Objective, Analysis, Plan): the most complete and interdisciplinary standard; ideal if you work as a team or do interconsultations
- **DAP** (Data, Analysis, Plan): the most agile; ideal for private clinical practice
- **BIRP** (Driving, Intervention, Response, Plan): the one that best documents therapeutic activity; ideal in institutions and before audits
- No format belongs to a theoretical orientation: choose by affinity and context, and sustain the choice in time
- Notes are part of the medical records: same rules of conservation (minimum 10 years), confidentiality (law 25.326) and patient access
- I wrote each note on the same day of the session, without personal judgments and knowing that the patient (or a judge) can read it
---
## Where your patient data is stored and why we chose AWS
- **URL**: https://brauni.io/en/blog/donde-se-guardan-datos-pacientes-aws
- **Category**: Privacy and Security
- **Date**: 2026-04-04
- **Tags**: AWS, AWS Startups, infrastructure, security, patient data, cloud, encryption, data center
We show you exactly where your patients' clinical data live in the AWS cloud, the world's largest and most secure infrastructure, and why that matters to your practice.
"Where are my patients' data?" It's probably the most important question you can ask any clinical software. And the answer should be clear, concrete and verifiable.
In Brauni, the answer is simple: **Amazon Web Services (AWS)**, the largest, most used and most secure cloud platform on the planet.
In this article we explain exactly where your patients' clinical information lives, why we choose AWS and what makes this infrastructure the gold standard for health data.
## What is "cloud" in simple terms?
When we say your data is "in the cloud," it doesn't mean they float on the internet without control. It means they're stored in **physical data centers** - real buildings, with real servers, guarded the 24 hours of the day, the 365 days of the year.
The difference is that instead of being on a hard disk under your desk (vulnerable to theft, fire, or mechanical failure), they are in facilities specifically designed to protect critical information.
## Why AWS?
### The largest cloud in the world
AWS is no longer a cloud. It is **the largest cloud infrastructure**:
- **34 geographical regions** with **108 areas of availability** worldwide
- **Millions of active customers**, including startups, governments and the largest companies on the planet
- More than **31% of the global cloud market** - more than Microsoft Azure and Google Cloud combined
- Infrastructure used by organizations such as NASA, the US Department of Defense and thousands of hospitals
AWS was the world’s first public cloud platform (launched in 2006) and has been perfecting its infrastructure for almost two decades. That time advantage translates into maturity, stability and an unmatched security ecosystem.
### The Safest Cloud in the World
The security of AWS is not marketing. It is engineering supported by **more than 140 security certifications and accreditations**, including:
- **SOC 1, SOC 2 and SOC 3** - independent audits of security controls
- **ISO 27001, 27017, 27018** - International standards for information security management
- **HIPAA** - U. S. federal law for health data protection (with BAA signed)
- **FedRAMP** - U. S. federal government authorization for government data
- **PCI DSS Level 1** - the highest standard for payment processing
- **HITRUST CSF** - the most rigorous safety framework in the health sector
### Designed for health data
AWS offers health sector-specific services that other providers simply do not have at the same level:
- **AWS HealthLake** for FHIR format clinical data storage
- **Automatic AES-128 encryption** on all storage services
- **AWS Key Management Service (KMS)** for centralized encryption key management
- **AWS CloudTrail** for immutable recording of all data activity
- **AWS Config** for continuous monitoring of compliance with security policies
## Where exactly do your data live?
Your patients' clinical data on Brauni reside in **AWS data centers in the United States**, within regions with signed HIPAA and BAA certification.
### What's inside an AWS data center?
We are not talking about a room with servers. AWS data centers are world-class facilities with:
- **Perimetral physical security**: fences, guards 24/7, intruder detection and continuous video surveillance
- **Biometric Access Control**: Only authorized personnel can enter, with multiple layers of verification
- **Electrical re-boot**: backup generators and UPS systems that ensure power outage performance
- **Fire systems**: Early detection and automatic suppression
- **Physical destruction of disks**: when a hard drive is removed, it is physically destroyed following DoD 5220.22-M standard protocols
If your current clinical software stores data on a local server or generic hosting without health certifications, your patients' information is exposed to risks that an AWS data center eliminates by design.
## Redundancy: Your data is never in one place
One of the most important advantages of AWS is **automatic redundancy**. This means that the data does not live on a single server or in a single building:
### Availability areas
Each region of AWS has **multiple areas of availability** (minimum 3). Each area is an independent data center, with its own power supply, cooling and network connectivity. If one area fails, the others continue to operate.
### Automatic replication
In Brauni we set up data replication so that each clinical record exists in **multiple copies** distributed in different areas. If a complete data center is out of service (something extremely unlikely), your data remains available from another location.
### Encrypted backups
In addition to real-time replication, we perform **automatic and encrypted backups** that are stored independently. This protects against human errors, ransomware attacks or any catastrophic scenario.
## How do you travel your data?
When you open Brauni from your computer or cell phone, information travels between your device and AWS servers. That path is also protected:
- **TLS 1.3** encrypts all communication between your browser and our servers
- **Transfer between services**: even within AWS, communication between our databases and application servers is encrypted
- **Managed SSL Certificates** and automatically renewed
No one can intercept the data while travelling. Neither your internet provider, nor an attacker on a public Wi-Fi network.
## AWS vs. other alternatives: numbers speak
| Characteristic | AWS | Generic Hosting | Local server |
|---|---|---|---|
| Safety certifications | 140+ | Few or none | None |
| HIPAA Compliance | Yeah, with BAA. | Usually not. | Not applicable |
| Geographical Redundancy | Automatic | Manual or non-existent | No such thing |
| Uptime | 99.99% | Variable | Depends on the hardware |
| Automatic Encryption | AES-128 at rest and transit | Manual Configuration | Own responsibility |
| Physical security | Military class | Variable | A locked door |
| Automatic backups | Multiregion, encryption | Depends on the plan. | Own responsibility |
| Safe destruction of data | DoD Protocol | No guarantee | No guarantee |
## Who else trusts AWS for sensitive data?
We are not the only ones who chose AWS to protect critical information:
- **Epic Systems** - the largest electronic medical records system in the U. S.
- **Pfizer** - for pharmaceutical research and clinical trials
- **Modern** - for vaccine development during the pandemic
- **GE Healthcare** - for medical imaging
- **United States Government** - including the Department of Defense and the CIA
If AWS is safe enough for the defense secrets of the world's greatest power, it's safe enough for your patients' session notes.
## Majily LLC is part of the AWS Startups program
Brauni is developed by **Majily LLC**, and we are proud to be part of the official program [**AWS Startups**](https://aws.amazon.com/startups/showcase/startup-details/610505b1-1a70-457a-9f94-c5cd5ebfd816). This is not just a label: it means that AWS evaluated our infrastructure, our business model and our technical architecture, and accepted us within its verified startup ecosystem.
### What does being in AWS Startups mean?
- **Access to AWS solution architects** who review and optimize our infrastructure
- **Credits and technical resources** to scale with AWS best practices
- **Technical validation** that our architecture meets AWS standards for health applications
- **Visibility in the official AWS showcase**, where anyone can verify our participation
You can see the Majily LLC profile directly in the [AWS Startups showcase](https://aws.amazon.com/startups/showcase/startup-details/610505b1-1a70-457a-9f94-c5cd5ebfd816). It is public and verifiable.
Being part of this program reinforces our commitment: not only do we use AWS, but we work directly with them to ensure that the infrastructure where your patients live is the best possible.
## Our responsibility for AWS
Using AWS does not mean we delegate security. AWS provides infrastructure; we build additional protections:
1. **[field by field](/blog/seguridad-privacidad-brauni)**: before a data reaches AWS, we already encrypt it with our own keys
2. **[BAA signed with AWS](/blog/baa-hipaa-google-cloud-brauni)**: legal contract that obliges AWS to comply with HIPAA on our data
3. **strict access control**: Not even our technical team can read clinical data in plain text
4. **Continuous monitoring**: Automatic alerts to any unusual activity
5. **[No AI Training Policy](/blog/tus-datos-no-entrenan-ia)**: Your data never feeds artificial intelligence models
## What does all this mean to you?
It means that when you save a session note in Brauni:
1. Encrypted in your browser before leaving your device
2. Travel through a channel encrypted with TLS 1.3
3. Reaches AWS servers protected with military-class physical security
4. It is stored with AES-128 encryption in multiple redundant locations
5. Automatically backed up in encrypted and independent backups
6. It is protected by legal contract (BAA) under the standards of HIPAA
All this happens in milliseconds, you don't have to do anything.
Your only responsibility is to care for your patients. Infrastructure security is ours.
---
Do you have questions about where your patients' data live? Write to [soporte@brauni.io](mailto:soporte@brauni.io). We are here to give you the peace of mind you need to focus on what matters: your clinical practice.
---
*Brauni uses Amazon Web Services (AWS) as the main provider of infrastructure, with BAA signed under HIPAA. We comply with the principles of Argentina's Personal Data Protection Act 25.326 and align ourselves with the most demanding international standards for the management of protected health information (PHI).*
---
## Brauni appointment Management: Creating, Repeating, Synchronizing and Canceling
- **URL**: https://brauni.io/en/blog/gestion-citas-psicologos
- **Category**: Management of clinical practice
- **Date**: 2026-04-02
- **Tags**: agenda, appointments, appointments, recurrent, Google Calendar, WhatsApp, psychologists
Complete Brauni appointment module guide: simple quotes, recurring series, Google Calendar, reminders via WhatsApp and states. Everything you need to know.
The schedule is the axis of a clinical practice. If appointment takes longer than necessary, something is failing.
This guide explains everything you can do with the Brauni appointment module: from creating a simple quote to managing a recurring series with dozens of sessions. If you look for the quick view of the functionality, it is in [schedule and appointments](/funcionalidades/agenda-turnos).
## Make an Appointment
To create a complete quote some basic fields:
- **Patient** - You select it from a search engine. If you don't have it loaded yet, you can create it from the same patient module.
- **Date and time** - The selector displays schedules at 15 minute intervals, from 7:00 to 21:00 intervals.
- **Estimated duration** - The pre-designed options are 30, 45, 60, 90 and 120 minutes. You can also enter any duration between 15 and 480 minutes in 5 minute increments. End time is calculated automatically.
- **Modality** - Virtual or face-to-face. If you choose virtual and have Google Calendar linked, a Google Meet link is automatically generated.
- **Comments** - A free field for internal annotations. Up to 5000 characters.
- **Reminder via WhatsApp** - Three options: use patient settings, force sending for this appointment, or delete it.
- **Color** - 24 colors available to visually distinguish appointments in the calendar.
The system warns if you are creating an appointment on an already busy schedule. It also shows a confirmation if the schedule is in the past, to avoid errors.
## Recurrent appointments
If you see the same patient every week at the same time, there is no point in creating each appointment separately.
When creating a quote you can activate the recurrence option. It works like this:
### Frequency
- **Weekly** - One appointment every seven days
- **Fifteenth** - An appointment every fortnight
- **Mensual** - An appointment on the same day of each month
### End of series
Two ways to define when it ends:
- **In quantity** - You create N sessions. For example: 10 weekly sessions. The system creates the 10 and numbered samples (#1 of 10, #2 of 10, etc.)
- **By date** - The series extends to a specific date and the system creates all intermediate sessions.
The ceiling is 100 meetings per series.
Once the series has been created, the system confirms how many sessions were generated: "10 sessions created successfully."
The frequency cannot be modified after creating the series. If you can edit individual quotes within it.
## Calendar view and list view
appointment can be seen in two ways.
**Calendar view** - Use FullCalendar in three modes: Month (monthly grid), Week (timeline per hour) and List (table format, automatically enabled on mobile).
Recurrent quotes show an icon 🔁 and the numbering within the series. Modified appointments with respect to the original pattern have an indicator ⚠️.
**List view** - Table with orderable columns: patient, date/time, duration, mode, status, comments and actions. On mobile switch to cards.
### Filters available
- Status: All scheduled, completed, cancelled, not attended
- Date range: all, today, this week, this month, next, past
- Modality: all, face-to-face, remote
- Search by patient name or comment content
### Ordering and pagination
You can sort by name, appointment, duration or status. The default page shows 10 quotes per page, changeable to 5, 20 or 50.
At the top are the counters: total of appointments, scheduled, completed and cancelled.
## appointment States
| State | Colour | Description |
|--------|-------|-------------|
| Scheduled | Blue | Default status when creating |
| Completed | Green | The session was held |
| Cancelled | Red | It's off, it's on the record. |
| He didn't attend. | Red/Amber | Patient did not show up |
Changing status can be done from the table, from the editing form, or with a quick button in the detail view.
## Edit Quote
From any view you can open the editing form. The editable fields are: date, time, duration, mode, comments, status and reminder settings.
The patient field is blocked: the patient cannot be changed from an existing appointment.
If the quote belongs to a recurring series, the system asks you the extent of the modification.
## Edit, cancel or delete recurring quotes
When you touch a quote that is part of a series, the system asks what you want to modify:
- **Only this quote** - Only the selected instance changes. The others remain intact.
- **This and the following** - Modify the selected quote and all that come next in the series.
This applies to editing, cancellation and deletion.
### Difference between canceling and deleting
**Cancel** marks the quote with the "Canceled" status. The quote remains visible in the history and in the counters. It is the recommended option because it preserves the record.
**Delete** deletes the quote permanently from the database. There is no way to recover it. The system always shows a warning before confirming this action: "This action is irreversible."
## View full series
From any recurring quote there is an option to view the entire series. The view shows:
- Description of recurrence (e.g. "weekly, 10 times")
- All instances ordered chronologically, numbered (#1, #2, etc.)
- Status of each: completed, scheduled or cancelled
- Which were modified from the original pattern (indicated with ⚠️)
- Summary: how many completed, cancelled and scheduled
## Google Calendar and Google Meet
If you link your Google account from the profile settings, quotes are automatically synchronized with your Google Calendar.
The system will let you know if Google Calendar is not linked to a dismissible banner at the top of the appointment page.
For virtual appointments, when Google Calendar is linked, the system automatically generates a Google Meet link. The link appears in the quote detail and can be shared with the patient. A link cannot be entered manually - it is generated only if integration is active.
If you create a virtual quote without Google Calendar linked, the system warns: "No Google Meet link will be generated." The quote is created the same, but without automatic link.
## Reminders via WhatsApp
Each quote has its own reminder settings:
- **Use patient configuration** - Respect the preference kept in the patient profile
- **Force Sending** - Send the reminder for this appointment even if the patient has the reminders disabled
- **Delete** - Does not send a reminder for this appointment even if the patient has them activated
## Next appointments Widget on Dashboard
The main dashboard shows the next 10 appointments with patient name, schedule, mode and status. You can update the list manually with a refresh button.
## Integrated conference notes
From any quote you can browse directly to create the corresponding session note. The system pre-completes the session field automatically so you don't have to look for it.
## What you can't do
For clarity, this is not available in the current appointment module:
- Modify the frequency of a recurring series after creating it (must be deleted and recreated)
- Changing the patient from an existing appointment
- Manually enter a video call link (Google Meet's link is automatic or non-existent)
- Create appointments for multiple patients at the same time
## Security and privacy
appointment comments, like all clinical data in Brauni, are stored encrypted with Fernet AES-128. The Brauni team cannot read the content of your notes or comments.
Access and appointment modification logs are registered in the audit system. This is relevant in legal contexts or before claims: you can demonstrate when each appointment was created, modified or cancelled.
Do you have any questions about functionality? email us at support from the platform or through the support section on the dashboard.
---
## Instagram for psychologists: what to post without violating ethics
- **URL**: https://brauni.io/en/blog/instagram-redes-sociales-psicologos
- **Category**: Management of clinical practice
- **Date**: 2026-03-31
- **Tags**: instagram, social networks, marketing for psychologists, professional ethics, patient uptake, psychologists
Instagram for psychologists: what to post without violating ethics, what FEPRA and schools prohibit, and how to turn visibility into smokeless queries.
If you're looking for information about Instagram for psychologists, you're going to find two opposite speeches. On the one hand, marketing gurus who promise to fill your agenda with reels, three-step formulas and courses that cost more than a four-year postgraduate. On the other, colleagues who consider that publishing content is unworthy of the profession, a banalization of the clinic that no serious psychologist should afford.
Between those two extremes there is a professional and ethical midpoint that almost no one explains: using Instagram as a tool of visibility, with realistic expectations and with the code of ethics in hand. Neither patient machine nor betrayal of the profession: one more channel, with its own rules.
In this guide we lower that middle point to the concrete: what can Instagram do for your practice and what not, where are the real ethical limits, what content works without compromising your professional license and how to handle the uncomfortable part that no course mentions: patients who follow you, followers who write you because they are wrong and the time that all this consumes.
## What can (and can't) do Instagram for your practice
Let's start by lowering expectations to an honest place, because most frustrations with social media for psychologists are born from waiting for what the channel cannot give.
What Instagram can do: build visibility and trust over time. When a colleague thinks of drifting or a person doubts between two professionals, he is likely to search for you in networks before writing to you, and a careful profile, with serious content and consistent with your approach, confirms that decision. Instagram works less as a patient magnet and more as a permanent cover letter.
What you can't do: fill your schedule in a month. No one serious can promise that. The decision to start therapy is slow and intimate, and the channels that most patients bring are still professional referral, mouth-to-mouth and Google search. We write about the whole picture in our guide to [how to get patients by being a psychologist](/blog/como-conseguir-pacientes-psicologia), where the networks occupy the 6 position of 10 for one reason: they yield less per hour inverted than almost everything else.
## The ethical framework before the strategy
Here is the difference between a psychologist and any other content account: your public communication is regulated. The Code of Ethics of FePRA and the regulations of the professional colleges of each jurisdiction place concrete limits on the advertising of psychological services, and apply to Instagram as well as to a poster on the public road.
Before thinking about strategy, formatting, or frequency, I was clear what's out there without discussion:
- Testimonies of patients for advertising purposes. Even if the patient offers it in good will, exposing it to promote your practice compromises confidentiality and therapeutic link.
- Promises of results or healing. "Overcome your anxiety", "sanate in 8 sessions", "guaranteed results": in addition to ethical breaches, they are clinical lies.
- The format "before and after" applied to mental health, in any of its variants.
- Display real cases, even if you change the name. A recognizable cartoon continues to violate professional secrecy: the patient can recognize himself, and his environment as well.
- To diagnose or intervene clinically by direct comments or messages. A diagnosis requires evaluation in a frame, not a quick reading of three lines.
- Sensationalist dramatizations of psychic suffering. Act a panic attack for the camera or stage a crisis to gain reach trivializes what your patients live seriously.
Each jurisdiction has its own college and its own professional advertising regulations. Before you build your profile or publish any piece, spend ten minutes reading the code of ethics that governs you: it is the best-cost-benefit reading of your entire network strategy.
The good news: none of this prevents you from having a presence on Instagram. It prevents you from doing the kind of content that, incidentally, is the one that most damages the public perception of the profession.
## The gray one to think about: psychoeducation or self-diagnosis factory
There is one area that codes do not solve with a clear rule and that deserves your clinical judgment: the type content "5 signs that you have anxiety", "this is how avoidative attachment is seen", "this makes a person with ADHD". It is the most viral format of network psychology, and also the most problematic.
The problem is not the psychoeducation itself. The problem is that that format invites self-diagnosis by checklist: the audience reads five generic signals, is recognized in three and comes out convinced that it has a disorder. When the content pathologizes the everyday to viralize (every tiredness is burnout, every distraction is ADHD, all social discomfort is anxiety), the reach rises and the informative quality low. And that audience comes to the consultation with borrowed labels that then have to be disarmed in session.
Responsible psychoeducation is distinguished by three things:
- Contextualizes rather than list: explains that an isolated symptom is not a diagnosis, that intensity and persistence matter, that the same can mean different things in different people.
- He does not use fear as a hook: "tell them that your partner is a narcissist" he sells; explain what is and what is not narcissism as a trait, he reports.
- Close by opening the right door: if any of this resonates with you, the step is a professional consultation, not another Instagram test.
A quick test before publishing: does this content help someone to understand something better, or push them to label themselves? If the honest answer is the second, the reach you gain is going to have a clinical and ethical cost that is not worth it.
## What works and is ethical on Instagram for psychologists
Taking out the forbidden and thought grey, there is a wide territory: there is no need to choose between integrity and visibility.
Specific psychoeducation of your niche. Not "mental health matters," but content that only someone with your training can do: what is and what is not a panic attack, how to accompany a teenager who does not want to go to therapy, what happens to sleep in the post-partum. The more specific your niche, the less competition your content has.
Explain how you work and what to expect from a therapy. This is the most underestimated and probably the most useful content: how a first session is, how long a process takes, what if you don't know what to say, what the online modality is. A lot of people who need therapy don't consult for fear of the unknown; every publication that disarms that mystery lowers the entry barrier.
Answer general frequently asked questions. The doubts that come to you repeatedly (the therapy is forever?, can I change psychologist?, what difference does it make with a psychiatrist?) are legitimate content, always in general and without turning the answer into individual advice.
Show your training and focus. Your journey, your theoretical orientation, why you work with the population you work with. It's not autobombo: it's the information a person needs to choose with judgment.
Content that will serve those who will never be your patient. It seems counterintuitive and is the mark of serious accounts: if your content only serves as bait, it is noticed; if it genuinely helps even if that person never hires you, build the reputation that later brings consultations along indirect paths.
## Patients and former patients following you
This is the topic that the marketing courses do not talk about and that will happen to you: your patient found you on Instagram and started following you. Or he tells you about the posts. Or he writes you by direct message on a Sunday night.
Do you accept followers who are patients? About follow-up itself there is no single rule: a professional profile is public and you can't control who looks at it. What you can control is the other way: don't follow your patients, don't look at their profiles and don't use what they post as unspoken clinical input.
And when they comment or write for DM? There applies the same principle that we work in our guide on [WhatsApp with patients](/blog/whatsapp-pacientes-psicologia): the framing does not end at the door of clinical practice, it extends to all digital channels. Direct messages are not a space of attention: what is session material, goes to session. A brief and cordial response that redirects ("this that you tell me is important, we talk about in the next session") maintains the framing without coldness. It is appropriate to explain this rule in the initial frame, before the situation appears.
Your personal profile: separate it from the professional and place it in private. Not because you have something to hide, but because your vacation and your opinions are not part of what your patients need from you; the asymmetry of the bond is also taken care of there.
## The operating without burning you
The number one reason for abandoning Instagram among psychologists is not the lack of results: it is exhaustion. The time to publish comes from somewhere, almost always from your hours off, and a strategy that consumes your nights is a second unpaid job that feeds the wear and tear on which we write in the [burnout in psychologists](/blog/burnout-psicologos-prevencion) guide.
Practical rules for networks not to eat your week:
- Sustainable frequency before ideal frequency. A dedicated publication per week, sustained over time, is worth more than a month of daily publication followed by six months of silence. Choose the pace you can keep in your worst week.
- Pillars of content of your niche. I defined three or four core themes (anxiety in young adults, how therapy works, your focus) and rotate between them. Every new idea falls into a pillar or is not published.
- It recycles formats. The same good idea is a carousel, a story, a text and a short video: deploying it yields more than chasing four new ideas.
- Don't run behind trends that don't go with your tone. If the viral audio of the moment bothers you, that discomfort is transmitted.
- Set a schedule. A fixed weekly block to create and program, and ready. Networks expand until you take up as much time as you give them; the limit is you.
## From profile to query: the link that almost everyone forgets
You can do all the above well and don't let anything happen, for a silly reason: the person who wants to consult you doesn't find how. The content generates interest; the profile has to turn it into contact.
Your bio has a specific job and there are two lines: to tell who you care and how to contact you. "Clinical psychologist. Adults, anxiety and grief. Online and face-to-face in Rosario. appointment on the link" turns; an inspirational appointment, no. Whoever comes to your profile has to solve in five seconds if you are for her and what to do next.
The link of bio is the final link. Sending people to "write for DM" adds friction just where it doesn't work. A link that leads to a verified professional profile with online booking solves that of one: this is where we use what we build. With the [public directorio de psychologists of Brauni](/blog/directorio-publico-psicologos), your bio link leads to a profile with verified enrollment, your specialty and your modalities, from where the patient can [reserve session directly](/blog/reserva-sesiones-directorio) by choosing day and schedule, without commissions per booking. Instagram generates trust; the verified profile confirms it and makes it an appointment.
I measured the whole link: when a new query arrives, ask how it found you. If after a year of posting no one arrives on Instagram, that data is worth gold: perhaps the content needs an adjustment, or maybe your time yields more on referrals and directory.
## What Never Must Be Done
Some concrete practices that we see followed and which should be mentioned without euphemisms:
- Buying followers. Besides the ethical problem, it does not fool anyone: a profile with thousands of followers and three likes per publication is transparent, and in mental health trust is the whole product.
- Sorting sessions. A therapy session is not a prize or a merchandising product: bypassing it trivializes the clinical act and rubs misleading advertising.
- Respond to clinical consultations in comments. Not with the best intention: you have no evaluation, no framing, no context, and your response is public as pseudoconsultation for anyone reading.
- Uploading stories from clinical practice with patients waiting or during hours of care. The waiting room is not a set.
- Use real cases as content, with or without a change of name. We repeat it because it is the most frequent and most serious lack: your clinical material is not your marketing material. Never.
## Frequently Asked Questions
### Do I need Instagram yes or yes to get patients?
No. There are full clinical practices built only on referrals, directories and mouth-to-mouth, without a single post. Instagram adds up if you enjoy creating content and you can sustain it; if you make it sloppy, those hours pay more on your referral network or on your Google profile and directories.
### What do I do if a follower writes me it's wrong?
I answered briefly, humanely and without clinically intervening: I appreciated the confidence, you explained that by that means you can not help him properly and oriented towards real attention: a professional consultation or, if there is risk, the emergency services and lines of assistance of your area. Save a model response so as not to improvise it at eleven o’clock at night. What is not appropriate is to open a therapeutic conversation for DM or leave the message unanswered.
### Do I agree to my patients following me?
Your professional profile is public and you won't control who follows it, so the real question is how you handle the interaction: don't follow them yourself, don't comment on their publications and take any exchange with clinical content to the session space. Your personal profile, separately and in private.
### How often do I have to publish?
As often as you can hold without stealing hours from the clinic or from rest. For most, that is one or two well-made weekly publications. Consistency over months weighs more than volume in any one week.
### Can I pay for advertising on Instagram?
It depends on your jurisdiction and piece: advertising pays for professional services is also achieved by your school regulations, so check them out first. And a practical warning: ads amplify what you already have. If your profile does not convert visits into queries, paying for more visits only makes the same problem more expensive.
## Summary
- Instagram builds visibility and confidence in the medium term; it does not fill agendas in a month. Derivation and mouth-to-mouth continue to weigh more.
- The ethical framework goes before the strategy: no testimonies of patients, promises of cure, "before and after", real cases or diagnosis by DM.
- Beware of the content of "signs you have X": responsible psychoeducation is contextualizing, not distributing tags by checklist.
- What works: niche psychoeducation, explain how you work and what to expect from therapy, answer general doubts, show training and focus.
- With patients following you: clear digital framing, no DM care, separate personal profile and in private.
- Sustainable frequency, content pillars and a fixed time block: that networks do not eat your clinical hours or your rest.
- The link that converts: clear bio and a link with direct reservation, such as the verified profile of the Brauni directory, without commissions.
- Never: buy followers, skip sessions, respond to clinical queries in comments, or use real cases as content.
---
## What is a BAA HIPAA and why Brauni signed one with Google Cloud and AWS
- **URL**: https://brauni.io/en/blog/baa-hipaa-google-cloud-brauni
- **Category**: Privacy and Security
- **Date**: 2026-03-28
- **Tags**: HIPAA, BAA, Google Cloud, AWS, security, patient data, compliance
We explain what is a Business Associate Agreement (BAA) under HIPAA and why Brauni signed this agreement with Google Cloud and AWS to protect your patients' clinical data.
If you use clinical software, you'll probably ask yourself: what about my data when it's "in the cloud"? Who's responsible if something goes wrong? The software provider? The infrastructure provider?
These questions have a specific legal answer in the health world: the **Business Associate Agreement**, or **BAA**. In this article we explain to you what it is and why the fact that Brauni has signed this agreement with the world's two largest cloud providers (Google Cloud and AWS) raises the standard of protection for your patients' data.
## What is HIPAA?
**HIPAA** (Health Insurance Portability and Accountability Act) is the U. S. federal law that sets the global gold standard for health data protection. It defines the **PHI** (Protected Health Information), which includes names, diagnoses, and session notes - basically everything a health professional handles on a daily basis.
Although Brauni complies with the 25.326 Personal Data Protection Act in Argentina, we adopt HIPAA because its technical controls are much more rigorous for clinical practice.
## What is a BAA?
It is a **legally binding contract** required by HIPAA. It is not a generic "term and condition." It is a commitment where the infrastructure provider (Google or AWS) accepts **legal liability** on:
1. **Encrypt data** at all times
2. **Do not use the information** for advertising or own analytics
3. **Report any security incidents** immediately
4. **Allow constant audits of your data centres**
### What if there's no BAA?
Without an BAA, the infrastructure provider has no specific legal obligation on the health data it stores. It may use the data for its own purposes, not report a security breach, or fail to implement the controls that HIPAA requires.
In practice, most generic cloud services **don't sign BAAs**. are only providers that offer specific services for the health sector and are willing to take on that legal responsibility.
Not all clinical software providers have a BAA with their infrastructure provider. Before entrusting your data to any platform, ask: do they have a signed BAA? If the answer is no or do not know what it is, it is an important warning signal.
## Why do we sign with Google Cloud and AWS?
At Brauni we do not leave security at random. Our infrastructure is **hybrid and redundant**, taking advantage of the best of each provider:
### AWS (Amazon Web Services)
AWS is the operating heart of Brauni: the databases are hosted here, the application is executed and multi-region storage backups are maintained within the United States. By signing the BAA with AWS, we ensure that each clinical record is under specific legal protection for health data.
### Google Cloud (Vertex AI)
This is where the magic of our artificial intelligence occurs. Thanks to BAA, we use advanced models (such as Gemini) with the assurance that your data **never used to train global models** from Google.
## Benefits of our two-way partnership
### Military grade encryption
Both providers use **AES-128** for saved data and **TLS 1.3** for data in transit. This automatically applies to all services that Brauni uses, including databases, file storage, and communications between services.
### Controlled Data Residence
We control exactly where the information lives, ensuring that it does not move without our permission. We can choose the specific geographic region where the data is stored in both providers.
### Zero AI training with your data
This is the most critical point. Both Google’s BAA and AWS’s **explicitly prohibit** the use of your clinical information to power their public algorithms. In addition, our [terms and conditions](/terminos) expressly establish it: neither Brauni nor its infrastructure providers will process, use or analyze clinical or personal data for the training of AI models. Brauni has its own policy of [not using clinical data to train AI](/blog/tus-datos-no-entrenan-ia), which applies independently of BAA.
## The full chain of responsibility
When using Brauni, each part has a defined role:
1. **Professional** is the controller of the data: responsible for the consent, ethics and configuration of the access controls in your account
2. **Brauni** acts as a data processor: responsible for the application, [field-by-field encryption](/blog/seguridad-privacidad-brauni) and security logic, processing information only according to professional instructions
3. **AWS and Google Cloud** provide physical and digital infrastructure where the data reside, under BAA contract
Each link has specific legal obligations. There are no grey areas or "good will": there are contracts.
## What does this mean to you?
It means that your clinical data is **protected by contract across the chain**, not just by promises. If a provider does not sign a BAA, it may legally have no specific obligations on the health data it stores. With Brauni, that does not happen.
We choose the world's leaders in infrastructure and formalize the relationship with the most stringent agreements that exist because we understand that your patient's trust is your most valuable asset.
Do you have any doubts about how we protect privacy? Write to [soporte@brauni.io](mailto:soporte@brauni.io). We are here to give you peace of mind.
---
*Brauni complies with the principles of Argentina's Personal Data Protection Act 25.326 and is aligned with the international standards of HIPAA for the management of protected health information (PHI). BAA with Google Cloud and AWS cover all services used to process clinical data.*
---
## How to install Brauni on your mobile or computer (no app store)
- **URL**: https://brauni.io/en/blog/instalar-brauni-como-app
- **Category**: Management of clinical practice
- **Date**: 2026-03-23
- **Tags**: install app, PWA, iPhone, Android, Windows, Mac, app mobile, psychologists
Step by step guide to install Brauni as an app on iPhone, Android, Windows and Mac. No store downloads, direct from the browser in less than 1 minute.
Brauni works from the browser, but you can also install it as a native app on your cell phone, tablet or computer. Without going through the App Store or Google Play. It installs in less than 1 minute and then you open it like any other app, with its own icon and full screen.
This is possible because Brauni is a **Progressive Web App (PWA)** - a technology that allows a web app to behave exactly like a native app: you receive notifications, it opens in full screen and takes up much less space than a traditional app.
## Why install Brauni as an app
- **Quick access**: a touch from your home screen, without opening the browser
- **Full screen**: No address bar or browser distractions
- **Notifications**: I received appointment alerts and reminders directly
- **Offline works**: basic functions are still available offline
- **Liviana**: occupies a fraction of what a store app would weigh
It doesn't matter if you already use Brauni from the browser. When you install the app, your session and all your data are maintained.
## Install on iPhone or iPad (Safari)
On Apple devices, the installation is done from Safari. It is the only browser that supports PWA on iOS.
### Step by step
1. Open **Safari** and enter [app.brauni.io](https://app.brauni.io)
2. Log in with your account
3. Tap the **Share** button (the square icon with up arrow, in the bottom bar)
4. Scroll the options down until you find **Add to Start**
5. Confirm the name (leave it as "Brauni") and tap **Add**
6. Ready - the Brauni icon appears on your home screen
On iPhone, the installation only works from Safari. If you use Chrome or Firefox on iOS, the "Add to Start" button does not appear. This is an Apple restriction, not Brauni.
### After Installing
When you touch the Brauni icon, the app opens in full screen, without the Safari bar. It works like any other app on your iPhone.
## Install on Android (Chrome)
In Android, Chrome automatically detects that Brauni is installable and suggests it.
### Step by step
1. I opened **Chrome** and entered [app.brauni.io](https://app.brauni.io)
2. Log in with your account
3. Chrome will show you a banner at the bottom saying **"Add Brauni to home screen"** - tap **Install**
4. If you don't see the banner, tap the three-point menu top right and select **Install app** or **Add to home screen**
5. Confirm playing **Install**
6. The Brauni icon appears in your home screen and app drawer
On Android, the installed app behaves like a complete native app. It appears in your list of recent apps, you can fix it in the taskbar and receive push notifications.
## Install on Windows (Chrome or Edge)
Both Chrome and Edge allow you to install Brauni as well as desktop app.
### With Google Chrome
1. I opened **Chrome** and entered [app.brauni.io](https://app.brauni.io)
2. Log in with your account
3. In the address bar, you will see an icon of **monitor with down arrow** (to the right) - click
4. Confirm playing **Install**
5. Brauni opens in its own window, without browser bars
### With Microsoft Edge
1. Open **Edge** and enter [app.brauni.io](https://app.brauni.io)
2. Start of session
3. Click on the **three points** icon above to the right
4. Select **Apps** → **Install Brauni**
5. Confirm installation
In both cases, Brauni appears as a shortcut on your desktop and on the Windows startup menu.
## Install on Mac (Chrome or Safari)
### With Google Chrome
1. I opened **Chrome** and entered [app.brauni.io](https://app.brauni.io)
2. Start of session
3. In the address bar, click the **install** icon (monitor with arrow)
4. Confirm with **Install**
5. Brauni is added to your Applications folder and Launchpad
### With Safari (macOS Sonoma or later)
1. Open **Safari** and enter [app.brauni.io](https://app.brauni.io)
2. Start of session
3. In the menu bar, click **File** → **Add to Dock**
4. Confirm the name and click on **Add**
5. The Brauni icon appears in your Dock
The "Add to the Dock" option in Safari requires macOS Sonoma (14) or later. If you have an older version, use Chrome.
## Frequently Asked Questions
### Is the installed app secure?
Yes. The installed app uses exactly the same encrypted connection (TLS 1.3 + AES-128) as the browser version. Your clinical data is equally protected.
### Can I use Brauni on more than one device?
Yes. Your account works on all your devices at the same time. Install Brauni on your cell phone, your clinical practice computer, and tablet if you want. Everything syncs in real time.
### Does it take a lot of space?
No. The installed app occupies less than 5 MB. A traditional management app usually weighs between 50 and 200 MB.
### How do I uninstall the app?
- **iPhone/iPad**: I kept the → icon pressed Delete app
- **Android**: I kept the → Uninstall icon pressed
- **Windows**: Start menu → right click on Brauni → Uninstall
- **Mac**: will drag the icon from Applications to Trash
Do not lose your account or data when uninstalling. It is only direct access.
## Summary
| Device | Browser | How to install |
|---|---|---|
| iPhone / iPad | Safari | Share → Add to Home |
| Android | Chrome | Auto Banner or Menu → Install app |
| Windows | Chrome / Edge | Icon in direction bar or menu → Install |
| Mac | Chrome | Icon in direction bar → Install |
| Mac | Safari (Sonoma+) | File → Add to Dock |
Brauni is designed so that you can manage your clinical practice from wherever you are. Whether in the collective by reviewing the agenda of the day, on your desktop documenting sessions or on your tablet between patients - you always have your clinical practice available.
---
## AFIP electronic invoicing for psychologists: complete guide with Brauni
- **URL**: https://brauni.io/en/blog/facturacion-electronica-afip-psicologos
- **Category**: Management of clinical practice
- **Date**: 2026-03-19
- **Tags**: invoicing, AFIP, electronic invoice, monotribute, CAE, psychologists
Step-by-step guide to issuing electronic invoices from Brauni. Set up your AFIP certificate in 5 minutes and issue C invoices with CAE without leaving the platform.
If you are a psychologist in Argentina, invoicing is part of your day to day. Whether you work with individuals, health insurance or private health plans, you need to issue electronic invoices authorized by ARCA (ex AFIP). The problem is that the process can be confusing, slow and completely disconnected from your clinical management.
With Brauni, issuing an electronic invoice with CAE takes less than 30 seconds. Without leaving the platform, without opening another tab, without copying and pasting data. In this article we explain how it works, how to configure it, and why it is safe.
## What is e-invoicing and why do you need it?
Electronic invoicing is the mandatory system in Argentina to issue tax vouchers. Each invoice you issue requires a **CAE** (Electronic Authorization Code) issued by ARCA in real time. Without the CAE, the invoice has no tax validity.
As a psychologist, you are likely to issue **Type C invoice** if you are a monotributist, or **Type B invoice** if you are responsible for enrolling and caring for final consumers. Whatever your case, Brauni handles both scenarios.
### What is CAE?
The CAE is a 14 digit code that ARCA assigns to each electronic voucher. It functions as a digital stamp that certifies that the invoice was authorized. Each CAE has an expiration date (usually 10 days from issue).
With Brauni, the CAE is automatically obtained when the invoice is issued. You do not have to enter the ARCA page or make any additional steps.
## How AFIP Integration Works in Brauni
Brauni connects directly with ARCA servers through their **official web services** (WSAA for authentication and WSFEv1 for invoicing). It is the same mechanism that the country's largest invoicing systems use.
### The flow in 3 steps
1. **You will set your digital certificate** (once, it takes 5 minutes)
2. **Creás una invoice** selecting the patient and the items to be invoiced
3. **You issue the invoice** and Brauni gets the CAE from ARCA in real time
The invoice is stored in your account with the CAE, QR verification and all tax data. You can download it as PDF in triple format (Original, Duplicate, Triplicate) as required by the regulations.
## Initial settings: your digital certificate
In order for Brauni to invoices on your behalf, you need a **digital certificate** issued by ARCA. Don't worry, you don't need technical knowledge. Brauni simplifies the whole process.
### Step 1: Generate your certificate application
From **Profile → AFIP**, enter:
- Your **CUIT**
- Your **condition versus IVA** (Responsible Inscribed or Exempt)
- Your **start date**
Brauni automatically generates a **certificate request** (CSR file). Your private key is stored securely and encrypted on our — servers never leaves the platform.
Once you complete the data and click **"Generate CSR"**, Brauni creates the request and shows you the button to download it:
### Step 2: Upload the application to ARCA
1. Enter [www.arca.gob.ar](https://www.arca.gob.ar) with your CUIT and Clave Fiscal
2. Find the service **"Digital Certificate Management"**
3. Click on **"Add alias"**, enter a name (for example "Brauni io") and upload the CSR file you downloaded from Brauni
4. ARCA generates the certificate. Download the file **.crt** from the certificate table
### Step 3: Upload the certificate to Brauni
Go back to **Profile → AFIP** and upload the .crt file you got from ARCA. Brauni automatically checks that the certificate matches your private key and is not expired.
### Step 4: Enables the invoicing web service
In ARCA, you need to authorize the use of the Electronic Invoicing web service. It is a multi-step process but only once:
**1. Look for "Clave Fiscal Relationship Manager"** in the ARCA portal search engine.
**2. Click on "New Relationship"** to create a new authorization.
**3. Search for and select the "Electronic invoicing" service** within ARCA → WebServices.
**4. Select the representative** and confirm the authorization.
**5. Authorization completed.** ARCA displays a summary with the data of the relationship created.
### Step 5: Check the connection
Go back to Brauni, go to **Profile → AFIP** and click **"Test connection"**. If everything is okay, you will see a successful message confirming that Brauni can communicate with ARCA.
This whole process is done only once. Then, each invoice is issued with one click.
## Issue an electronic invoice
Once the certificate is set up, issuing invoices is very simple.
### Create invoice
From **New invoicing →**:
1. **Select the patient** — the system displays its pending transactions
2. **Choose the invoice type** — A, B or C according to your tax status
3. **Configures recipient data** — condition against IVA, type and document number
4. **Select the point of sale** — Brauni automatically brings your sales points registered with ARCA
5. **Add items** — you can add outstanding transactions or manual items
6. **Emits invoice** — Brauni sends data to ARCA and obtains the CAE in real time
{/* screenshot: formulario de nueva factura */}
### What if ARCA is down?
If ARCA does not respond at the time of issue, the invoice is saved with status **"AFIP pendiente"**. From the invoice list you can retry shipping when ARCA becomes available again. Your invoice is not lost.
## The PDF of your invoice
Each invoice issued generates an PDF in **triplicate format** (Original, Duplicate, Triplicate) that meets all ARCA requirements:
| Data | Included |
|------|----------|
| The issuer’s legal name and CUIT | Yes |
| Condition against IVA | Yes |
| Commercial address | Yes |
| Start of activities | Yes |
| Receiver data (name, CUIT/DNI) | Yes |
| Detail of items with prices | Yes |
| Subtotal, IVA and total amount | Yes |
| Number of CAE and expiration date | Yes |
| QR ARCA verification | Yes |
| Clickable verification link | Yes |
The QR and the verification link lead directly to the ARCA page where anyone can verify that the voucher is authentic. It is the same system that uses invoices issued from ARCA's "On-Line Testers".
The PDF is generated on demand every time you download it, so it always reflects the most up-to-date invoice data.
## Security: how we protect your digital certificate
Your digital certificate is the key that allows you to check in on your behalf. We take your security very seriously.
### Hybrid approach
Brauni uses a **hybrid** approach to certificate management:
1. **Private key is generated on our server** and stored encrypted with AES-128 (Fernet encryption)
2. **Only you subdue the certificate** (.crt) that gives you ARCA
3. **Private key never leaves the server** — neither you nor anyone can download it
This approach is safer than alternatives where the user handles the private key on his computer, where it could be lost, stolen or accidentally shared.
### Additional protections
- **Still-enclosed**: both private key and certificate are stored encrypted in secure storage (AWS S3 with Fernet)
- **Verified integrity**: hash SHA-256 of each file to detect any alteration
- **Currency Validation**: When uploading the .crt, we verify that the public key matches the stored private key
- **Maturity Control**: the system alerts when your certificate is close to expire
- **Revocation**: you can revoke your certificate at any time from the platform
Never share your Clave Fiscal ARCA with anyone. Brauni does not need your Clave Fiscal — just the digital certificate you generated from ARCA.
## WSAA authentication tokens
Every time Brauni needs to communicate with ARCA, the process is:
1. A **required ticket** is signed with your digital certificate
2. ARCA validates the signature and returns a **temporal token** (valid for 12 hours)
3. Brauni uses that token for invoicing operations
4. The token is stored in safe cache (Redis) so you don't order a new one in each operation
This mechanism is the standard defined by ARCA for all systems that use web services. Permanent credentials — are not stored every token automatically expires.
## Frequently Asked Questions
### Do I need a special point of sale?
Yes, you need a type **"Web Services"** point of sale registered with ARCA. It is different from the point of sale you use to manually invoice from "Online Testers". You create it from ARCA → "Management of points of sale and address".
### Can I still invoices from the ARCA page?
Yes, the points of sale are independent. You can have one point of sale for manually invoicing and another for Brauni. Invoices for each point of sale have their own sequential numbering.
### What kind of invoices can I issue?
- **Type C invoice**: for monotributists (the most common among psychologists)
- **Type B invoice**: for registered controllers invoicing final consumers
- **Type A invoice**: for registered officials invoicing other registered officials
### Does Brauni work with ARCA production or testing?
Brauni connects directly to the ARCA **production** servers. The invoices you issue are real and have tax validity. We do not use the testing environment.
### What happens if I change from mono-attribute to registered responsible?
You can update your condition in front of the IVA from **Profile → AFIP** at any time. The available invoice type is automatically adjusted.
### Do you have any additional cost?
Electronic invoicing is included in your Brauni plan. There are no invoice costs issued or quantity limits.
## Current ARCA requirements
As of **April 1, 2026**, ARCA requires that all electronic invoices include the **Condition vs. IVA of the receiver** (General Resolution No. 5616). Brauni already meets this requirement — when creating an invoice, you can select the condition of the recipient (Final Consumer, Inscription Responsible, Monotributist or Exento) and optionally enter your CUIT or DNI.
Brauni is automatically updated to comply with the new ARCA regulations. You don't have to do anything on your side.
## Summary: from the configuration to the first invoice
| Step | Time | Frequency |
|------|--------|------------|
| Generate certificate request in Brauni | 1 minute | Once only |
| Upload CSR to ARCA and download .crt | 3 minutes | Once only |
| Upload .crt to Brauni and check connection | 1 minute | Once only |
| Enable web service in ARCA | 2 minutes | Once only |
| Issue an invoice | 30 seconds | Every time |
The initial configuration takes less than 10 minutes. Then, each invoices is issued in seconds, directly from the same platform where you manage your patients, sessions and clinical notes.
## Conclusion
Invoicing does not have to be an administrative burden separate from your practice. With Brauni, [electronic invoicing](/funcionalidades/facturacion-afip) is integrated into your daily workflow: you finish a session, you register payment, and you issue the invoice with one click. Everything in one place, with the security and tranquility of knowing that your invoices are authorized by ARCA and comply with all the regulations in force.
---
## Digitally Verified Clinical Reports: How Brauni Protects Your Professional Reports
- **URL**: https://brauni.io/en/blog/informes-clinicos-verificacion-digital
- **Category**: Professional practice
- **Date**: 2026-03-15
- **Tags**: clinical reports, Digital verification, PDF, psychological reports, Clinical documentation
Find out how Brauni generates clinical reports with cryptographic protection, unique verification code and public portal to check their authenticity.
As a psychologist, clinical reports are an essential part of your practice. You order them for health insurance, you need them for referrals, they request them from courts or educational institutions. The problem is that a common PDF offers no guarantee: anyone can edit it, modify a date, change a diagnosis, or even invent a full report.
How can a health insurance, a judge or an institution know that the report they received is authentic and not altered? That is the problem we solve.
In Brauni, each clinical report you generate is cryptographically protected and has a digital verification system that allows any third party to check its authenticity in seconds.
## What a clinical report is in Brauni
In Brauni you can create clinical reports directly from the platform, associated with a specific patient. The editor allows you to write the content in enriched format: titles, lists, bolds, tables and everything you need for a professional report.
When you finish writing, you can download the report as **PDF ready to print or send**. But this is not just any PDF.
### An PDF with its own identity
Each report you generate in Brauni automatically includes:
- A **single verification code** (such as a fingerprint of the document)
- The **name of the professional** who issued it
- The **date of issue**
- A **verification URL** where anyone can check the authenticity
- The legend **"Digitally Verified Document"** on each page
This footer appears on **all pages** of the PDF, not just on the first page. It is impossible to separate a sheet from the report without noting the lack of verification.
## Cryptographic protection: how each report is protected
The protection of your reports works in two complementary layers:
### Content encryption (rest data)
The title and contents of each report are encrypted with **AES-128 in CBC mode with HMAC authentication** (Fernet encryption) before being saved to the database. This means that even if someone accessed the database directly, they would see incomprehensible text strings. Without the encryption key, the content is unreadable.
### Cryptographic Hash (document integrity)
When you download the PDF, the system calculates a **SHA-256 hash** on the generated file. This hash is a unique string of 64 characters that works as a fingerprint of the document.
What does this mean? If someone modifies even one character, a comma, or space in the PDF, the hash changes completely. It is mathematically impossible to alter the document without verification detecting it.
SHA-256 is the same algorithm that Bitcoin uses, your browser's SSL certificates and banking systems to verify data integrity. It's a proven and reliable cryptographic standard.
## The verification code: your seal of authenticity
Each report receives a **single verification code** at the time of its creation. This code is a universal identifier (UUID) that is never repeated.
This code is printed on the footer of each PDF page along with a verification URL. When you deliver a report to a health insurance, a court or any institution, that person can:
1. Visit the verification URL that appears in the document
2. Enter the code or upload the PDF
3. Receive instant confirmation that the document is authentic
It's like a notary stamp, but digital, automatic and verifiable 24 hours of the day.
## Public verification: anyone can verify authenticity
Brauni offers a **public verification portal** that does not require account or login. It works like this:
| Step | What the verifier does |
|------|------------------------|
| **1** | Access the printed verification URL on the PDF |
| **2** | Upload the PDF file you received |
| **3** | The system calculates the uploaded PDF hash and compares it to the original |
| **4** | Get a clear answer: the document is authentic or has been modified |
The hashes comparison is performed with a **constant time** algorithm (`secrets.compare_digest`), which means that not even a sophisticated attacker could obtain partial information about the correct hash by timing attacks.
### What information is shown in the verification?
This is where privacy becomes critical. When a third party verifies a report, the system **never discloses** the content of the report or complete personal data. It only shows:
- That the document **is and was issued** by a professional at Brauni
- The **initial** of the professional (e.g., "J. D.") - never the full name
- The **initial** of the patient (e.g., "C. R.") - never the full name
- The **date of issue**
- Whether the PDF uploaded **matches or not** with the original
The actual title of the report is never publicly exposed. In the verification it always appears as "Psychological Report", no matter what title you have given it. This protects the privacy of the patient even in the verification process.
## Privacy above all: what is shown and what is not
Public verification is designed with the principle of **minimum data exposure**. Compare:
| Data | Is it shown in the PDF? | Is it shown in public verification? |
|------|------------------------|-----------------------------------------|
| Contents of the report | Yes (it is the report) | No, never. |
| Name of professional | Yeah, full. | Initials only |
| Patient name | Yeah, in the report. | Initials only |
| Title of report | Yes | No (appears as "Psychological Report") |
| Verification code | Yes | Yes |
| Date of issue | Yes | Yes |
| State of authenticity | -| Yes (authentic/modified) |
This means that if someone finds a loose verification code, they cannot use it to obtain clinical information. They can only verify an PDF already in their possession.
## Use cases: when you need a verifiable report
### health insurance and private health plans
When health insurance asks for a report to authorize sessions or treatments, they need to know that the document is legitimate. With Brauni, they can verify it in seconds without calling you.
### Courts and expertise
In legal contexts, the authenticity of a clinical report is critical. A Brauni report includes cryptographic protection that demonstrates that it has not been altered since its issuance. The verification code works as additional evidence of authenticity.
### Educational institutions
When a patient needs a report to present at a school or university, the institution can verify that the document is genuine without having to contact the professional.
### Referrals to other professionals
By referring a patient to a psychiatrist, neurologist or other professional, you can share the report with the peace of mind that the recipient can verify its authenticity.
## Complete audit: each action is recorded
Each operation on a report is recorded in an **unchangeable audit log**:
- **Creation**: who created the report, for what patient, when
- **Reading**: who agreed to the report and when
- **Modification**: who edited the report (and the hash is automatically invalidated)
- **PDF download**: who downloaded the PDF and when
- **Elimination**: who deleted the report
This traceability is essential to comply with health data protection regulations. You will always be able to show who did what and when.
If you modify the content of a report after downloading it as PDF, the previous hash is automatically invalidated. This means that any PDF generated before the modification will remain verifiable, but reflects the previous version of the content. The new PDF will have a new hash.
## Paper vs Digital: Why Verifiable Digital Reports Are the Future
| Aspect | Paper report | Digital report on Brauni |
|---------|-----------------|---------------------------|
| **Autentity** | Hard to verify, easy to forge | Instant checkable with cryptographic hash |
| **Integrity** | No guarantee it wasn't altered. | Any modification is detected automatically |
| **Privacy** | Anyone who has it sees everything. | Public verification without content |
| **Storage** | It deteriorates, loses, occupies space | Cloud encryption, always available |
| **Traceability** | None (who read it? when?) | Complete audit of each action |
| **Availability** | Only the original | Downloadable at any time |
| **Verification** | Calling the professional on the phone | Automatic public portal, 24/7 |
## How to create and share a report in Brauni
The process is simple:
1. **Select a patient** from your panel
2. **Create a new report** with rich text editor
3. **Read the content** in the format you need
4. **Download the PDF** -Automatically includes the verification watermark, unique code and cryptographic hash
5. **I shared the PDF** by email, WhatsApp or print it. The receiver can verify the authenticity at any time
You don't need to do anything extra. Cryptographic protection, verification code, and auditing apply automatically to every report you create.
## Additional security that protects your reports
In addition to digital verification, each report has additional technical protections:
- **Anti-XSS Validation**: Report content is sanitized to prevent malicious code injection
- **SSRF protection**: PDF generator blocks any attempt to load external resources, preventing network attacks
- **Size Limits**: PDFs have a 20 MB limit to prevent denial of service attacks
- **Validation of ownership**: Only you can access your patients' reports. No other professional can view, edit or download your reports.
## A professional standard for your practice
Clinical reports are documents that transcend your clinical practice. They read health insurance, judges, institutions and other professionals. That these documents have digital verification is not a luxury: it is a standard of professionalism that protects both you and your patients.
With Brauni, every report you issue bears your name backed by cryptography. Verifiable. Unchangeable. Professional. Everything included in it is in [verifiable reports](/funcionalidades/informes-verificables).
---
*Reports generated in Brauni comply with the principles of Argentina's Personal Data Protection Act 25.326. Clinical content is encrypted at rest and protected with SHA-256 cryptographic verification.*
---
## How to start your psychological clinical practice from scratch: complete guide
- **URL**: https://brauni.io/en/blog/como-empezar-consultorio-psicologico
- **Category**: Management of clinical practice
- **Date**: 2026-03-13
- **Tags**: begin clinical practice, newly received, registration, clinical practice, first patients, psychologists
Complete guide to start your psychological clinical practice from scratch: enrollment, monotribute, insurance, space, fees, documents and first patients.
You received, you have the title in hand and a question that the faculty never answered: and now what? You know how to evaluate, interview, intervene. What nobody taught you is how to open a psychological clinical practice: what procedure goes first, whether it is advisable to rent by hour or start online, how much to charge, how to invoices, where the first patients appear.
That gap between knowing how to attend and know how to set up a practice is real, and happens to almost all newly received. Starting as a psychologist implies, in addition to the clinic, a series of legal, fiscal and commercial decisions that no one should solve to the decks, with the first patient already sitting in front.
This is the guide that we would have liked to have: ten steps in chronological order, from enrollment to supervision, with links to the deep guides that we wrote on each topic. Read it complete once to have the map, and then go back to the step you are in.
## 1 professional license: the first step to starting as a psychologist
Nothing that follows makes sense without this step. In Argentina, the professional exercise of psychology is regulated by the 23.277 Law, and each jurisdiction has its own college or professional council that grants and controls the tuition. Without tuition you cannot attend: doing so constitutes illegal exercise of the profession, no matter how formed you are.
professional license enables you to practice in that jurisdiction, invoices as a health professional, sign valid reports and, later, register as a health insurance provider. It also brings obligations: keep payment up to date, exercise within the limits of your responsibility and conform to the code of ethics of your school, which regulates from professional secrecy to how you can advertise your services.
The requirements, tariffs and deadlines of the procedure vary between jurisdictions, so the only universal council is this: consult the school of your jurisdiction as soon as you have the degree in hand, or even before. And if you plan to attend patients from other provinces online, also ask how your school frames that situation, because the criterion is not uniform.
## 2. The fiscal framework: mono-tribut and invoicing from day one.
The second procedure is the prosecutor, and it should be resolved before the first patient, not later. For most psychologists who start, the path is the monotribut: a category according to your projected income, a monthly fee and the obligation to issue invoice for each session you will receive.
Invoicing from day one is not an excess of prolijidad, it is the basis of a proper practice: it protects you from any claim, allows you to work with health insurance and private health plans, and builds the income history that you will need to rent, ask for a credit or re-recognize yourself without shock. Attending without invoicing, even if it is "while so much", is a fiscal and professional risk that is not worth what you save.
We write two complete guides on this topic: one on the [monotribute for psychologists](/blog/monotributo-psicologos-argentina), with categories, registration and re-categorization, and another on [electronic invoicing for psychologists](/blog/facturacion-electronica-afip-psicologos), with the step by step to issue your first invoice.
Do the prosecutor's discharge as soon as you have your tuition, even if you don't have patients yet. It's much easier to start in order than regularize months of sessions charged without checking in.
## 3. Professional Liability Insurance
It is the step that almost all newly received people skip, in part because no one mentions them. Professional liability insurance (also called malpractice) covers defense costs and any compensation if a patient initiates a claim for your professional exercise.
In general it is not mandatory to exercise, but it is advisable to have it from the beginning: a claim can arrive without you having done anything wrong, and defending itself costs money even if the result gives you the right. And it is precisely at the beginning that you have the least financial back to absorb that blow.
Where is it hired? Two main ways: Many professional colleges offer coverage for their enrolled, sometimes included or registered, and you can also hire it directly with insurers working with health professionals. Start by asking at your school: if you already have a coverage included, you don't need to double it.
## 4. Space: hourly rental, own clinical practice or online
Here comes the first big economic decision, and the correct answer depends on your situation. All three paths have real pros and cons:
- It is the lowest risk option to start: you pay only the hours you use, in a space already equipped and enabled, without long contract or initial investment. The contra: the most demanded schedules are disputed among several professionals, you can not customize the space and the cost per session is higher than apportioning a rent own when the agenda grows.
- It gives stability, identity and total freedom of hours. The contra is strong: it is a fixed cost that runs from the first month, you have two patients or twenty. Assume it before having a schedule that pays it is one of the fastest ways to melt a practice that has just begun.
- Online first. Starting with online mode reduces the initial cost to almost zero and allows you to attend patients from other cities. It is not an improvised version of therapy: it requires the same framing, an appropriate platform and clear criteria on which cases should be referred to face-to-face care. We write a complete guide of [online therapy in Argentina](/blog/terapia-online-argentina-guia) with the practical framework and care of the format.
For most starters, the reasonable sequence is online or hourly rent first, and self-practice only when the schedule justifies it with numbers, not with expectation.
## 5 Your fees: set them by method, not by fear
How much to collect is the question that generates the most anxiety at the beginning, and the one that gets the most answered wrongly: copying what a acquaintance charges or putting a low price "to catch rhythm." Both fail for the same reason: they do not start from your numbers.
A sustainable fee is built using a method: calculate your real costs (renting space, monotribute, insurance, supervision, tools), define how many weekly sessions you can hold with quality and look at the reference values of your area and your training. In our [psychologist fees](/blog/honorarios-psicologos-argentina) guide we develop the complete calculation, how to communicate the value and when to adjust it. The essential thing for this stage: I defined the number before the first consultation, so as not to negotiate it with the patient in front, and set a review date.
## 6. Base documents: have them ready before the first patient
There are three documents that define the formal framing of your practice, and all three share a rule: they are prepared before the first patient, they are not improvised during the first session.
- Informed consent: what is the treatment, its scope, confidentiality and its limits, all signed before beginning. In the [informed consent in psychology](/blog/consentimiento-informado-psicologia) guide we explain what has to include and share a model.
- The medical records: the registration of each patient that the health regulations require to carry, and that is also your best professional support. In the guide to [medical records in psychology](/blog/historia-clinica-psicologia) we cover what to register, how to preserve it and for how long.
- The cancellation policy: what happens when a patient fails or cancels at the last moment. To define the entry, in writing and communicated in the first interview, avoids the uncomfortable conversation that comes late. We have a guide dedicated to [the cancellation policy of clinical practice](/blog/politica-cancelacion-consultorio-psicologia).
Improvising these documents with the patient across the street conveys exactly the opposite of what a frame seeks: predictability. Arm them in an afternoon, check them with your supervisor if you have doubts and leave them ready to reuse.
## 7 The first interview: prepare for the real moment
All of the above exists for this moment to go well: the first time a patient sits in front of (or appears on the screen). The first interview has its own objectives: to evaluate the reason for consultation, to decide if the case is for you, to present the frame and for the person to leave with a clear idea of how it follows.
It doesn’t have to be perfect, but you do come up with a thought structure, rather than solving it on the fly. We write a complete guide to the [first psychological interview](/blog/primera-entrevista-psicologica), with suggested structure, key questions and the most common mistakes of those who just started.
## 8. Getting the first patients: realistic expectations
The agenda is not filled alone, and neither is it filled from one month to the next. The channels that really bring patients (leaders of colleagues and doctors, Google searches, verified directories, mouth-to-mouth) are cumulative: they yield little at the beginning and more and more over time. Anyone who promises full agenda in a fixed time is selling smoke.
What is in your hands from day one: to define a clear niche instead of "taking care of everything", to present you to colleagues and professionals who can derive you, to have presence where people seek and respond quickly every consultation that arrives. The card of some health insurance can provide initial volume as the other channels mature.
This topic has its own deep guide: [how to get patients by being a psychologist](/blog/como-conseguir-pacientes-psicologia), with ten strategies ordered by return and the ethical limits that mental health advertising cannot cross.
## 9. Minimum tools: agenda, reminders and clinical record
You don't need an arsenal of software to start with, but there are two functions that need to be solved well from the first patient:
- An agenda with automatic reminders. Those who are absent hurt double to a small clinical practice: the lost income and the gap that no one else occupies. An automatic reminder before each session reduces the faults without you spending time chasing confirmations.
- A secure digital clinical record. Session notes and medical records are health data, the category most protected by Argentine law. A Word document in your notebook or a notebook in a drawer does not meet that standard. Before choosing where to store your clinical information, review the criteria of our guide to [choose safe clinical software](/blog/como-elegir-software-clinico-seguro): encryption, backup, access control and what the provider does with your data.
Here it is appropriate to be transparent: we build Brauni thinking precisely about this stage. Agenda with automatic reminders, encrypted digital medical records and AI-assisted session notes, in a single tool that you can try for free and without a card, to decide with the product in front and not with a promise.
Choose the tool you choose, the criterion is the same: that the system works for you from patient number one. Migrating papers and sheets when you already have twenty active patients costs much more than starting orderly.
## 10. Supervision from day one
The last step of this guide is, in clinical terms, the first in importance. Supervision is not a postgraduate procedure or a sign that you are not ready: it is the practice that sustains the quality of your work, and you will never need it as much as at first, when each case brings situations that you have not yet gone through and difficult decisions do not have the support of the experience.
A supervisor helps you to think about cases, to detect blind spots and to pass the first treatments with a network. It is also the antidote against the silent risk that starts only: professional isolation. Presupposing it as a fixed cost more of your practice, at the same level as rent or the monotribute. In our [clinical supervision in psychology](/blog/supervision-clinica-psicologia) guide we explain how to choose supervisor, formats and frequency.
## The most common mistakes of the first year
We repeat them here together because they are seen over and over again, and they are all avoidable:
- Paying attention without invoicing "for now." Tax disorder builds up quickly and regularizing it costs more than getting started in order.
- Launch fees that become eternal. A low entry price without revision date becomes the roof of your practice: subsequent increases are made uphill with patients who have already become accustomed.
- Accepting every patient without criteria. Taking cases out of your training out of fear that the agenda will be empty is bad clinical and ethical business. Knowing how to say it is not part of the trade: we write about it in the [Responsible Derivation](/blog/derivacion-responsable-psicologia) guide.
- Isolating. Without colleagues, unsupervised and networked, the problems of clinical practice ruminate in solitude and grow. The profession is sustained in community.
- Spending too much in the practice before having patients. Beautiful clinical practice with a two-year contract does not bring patients; patients, over time, pay for beautiful clinical practice. The order of that phrase matters.
## Frequently Asked Questions
### Can I take care of patients while I'm handling the license plate?
No. Until the school grants you tuition, you are not entitled to practice, and doing so constitutes illegal exercise of the profession, even if the procedure is in progress. Consult the deadlines in the school of your jurisdiction and use that time to advance the rest of the steps: fiscal framing, documents, fees and space.
### Do I need to enable clinical practice before an organism?
It depends on the jurisdiction. Some require the physical space to be habilitation before the school, the provincial health ministry or the municipality; others do not, or only for certain cases. If you rent per hour in a space of clinical practices, the habilitation is usually decided by the person who manages the place, but it should be confirmed. The reliable source is always the school of your jurisdiction.
### Should we start online or with physical clinical practice?
There is no one-size-fits-all answer, but a logic: start on the lowest-cost path that is compatible with your population. Online or hourly rental allow you to validate your practice without debt; your own clinical practice is justified when the schedule pays for it with real numbers. Many professionals end up in a mixed scheme, and it is perfect.
### Do I have to invoices for two patients a week?
Yes. The invoicing requirement does not depend on the volume: each session charged requires your voucher. The proper history you built from the start is worth more than saving to avoid it.
### How long does it take for the first patients to arrive?
There is no standard time frame and don't trust anyone who gives you one. It depends on your area, your niche, your previous network and how many channels you work in parallel. What is constant: fast channels (letter, online booking, referrals from colleagues with waiting list) move the needle before the deep ones (Google, mouth-to-mouth), which take time to mature but then hold the agenda.
## Summary
- professional license goes first: the 23.277 Act regulates the exercise and each jurisdiction has its school; no tuition is provided.
- The tax framework from day one: monotribute and invoices for each session, without "while".
- Professional liability insurance: it's not usually compulsory, but it's convenient; start by asking at your school.
- Space according to your stage: online or hourly rent to start; own clinical practice when the schedule pays for it.
- Method fees: actual costs, reference values and revision date, defined before the first consultation.
- Documents ready before the first patient: informed consent, medical records and cancellation policy.
- First interview with structure and patient acquisition with realistic expectations: serious channels are cumulative.
- Minimum tools: calendar with reminders and secure digital clinical registration; Brauni resolves both and is tested free without a card.
- Monitoring from the beginning: it is when you need it most, and it is the best vaccine against isolation.
---
## Dynamic Templates: Why Each Psychologist Documents Different (And It's OK)
- **URL**: https://brauni.io/en/blog/templates-dinamicos-documentacion-clinica
- **Category**: Management of clinical practice
- **Date**: 2026-03-11
- **Tags**: clinic temperates, session notes, clinical history, Documentation, customization
Find out how the dynamic Brauni templates fit your way of documenting. Customize fields, sections and formats without touching a line of code.
A cognitive-behavioral psychologist needs fields for thought records, intersession tasks, and mood scales. A psychalist needs space for associative material, transfer and dreams. A systemic therapist needs to record family dynamics, genograms, and alliances.
Then why do most clinical software force you to use the same rigid form for everyone?
In Brauni, documentation templates are **dynamic and customizable**. You decide what fields to have, how to organize them and what kind of information to register. And if you don't want to configure anything, the pre-designed templates already cover the essentials.
## What is a dynamic temperate?
A template in Brauni is the **structure** that defines which fields your session note, your patient profile, or your medical records has. Think of it as a customizable mold:
- **Sections**: groups of related fields (e.g. "Emotional State", "Interventions", "Planning")
- **Camps**: each individual data within a section (e.g. "Level of mind", "Used techniques", "Tasks")
- **field types**: free text, multiple selection, numerical scales, dates, checkboxes and more
The key is that this mold can be completely modified without the need to program. Add a field, change a section, reorder the structure - everything is done from the interface.
## Three categories of temperates
Brauni uses dynamic templates in three areas of clinical documentation:
### 1.
The most used template. Define which fields you complete after each session with a patient. A typical template includes:
| Section | Example Fields |
|---------|-------------------|
| **Session information** | Participants, modality |
| **Emotional state** | Mood level (scale), state at start, state at close |
| **Clinical content** | Topics worked, comments, interventions |
| **Planning** | Intersession tasks, agreements, next steps |
### 2. Patient Profile
Define what information you collect from each new patient:
| Section | Example Fields |
|---------|-------------------|
| **Reason for consultation** | Description, source of referral, onset of symptoms |
| **Personal context** | Civil status, coexistence, support network |
| **Labour context** | Labour situation, occupation, work environment |
| **Medical background** | Medical conditions, current medication |
### 3. medical records
The structure of your formal clinical record:
| Section | Example Fields |
|---------|-------------------|
| **Background** | Personal, family, prior treatment |
| **Diagnosis** | Diagnostic assumptions, criteria, instruments |
| **Treatment plan** | Objectives, frequency, planned techniques |
## 14 types of field to cover any need
Each field of a template can be of one of these types:
| Type | What's the point? | Example: |
|------|----------------|---------|
| **Text** | Short Responses | Name of participant |
| **Text area** | Long replies, paragraphs | Clinical observations |
| **Number** | Numerical values | Duration in minutes |
| **Selection** | Choose an option from a list | Marital status, mood |
| **Radio** | Mutually exclusive options | Yes / No / Not applicable |
| **Checkbox** | Multiple selection | Techniques used (various) |
| **Scale** | Customizable numerical range | Anxiety from 1 to 10 |
| **Valuation** | Stars from 1 to 5 | Adherence to treatment |
| **Date** | Date selection | The onset of symptoms |
| **Time** | Time selection | Time of session |
| **Date and time** | Combination of both | Next appointment |
| **Email** | Mail address | Emergency contact |
| **Telephone** | Telephone number | Responsible family |
| **Document** | Attachment | Consent signed |
Each type has **automatic validation**. A selection field only accepts the options you defined. A scale only accepts numbers within the configured range. A mandatory field cannot be left empty.
## Customization: how to adapt a template
### Cloning and modifying
The easiest way to start is to **closure a pre-designed template** and adapt it. Brauni comes with general templates that cover the basics. You clone them and:
- **Add fields** you need (e.g. a "Reported Dreams" field for psychoanalysts)
- **Remove fields** that you do not use (e.g. remove "intersession tasks" if you do not work with tasks)
- **Reorder sections** according to your workflow
- **Changing field types** (e.g. converting a text field into a scale from 1 to 10)
- **Modify options** of selection fields (e.g. add your own mood categories)
### Create From Zero
You can also create a completely new template. You define the sections, fields, types and order. Total freedom.
### Edit with AI
Don't you feel like setting field by field? You can ask AI to modify your template in natural language:
> "Add a risk assessment section with a scale field from 1 to 5 and a text field for observations"
The AI modifies the template structure in real time and shows you the changes instantly. You can keep asking for adjustments in a fluid conversation until the template is as needed.
Editing with AI is especially useful when you want to rearrange a large template. Instead of moving fields manually, you say "I moved the planning section to the end" and ready.
## Versioned: your changes are safe
Every time you modify a template, Brauni saves a **new version**. This means that:
- You can **back to previous versions** if a change doesn't convince you
- Session notes already created **are not affected** by changes in the template
- You can see the **history of changes** of each template
If you experience a new structure and don't like it, you can always go back.
## Templates and AI: A Powerful Combination
Dynamic templates are not just pretty forms. They are the basis that allows the [IA to automatically complete your session notes](/blog/ia-completar-notas-sesion).
When you send an audio, photo or text describing your session, the AI reads the structure of your template and knows exactly:
- **What fields exist** and what type of information each expects
- **Which options are valid** in selection fields (do not invent options)
- **What ranges are acceptable** on scales and ratings
- **Which fields are mandatory** and prioritizes completing them
If your template has a used "Respiration Techniques" field with a checkbox of options, the AI will specifically search for that information in your audio and mark the correct options. If you have a generic "Interventions" field as a free text, the AI will write a descriptive paragraph.
**The structure of your template guides the AI.** A well-designed template produces better completed notes.
This is what makes Brauni templates really dynamic: they are not static forms that you fill by hand. They are intelligent structures that the AI interprets to automate your documentation.
## Import and export: share templates
Do you have a colleague who uses Brauni and you want to share your temperate? You can **export it as JSON** and send it to him. Your colleague cares about it on his account and adapts it to his taste.
This is especially useful for:
- **Supervisors** who want their supervisors to use a standardized structure
- **Clinical team** that needs consistency in documentation
- **Institutions** that have specific registration requirements
## File what you don't use
Over time, you may create several templates for different types of patients or situations. Those that you no longer use, you can **archive them** without removing them. They are saved if you need them in the future, but they don't appear on your active list.
## Predesigned Templates: Ready to use
If you don't want to customize anything, Brauni includes pre-designed templates that work for most professionals:
### General Template of Session Notes
Designed to cover the basics of any orientation:
- **Session information**: participants, modality
- **Emotional state**: mood level (selection scale), state observations
- **Clinical content**: topics worked, interventions, observations
- **Planning**: tasks, agreements, next steps
### Adult Patient Profile Template
Covers the full initial assessment:
- **Consult**: motive, referral, onset of symptoms
- **Personal data**: family situation, cohabitation, support network
- **Labour context**: Occupation, environment, satisfaction
- **Medical background**: conditions, medication
These temperates are a starting point. The idea is that clones and adapt them to your practice, or that you use them as if they served you.
## Why does the structure of your notes matter
A good documentation structure is not just organization - it has a direct impact on your practice:
- **Consistency**: You will always record the same information, session after session
- **Pattern detection**: structured fields allow tracking evolution over time
- **Communication**: reports and referrals are clearer when baseline information is well organised
- **Legal**: before a court order, structured notes are more solid than loose notes
- **More precise AI**: The more structured your template, the better the AI works by completing your notes
## Your documentation, your structure, your rhythm
Each psychologist works differently. The way you document a TCC session with an adult has nothing to do with how you document a play session with a child. And both are perfectly valid.
The dynamic templates of Brauni exist so that your documentation tool adapts to you, and not the other way around. Set them once, always use them, adjust them when you need them. Simple as that.
---
*Brauni templates store their structure as JSONB versioned and completed clinical data are encrypted with AES-128 (Fernet) before being saved. Template customization does not compromise the security of clinical information.*
---
## How the Brauni AI helps you complete session notes in minutes
- **URL**: https://brauni.io/en/blog/ia-completar-notas-sesion
- **Category**: Clinical Technology
- **Date**: 2026-03-07
- **Tags**: artificial intelligence, session notes, audio transcription, Clinical documentation, productivity
Send an audio, photo or text and the AI completes your session note adapted to your therapeutic orientation. Find out how it works step by step.
You finish a session. It was 50 intense minutes. Your patient made important advances and you have a head full of clinical observations. Now comes the part that no psychologist enjoys: sit down to complete the field-by-field session note.
What if you could just talk, like you were telling a colleague what happened in the session, and that the note was completed by itself?
In Brauni, that's exactly what happens. You can send a **audio**, **photo** of your notes on paper, or simply **write** a free summary, and AI is responsible for extracting relevant clinical information and completing each field of your session note. All adapted to your therapeutic orientation and the context of your patient.
## Three ways of documenting: you choose
### Audio: Speak and get ready
After a session, record an audio describing what happened. It can be from your cell phone, computer, or any device. You don't need to be structured or formal - speak as you would tell a supervisor.
The AI automatically transcribes your audio and extracts the relevant information for each field of the note. It supports files in format **WebM, OGG, MP3 and WAV** up to 25 MB, sufficient for multi-minute recordings.
**Example**: You record an audio of 2 minutes saying:
> "The patient arrived quite anxious today, shaking a bit. We worked diaphragmatic breathing techniques during the first 20 minutes. Then we could talk about the conflicts with his boss that we had left pending last session. At the end of the session I was much calmer. I left him as a task to practice breathing 5 minutes per day before sleeping."
The AI automatically extracts:
| Field | Extracted value |
|-------|---------------|
| Emotional status at the beginning | Anxious, trembling |
| Interventions | Diaphragmatic breathing techniques |
| Topics worked | Labour disputes (with chief), continuation of previous session |
| Emotional state at close | Much quieter. |
| Intersession tasks | Breathing 5 min/day before bedtime |
### Photos: your notes on paper, digitized
Do you take notes by hand during the session? Take a picture of your notebook and upload it. AI reads your handwritten notes and turns them into structured fields.
You can upload up to **5 images per message**, ideal if you have notes on multiple pages or if you included diagrams, scales or thought records that the patient completed during the session.
### Text: I wrote a free summary
If you prefer to type, I simply wrote a summary in natural language. You do not need to follow any format. AI interprets your text and distributes the information in the relevant fields.
And best: you can **combin formats**. send an audio with the general summary, then upload a photo of the patient's thoughts record and add a written comment with an observation that you forgot to mention. AI integrates everything into a single coherent note.
You don't need to be exhaustive in a single message. You can add information in multiple conversation quotes and the AI is updating the fields in real time.
## The AI knows how you work
Here is the fundamental difference with any other automatic transcription or completion tool: **Brauni AI knows your therapeutic orientation**.
When you set your profile in Brauni, you define your theoretical approach, your working methodology and your professional experience. This information is injected as a context in each interaction with AI. [If you want to understand in detail how this context system works, we explain it in this article](/blog/como-ia-entiende-tu-forma-de-trabajar).
### How does extraction change according to your orientation?
**If you work with TCC:**
AI prioritizes identifying automatic thoughts, cognitive distortions, restructuring techniques, behavioral tasks and activity records. It actively seeks mood scales, evidence for and against beliefs, and exposure techniques.
**If you work with a psychoanalytic approach:**
AI focuses on associative material, transferable content, observed resistances, performed interpretations and dream material if any. Pay attention to latent discourse and analyst interventions.
**If you work with a systemic approach:**
AI identifies relational dynamics, alliances, coalitions, communicational patterns and genograms mentioned. It seeks changes in the family or partner system.
**If your approach is integrative:**
AI combines elements from multiple theoretical frameworks according to what you describe. If in one session you used mindfulness techniques and in another you worked with gestaltic techniques, AI adapts to each case.
Adaptation is not a rigid filter. AI interprets your professional description flexibly and applies it when extracting information. If you mention anything outside your usual orientation, it also includes it - it does not rule out relevant clinical information.
## Fields completed in real time
While you talk, write or upload photos, the fields in your session note are being completed **in real time** via streaming. You see each field fill instantly, without waiting for the entire processing to end.
The fields depend on your [session note template](/blog/templates-dinamicos-documentacion-clinica) - which is completely customizable - but a typical template includes:
- **Participants of the session**
- **Emotional state at start and close** (scale or text)
- **Main themes worked**
- **Interventions and techniques used**
- **Clinical observations**
- **Tasks and intersession agreements**
- **Follow-up to previous session tasks**
- **Encouragement level** (selection scale)
- **Planning for next session**
The AI respects the constraints of each field. If a field is "selection" type with fixed options (such as "Very good", "Good", "Normal", "Mal", "Very bad"), the AI chooses the option that best corresponds to what you described. If a field is "scale" type from the 1 to the 10, assigns a number within the range. It never invents options that do not exist.
## Patient context: do not start from scratch
AI not only knows how you work - it also knows your patient. When you complete a note, the system automatically gives context about:
- **Name, age and gender** of the patient
- **Diagnosis** Current
- **Session number** (not the same session 3 as 40)
- **Modality** (presential or remote)
- **Duration** of the session
- **Previous session tasks** (to follow up)
This means that if you say in your audio "today we take back what we have left pending", the AI knows that it refers to the tasks of the previous session and connects them.
## You have final control.
It is important to clarify something: **the AI completes fields, you approve them**. The flow is:
1. Send your input (audio, photo, text or combination)
2. The AI completes the fields in real time
3. You check every field and adjust what you need.
4. You keep the note when you're okay.
You can edit any field after the AI completes it. You can delete a field that the AI incorrectly filled in. You can add information that the AI did not capture. The final result is always your note, with your professional judgment.
You can always edit your notes, even those already saved. What AI cannot do is modify them on its own - only act when you ask it to complete fields. Editorial control is always yours.
## How much time do you save?
The documentation of a typical session takes between 10 and 20 minutes when done manually. With the AI wizard, the process is reduced to:
- **2 minutes** of audio describing the session
- **30 seconds** by reviewing and adjusting completed fields
- **Ready.** Note is saved, encrypted and with all structured fields
That's a **75-85% saving of documentation time**. In a week of 20 patients, it's between 3 and 5 hours you'll recover.
## Security at every step
All AI processing meets the same safety standards as the rest of the platform:
- **Your audio is not stored** on third-party servers - it is transcribed and the result is encrypted
- **Notes are saved encrypted** with Fernet (AES-128) and the platform adds protection with rest encryption and TLS 1.3 in transit
- **Only you can access** the notes of your patients (validation of ownership in each operation)
- **All activity is audited**: who created the note, when, from where
- **Data is never used to train AI models** - processing is temporary and disposable
For more details on how we protect your information, read our article on [security and privacy in Brauni](/blog/seguridad-privacidad-brauni).
## Beyond the session notes
The same intelligent completion system works for other clinical forms:
- **Patient Profiles**: Describe the patient and the complete AI reason for consultation, work situation, history and more
- **Clinical Stories**: AI extracts relevant information from your descriptions and organizes it in your template structure
And all these forms use [dynamic templates that you can customize](/blog/templates-dinamicos-documentacion-clinica) to fit exactly your way of working.
## Your voice, your judgment, your note
The Brauni AI does not replace your clinical judgment. What it does is remove the mechanical part of the documentation - that daily time you spend typing fields that you already have clear in your head.
Speak as you speak. I wrote as you wrote. Write down as notes. AI takes care of the rest.
Everything that includes functionality is in [session notes with AI](/funcionalidades/notas-de-sesion-ia).
---
*The Note Completion Assistant uses Google Gemini via Vertex AI. Clinical data is processed under strict safety protocols and is never used to train artificial intelligence models. Clinical fields are encrypted with Fernet (AES-128) and also operate on secure infrastructure with rest encryption and TLS 1.3 in transit. Brauni complies with the principles of Personal Data Protection Act 25.326.*
---
## How Much a Psychologist Wins in Argentina: What It Really Depends on
- **URL**: https://brauni.io/en/blog/cuanto-gana-psicologo-argentina
- **Category**: Management of clinical practice
- **Date**: 2026-03-05
- **Tags**: revenue, how much a psychologist earns, fees, clinical practice, professional career, psychologists
How much a psychologist in Argentina earns: without figures that expire a month, we explain the real income model, the variables that weigh and how to estimate your number.
"How much a psychologist in Argentina earns" is probably the most repeated search about the profession. They make it students choosing a career, newly enrolled who want to know if they will be able to live from this, and colleagues who suspect they could be better. And almost everything published about it has the same defect: it responds with a figure.
Let's be direct: any article that gives you an exact figure is failing you twice. First, because with inflation that number gets old before the page ends indexing on Google. Second, because the actual dispersion is so big that the average does not describe anyone: between a hospital resident, a notebook psychologist with a full schedule and a specialist with fifteen years of trajectory and waiting list there is no "a psychologist's salary", there are three different economies.
That's why you're not going to find a single amount here. You're going to find something more useful: the career income model, honestly explained. What depends on what a psychologist earns, what variables move the needle and how to put together the count with your numbers, the only ones that matter.
## Why don't you find a figure here?
There are three reasons, and understanding them already tells you a lot about how admission to this profession works.
The first is dispersion. "Psychologist" is not a job: it is a tuition that enables very different exercises. particular clinical practice, booklet, public hospital, residence, companies, teaching, expertise. Each field has its own logic of income, and each jurisdiction its reference values and its cost of living. Promediating all that produces a number that does not serve anyone.
The second is inflation. Any published amount ages in weeks. The articles with exact figures that dominate this search usually drag old values, copied from other articles that in turn copied them from another. Read that does not inform you: it misinforms you with decimal precision.
The third is the one that almost nobody explains: invoicing is not income. What an independent psychologist charges in the month is not what he has left: first we have to discount monotribute, tuition, supervision, clinical practice and training. Two colleagues can invoices the same and take very different amounts. Below we disarm it in detail.
For current reference values, go to serious sources: schools and councils in each jurisdiction publish up-to-date minimum ethical fees, and equals define wages in relation to dependency. Consult those sources, not a blog: they are updated, and a post is not.
## The independent clinical psychologist's income model
For those exercising in clinical practice, monthly income comes from an equation of few variables:
> Income = (actual month sessions × fee) - costs of clinical practice
Effective sessions, in turn, depend on active patients, frequency and absences. Let's look at each piece.
### Active patients
It's not the amount of medical records you have open: they're the people who actually come to the session this month. A weekly patient doesn't contribute the same as a fortnightly patient or one who "is seeing if he takes it back." The honest picture of your practice isn't your list of patients: it's your schedule for the last four weeks.
### Effective meetings, not scheduled meetings
It is the variable that is most ignored and the one that moves the needle the most. Between Monday’s agenda and Friday’s box there is a silent wear: cancellations, absences without notice, holidays, empty spaces. The difference between the scheduled and the actually charged can be enormous.
The good news is that it is the most recoverable variable in the entire equation. The fee has a market ceiling and the clinical hours have a physical roof, but the gap between schedule and cash is narrowed by method: a clear [cancellation policy](/blog/politica-cancelacion-consultorio-psicologia) and reminders that work.
### The fee
It is the most visible variable and the one that generates the most anxiety, but it is not defined by intuition: it has an ethical floor that publishes your school and a personal floor that comes out of your costs. How to calculate it and how to adjust it without guilt is a topic in itself: we dedicate a [full fee guide](/blog/honorarios-psicologos-argentina). The two posts complement each other: that puts a price on the session; this explains what depends on your total income.
### Costs
Everything you pay to exercise, plus the hours that are not invoiced. They turn invoicing into real income, and they weigh so much that they have their own section below.
## How much a psychologist earns depending on the field of work
The same professional license, in different areas, produces different economies. It is not about which one "pays more" in abstract, but about understanding each other's logic.
### Pure particular clinical practice
You set the fee, you will charge at the time and you will not depend on any funder. It is the area with the highest income potential per hour and also the one with the highest risk: if the agenda is empty, the income is zero, without aguinald or licenses that amortigüen. Your stability is your drift flow.
### Private health insurance card and health plans
Here the logic is reversed: the funder brings you the patients, but also sets the tariff, which is usually located below the individual. To that are added delays of payment, monthly invoicing and authorizations. It is a model of volume and predictability, not of value per session. How it works inside and what to look at before joining you we explain it in our guide to [private health insurance and health plans for psychologists](/blog/obras-sociales-prepagas-psicologos).
### Dependency ratio
Public hospital, residence, institutions, companies. I receive salary, contributions, aguinaldo: the predictability that clinical practice does not give. Contraface: the roof is defined by a parity or a scale, not your individual work, and growth is institutional. Residence, moreover, is a stage where income matters less than what it builds: clinical experience and professional network.
### Teaching and research
University positions, scholarships, postgraduate courses. With simple dedications, they rarely sustain an economy on their own, but provide a predictable income that cushions the vagaries of clinical practice and a reputation that eventually becomes referrals and courses of its own.
### The mixed scheme: the most common
Most psychologists in Argentina do not choose an area: it combines several. A few hours of institution or booklet that put a predictable floor, more particular clinical practice that provides the best value per hour. The composition of that mix, and how it evolves over the years, explains much of the differences of entry between colleagues with the same antigüedad.
## The variables that weigh the most on how much a psychologist earns
Beyond the scope, there are four factors that separate those who arrive comfortable at the end of the month from those who do not.
### Jurisdiction and cost of living
Each school publishes its own reference values, and the ability of patients to pay changes a lot between a capital and a small city. Telepsychology blurs this border (you can take care of patients from another jurisdiction or from another country) but does not erase it: your cost structure remains anchored where you live.
### Years of exercise and reputation
In this profession the most profitable asset is the network of referrals: colleagues who derive what they do not take, doctors who trust your work, former patients who recommend you. That is not built in months, and explains why the first years are usually the hardest: the income curve is slow at first and composed later.
### Specialization and niche
The more specific the problem you solve, the less alternatives you have who consults you and the less price sensitive the demand. Perinatal psychology, neuropsychology, forensic evaluation, eating behavior disorders: niches with little supply hold higher fees and waiting lists longer than the general clinic.
### Sustainable clinical hours
The final roof is not commercial: it is physical and emotional. Every hour of session requires full presence, and behind there are notes, supervision and personal work. Filling the agenda to the edge is paid with health and clinical quality. The correct question is not how many hours you can put in a week, but how many you can sustain for years without [burning](/blog/burnout-psicologos-prevencion). That number, for your fee, is your real invoicing ceiling.
## Invoicing is not income: invisible costs
If you come from comparing your clinical practice invoices with the salary of a job, you are comparing pears with apples. Of the total invoiced you have to discount:
- [Monotributo](/blog/monotributo-psicologos-argentina): the monthly fee, and the category jump when invoicing grows.
- professional license: The college fee of your jurisdiction.
- Supervision: is not optional in a serious practice, and is paid.
- Personal therapy: part of the trade, not a leisure expense.
- Continuous training: postgraduate courses, courses, congresses. Prorated per month, they weigh.
- clinical practice: monthly or hourly rental, expense, services.
- Tools: calendar, video calls, management software, malpractice insurance if you have it.
- Non-invoicing hours: notes of evolution, reports, coordination of appointments, messages, invoicing. It is real work that does not generate direct income.
The classic error when comparing proposals: look at the invoicing of clinical practice against the gross of a salary. Compare net against net: what you have left after costs and taxes, divided by the total hours you dedicate to it, including the non-invoiceable ones.
## How to estimate your number: the account on a spreadsheet
No one can tell you how much you're going to earn, but you can estimate it quite accurately in one afternoon. I opened a sheet and arm five rows.
1. **Actual capacity of sessions.** I defined how many weekly clinical hours you can hold without burning, subtract the weeks of vacation and holidays of the year, and convert into a monthly average of scheduled sessions. Be conservative: theoretical ability is always greater than the real one.
2. **Honorary.** Out of the [ Fees Guide](/blog/honorarios-psicologos-argentina) method: school floor, proper balance point and positioning. If you work with a card, charge each tariff separately, because the mix changes the result.
3. **Absence rate.** Look at your last three months: from the scheduled sessions, how many did you actually give and charge. Apply that proportion to your ability. If you just start and have no history, I assumed that the gap exists and is greater than you would like.
4. **Costs.** The complete list of the previous section, in today's values, added per month.
5. **The result.** Actual sessions per fee, less costs. That's your estimated income. Compare what you need to live and play with the variables: absences, honorarium, card mix and private.
The two data that cost the most to rebuild by hand are actual invoicing and absence rates. If you register payments in Brauni, they both come out of the payment module without putting together anything: how much you invoiced each month and how many sessions fell. With that, the spreadsheet stops being an estimate and becomes your dashboard.
The account is not done once: it is checked. Every time you change a large cost, every time you adjust fees and at least a couple of times a year. It’s the difference between managing your economy and finding out about it at the end of the month.
## How Revenue Grows in Real Practice
There are no magic formulas, but there are concrete levers that colleagues who live well at the clinic use consistently.
- **Update fees with method.** Often defined in advance, advance communication and without apologizing. In an inflationary context, not adjusting is lowering the income in silence.
- **Improve the mix.** The booklet is a great source of patients at first; over the years, as referrals grow, many colleagues shift weight toward the individual. It is not dogma: it is a gradual transition that each one calibrates according to their need for predictability.
- **Low absenteeism.** It is the cheapest lever: it does not require more patients or more hours, only clear cancellation policy and consistent reminders. Each avoided absence is a session that was already on your agenda.
- **Diversify without dispersing.** Supervision of colleagues, workshops, groups, teaching: income that leverages your experience without adding up to hours of individual attention and that cushions the slack months.
Neither of these levers gives results from one month to the other, and none of them works without a solid clinical basis. But operated together, for years, they explain the difference between a practice that survives and one that thrives.
## Frequently Asked Questions
### Is it more convenient to work with a card or with particular patients?
It depends on the time of your practice. The booklet solves the most difficult problem of getting started (getting patients) in exchange for a tariff that fixes the funder and late fees. The individual pays better per session and charges at the time, but demands a demand that takes years to build. For most, the answer is not one or the other: it is a mix that evolves with reputation.
### How many patients do I need to live at the clinic?
There's no magic number, and don't trust anyone to give it to you. It depends on your fee, the frequency of your patients, your absence rate, your costs and your standard of living. The only serious answer is the bill account: capacity, honorary, absences, costs. Do it with your numbers and the result is yours.
### Where do I find updated reference values?
In the sources that are updated: the college or council of your jurisdiction publishes the current minimum ethical fees, the paritarians define the salaries of the public sector, and each funder reports their card fees. Any number from a blog or a forum has an expiration date and probably already passed.
### Do you earn more by attending online?
The fee does not have to be different: the online session is full clinical work. What changes is the structure: without physical clinical practice they lower costs, and the market expands to other jurisdictions and to the outside. The roof of sustainable hours is the same: the screen does not reduce wear.
### Can a newly received psychologist live from clinical practice?
With honesty: the first years are usually of construction, not of harvest. The agenda is filled by derivation and reputation, and that takes time. That is why the mixed scheme (institution or most practical incipient clinical card) is the norm at the beginning. What accelerates the process: to choose a niche, to build a network of colleagues deliberately and not to freeze the fees "while starting", because that initial discount tends to become permanent.
## Summary
- "How much a psychologist in Argentina earns" does not have an answer in pesos that is worth publishing: the dispersion between fields and jurisdictions is huge and inflation sprays any figure in weeks.
- The admission of the independent clinician comes from an equation: effective sessions per fee, less costs. Effective sessions (not scheduled sessions) are the variable that moves the needle the most.
- Each area has its own logic: the particular maximizes value per hour with risk, the card gives volume with tariffs from the funder, the dependency gives predictability with roof. The mix is the most common.
- The variables that weigh the most: jurisdiction, years and network of referrals, specialization, and sustainable clinical hours without burning.
- Invoicing is not income: monotribute, tuition, supervision, therapy, training, clinical practice and non-countable hours are discounted before comparing with any salary.
- Your number is estimated in a form: actual session capacity, method fee, absence rate and costs. The current reference values are in your school, not in a blog.
- Revenues grow with slow but cumulative levers: adjusting fees with method, improving the mix, lowering absenteeism and diversifying with supervision, workshops and teaching.
---
## How the Brauni AI understands your way of working as a psychologist
- **URL**: https://brauni.io/en/blog/como-ia-entiende-tu-forma-de-trabajar
- **Category**: Clinical Technology
- **Date**: 2026-03-03
- **Tags**: artificial intelligence, clinical assistant, session notes, therapeutic orientation, technology for psychologists
Find out how Brauni's AI assistant adapts to your therapeutic orientation, your patients, and your professional style without you having to set up anything.
"And AI understands that I work from the cognitive-behavioral?" - is one of the most frequent questions we receive from psychologists testing Brauni for the first time. The short answer is yes. The long answer is much more interesting.
The Brauni AI Assistant is not a generic chatbot. It is a system specifically designed for clinical psychologists that adapts to your therapeutic orientation, knows your patients and learns from your way of documenting. In this article we explain, with transparency, how it works inside.
## Your professional profile: the starting point
When you set up your account in Brauni, you can complete three fields that define your professional identity:
- **Theoretical orientation**: your theoretical approach (TCC, psychoanalytic, systemic, humanist, integrative, etc.)
- **Working Methodology**: how to structure your sessions (duration, frequency, techniques you use)
- **Professional profile**: your experience, specializations and areas of interest
These three fields are the first level of context that AI uses to adapt each response. They are not rigid forms: they are free text fields where you describe your practice with your own words.
### What does AI do with this information?
Every time you interact with the assistant, your professional profile is injected into the conversation as context. This means that AI **always knows** who you are and how you work, without you having to repeat it in each query.
If your orientation is cognitive-behavioral, AI will:
- Suggest evaluation tools related to your approach (BDI-II, BAI, STAI)
- Structure session notes in the format you would use
- Prioritizing evidence-based interventions
- Talk in terms of cognitions, schemes and restructuring techniques
If you work from the psychoanalytic, the suggestions change completely:
- Instruments such as TAT, Rorschach or SWAP-200
- Focus on transfer, resistance and unconscious processes
- Interpretation-oriented notes and associative material
Adaptation is not a fixed template. AI interprets your description flexibly. If you write "integrative work, combination TCC with mindfulness and narrative therapy", it will integrate elements of all those approaches into your responses.
## Patient context: AI knows the story
The second level of context is the specific patient you are working with. When you open the AI assistant in a patient’s profile, the system automatically gives you access to:
- **Basic data**: name, age, gender, treatment status, starting date
- **medical records**: history, diagnosis, therapeutic objectives
- **Contacts**: tutors, emergency contacts (relevant to minor patients)
This information is injected directly into the wizard's instructions, so from the first message the AI already knows who you're working with.
### Access to pre-session notes
This is where AI becomes really useful. The wizard has the ability to **read your previous session notes** when you need it. It can:
- **List sessions** by date, with their metadata (session number, mode, duration)
- **Read full content** of specific notes you need to answer your query
- **Find patterns** semantically throughout many sessions
The latter is key: if you ask him "how did this patient's anxiety evolve in the last 3 months?", AI does not look for the word "anxiety" literally. Use **semantic search** to find related mentions even if you use different terms such as "excessive concern," "rumiation," "panic attacks," or "anticipatory malfeasance."
## Semantic search: how you find patterns in your notes
Brauni uses a **vector embeddings** to understand the meaning of your notes, not just the words. It works like this:
1. Each session note you save is transformed into a **number representation** (a vector of 3.072 dimensions) that captures its semantic meaning
2. These vectors are stored in the database using **pgvector**, a specialized postgreSQL extension
3. When AI needs to search for relevant information, turn your question into a similar vector and search for notes with closer meaning
### What does this mean in practice?
Imagine that you have a patient with 40 sessions. You ask AI: "When did family conflicts begin?" The system:
1. Turns that question into a semantic vector
2. Compare that vector against the vectors of 40 notes
3. Find the most relevant 5 notes, even if you have never written the phrase "family conflicts" textually
4. Presents that information to the AI to respond to your query
This is **radically different** to search by keywords. The system understands concepts, not just text.
Semantic search works with both session notes and clinical notebook documents. Everything you document in Brauni becomes searchable by meaning.
## AI tools: what you can do (and what not)
The AI wizard has access to a specific set of tools that allow you to interact with your patients' information. Each tool is designed for a specific purpose:
### Patient information
| Tool | What's he doing? |
|-------------|----------|
| **Patient profile** | Read basic data, age, gender, treatment status |
| **medical records** | Access background, diagnostics, therapeutic goals |
| **Contacts** | Consultation of guardians and emergency contacts |
| **Diagnostic information** | Complete detail of a specific diagnosis |
### Meetings and notes
| Tool | What's he doing? |
|-------------|----------|
| **List sessions** | See sessions with date, number and format |
| **List notes (metadata)** | View the titles and dates of notes, without loading the full content |
| **Read specific notes** | Access the full content of selected notes |
| **Find Content** | Semantic search in notes and documents |
| **Next sessions** | Refers to scheduled meetings |
### Documentation
| Tool | What's he doing? |
|-------------|----------|
| **Clinical reports** | List and read generated reports |
| **Patient documents** | Access consents and uploaded files |
| **Clinical Notebook** | Read and create documents in your workbook |
### What can AI create?
The AI can create **documents in your clinical notebook**: session preparations, reflections, progress summaries or any note you need. These documents are saved as drafts that you review and edit before you finish.
In addition, from a **chat-separated interface**, you can ask AI to help you complete or edit existing session notes. Chat itself does not directly modify documents: it is always an action that you start from the editor.
## How do you know which tool to use?
AI does not need to be told what tool to use. When you ask a question, decide autonomously what information you need to consult. Some examples:
**"What was the original reason for consultation?"**
→ AI calls the medical records tool and looks for history.
**"How did the mood evolve in the last 5 sessions?"**
→ The AI lists the last sessions, reads their notes and generates a summary of evolution.
**"I need to prepare tomorrow's session, what issues remained pending?"**
→ AI semantically searches for unfinished topics in the last notes and generates a preparation guide.
**"Arm me a draft report for health insurance"**
→ The AI reads the medical records, recent notes and generates a document in your notebook with a draft that you review.
## Smart Form Completed
In addition to chatting, AI helps **complete clinical forms** such as session notes, patient profiles, and medical records.
When recording or writing a session summary, AI can automatically extract:
- State of mind at the beginning and end of the session
- Main topics discussed
- Techniques or interventions used
- Therapeutic approach applied
- Relevant clinical observations
And here again your therapeutic orientation matters: if you work with CCT, AI will look for automatic thought records, intersession tasks, and cognitive restructuring. If you work with a systemic approach, it will identify family dynamics, alliances, and relational patterns.
## Context security: how your information is protected
This is the part that matters most to us. Having an AI that accesses clinical information requires an exceptional level of security. This is how we implement:
### Insulation by professional
The AI **can only access data from your patients**. Each tool validates that the patient belongs to the professional doing the consultation. It is impossible for the AI of one psychologist to access data from another.
### Separation of professional context
Your professional profile (orientation, methodology, bio) is injected as a separate message, not as part of the basic instructions of the system. Why? For safety. By keeping it separate, the risk of malicious content in a text field is mitigated.
### Encrypted Embeddings
The semantic vectors of your notes are **encrypted with Fernet** before they are stored. They are only deciphered at the time of search. Even the Brauni technical team cannot read the stored embeddings.
### No training with your data
The Brauni AI uses third-party language models (Google Gemini via Vertex AI) but **never send your data to train models**. Clinical data is sent as a temporary context to generate a response and is not stored on AI provider servers.
### Access audit
Every interaction with AI is recorded in the audit log: what queries you did, what tools the AI used, what data you accessed. Full traceability.
## AI as a co-pilot, not as a replacement
It is important to clarify something: Brauni AI is a **assistant**, not a diagnoser. Its role is:
- Help you quickly access relevant information
- Identify patterns that could go unnoticed in 40+ sessions
- Reduce administrative documentation time
- Suggest (never impose) instruments or approaches compatible with your guidance
You are still the professional who makes clinical decisions. AI saves time, organizes information and gives you perspective, but clinical evaluation and professional judgment are always yours.
## A system that improves with your use
The more documents in Brauni, the more context the AI has to help you:
- **[More session notes](/funcionalidades/notas-de-sesion-ia)** = best semantic search and pattern detection over time
- **[Full medical records](/funcionalidades/historia-clinica-digital)** = More precise answers about history and evolution
- **Active Clinical Notebook** = more material to prepare sessions and reflect
You don't need to "teach" anything to AI. Your way of working is already in your professional profile and your clinical documents. AI simply reads, understands and adapts.
---
*The Brauni AI Assistant uses advanced language models via Google Vertex AI. Clinical data is processed under strict security protocols and is never used to train artificial intelligence models. Clinical fields are encrypted with Fernet (AES-128) and also operate on secure infrastructure with rest encryption and TLS 1.3 in transit. Brauni complies with the principles of Personal Data Protection Act 25.326.*
---
## Responsible Derivation in Psychology: When to Derive, How to Do It, and Note Model
- **URL**: https://brauni.io/en/blog/derivacion-responsable-psicologia
- **Category**: Professional practice
- **Date**: 2026-02-27
- **Tags**: derivation, interconsultation, professional ethics, interdisciplinary work, psychologists, template
Practical guide on responsible referral in psychology. When it is necessary to derive, how to write a derivation note, post-derivation responsibility and template ready to use.
Deriving is not failure. It is one of the most responsible and ethical clinical decisions you can make as a psychologist. The problem is that many professionals do not know when to do it, how to communicate it to the patient, or what information to include in the referral note.
In this article we explain everything: the criteria to derive, how to handle the situation with the patient, how to write the note and what responsibility you have after referral.
## What is responsible referral?
Referral is the act of **directing a patient to another professional or service** that can provide more appropriate attention to his needs. "Responsible" implies that:
- It is based on a **reasoned clinical assessment**
- The patient is communicated in a **clear and respectful** manner
- Facilitating **continuity of care** through relevant information
- It is done to a professional or service **specific and competent**
- Documented in **medical records**
Deriving does not mean leaving the patient. It is an act of professional care that prioritizes the well-being of the person above any other interest.
## When do you have to drift?
### 1. Limits of your competence
When the patient presents a problem that exceeds your clinical training or experience.
**Examples:**
- A patient with a severe eating disorder and you have no TCA training
- A situation of child sexual abuse and you have no experience in complex trauma
- A case requiring neuropsychological evaluation
- A patient who needs partner therapy and only individual work
**Ethical framework:** Codes of ethics are clear — working outside your area of competence is a lack of ethics. It’s not about knowing everything, but about recognizing what you don’t know.
### 2 Need for pharmacological treatment
When you evaluate that the patient could benefit from psychoactive medication.
**Examples:**
- Major depression with severe symptoms that do not respond to psychotherapy alone
- Severe anxiety disorders with frequent panic attacks
- Bipolar disorder, schizophrenia, or other conditions requiring medication
- Severe insomnia affecting daily functioning
**Important:** This referral is usually a **interconsultation**, not a transfer. The patient is still in therapy with you and, in parallel, consults the psychiatrist. You need to coordinate with the colleague.
### 3. Absence of therapeutic progress
When no significant progress is observed after a reasonable period of time.
**Alert signs:**
- Therapeutic objectives are not met after several months
- Patient expresses sustained dissatisfaction with the process
- You feel that the therapeutic relationship is not consolidated.
- You notice that your approach is not the most appropriate for this problem.
Before drifting for lack of progress, evaluate: Is there a need for a change of strategy within the same treatment? Is it a time of expected stagnation? Derivation should be after having exhausted reasonable alternatives.
### 4. Conflict of interest
When a situation exists or arises that compromises your professional objectivity.
**Examples:**
- You discover that the patient is familiar, friend or close acquaintance of someone in your environment.
- The patient is the ex-partner of another patient of yours.
- Countertransferential feelings arise that you cannot handle
- There is a labor, commercial or social link that interferes
### 5.
When the patient requires attention that you cannot provide at that time.
**Examples:**
- Suicide crisis requiring hospitalization
- Acute psychotic decompensation
- Substance poisoning
- Active domestic violence requiring immediate intervention
### 6. Patient application
When the patient asks to be referred to another professional, it may be due to:
- Preference for another therapeutic approach
- A desire to work with a professional of another gender
- Moving or other logistical changes
- Dissatisfaction with the process (although it does not always say it directly)
**Important:** You have an ethical obligation to facilitate referral, not to retain the patient.
## How to communicate referral to the patient?
This is the most delicate part. A miscommunicated derivation may feel like a rejection or abandonment.
### WHAT YOU DO
1. **Explain the clinical motive** honestly and without technicalities
2. **Standardize** the decision: "It is part of professional care to seek the most suitable specialist"
3. **Give options**: offer more than one professional or service where possible
4. **To accompany the transition**: offer closing sessions and facilitate contact with the new professional
5. **Leave the door open**: "If you ever need to come back, I'm available"
6. **Documenting** conversation in medical records
### What NOT to do
- Derive by text or email message without an in-person session
- Say "I can't help you" without offering a concrete alternative
- To give the feeling that the patient "is too" or "his case is very serious"
- Derive overnight without closing sessions
- Derive without having a specific professional or service to recommend
### Useful phrases
> "After evaluating your situation, I think you would benefit from working with a professional who specializes in [area]. It's not that I can't accompany you, but I want to make sure you get the best care possible."
> "I think it's important for a psychiatrist to evaluate if the medication could help you right now. That doesn't mean we can stop — therapy we can keep working together."
> "I notice that treatment is not progressing as we would expect. I think a change of approach could be positive, and I have a colleague who works very well with these kinds of situations."
## Derivation vs. interconsultation
It is important to distinguish between the two:
| | Derivation | Interconsultation |
|---|---|---|
| **What does it imply?** | Transfer of the patient to another professional | Consult another professional while maintaining treatment |
| **Who follows the case?** | The new professional | You, with the help of the consultant |
| **When is it used?** | When the problem exceeds your competence or there is conflict of interest | When you need a complementary opinion (psychiatric, neuropsychological, etc.) |
| **Patient relationship** | Finish your treatment (with proper closure) | Continue your treatment |
| **Example** | Derive to an addiction specialist | Interconsultation with psychiatry for medication |
Interconsultation requires the patient's consent to share information with the other professional. Ideally, this is provided for in the initial [informed consent](/blog/consentimiento-informado-psicologia).
## What to include in a referral note?
The referral note is a clinical document that facilitates continuity of care. It should be **concise, relevant and respectful** of professional secrecy.
### The essential content
| Element | Description |
|----------|-------------|
| **Data of the drifting professional** | Name, registration, specialty, contact |
| **Patient data** | Name, age, DNI |
| **Destination** | Professional or related service |
| **Reason of derivation** | Why it is derived (clinically substantiated) |
| **Clinical synthesis** | Diagnosis, treatment time, focus used, current status |
| **relevant information** | Medication, significant history, risk factors |
| **Objective of derivation** | What is expected of the new professional |
| **Date and signature** | Of the professional who derives |
### What NOT to Include
- Detailed content of meetings
- Unsubstantiated interpretations or assumptions
- Valuable judgments on the patient or his/her environment
- Information that the patient explicitly requested not to be shared
- More information than is strictly necessary
Remember that the referral note is subject to the [professional secret](/blog/secreto-profesional-psicologia). It only includes the information necessary for continuity of care, with the patient's consent.
## Derivation note template
---
### DERIVATION NOTE
**Date:** ___________________
---
**Direct profession:**
Lic. [Name and Surname] — M. P. [Number]
[Speciality / Approach]
[Address of clinical practice]
[Telephone / Email]
---
**Patient:** [Name and Surname] — DNI [Number]
**Age:** [Age] years
**Health insurance/private health plan:** [Name] — Affiliate N° [Number]
---
**Addressed to:** [Name of the recipient professional or service]
---
**1. Reason for derivation**
[Simply explain why the derivation is performed. Examples:]
- Psychiatric evaluation is requested to consider complementary psychopharmacological approach
- It is derived for specialized treatment in [area] given the complexity of the table
- Neuropsychological evaluation is suggested to rule out [hypothesis]
**2. Clinical synthesis**
The patient has been undergoing psychotherapeutic treatment since [date], with a frequency of [quantity] session/is [weekly/in/fifth], under a [theoretical] approach.
**Original query reason:** [Short description]
**Diagnosis / Diagnostic hypothesis:** [Diagnosis with criteria used]
**Actual state:** [Description of clinical status at the time of referral]
**3. Treatment performed**
- Therapeutic approach: [Guidance]
- Duration of treatment: [Time]
- Key interventions: [Summary of strategies used]
- General evolution: [Improvement, stagnation, aggravation]
**4. Relevant information**
- **Current medicine:** [If applicable, or "Does not refer to current medication"]
- **Significant background:** [Pre-treatment, hospitalization, risk factors]
- **Current risk factors:** [If there are: suicidal ideation, substance use, violence situation, etc.]
- **Support Network:** [Family, significant links, available contents]
**5. Purpose of derivation**
[What is expected of the recipient professional. Examples:]
- Evaluation and possible indication of psychopharmacological treatment
- Continuity of psychotherapeutic treatment with a focus on [area]
- Psychodiagnostic / neuropsychological evaluation
**6. Additional comments**
[Any additional information that facilitates attention. For example:]
- The patient has knowledge and consents to this referral
- The possibility of coordination between professionals was open
- Attached [consent / report / previous studies]
---
**Signature:** _____________________
**Seal:** _____________________
---
*Note: This referral is made with the consent of the patient. The information contained is confidential and is intended exclusively for the receiving professional.*
---
## Interconsultation template
When it is not a referral but a supplementary consultation, the format is shorter:
---
### Request for interconsultation
**Date:** ___________________
**From:** Lic. [Name and Surname] — M. P. [Number]
**For:** [Professional / Service name]
**Patient:** [Name and Surname] — [Age] years
---
**Reason for interconsultation:**
[Short description of what is requested to be evaluated]
**relevant clinical data:**
- Diagnosis / hypothesis: [Description]
- Time in treatment: [Period]
- Current Symptoms: [Those Relevant to Interconsultation]
- Medication: [If applicable]
**Specific question:**
[What do you need the other professional to evaluate or respond to?]
---
**Signature:** _____________________ **Seal:** _____________________
---
## Post-derivation liability
### Until the derivation is completed
Your responsibility as a treating professional **does not end** when you write the derivation note. Continue until:
- The patient effectively begins care with the new professional
- Or the patient decides not to continue any treatment (having been informed of the implications)
This means that if you give a patient and the new professional does not have an appointment for another month, **you are still responsible** during that period.
### Closing meetings
If referral involves finishing your treatment, closing sessions are essential:
1. **Review the process**: what was worked out, what was achieved, what is pending
2. **Develop farewell**: give space to the emotions generated by closure
3. **Preparing transition**: explain what you can expect from the new professional
4. **Delivery of documentation**: referral note, and copy of medical records if requested by the patient
### Coordination with the recipient professional
When possible and the patient consents:
- Direct communication (call or email) between professionals facilitates the transition
- It's not mandatory, but it's good clinical practice.
- Document any communication in [medical records](/blog/historia-clinica-psicologia)
## Derivation in emergencies
When derivation is urgent (suicide crisis, psychotic decompensation, active violence), the protocol changes:
### Immediate steps
1. **Assess risk** and the need for immediate intervention
2. **Contact the emergency service** or accompany the patient to the guard
3. **Communicate essential clinical information** to emergency team (verbally if necessary)
4. **Contact a relative** or patient reference person
5. **Document** everything in the medical records as soon as possible
### Minimum information for emergencies
In an emergency referral, the recipient professional needs to know:
- Name and age of the patient
- Reason for the emergency (current risk)
- Diagnosis if there is
- Current medication
- Emergency contact
- If there were previous attempts (in case of suicidal risk)
## Frequent errors
### Derive without a specific destination
"You should see a psychiatrist" is not a referral. A responsible referral includes a name, telephone and, if possible, a managed appointment.
### Do not document
If the derivation is not recorded in the medical records, it is as if it did not exist. Faced with a claim, you have no support.
### Derive too late
Waiting for the picture to become worse or for the patient to enter crisis to derive is a common mistake. If you identify the need, actuate.
### Unclosed derivatives
Simply stopping taking care of the patient without closing sessions is a discontinuation of treatment, not a referral.
### Not asking for consent
Sharing clinical information with another professional without the patient's consent violates professional secrecy, even in a referral.
### Derive for comfort
Deriving because a patient "is difficult" or "I don't like him" is unethical. If there are countertransferal difficulties, the first step is supervision, not referral.
## How to manage drifts with Brauni
Brauni simplifies the entire bypass flow:
1. **Template referral notes**: Generates the note with preloaded patient data
2. **Recorded interviews**: Document communications with other professionals
3. **Follow-up alerts**: Remember to follow up to verify that the patient is specific to the referral
4. **Full History**: Referral is recorded in the patient's medical records
5. **Secure export**: Send the note to the recipient professional encryptedly
And if the recipient needs a formal report, you can generate it with [digital verification](/funcionalidades/informes-verificables) from the patient's same file.
## Summary
| Concept | Description |
|----------|-------------|
| **What is it?** | Leading the patient to another professional who can provide better care |
| **When to derive?** | Limits of competence, need for medication, lack of progress, conflict of interest, emergencies, patient request |
| **Derivation vs. interconsultation** | Referral = transfer of case. Interconsultation = supplementary consultation without leaving treatment |
| **Derivation note** | Clinical synthesis with reason, diagnosis, treatment performed and objective of referral |
| **Responsibility** | Continue until the patient begins care with the new professional |
| **Golden rule** | Deriving is an act of professional care, not a failure |
---
## Record therapy sessions: what the law says and how to do it right
- **URL**: https://brauni.io/en/blog/grabar-sesiones-terapia-legalidad
- **Category**: Privacy and Security
- **Date**: 2026-02-24
- **Tags**: recording sessions, informed consent, sensitive data, privacy, oversight, psychologists
Recording therapy sessions is legal only with prior informed consent. What Argentine law requires, how to write the clause and how to save the audio.
Between supervision, postgraduate training and AI tools that transcribe audio, more and more professionals wonder if they can record therapy sessions. The question comes through different paths: a supervisor who asks to listen to clinical material, or an app that promises to "transcribe the session and arm the note".
The short answer is yes: recording a psychology session is legal. The whole: depends on how. The difference between a legitimate practice and a serious breach of confidentiality is not in the act of recording, but in consent, purpose and storage.
In this article we explain what Argentine law says, what must include consent, where storage usually fails, and an alternative that often solves the root problem: not recording the patient at all.
## Is recording a psychology session legal?
Yes, with an unnegotiable condition: the informed, explicit and prior consent of the patient. There is no law prohibiting recording a session in itself. What the law regulates, and quite precisely, is the treatment of the information that that recording contains.
A session recording is not an ordinary audio. It is the voice of an identifiable person telling his privacy: his history, his symptoms, his ties, his fears. Under the 25.326 Law on Protection of Personal Data, that is the treatment of sensitive data, the category with the highest protection of the legal regime. To this are added the [professional secret](/blog/secreto-profesional-psicologia), the right to confidentiality enshrined in the 26.529 Law on the Rights of the Patient, and the reserve obligations of the Code of Ethics of FePRA.
In practice, this means that recording therapy sessions is legal when three conditions are met at once:
1. **Previous and explicit consent**: the patient knows that it is recorded, understands for what and accepts before the recording begins
2. **Finality determined**: the recording has a concrete and stated purpose, it is not recorded "in case of doubt"
3. **Save safe**: file is stored with security measures according to sensitive data and deleted when it fulfilled its function
If any of the three are missing, the legal problem appears.
## Recording without warning is not a grey area
It is worth saying bluntly: recording a session without the patient knowing it is a serious violation of confidentiality and the regime of sensitive data, even if the recording "is for you", even if you never share it with anyone, even if you delete it the next day.
The argument of "only for my personal use" does not work, for two reasons. The first is legal: the 25.326 law protects data since they are collected, not only when they are transferred to third parties; recording a person's voice by relating their privacy, without their knowledge, is already a processing of data without consent. The second is clinical: the framing is held in the confidence that what happens in session is protected, and the therapeutic bond rarely survives intact to discover a hidden recording.
The hidden recording does not become acceptable for good intentions. If you need to register a session and you still do not have the patient's consent, the answer is simple: do not record that session. I asked for consent and recorded the following.
## Why a session is recorded (and why the purpose legally matters)
Not all recordings are born equal. These are the most frequent legitimate purposes:
### Monitoring and training
It is the classic case. Listening to session material with a supervisor allows you to work on what actually happened, not on the edited memory. In postgraduates and residences, recording cases with audio is an established pedagogical tool.
### Performance review
Some professionals record to listen: to review their interventions, to detect musks, to evaluate the management of the times. It is a valid purpose, but it requires the same consent as any other.
### Support for specific approaches
Certain protocols and techniques include the recording of sessions as part of the device, for example for the patient to hear a slogan or an exercise between sessions. There the recording is part of the treatment and is agreed within the frame.
### Transcription for clinical notes
It is the new purpose that the AI brought: to record the session so that a tool transcribes it and generates the note. It is possible, but it is the modality that opens the most risk, because it implies that the patient's voice travels to a processing service. On this we go back down, because there is a better alternative.
Why does it matter to distinguish the purpose? Because [Law 25.326](/blog/ley-proteccion-datos-personales-psicologos) requires that the data be collected for a particular purpose and not be used for different or incompatible purposes. In Creole: You cannot record "for any doubt." A recording made for supervision cannot end up used in a class or in any destination that the patient has not consented to. Each new purpose requires a new consent.
## Consent to record: what does it have to say
The general [informed consent](/blog/consentimiento-informado-psicologia) of the beginning of the treatment does not reach. The recording needs a specific consent, and to be valid it has to report clearly:
- **What is recorded**: audio, video, spot sessions or all
- **For what purpose**: supervision, training, review of treatment, transcription
- **Who will access**: only you, your supervisor, a training space
- **Where is stored**: on which device or service, with which security measures
- **How long a specific period of time or a clear disposal criterion is retained**:
- **The right to refuse**: without affecting treatment or quality of care
- **The right to request removal**: at any time, without needing to justify the order
This last point deserves emphasis: the patient's refusal cannot condition the attention. If someone does not want to be recorded, the professional response is "perfect, it is not recorded", and the therapy remains exactly the same. A consent obtained under the feeling that refusing brings consequences is not free, and legally worth little.
The consent to record is revocable. That the patient has accepted in March does not require it in August: he may ask that you stop recording and remove the engraving, and that request is fulfilled without discussion.
## Storage: the weak link
This is where most good intentions fall. You can have the perfect consent and still generate a huge risk if the recording ends in:
- **Personal cell phone**, without encryption, on a device that can be lost or stolen
- **WhatsApp**, forwarded to supervisor "to save time", with automatic copying on Google or Apple backups
- **Unencrypted Personal Drive**, shared with a link that anyone with the link can open
These are the same problems as always, which we already review in our [cybersecurity for clinical practice](/blog/ciberseguridad-consultorio-psicologico) guide, but aggravated: a leaked session audio is not a appointment sheet, it is a person's voice telling his or her intimacy.
If you're going to keep recordings, the minimum standard you have to require (and require any tool you use) is:
1. **Custrated**: file protected at rest and in transit, not a loose mp3 in a folder
2. **Restricted access**: only persons mentioned by the consent, with actual authentication
3. **Effective removal**: when the purpose was fulfilled or the patient requests it, the file is truly deleted, including backups and forward copies
And a practical rule: the less time the recording lives, the better. You recorded to supervise a case, you supervised it, you eliminated it. Eternal recording "just in case" is exactly what the law does not allow.
## What if the patient wants to record the session?
It happens more often than you think: a patient who wants to record to listen again to something that it took him to process, or who directly supports the cell phone on the table and asks if he can.
The patient is entitled to the information of his or her own attention, but the subject has nuances. The session does not contain only his or her voice: it also contains your interventions and your way of working. And a recording that comes out of clinical practice on the patient's cell is out of control: it can be shared or ended in contexts outside the treatment, such as a family or legal conflict.
This does not mean refusing by system, but treating it as a framing decision that is discussed. If you find it clinically valuable for the patient to keep a record, agree explicitly (which is recorded, for what, the commitment not to spread it) and leave the agreement recorded in the medical records. If it seems to you that the recording interferes with therapeutic work, you can also say it and explain why: the framing you define it as a professional.
## The alternative that is usually best: not recording the patient, record your summary
Let’s go back to the newest goal: recording the session for an AI to transcribe and arm the note. Before going that way, you should ask yourself what you really need: the full session or your clinical record of the session?
To document, it almost always reaches the second. And there is a way to achieve it without recording the patient: you finish the session and you dictate your own audio of two or three minutes with your observations: what was worked, what appeared, what is pending. That audio is your professional elaboration, it does not expose the patient's voice or his first-person story, and it serves the same for the note. The leap in legal and ethical risk between one thing and the other is enormous.
The Brauni AI works exactly like this. It does not record sessions or listen to the patient: you send him your summary audio, a photo of your paper notes or a short text, and complete the clinical note that you then review and adjust. The voice that is processed is yours, the clinical judgment is yours, and the final decision on what is written also. The tool accelerates the mechanical part of documenting; it does not replace your professional judgment.
If your only reason for recording sessions was to save documentation time, you probably don't need to record any. A summary dictated by you solves the same problem without touching the patient's voice.
## Recordings and minors
With children and adolescents, all of the above applies with double care. Consent to record must be given by the legal guardians, and according to the age and maturity of the adolescent it is also necessary to seek their assent: to understand what is recorded and for what, and to agree. Recording a minor "because the parents signed", without the boy knowing what is going on, is bad practice even if the role is in order.
Storage also requires more rigour: the material of minors is especially delicate if it is filtered. In the event of doubt, do not record; and if you record, the minimum period of conservation is indispensable.
## Template: consent clause for recording
We leave you a basic model to adapt to your practice. As always, it is a general guide: adjust it with your professional school according to the regulations of your jurisdiction.
---
### Consent to recording of meetings
**Professional:** Lic. [Name and Surname] - M. P. [professional license number]
**Patient:** [Name and Surname] - DNI [Number]
**1. Object.** I authorize the recording in [audio / audio and video] of [sessions indicated in each case / treatment sessions] performed with the above professional.
**2. Purpose.** The recording shall be made for the sole purpose of [clinical supervision/vocational training/treatment review], and may not be used for any other purpose without express new consent.
**3. Access.** The recorded material shall be accessed only [the professional/the professional and its supervisor, Lic. (name)], who are reached by the duty of professional secrecy.
**4. Storage.** Recordings shall be kept in [write: device or service, with encryption and restricted access] and shall not be shared by messaging or unencrypted services.
**5. Deadline.** The material shall be permanently disposed of after the stated purpose has been fulfilled and, at the latest, at the [period] of the recording.
**6. Right to refuse.** I understand that I can refuse to record, in whole or in part, without any expression of reason, and that my refusal will in no way affect the treatment or quality of the care received.
**7. Revocation and deletion.** I may revoke this consent and request the deletion of existing recordings at any time, and that request will be fulfilled without conditions.
**Patient's signature:** _____________________ **Date:** ________________
**Signature of the professional:** _____________________
---
## Frequently Asked Questions
### Can I use a recording on supervision?
Yes, if the patient’s consent expressly mentions supervision as a purpose and identifies that a supervisor will access the material. The supervisor is reached by the same reservation duty. Take care of the channel: share the audio via WhatsApp or by an open Drive link disarms all protection. And when supervision ends, remove the file.
### How long can I keep a recording?
The law does not set a specific time limit for session recordings; it sets the criterion: the data are retained for the duration of the purpose for which they were collected, and the purpose is eliminated. The most neat is to define a specific time frame for consent and to comply with it. Eye with frequent confusion: recording is not the medical records, and the obligation to preserve the medical records does not oblige you to keep session audios.
### What do I do if I record sessions without consent?
First, stop doing it. Second, remove the material effectively, including automatic cloud backups. Third, evaluate the case: you can match it with the patient, and you should consult with your professional college or a legal advisor. Forward, regularize the practice: specific and written consent before re-recording.
### Is recording an online session different?
The principle is identical: same consent, same purpose, same secure save. There is an extra risk: the "record meeting" button of the video call platforms usually saves the file on the servers of the provider, under its terms. Before using it, find out where that file is and who can access it; many times it is advisable to avoid it.
### Is it reached with the general informed consent of treatment?
No. General consent covers psychological treatment and the routine management of clinical information. Recording is an additional data treatment, with its own risks, and requires specific consent that details purpose, access, storage and time frame. You can incorporate it as a clause within the general document, but differentiated and clear.
## Summary
- Recording therapy sessions is legal only with informed, explicit and prior consent; recording without notice violates confidentiality and the 25.326 law, even if the recording "is for you"
- The purpose matters: it is recorded for something concrete (supervision, training, clinical support), never "because of doubt", and each new purpose requires a new consent
- Specific consent says what is recorded, for what, who accesses, where is kept and for how long, and guarantees the right to refuse without affecting attention and to ask for elimination at any time
- Storage is the weak link: no unencrypted cell phone, WhatsApp or Open Drive; I required encryption, restricted access and effective removal
- If the patient wants to record, treat it as a framing decision: talk about it, agree on the terms and record it in the medical records
- To document, the best alternative is not to record the patient: dictate your own post-session summary; the Brauni AI works on that audio, your notes or a text, and never records or listens to the patient
- With minors, dual care: consent of legal guardians, consent of the adolescent according to maturity and minimum preservation
---
## Do you use ChatGPT to write clinical reports? What you need to know about your data
- **URL**: https://brauni.io/en/blog/ia-chatgpt-datos-clinicos-psicologia
- **Category**: Privacy and Security
- **Date**: 2026-02-20
- **Tags**: artificial intelligence, ChatGPT, clinical data, privacy, professional ethics, psychologists
What happens to your patients' data when you use ChatGPT, Gemini, or other generational AIs to write clinical reports or notes. Legal, ethical, and safe alternatives.
"Write a clinical report for a 32 year-old patient diagnosed with generalized anxiety disorder who has been 6 months of cognitive-behavioral treatment..."
If you ever hit something similar in ChatGPT, Gemini, Claude or any other generative AI, this article is for you. Because what you just did is **send sensitive mental health data to a foreign company**, probably without the patient's consent and in violation of at least three Argentine laws.
It's not a — trial is a reality. Many psychologists do it in good faith, trying to save time on administrative tasks. The problem is that most don't know what happens to those data after pressing "Enter".
## What about the data you send to ChatGPT?
### The short version
When you paste clinical data into ChatGPT (or other public generation AI), those data:
1. **Travel to servers in the US** (or another country where the provider operates)
2. **They are stored** by the supplier (at least temporarily)
3. **Can be reviewed** by employees of the supplier for quality control
4. **Can be used to train** future AI models (unless you explicitly disable it)
5. **Staff out of your control** once you send them
### The detailed version
#### OpenAI (ChatGPT)
According to OpenAI's terms of service (updated to 2025):
- **Free and Plus**: by default, conversations **if used to train models**. You can disable it in Settings → Data Controls → "Improve model for all." But even by deactivating it, OpenAI retains data for 30 days "for abuse monitoring"
- **ChatGPT Team / Enterprise**: data **not used for training**, but still stored on US servers
- **API**: data sent via API **not used for training** by default
#### Google (Gemini)
- Talks with Gemini (free version) **used to improve product**
- Google human reviewers **can read your conversations**
- Data is stored for up to 3 years
#### Other AIs (Claude, Copilot, etc.)
Each has its own policies, but the pattern is similar: the data you send is stored on the provider's servers, usually in the US.
Even if you disable training, the data has already come out of your control. They are on servers of a foreign company, subject to legislation from another country, and you have no way of verifying that they were actually deleted.
## Why is it a legal problem?
### Violation of the 25.326 Law (Protection of Personal Data)
Mental health data are **sensitive data** (Art. 2). While Art. 8 enables you as a health professional to treat data from your patients, this has clear limits:
- **Finality (Art. 4.3)**: Data cannot be used for purposes other than or incompatible with those that motivated its acquisition. The patient gave you his data for clinical care, not to send them to a technology company.
- **Cession to third parties (Art. 11)**: Giving data to OpenAI or Google requires prior consent of the patient, informing him of the purpose and identity of the assignee. The assignee is subject to the same obligations and both respond jointly (Art. 11.4)
- **International Transfer (Art. 12)**: Transfer of data to other countries requires adequate contractual guarantees (such as data processing agreements) and informed consent of the holder
- **Service provision (Art. 25)**: When a third party provides data processing services, it cannot use them for any purpose other than that of the contract, nor assign them to other persons.
Does your patient know that your clinical data is on OpenAI servers? Probably not. Did you consent to that assignment? Almost certainly not.
### Violation of professional secrecy
The [professional secret](/blog/secreto-profesional-psicologia) obliges you not to disclose known information for the purpose of exercising your profession. When you post clinical data on ChatGPT, you are **disclosure of confidential information to a third party** (OpenAI, Google, etc.) without legal justification.
Article 156 of the Criminal Code punishes this conduct with a fine of $1.500 to $90.000 and a special disqualification from 6 months to 3 years.
### Violation of the 26.529 Act (Patient's Rights)
The law establishes the patient's right to confidentiality of his health information. Sharing this information with an AI platform without consent violates this right.
### Possible consequences
| Scope | Consequence |
|--------|-------------|
| **Legal (civil)** | Claim for damages of the patient |
| **Legal (criminal)** | Art. 156 CP: fine from $1.500 to $90.000 and special disqualification from 6 months to 3 years |
| **Administrative** | Penalty of the AAIP (fines up to $100.000) |
| **Ethics** | Penalty of the professional college (up to suspension of professional license) |
| **Professional** | Loss of confidence, reputational damage |
## "But I anonymize the data before I paste it."
It's the most common answer, and it's a good instinct, but it has problems:
### Real anonymization is very difficult
Taking out the name is not enough. Mental health data are **highly identifiable** by context:
- "Patient of 34 years, psychologist, divorced 6 months ago, mother of two, attends in Palermo, with diagnosis of major depression..."
- Even if you don't name it, how many people fit that description in your professional circle?
### Language models can reidentify
LLMs (Large Language Models) have the ability to cross information. If you mention sufficient details in a conversation, the model (or anyone accessing that data) could potentially identify the person.
### It does not eliminate the legal problem
Even if the anonymization is perfect, the law specifically provides for **dissociation of data** (Art. 2): the processing of data in such a way that the information cannot be associated with a particular or determinable person. If the dissociation is complete, the data ceases to be personal. But if there is any element that allows them to associate with a person (directly or indirectly), they remain protected personal data and their transfer to a third party such as OpenAI requires consent (Art. 11).
Anonymization reduces risk, but does not eliminate it. The only way to eliminate risk is not to send clinical data to public AI platforms.
## What can you do with AI safely?
AI can be extremely useful for a psychologist. The problem is not the AI itself — is **how and where** the data is processed. Here are the safe ways:
### 1. Use AI without actual data
You can use ChatGPT or any AI for:
- Learning about a therapeutic approach or technique
- Order generic reporting models (no patient data)
- Researching a diagnosis or medication
- Writing texts for your website or social networks
- Preparation of psycho-educational material
**Rule:** If it does not include data from any actual patient, there is no problem.
### 2 Use clinical software with integrated and secure AI
The key difference is **where data is processed**. A clinical software that integrates AI safely:
- Processes data in a controlled environment
- It does not send them to public platforms
- He doesn't use them to train models.
- It's got end to end encryption.
- Compliance with data protection legislation
### 3. Use local AI (for advanced users)
There are AI models that run locally on your computer, without sending data to any server:
- **LM Studio**: free interface for running local models
- **Call**: command line tool for local models
Data never leaves your computer. The disadvantage is that it requires technical knowledge and a powerful computer.
## What Many Psychologists Do Wrong (Unknowingly)
### Paste session notes in ChatGPT to "improve writing"
You're sending the full content of a session to OpenAI. It's the most direct violation.
### Tell an AI the session summary
If you use a cloud transcription or dictation service (non-local), audio data travels to external servers.
### Ask AI to "analyze" a case
"I have a patient with these characteristics, what differential diagnosis would you do?" — if you included real data, you already shared them.
### Upload clinical documents for the AI to summarize
PDFs of evaluations, reports from other professionals, test protocols... if you upload them to ChatGPT, they're stored.
### Use AI browser extensions
Some extensions that offer "assisted writing" send everything you write to their servers. If you use them while completing an online medical records, that data is leaking.
Check your browser extensions. Some AI extensions read everything you write on any — website including your clinical software.
## Comparative: Public AI vs. Integrated Clinical AI
| Criterion | ChatGPT / Gemini (public) | IA integrated into safe clinical software |
|----------|------|------|
| **Where are the data processed?** | Provider Servers (USA) | Environment controlled by clinical software |
| **Are they used to train AI?** | Possibly (depends on plan) | No |
| **Who can access?** | Provider employees, possible gaps | Only you. |
| **Does Law 25.326 comply?** | Not automatically | Should (check with provider) |
| **Does anonymization require?** | Yes (and still risky) | No (data are already in a protected environment) |
| **Patient consent** | Necessary and probably not granted | Covered by consent of clinical software |
| **What if there is a gap?** | You have no control or information. | The provider must notify you |
## What should your informed consent say?
If you use AI tools in your practice (of any kind), your [informed consent](/blog/consentimiento-informado-psicologia) should include:
1. **What AI tools you use** (name them)
2. **What do you use them for** (reporting, transcription, clinical suggestions)
3. **If patient data are processed by AI** and, if so, where
4. **What security measures** the tool has
5. **That data is not used to train models** (if applicable)
## Frequently Asked Questions
### "Is ChatGPT Team or Enterprise safe for clinical data?"
It is significantly better than the free version because it does not use data to train. But the data is still stored on OpenAI servers in the US, and OpenAI employees can access it in exceptional circumstances. For mental health data in Argentina, it remains problematic from the point of view of the 25.326 Law.
### "What if I use the OpenAI API?"
Better than chat, because the data sent via API is not used to train by default and the retention is 30 days. But it is still a data transfer to a third party (Art. 11). You would need the patient's consent informing the purpose and identity of the assignee, and Art. 25 requires the service provider not to use the data for a different purpose than the contracted one.
### "Is it the same as using Google Docs to write reports?"
It is similar in the sense that data is on Google servers. The difference is that with ChatGPT there is the possibility (depending on the plan) that data is used to train AI and that human reviewers read them. With Google Docs, data is stored but not used to train language models.
### "Brauni uses AI? Is it different?"
Yes, Brauni uses AI to assist in clinical documentation. The fundamental difference is that data is processed in a safe environment with end-to-end encryption, is not sent to public AI platforms and is never used to train models. The patient is also informed through informed consent.
## How to use AI safely with Brauni
Brauni integrates artificial intelligence responsibly:
1. **IA that does not train with your data**: Your clinical information is never used to improve AI models
2. **End-to-end encryption**: Clinical data remain encrypted at all times
3. **No third-party access**: Data is not sent to OpenAI, Google or any other public platform
4. **Safe processing**: AI assists without compromising confidentiality
5. **Total transparency**: You know exactly what AI does with your data
6. **Integrated Consent**: The use of AI is covered in the informed consent of the patient
## Summary
| Question | Response |
|----------|-----------|
| **Can I paste clinical data into ChatGPT?** | No. It violates 25.326 law, professional secrecy and the 26.529 law |
| **What if I anonymize the data?** | It reduces the risk but does not eliminate it. Real anonymization is very difficult |
| **Can I use ChatGPT for generic questions?** | Yeah, as long as you don't include real patient data. |
| **What alternative do I have?** | Clinical software with integrated AI securely, or local AI |
| **What if I already did?** | Disable training, delete conversations, and do no more. Evaluate whether you need to notify the patient |
| **Is AI bad for psychology?** | No. AI can be very useful. The problem is to use public AI with sensitive data |
---
## Personal therapy of the psychologist: is it compulsory to practice?
- **URL**: https://brauni.io/en/blog/terapia-personal-del-psicologo
- **Category**: Mental Health of the Professional
- **Date**: 2026-02-17
- **Tags**: personal therapy, Self-care, training, mental health of the professional, psychologists
Personal therapy of the psychologist: if it is mandatory in Argentina, what the formations ask for, what it contributes to the clinic and how to choose therapist by being a colleague.
At some roast, birthday or family table, every psychologist heard the same question: "Are you going to therapy?" Sometimes it comes in a chicana tone, sometimes with genuine curiosity, and almost always with the implicit suspicion that it would be rare that it would not. The question seems to be of occasion, but it has more depth than it appears: it touches on the statute of personal therapy of the psychologist, a subject that the profession discusses decades ago and that each colleague resolves in private.
Because the honest answer is less simple than a yes or a no. There are colleagues who have spent fifteen years of analysis and don’t imagine attending without that space, colleagues who closed their process during training, and colleagues who never went and wondered, with a certain discomfort, if that makes them missing.
In this article we order the discussion: what the law demands and what it does not, what the formations ask for, what personal therapy actually contributes, how it differs from supervision and how to choose therapist when the patient is also a psychologist.
## The short answer: personal therapy of the psychologist is not mandatory by law
Let’s start with the concrete. In Argentina, personal therapy is not a legal requirement to obtain tuition or to exercise: no professional exercise law requires the psychologist to be in or have been in treatment to care for patients. You can enroll, open clinical practice and work your entire career without ever stepping on the clinical practice of another colleague, and no one will punish you for that.
However, the fact that it is not compulsory by law does not mean that the profession considers it a detail.
### What the formations ask for
Many postgraduate courses do demand it, and some consider it to constitute the course. The clearest case is psychoanalysis: personal analysis (educational analysis, in training institutions) is not a complement to training but one of its pillars, together with supervision and theoretical study. The premise is that one cannot operate with the unconscious of another without having worked on one’s own.
Other currents do not formally require it, but they recommend it with different degrees of emphasis: formations in humanistic, systemic and third wave therapies usually include instances of personal or experiential work, and much of the trainers suggest it as a basic practice.
### What Professional Ethics Says
Codes of ethics do not require therapy, but they do establish something that makes it difficult to avoid: the psychologist is responsible for not exercising when his personal conditions compromise the quality of his work. And to know if that is happening, you need some space where you can see it. Personal therapy is not the only one, but it is the most direct.
The distinction matters: the law regulates the minimum floor to exercise, the training defines what each current demands, and ethics speaks of the conditions under which you attend. That personal therapy does not appear on the first level does not remove it from the other two.
## The instrument of work is you
Here is the core of the matter. A surgeon calibrates his instruments, a musician refines his instrument, a laboratory validates his equipment. In the psychological clinic, the working instrument is your own subjectivity: your listening, your ability to record what the patient produces you, your tolerance to the anguish of others, your personal history with everything that resonates when the story of the other brushes it.
That's not a cute metaphor: it's a technical description. Countertransfer, it's called that or otherwise according to the current, it's clinical information. What you feel in front of a patient (boring, annoying, tender, wanting to rescue him) says something about the link and the material at stake. But it only works as information if you can tell which part comes from the patient and which part is yours. An uncalibrated instrument doesn't stop measuring: it measures badly, and doesn't warn.
And subjectivity is not calibrated alone: no one has direct access to their own blind spots, by definition. You can read the entire bibliography on countertransfer and continue not to see that that patient irritates you because it reminds you of your father. That takes another one to listen.
## What the psychologist’s personal therapy actually does
Let us lower the argument for observable purposes.
### Detect blind spots
We all have areas of experience that we can't think about because they compromise us too much. In the clinic, these zones translate into topics that you don't explore, questions that you don't ask, hypotheses that you rule out too quickly. Personal therapy doesn't eliminate blind spots (there is always another), but it reduces their surface and trains you in the suspicion that they exist.
### Separate yours from the patient.
When a patient relates a duel and you are going through one, when he talks about his partner and what he describes is too much like your home, listening becomes contaminated without asking for permission. A space of his own where that material is worked makes it less likely to leak into the session as quick advice, change of subject or silent identification that takes you out of the role.
### Hold the role without overflowing
Clinical work involves receiving heavy material regularly and having no one to process it with, because professional secrecy limits what you can share. Personal therapy is one of the few spaces where that can be deposited with framing. It is not casual that it appears among protective practices when talking about [preventing burnout in psychologists](/blog/burnout-psicologos-prevencion): those who sustain other people's processes need a place to be sustained.
### Knowing what it feels like to be on the other side
This contribution is underestimated and enormous: to have been patient. To know in one’s own flesh the vergüenza to tell something for the first time, the irritation with a certain signpost, the desire to miss when the subject becomes difficult. That experience is not learned in any seminar and changes how you treat the resistances and silences of your own patients. It is difficult to ask someone to trust in a process that you were never willing to go through.
## Personal therapy and supervision: not interchangeable
A frequent confusion, especially in the first years of exercise: to believe that with supervision it reaches, or that therapy can absorb what corresponds to supervision. They are different spaces, with different objects.
[Clinical monitoring](/blog/supervision-clinica-psicologia) works on the case: strategy, hypotheses, interventions, treatment impasses. The focus is on the patient, although your involvement appears as data. Personal therapy works on you: your history, your symptoms, your bonds, your desire, including your relationship with the profession, without the obligation that everything should lead to a case.
A practical rule to guide yourself: if the problem is what to do with the patient, it goes to supervision. If the problem is what the patient does with you (especially if that happens to you outside of clinical practice), it goes to therapy. Often a topic starts in one space and the supervisor or therapist himself redirects it to the other: that is not a bounce, it is the system working well. What does not work is to use supervision as undercover therapy (the supervisor has no framing for that) or to use therapy as cheap supervision, where you talk about your cases not to talk about you.
## When personal therapy ceases to be optional
You can discuss whether the psychologist should always be in therapy. What hardly admits discussion is that there are times when the space itself ceases to be a choice of style and becomes a condition to continue to attend well. Some signs:
- **Patients that deregulate you.** You leave certain sessions altered, rumming for hours, or you activate in session in a way that the material does not explain.
- **Themes you avoid in session.** There are areas (death, sexuality, violence, motherhood) where your patients never deepen, and you begin to suspect that you are the one who dodges.
- **You wear out.** New irritability, relief from cancellations, cumulative notes. If you recognize several of the [early burnout signs](/blog/burnout-psicologos-prevencion), personal therapy is one of the first steps to consider, not the last.
- **Own vital moments.** Duels, separations, economic crisis, parentality, illness of one's own or of a relative. To go through a vital earthquake while sustaining ten processes of others without any space of their own is a risky bet.
Attending through something you are not working is not neutral for the patient. If your situation compromises your clinical availability and your own space does not reach, the responsible step may include reducing the schedule or [leading some processes](/blog/derivacion-responsable-psicologia) while you recover. That is not leaving patients: it is caring for them.
## Honest objections (and answers)
The reasons for not going to therapy are rarely said out loud among colleagues, but they exist and deserve an answer, not a sermon.
### "I don't have time or money"
It is the most real objection, especially in the early years, when the fees are low and the agenda unstable. The uncomfortable answer is that personal therapy, such as supervision, is part of the cost structure of exercising: it is not a personal expense that competes with leisure, it is an input of work. That said, there are ways to make it viable: colleagues who serve colleagues with differentiated fees, services of training institutions, more spaced frequencies as a starting point. A sustained fortnight space is worth more than a weekly ideal that never starts.
### "I've done years of analysis during training."
It may be true and sufficient for that moment. But practice changes and so do you: who finished his analysis to the 28 is not who 40 goes through a separation while caring for couples. Personal therapy is not a single dose vaccine: it is a resource that turns to when life or the clinic asks for it. Having done a good process before plays in favor, because you already know how you enter.
### "Gives me vergüenza to be known in the environment"
Very little object said and very frequent, especially in small cities or endogamous circuits: the fear that your therapist will be a colleague of your colleagues, teacher of your graduate or supervisor of your friend. It is a legitimate concern with practical solutions: to choose from outside your institutional circuit and your current, or directly outside your city. The consolidation of [online therapy](/blog/terapia-online-argentina-guia) greatly expanded the options: today you can analyze with someone 800 kilometers that does not share a corridor with your professional life.
## How to choose a therapist by being a psychologist
Choosing a therapist is already difficult for anyone. Being a psychologist, they add up to the traps of the trade.
### Same or different orientation?
There is no single answer. A therapist of your own current offers consistency with your training (and in some cases it is a requirement of it). One of another orientation can help you get out of the script: you don't know the movements beforehand and you find it harder to play local. The bottom line is what you would say to any consultant: more than the current, it matters that he is a good clinician and that with that person you can talk seriously.
### The temptation to intellectualize
It is the occupational risk of the psychologist in therapy: turning the session into anatheneum. Diagnosing yourself before telling what happens to you, discussing the intervention of the therapist instead of letting him work, quoting bibliography as a shield. A good psychologist therapist knows the maneuver and does not buy it, but it helps to have a look at it: every time you explain your discomfort with technical vocabulary, you are probably avoiding feeling it.
### Be patient, no mate.
In that clinical practice you are not a psychologist: you are a patient. It is not your function to evaluate the framing of the other, to provide hypothesis about your own case or to establish union camaraderie. If you notice that after months you continue to sit as a visiting colleague, that is a good topic to take to the next session.
A simple test to find out if space works: see what you're talking about. If you talk mostly about your patients in your therapy and almost never about your history, your ties, and what hurts you, you might be using space as supervision under another name.
## Frequently Asked Questions
### Is it mandatory for a psychologist to go to therapy to enroll in Argentina?
No. professional license does not require personal therapy, either at the beginning or as a condition of permanence. Formal requirements come from training institutions: psychoanalytical schools require it as part of training, and various postgraduate courses include instances of personal work. Outside these contexts, it is a professional and ethical decision, not legal.
### How many years of therapy does a psychologist need?
There is no number, and don’t trust anyone to give you one. There are colleagues who support decades-long analyses and colleagues who make limited processes and come back when they need it. The useful criterion is not the number of years but the function: to have a space available when the clinic or life asks for it, and the honesty of recognizing when they are asking.
### Can I see if I'm going through a personal crisis?
It depends on the crisis and your resources to get through it. A duel or separation does not disable you from working: psychologists also live. The honest question is whether your situation compromises your clinical availability: if you cry between sessions, avoid issues that your patients need to touch or you cannot focus on each other's story. In that case, the responsible response usually includes personal therapy, more frequent supervision, and, if not, a [responsible derivation](/blog/derivacion-responsable-psicologia) of the processes you cannot sustain.
### Does personal therapy replace supervision?
No, and the reverse either. Supervision works on your cases; therapy, on you. You may need both at once or prioritize one according to the moment, but it is not right to expect one to do the work of the other: the supervisor has no frame to deal with your story, and your therapist is not there to direct your treatments.
### What do I do if I don't want someone from my professional environment to take care of me?
It's a valid and more common concern than you admit. Concrete options: search outside your training institution and your peer circuit, choose another current, or opt for online therapy with someone from another city. If crossing your therapist at a congress would make you censor material, it's reasonable to choose someone with whom that crossing is unlikely.
## Summary
- In Argentina, the psychologist's personal therapy is not a legal requirement to enrol or to practice: no law requires it.
- Many formations do: psychoanalysis considers it constitutive (educational analysis) and other currents strongly recommend it.
- Ethics makes it difficult to avoid: you are responsible for not attending in conditions that compromise your work, and you need a space where that can be seen.
- The underlying argument: the working instrument is your own subjectivity, and an uncalibrated instrument does not stop measuring, mismeasures.
- Concrete contributions: to detect blind spots, to separate yours from the patient, to sustain the role without overflowing and to know the experience of being patient.
- Therapy and supervision are not interchangeable: supervision works on the case, therapy on you.
- Stop being optional when there are patients who deregulate you, avoid topics, burnout in progress or your own vital crises.
- Objections (time, silver, "I've already made years", vergüenza from the environment) have practical answers: it's part of the costs of exercising, practice changes, and choosing out of the circuit (or online) resolves exposure.
- When choosing a therapist, the key is being able to be patient and not a colleague: if you intellectualize each session, it takes that same session.
---
## Cybersecurity for psychologists: how to protect your patients' data
- **URL**: https://brauni.io/en/blog/ciberseguridad-consultorio-psicologico
- **Category**: Privacy and Security
- **Date**: 2026-02-13
- **Tags**: cybersecurity, digital security, data protection, clinical practice, psychologists, privacy
Practical cybersecurity guide for psychological clinical practice. Passwords, WiFi, phishing, ransomware, backups and what to do if they steal your notebook with medical records.
You don't need to be a tech expert to protect your patients' data, but if you need to take some basic precautions that most psychologists ignore.
The reality is that a psychological clinical practice is an attractive target for cyberattacks: it has sensitive mental health data, little security infrastructure and professionals who usually have no training in technology. A ransomware that encrypts your medical records or a passwordless notebook theft can be catastrophic.
In this article we give you a practical guide with everything you need to implement, ordered from more urgent to less urgent.
## Why should a psychologist worry about cybersecurity?
Because you handle the most sensitive data that exist: mental health information. A patient entrusts to you his fears, traumas, diagnoses, medication, sexual orientation, suicidal ideas. If that information leaks:
- **For the patient**: emotional damage, stigmatization, work discrimination, family problems
- **For you**: legal liability (Ley 25.326), ethical sanctions, loss of professional confidence, claims for damages
- **For treatment**: rupture of therapeutic alliance with all your patients if they find out
You don’t need a sophisticated hacker. Most of the data leaks in clinical practice happen because of simple things: a notebook without a password, a backup on a lost pendrive, or an email sent to the wrong person.
## The 10 essential measures
### 1. Secure passwords
It's the basics, but most of them fail here.
**What should NOT be done:**
- Use the same password for everything
- Use "123456", your date of birth or the name of your pet
- Save passwords to a little paper attached to the monitor
- Share passwords via WhatsApp
**What IS TO BE done:**
- Use a **password manager** (Bitwarden is free and secure, 1Password is another good option)
- Each account must have a **single password**
- Passwords must have at least **12 characters** with uppercase, lowercase, numbers and symbols
- Change passwords if you suspect they were compromised
**Critical passwords that should be strong:**
| Account | Why is it critical? |
|--------|---------------------|
| Professional Email | Access door to all other accounts (password recovery) |
| Clinical software | Direct access to medical records |
| Computer/notebook | Physical access to everything |
| Cloud (Google Drive, Dropbox) | If you keep clinical files there. |
| Bank / invoicing | Own and patient financial data |
### 2 Two-step verification (2FA)
Two-step verification adds an extra layer of security. Even if someone discovers your password, they cannot enter without the second factor (usually a code on your cell phone).
**Activate in:**
- Your professional email (Gmail, Outlook, etc.)
- Your clinical software (if allowed)
- Your bank account
- Professional social networks
**How to activate it?**
- In Gmail: Configuration → Security → Two-step verification
- In most services: Configuration → Security → 2FA
**Recommendation:** Use an authentication app (Google Authenticator, Authy) instead of SMS. SMS can be intercepted.
### 3. Disk encryption
If someone steals your notebook or cell phone, the disk encryption makes the data unreadable without your password.
**On Windows:**
- Find "BitLocker" in Settings → guides you step by step
- On Windows 11 Home: Settings → Privacy & Security → Device Encryption
**On Mac:**
- System Preferences → Security & Privacy → FileVault → Enable
**On cell phone:**
- Android and iOS already come encrypted by default if you have PIN/password active
- Verify: Configuration → Security → Encryption
If your notebook does not have encryption enabled and you miss or steal it, anyone can access all your files simply by extracting the hard drive. No matter if you have Windows password — that only protects the login, not the data.
### 4. Backup of medical records
Losing medical records is a legal breach (Law 26.529, 10 years of conservation) and a clinical catastrophe.
**Rule 3-2-1:**
- **3** copies of your data
- In **2** different media types
- **1** copy out of your clinical practice
**Backup options:**
| Medium | Advantages | Disadvantages |
|-------|----------|-------------|
| **Encrypted Cloud** (Google Drive + Cryptomator) | Automatic, accessible, safe | Requires configuration |
| **External disk** | Simple, economical | It can be damaged, you have to remember |
| **Clinical software with automatic backup** | No effort, professional. | Supplier Dependencies |
**Frequency:** If you keep digital records, daily (or automatic) backup. If you keep records on paper, periodic scanning.
### 5. Safe WiFi
WiFi from your clinical practice is a gateway to your network.
**Basic measures:**
- Password WPA3 (or WPA2 at least). Never WEP
- Password of at least 12 characters other than "consultory123"
- Change your router password (the one that comes from factory is on the internet)
- If you offer WiFi to patients, use a **separate network** (guest network)
- Deactivate WPS (it's a known vulnerability)
**Guest Network?** Most modern routers allow you to create two networks: one for you (where your computer is) and one for guests (patients). So, even if someone connected to the guest network tries something, they cannot access your computer.
### 6. Software Updates
Updates are not just for new functions — fix **security vulnerabilities**. A outdated system is a vulnerable system.
**I keep updated:**
- Operating system (Windows, macOS)
- Browser (Chrome, Firefox, Safari)
- Clinical software
- Antivirus
- Mobile Apps
**Tip:** Enable automatic updates. It's the easiest way to keep up to date.
### 7 Phishing: the most common deception
Phishing is an attack where someone pretends to be a reliable entity (bank, AFIP, Google, your health insurance) to steal your data.
**How to detect it:**
| Signal | Example: |
|-------|---------|
| **Artificial urgency** | "Your account will be suspended in 24 hours" |
| **Spell error** | "Dear wearer, your cut..." |
| **Suspicious sender** | soporte@go0gle.com (with zero instead of "or") |
| **Links that do not match** | The text says "www.banco.com" but the link goes to another URL |
| **Unexpected attachments** | "Deputy Bill" from someone you don't know. |
| **Request for sensitive data** | "Enter your password to verify your account" |
**What to do if you suspect:**
- Do not click on any link
- Do not download any attachments
- Don't answer the email.
- If it appears to be from your bank or other entity, contact them directly through their official channels
If you have doubts about an email, search the sender's address on Google. If it is phishing, someone probably already reported it.
### 8 Ransomware: Digital Kidnapping
Ransomware is a type of malware that **encrypts all your files** and asks for a ransom (usually in cryptocurrencies) to return them to you.
**How a computer gets infected:**
- Opening an infected email attachment
- Downloading Pirate Software
- Visiting malicious websites
- Through infected pendrives
**How to prevent it:**
- I kept a backup up to date (if you get encrypted, you'll restore the backup)
- Do not open attachments from unknown senders
- Don't download software from unofficial sites
- Use updated antivirus
- I kept the operating system up to date.
**If you happen:**
1. Unplug the internet computer immediately
2. Do not pay the ransom (do not guarantee that the data will be returned to you)
3. Contact a specialist technician
4. Restore from your backup
5. Report to the UFECI (Tax Unit Specialized in Cybercrime)
### 9. Cellular safety
Your cell phone probably has patient data: WhatsApp messages, calendars, document photos, professional email access.
**Essential measures:**
- PIN or biometrics (print/face) activated
- Encryption activated (comes by default in most modern cell phones)
- Automatic locking after 1-2 minutes of inactivity
- "Find My Device" function enabled (to remotely delete if you miss it)
- Do not install apps from unknown sources
- Check app permissions periodically
### 10. Physical security
Not everything is digital. Physical security remains important.
- **Clinical Paper Stories**: kept under lock and key, not on the desktop
- **Notebook**: not to leave it in the car, in the waiting room or in public places
- **screen**: locks the screen (Windows + L, or Ctrl + Cmd + Q on Mac) when you wake up
- **Destruction of documents**: Use paper shredder, do not throw clinical documents into the trash without destroying
- **Pendrive / external disk**: saves in safe place, ideally encrypted
## What to do if your notebook is stolen?
If your notebook has patient data and is stolen or lost:
### Step 1: Act fast (first hours)
1. Try to locate the device remotely (Find my device on Windows / Find my Mac)
2. If you can't recover it, **delete remotely** the data
3. Change passwords for all the accounts you had logged in (email, clinical software, bank, networks)
### Step 2: Assess damage
- Was the disk encrypted? Yes → low risk. No → high risk
- What information was there? Clinical records, patient data, sensitive documents?
- Did you have a session with cloud services?
### Step 3: Notify
- **If the data were not encrypted**, you may be required to notify the affected patients and AAIP
- Consult with a lawyer about your specific obligations
- Make the police report (it serves as legal support)
### Step 4: Document
- Register in the medical records of each patient affected that there was a safety incident
- Document what steps you took to mitigate the damage
- Implement the missing measures so that it does not happen again
If your notebook did not have secure disk encryption or password, and had medical records stored locally, it is considered a sensitive data breach. The legal consequences may be severe.
## Safety Checklist for Your Clinical Practice
Print and verify:
### Urgent (to do today)
- [ ] Put strong password to computer
- [ ] Enable two-step verification in the email
- [ ] Enable disk encryption (BitLocker / FileVault)
- [ ] Verify that the cell has PIN or biometrics
### This week
- [ ] Install a password manager and migrate passwords
- [ ] Configure Auto Backup
- [ ] Update operating system and browser
- [ ] Change WiFi password if weak
### This month
- [ ] Create Guest Network for Patients WiFi
- [ ] Enable "Find My Device" in the notebook and cell phone
- [ ] Check which mobile apps have access to sensitive data
- [ ] Training administrative staff on phishing
### Recurrent maintenance
- [ ] Update software (monthly)
- [ ] Verify that backups work (quarterly)
- [ ] Change critical passwords (annual or suspected breach)
- [ ] Review accesses and permissions (monthly)
## How Brauni solves cybersecurity for you
With Brauni, most of these concerns disappear because security is integrated into the platform:
1. **End-to-end encryption**: Your data is encrypted at rest and in transit — even if someone accesses the servers, they cannot read them
2. **Auto-Backups**: Don't remember to back up
3. **Safe Access**: Two-step verification available, automatic expiration sessions
4. **No local data**: Your medical records are not stored in your notebook — if stolen, your clinical data is safe in the cloud
5. **Automatic Updates**: The platform is always updated with the latest security patches
6. **Access Log**: You know exactly who agreed to what and when
## Summary
| Measure | Priority | Difficulty |
|--------|-----------|------------|
| Secure passwords + manager | Urgent | Easy |
| Two-step verification | Urgent | Easy |
| Disk encryption | Urgent | Average |
| Backup 3-2-1 | High | Average |
| Safe WiFi + network guests | High | Average |
| Automatic updates | High | Easy |
| Recognize phishing | High | It requires practice. |
| Ransomware protection | High | Average |
| Cell phone security | Average | Easy |
| Physical security | Average | Easy |
---
## Clinical supervision: what it's for, how to choose, and how to register it
- **URL**: https://brauni.io/en/blog/supervision-clinica-psicologia
- **Category**: Professional practice
- **Date**: 2026-02-10
- **Tags**: clinical supervision, training, professional ethics, professional practice, psychologists
Clinical supervision guide for psychologists: what it's for, formats, how to choose supervisor, confidentiality of the case and how to register the work.
Clinical supervision in psychology carries with it a prejudice that is difficult to shake: it is thought of as something recently received, a stage that passes through the first years and is abandoned when the practice "mature". The reality is exactly the other way around. Professionals with the most track record are usually the ones who value supervising, because they learned something that is only learned with years of clinical practice: clinical quality is not supported alone.
Working in psychotherapy is working in a structural loneliness. No one sees what happens within the session except you and your patient. That intimacy is the condition of treatment, but it is also their weak point: without an external look, the biases, the blind spots and the habits that are fixed have nothing to contrast with.
In this guide we tell you what is (and what is not) supervision in psychology, what is it for, what formats exist, how to choose supervisor, how to prepare a case, how to take care of confidentiality and why to register the work.
## What is clinical supervision (and what is not)
Clinical supervision is a systematic working space about your practice, with an experienced third party not involved in treatment. You have a case, a technical doubt or a situation that exceeds you, and you think about it with someone who can see what you, by being inside, do not see.
Defining it by negative helps to use it better:
- **It's not therapist therapy.** Under supervision, what happens to a patient may appear, and it's okay to show up, but the focus is your practice, not your personal history. If something of yours interferes in a sustained way, the space to work it is your own therapy.
- **It is not administrative control.** The supervisor does not audit your schedule or review that you comply with protocols. There is no hierarchical sanction relationship: there is a working relationship between colleagues with different experience.
- **It is not a theoretical class.** There may be reading recommendations, but the supervision part of concrete clinical material, not a content program. If you leave each meeting with bibliography and without decisions about the case, some framing is failing.
Supervision and personal therapy complement each other, they are not replaced. Supervision works on what you do with your patients; therapy works on you. A professional care usually needs both, in different doses depending on the moment.
## What is the point of psychology supervision?
"To improve as a professional" is true but abstract. Here are the concrete contributions:
### Detect the blind spot
Every therapist develops a way of looking, and every way of looking leaves things out. The supervisor sees no more because he is smarter: go from another position, without the transfer charge or your need for treatment to work.
### Work the countertransfer
That patient that irritates you for no apparent reason, the one that gives you pity, the one that mentally postpones between session and session. What happens to you with a patient is valuable clinical information, but only if someone helps you read it instead of acting on it.
### Making tough decisions with backing
Suicidal risk assessment, suspicion of a problem that exceeds your training, a stagnant treatment, the closure of a long process. These are decisions that should not be taken alone. Supervision does not take your responsibility, but adds a second test before deciding.
### Validate (or correct) your technique
Over the years, practice is automated. That is partly expertise and partly risk: vices are also automated. Supervision is the only space where your technique is exposed to regular review.
### Preventing professional isolation
Private clinical practice can go on for years without another colleague hearing how you work. Supervision keeps you in conversation with discipline: other frameworks, other readings, another generation.
## Monitoring formats: honest pros and cons
### Individual supervision
A supervisor, you and your cases.
- **In favor:** maximum depth, own agenda, easier to take care of confidentiality, space for aspects of your practice that you would not expose in group.
- **Contra:** is the most expensive format, depends entirely on the quality of that supervisor and deprives you of listening to how other colleagues work.
### Group supervision
A supervisor coordinates a group of professionals who rotate the presentation of cases.
- **In favor of:** lower cost, learning from other people's cases (sometimes more than their own), the group multiplies the gazes.
- **Contrary:** Your case is less often worked, exposure to pairs can inhibit and confidentiality requires more care because more people listen to the material.
### Peer intervision or supervision
Colleagues of similar experience who meet without a designated supervisor.
- **For:** free or almost horizontal, sustains the habit of thinking about cases with others and combats isolation.
- **Contra:** No one in the group necessarily has more experience than you, so the shared blind spot remains uncovered. It works very well as a complement; as only space, it is short for complex cases.
### Online monitoring
Any of the above formats, by video call.
- **In favor:** gives you access to supervisors from other cities or countries, especially valuable if you work a rare problem or live far from large training centers.
- **Contra:** requires more discipline to support the framing and more technical care with confidentiality (safe platform, private environment, nothing identifiable on shared screen).
## How to Choose Supervisor
There is no one-size-fits-all criterion, but questions need to be asked before deciding:
- **Theoretical orientation: compatible or deliberately different?** It is usual to supervise with someone in your frame, who shares your language and your criteria. But choosing another orientation, as a conscious decision, may be what your practice needs to exit the autopilot.
- **Experience in your population or problem.** If you work with adolescents, with problem consumption or with patients at risk, look for someone who has attended to that for years. General supervision serves; supervision with specific experience serves more.
- **Someone who makes you uncomfortable productively.** The best supervisor isn't the one that makes you feel good: it's the one who asks you questions that you didn't ask yourself. If after several months you never got out of supervision by rethinking something, you're probably paying for confirmation.
- **Not your friend.** Trust helps; friendship hinders. A friend has a bond to take care of with you, and that limits what he is willing to point out to you. Supervision needs a role asymmetry that friendship dissolves.
## What to bring to supervision and how to prepare it
The difference between performance and dilute supervision is usually in preparation, not in the supervisor.
**The case, with concrete material.** It is not enough to count the case of memory: the memory edits, softens and completes. It carries real material: session cartoons, textual interventions you made, the evolution of the last weeks. Here your session notes are the natural input; if you register with a consistent format like [SOAP, DAP or BIRP](/blog/notas-soap-dap-birp-psicologia), rebuilding the course of the case takes minutes instead of hours. It is one of the reasons why in Brauni we insist so much with the orderly registration: a tool can leave the material ready to monitor, but the clinical reading of that material remains human work, yours and your supervisor.
**A specific question.** "I bring you the case of M." is not a question. "I don't know if what I'm reading as resistance is actually a framing problem that I will create." It is. The question focuses on the encounter and forces you to think about the case before you arrive.
**What happens to you with the patient.** I include in the preparation although uncomfortable: boredom, irritation, excess effort, the desire to miss. It is usually the most fertile data of all supervision.
Before each supervision, I wrote in a line what you want to be able to decide or understand when you leave. If you cannot formulate it, that difficulty is already material to carry: sometimes not knowing what to ask is the symptom of the case.
## Confidentiality in supervision: presenting cases without exposing the patient
To present a case involves sharing sensitive information with someone outside the treatment. That it is an accepted and valuable practice does not exempt you from care:
- **Anonymize the material.** Nothing of full name, and removes or modifies the data that allow to identify the person: very specific occupations, places, recognizable links. Initial use or a pseudonym.
- **I shared the minimum information needed.** The supervisor needs to understand the clinical dynamics, not know the complete biography. Ask what data is needed to work your question and leave the rest outside.
- **Formify the reservation with a confidentiality agreement.** Professional secrecy obliges you; the supervisor's obligation should be left in writing, especially if there is material registered through. We tell you how to do so, with model included, in our guide on the [disclosure agreement in psychology](/blog/acuerdo-confidencialidad-psicologia).
- **Take care of the channel.** If the monitoring is online or exchange material, use secure means and avoid sending identifiable clinical information by common messaging.
Never share the complete medical records or material with identifying data "so that the supervisor has context." The rule is the opposite: minimum information needed, anonymized, by safe channel. The context that matters is built in conversation.
## Register the supervised: why write down the work
From each supervision it is appropriate to keep a brief record, yours, with date: what case you carried, what work was done, what decisions you made and what was pending. Two reasons:
- **Continuity.** Monitoring yields when each encounter resumes the previous one. Without registration, at three months you don't remember what hypothesis they ruled out or why you decided to hold that frame. The record turns loose encounters into a process.
- **Professional care support.** If a clinical decision (a risk assessment, referral, closure) is ever questioned, being able to show that you consulted with an experienced colleague, when and what was decided, supports that you acted diligently. It is the same logic by which you document informed consent.
The record does not need to be extensive: a few lines per meeting, saved with your clinical documentation and anonymized with the same criteria you used to present the case.
## Supervision as a professional cost
Regular supervision costs money, and there is the temptation to treat it as a trimmable luxury. It is a category error: supervision is not an extra, it is part of the cost structure of exercising well, as well as tuition, insurance or continuing training.
That has a practical consequence: your fees should look at it. If your rate barely covers the rental of clinical practice and taxes, supervision will always be the first thing to fall. How to build a rate that reflects your actual cost structure we develop it in our [psychologist fees](/blog/honorarios-psicologos-argentina) guide.
## When supervision is especially necessary
If regular supervision is always desirable, there are times when it is no longer optional in terms of good practice:
- **Risk cases.** Suicidal ideation, violence, situations that may require breaking professional secrecy. These are the most heavy decisions of the clinic and the ones that should be taken the least without a second criterion.
- **New themes or populations.** Your first patient with an eating disorder, your first partner, your first child. Theoretical training does not replace the accompaniment of someone who has already traveled that field.
- **When you notice wear.** If you attend autopilot, find yourself irritable with patients or work lost meaning, supervision is one of the best identified factors of protection against professional exhaustion. We develop it in our guide on [burnout in psychologists](/blog/burnout-psicologos-prevencion).
- **Stocked Treatments or Rare Linkages.** When "nothing" has happened for months or when the therapeutic relationship has become uncomfortable in a way you cannot name.
## Frequent errors
### Monitor only when there is a crisis
It is the most common pattern: months unsupervised and an urgent consultation when the case has already become complicated. Emergency supervision serves, but is late. Regularity is what allows you to see problems when they are still small.
### Choosing a supervisor that only confirms
If each supervision ends in "you're going very well, I kept it that way," you're not monitoring: you're paying for emotional reassurance.
### Carrying the case without question
Tell 40 minutes of medical records and expect the supervisor to "say something" to miss the space. The question is your part of the job.
### Abandon supervision when the agenda is filled
It is the classic paradox: the more patients you have, the less time you feel you have to supervise, and the more you need it. The full schedule is the moment of greatest risk of automation and wear.
## Frequently Asked Questions
### Is clinical supervision mandatory in Argentina?
There is no law requiring supervision in order to exercise psychology. It is a requirement of good practices, recommended by the ethical frameworks of the profession, and many institutions (hospitals, mental health centers, training spaces) demand it to care for patients in their field. That it is not mandatory by law does not make it expendable: it is one of the most consensual quality standards of discipline.
### How often do you want to supervise?
There is no single correct frequency: it depends on your patient volume, the complexity of the cases and your professional moment. The useful criterion is regularity: a sustained frequency, existing before the crisis, yields more than intensive and spaced consultations. If you are starting, attend risk cases or incorporate a new population, it is appropriate to shorten the interval.
### Is supervision replacing personal therapy?
No, and confusion is frequent because personal matters also appear in supervision. The difference is in the focus: supervision works on your practice with patients; therapy works on you. When something of yours repeatedly interferes with various treatments, the supervisor can point it out, but the place to develop it is your own therapy.
### Who can supervise?
There is no unique formal qualification of "supervisor." In practice, they supervise colleagues with recognized clinical trajectory, often with specific training in supervision or years of teaching within their framework. More than a degree, seek real experience in the clinic that you do and the ability to make you think.
### Is online supervision valid?
Yes, and for many professionals it is the only way to access supervisors with experience in their specific problems. Care is the same as in online therapy: secure platform, private environment at both ends and anonymized material, especially if screen sharing or documents are sent.
### Do I have to tell the patient that I'm overseeing his case?
It is a good practice for informed consent to mention that you can present clinical material in supervision, always in anonymized form and in order to improve care. Most patients not only accept it: read it as a sign of professional seriousness.
## Summary
- Clinical supervision is not a beginner stage: it is the practice that sustains clinical quality throughout the career.
- It's not therapist therapy, administrative control, or theoretical class: it's work on your practice with an experienced third party.
- It serves to detect blind spots, read countertransfer, make tough decisions with backup and prevent professional isolation.
- Choose a supervisor that makes you uncomfortable productively, with experience in your population; not your friend.
- Prepare each meeting: concrete material (your session notes are the input), a specific question and what happens to you with the patient.
- It presents anonymized cases, with the minimum necessary information, and formalizes the reservation with a confidentiality agreement.
- Register the work and decisions made: give continuity to the process and support your professional diligence.
- Supervision is part of your cost structure: your fees should look at it. It is not mandatory by law, but it is a requirement of good practices and many institutions.
---
## Choosing Safe Clinical Software: 10 Questions to Ask Your Provider
- **URL**: https://brauni.io/en/blog/como-elegir-software-clinico-seguro
- **Category**: Privacy and Security
- **Date**: 2026-02-06
- **Tags**: clinical software, security, encryption, data protection, psychologists, evaluation
Security Checklist to evaluate any clinical management software for psychologists. Encryption, data residence, supplier access, certifications and 10 key questions.
More and more psychologists migrate their clinical records to digital platforms. It is logical: a well implemented clinical software is safer than a notebook, more efficient than an Excel spreadsheet and more accessible than a folder archiver.
But not all software is the same. Some encrypt your data; others store it in plain text. Some ensure that no one else accesses information; others use it to train artificial intelligence models. The difference between a secure software and one that is not can be the difference between complying with the law and facing a demand.
In this article we give you a clear framework to evaluate any platform before entrusting you with the most sensitive data of your patients.
## Why does software security matter?
When you use clinical software, you're trusting him:
- Names, IDs and contact details of your patients
- Diagnosis and treatment plans
- Contents of therapeutic sessions
- Medication and health history
- Information on suicidal ideation, abuse, addictions
They are the most sensitive data that exist. [Law 25.326](/blog/ley-proteccion-datos-personales-psicologos) makes you responsible for the security of that data. Art. 25 specifically regulates the provision of computer services: the provider cannot use the data for a purpose other than the contracted one, nor assign them to third parties. And Art. 11.4 states that assignor and transferee respond **solidarly** — that is, if your software provider has a breach, you are also responsible.
If your software provider suffers a data breach, you are also responsible to your patients. Choosing secure software is not a luxury — is a legal obligation.
## The 10 questions to ask the provider
Before you entrust your data to any platform, ask them these questions. If they cannot answer them or become evasive, it is a warning signal.
### 1. Are the data encrypted?
**What exactly to ask?**
- Are the data encrypted at rest (at rest)?
- Are the data encrypted in transit (in transit)?
- What encryption algorithm do they use?
- Who has the encryption keys?
**What answer to expect?**
| Level | What does it mean? | Is that enough? |
|-------|--------------|-----------------|
| **No encryption** | Data is stored in plain text | No. Delete this software |
| **Encryption in transit (HTTPS)** | Data travels encrypted between your browser and the server | Minimum indispensable, but not sufficient |
| **Encryption at rest** | Data is encrypted on the server | Okay, but the supplier can decipher them. |
| **End-to-end encryption (E2E)** | Only you can decipher your data, nor can the provider read them. | Ideal. Maximum standard |
**Red flag:** If they call you "we use HTTPS" as if it were enough. HTTPS is the minimum for any website — your bank, your social network, your online store. For mental health data, you need much more.
### 2. Where are the data stored?
**What to ask?**
- What country are the servers in?
- What cloud provider do you use (AWS, Google Cloud, Azure, another)?
- Can the data be transferred to other countries?
**Why Does It Matter?**
Knowing where your data is allows you to evaluate the security guarantees and contractual obligations of the provider. It is not the same a datacenter with international certifications as a server without audits.
**The ideal:**
- Recognized cloud provider (AWS, Google Cloud, Azure) with security certifications
- Data encryption at rest and in transit
- Clear policy on where the data are and if they move
### 3. Who can access my clinical data?
**What to ask?**
- Can the support team view the contents of the medical records?
- Do developers have access to production data?
- Are there records (logs) of who accesses what?
**What answer to expect?**
| Response | Security level |
|-----------|--------------------|
| "No one accesses your data, they're encrypted and we don't have the keys." | Excellent (real E2E encryption) |
| "Only limited team with permission can be accessed in exceptional cases" | Acceptable, if documented |
| "Our support team can access to help you." | It means they can read your medical records. |
| They don't know/don't answer | Discard this software |
### 4. Are my data used to train AI models?
This question is becoming increasingly relevant. Many software incorporates AI functions (transcription, summary of sessions, suggestions).
**What to ask?**
- Are my patients' clinical data used to train or improve AI models?
- Are data shared with third parties (OpenAI, Google, etc.) for processing?
- Can I choose not to use AI functions without losing functionality?
**The only acceptable answer is NO.** Your clinical data should not be used to train AI models. Art. 4.3 of the 25.326 Law prohibits using data for purposes other than or incompatible with those that motivated its acquisition, and Art. 25 states that the computer service provider cannot apply the data for a purpose other than the contracted one.
A software that uses AI to help you is not bad. What is unacceptable is that it uses your patients’ data to train that AI. It’s two very different things.
### 5. What happens to my data if I cancel the subscription?
**What to ask?**
- Can I export all my data before I cancel?
- In what format are they exported? (PDF, CSV, other)
- How long do you keep my data after you cancel?
- Are they definitely eliminated after a period?
**Why Does It Matter?**
If a software closes, changes policies or simply stops agreeing, you need to be able to take your data. Remember that the 26.529 Act requires you to keep medical records for 10 years. If you cannot export, you have a legal problem.
**The ideal:**
- Complete export in standard format (PDF at least)
- Grace period after cancellation (30-90 days)
- Final elimination after grace period, with confirmation
**Red flag:** Software that does not allow you to export data or charges you extra for doing so.
### 6. Do they have backups? How often?
**What to ask?**
- How often are backups made?
- Are backups encrypted, too?
- Where are backups stored? (different location than main data?)
- How long does it take to restore data if there is a problem?
**The ideal:**
- Daily backups at least
- Encrypted Backups
- Storage at different geographical location
- RPO (Recovery Point Objective) maximum 24 hours
- RTO (Recovery Time Objective) for up to a few hours
### 7. Do they comply with Argentine data protection legislation?
**What to ask?**
- Do they comply with the 25.326 Law?
- Are they registered to the AAIP?
- Do you have a Data Protection Delegate?
- Do they perform privacy impact assessments?
**Context:** Many clinical software are of foreign origin (USA, Spain) and are not familiar with Argentine legislation. If the provider does not know the 25.326 Law or the 26.529 Law, that is a problem.
### 8. What security measures do you have in place?
**What to ask?**
- Do you offer two-step verification (2FA)?
- Do sessions automatically expire due to inactivity?
- Is there log-in log-in?
- Do they perform periodic security audits?
- Do they do penetration tests?
**Minimum Checklist:**
| Measure | Is it essential? |
|--------|---------------------|
| HTTPS across the platform | Yes |
| Two-step verification | Yes |
| Session Expiration by Inactivity | Yes |
| Access Recording | Yes |
| Security audits | Highly recommended |
| Periodic Pentesting | Highly recommended |
| Certifications (SOC 2, ISO 27001) | Ideal |
### 9. What happens in case of a security breach?
**What to ask?**
- Do you have an incident response plan?
- How long do they notify me if there's a breach?
- What information do you give me about the extent of the incident?
- Have you had security breaches before?
**The ideal:**
- Notification in less than 72 hours
- Detailed information on which data were affected
- Action plan to mitigate harm
- Total transparency (if you hide incidents, it's a huge red flag)
### 10. Do you have clear terms of service and privacy policy?
**What to verify?**
- Are the terms in Spanish and are they understandable?
- Does the privacy policy detail what data they collect and for what?
- Are there abusive clauses? (e.g. "we reserve the right to use your data for any purpose")
- Can you change the terms without notice?
**Red flags in terms of service:**
- "You grant us an irrevocable license over your data"
- "We can share data with third parties to improve our services"
- "We reserve the right to modify these terms at any time"
- Total absence of mention of the Law 25.326
## Comparative table: types of software
| Criterion | Excel / Google Sheets | Generic software (Notion, Trello) | Specialized clinical software |
|----------|------|------|------|
| **E2E encryption** | No | No | Depends on the supplier |
| **Designed for health data** | No | No | Yes |
| **Compliance with Law 25.326** | Your responsibility | Unlikely | I should. |
| **Auto-Backup** | No (except Google) | Partial | Generally, yes. |
| **Grenular access control** | No | Limited | Yes |
| **Data export** | Yes | Partial | I should. |
| **Incident support** | No | Generic | Specialized |
Using Google Sheets, Notion or Trello to store medical records is not illegal, but makes you 100% responsible for the security of that data. These platforms were not designed for mental health data and do not automatically comply with the legislation.
## Warning signs
Distrust a clinical software if:
- **No privacy policy** or generic/copied
- **Can't explain how it encrypts the data** or uses vague terms ("we use the latest technology")
- **The support team can read your clinical notes** "to help you better"
- **Does not allow export of data** or charges for doing so
- **Does not offer 2FA** (two-step verification)
- **Service terms give you rights to your data**
- **They are not aware of Law 25.326** or the Law 26.529
- **Use your data to train AI** or share it with third parties
- **Never had a security audit**
- **They are evasive** when you ask about safety
## Positive signs
Trust more in clinical software if:
- Has **end to end encryption** documented
- Publishes its **security policy** and is specific
- It has recognized **certifications** (SOC 2, ISO 27001, HIPAA)
- Offers **2FA** and actively recommends it
- Allows **full export** of data in standard format
- It has **policy not to train AI with your data** explicit
- Makes **security audits** and communicates them
- Meets and complies with the **Argentine legislation**
- It is **transparent** about past incidents (if any)
- Has **clear documentation** about where the data are and who accesses
## How Brauni answers these 10 questions
| Question | Brauni Response |
|----------|-------------------|
| **1. Encryption?** | End-to-end encryption. Neither Brauni computer can read your data |
| **2. Where are the data?** | Cloud infrastructure with certified providers |
| **3. Who agrees?** | Only you. The Brauni team has no access to clinical content |
| **4. Do you train AI with my data?** | No. Never. Your clinical information is not used to train models. |
| **5. Can I export?** | Yes. Complete export in PDF at any time |
| **6. Backpacks?** | Automatic and daily, encrypted and in separate location |
| **7. Argentine legislation?** | Designed to comply with the 25.326 and 26.529 Law |
| **8. Security measures?** | 2FA, end of session, access register, periodic audits |
| **9. Plan for gaps?** | Incident response plan with immediate notification |
| **10. Clear terms?** | Privacy policy in Spanish, without unfair terms |
## Summary
| Criterion | Acceptable minimum | Ideal |
|----------|-----------------|-------|
| **Encryption** | In transit (HTTPS) + at rest | End to end |
| **Supplier access** | Limited and documented | Zero access to clinical content |
| **Use of data for AI** | Opt-out available | They're never used. |
| **Export** | Basic PDF | Full export in standard format |
| **Backups** | Journals | Diaries, encrypted, in separate location |
| **2FA** | Available | Available and recommended |
| **Legislation** | Generic Mention | Specific compliance with Law 25.326 and 26.529 |
| **Transparency** | Privacy policy | Public security documentation + audits |
---
## Children and adolescents in therapy: consent and confidentiality
- **URL**: https://brauni.io/en/blog/psicologia-ninos-adolescentes-consentimiento
- **Category**: Professional practice
- **Date**: 2026-02-03
- **Tags**: minors, informed consent, progressive autonomia, confidentiality, children and adolescents, psychologists
Informed consent in the care of children and adolescents: who signs according to age, progressive autonomy and what to tell parents.
The psychological care of children and adolescents multiplies legal questions. Who signs consent when the patient is 9 years old? And when he is 15? What can you tell parents about what happens in session? What do you do if they are separated and one does not agree with your child doing therapy?
These are questions that appear before you can even start working. And the intuitive answer ("parents sign and ready") became old: the Civil and Commercial Code changed the paradigm and today adolescents have a degree of autonomy that many professionals have not yet incorporated into their frame.
In this article we explain to you who signs informed consent according to age, how to agree confidentiality with parents and what to do when parents are separated or in dispute, with a model of consent ready to adapt.
## From "less incapable" to progressive autonomy: the paradigm shift
For decades, the minor was treated legally as an incapable person by whom others decided. That scheme changed. The current framework is based on four rules:
- **Civil and Commercial Code, art. 26**: Consecrates Progressive Autonomy. Between 13 and 16 years, the adolescent can decide for himself about non-invasive treatments that do not compromise his health. From 16, he is considered as an adult for decisions about the care of his own body.
- **Law 26.061** (Integrated Protection): establishes the best interests of the child as the guiding criterion and his or her right to be heard in all matters affecting him or her.
- **Law 26.529** (Patient's Rights): regulates informed consent, medical records and confidentiality.
- **Law 26.657** (Mind Health): Requires informed consent for all types of mental health intervention.
What does this mean in clinical practice? That the child or adolescent is not an object of treatment that adults hire: he or she is a subject of rights. He or she has the right to explain to him or her, to be heard and, as he or she grows, to decide.
Progressive autonomy is the criterion that orders everything else: at the patient's older age and maturity, greater weight has its own will vis-à-vis that of those responsible.
## Who signs informed consent according to age
Article 26 of the Civil and Commercial Code orders the practice in three stripes. Faced with a doubtful case, consult with your professional college.
### Under 13 years
The consent is signed by the parents or legal guardians: they authorize the beginning of the treatment, receive information about framing, fees and limits of confidentiality, and sign the document.
This does not mean that the child is left out: his right to be heard (Law 26.061) translates into assent, which we see below.
### Between 13 and 16 years
Here is the most important change. Teenagers in this strip can consent to non-invasive treatments that do not compromise their health, and psychotherapy in general falls into that category.
That is to say: a 14 teen can, in principle, consent for himself to the initiation of psychotherapy. To do so does not mean that it is appropriate to leave adults outside: unless there are clinical or protective reasons, adding to those responsible usually strengthens the treatment.
With teenagers from 13 to 16, a good formula: the teenager consents for himself and those responsible also sign their agreement with the framing. You respect autonomy without giving up work with the family.
### Since the 16 years
From the 16, the adolescent is considered as an adult for decisions about the care of his own body. For the consent of a psychotherapy, treat him as an adult patient: he signs and he decides.
### Assent: Always explain to him, be as old as he is
Regardless of who signs, the child or adolescent has the right to understand what is going to happen. Assent is that explanation adapted to their language: what they will do in the sessions, which can say if they do not want to talk about something, that what counts is private unless they are in danger.
With a child of 7 years it can be a talk with drawings; with one of 11, a short text that reads and signs. It has no legal force on its own, but it is an ethical requirement and a clinical tool. In our [informed consent in psychology](/blog/consentimiento-informado-psicologia) guide you have an assent template ready to adapt.
## Confidentiality with parents: the three-part framing
What are you going to tell the parents? If you tell them everything, the teenager doesn’t talk anymore. If you don’t tell them anything, the parents distrust and the treatment falls.
The rule that works best: **process yes, content no**. Those responsible will be informed about the process (assistance, general evolution, guidelines to accompany at home), but not the content of the sessions (what he said, who he talked about, what he's worried about).
The important thing is not only the rule, but when and how you agree:
1. **In the first interview, with everyone present.** Parents and patient hear the same at the same time: "What we talk about in session is private; to you I will tell you how the process comes, not the detail."
2. **With the explicit exception.** Everyone has to know from the outset that in the face of a risk situation confidentiality gives way to protect the patient, and that includes talking to adults.
3. **In writing.** The pact goes in the consent signed by those responsible and in the agreement you present to the teenager. Below we leave the model text.
This three-part frame avoids the worst scenario: the teenager who learns that you talked to his parents about something he believed was private. That trust does not recover.
## Separate parents: the situation that generates the most consultations
When parents are separated, the good practice is to have the consent of both parents to initiate treatment: even if one brings the child to clinical practice, the other generally retains parental responsibility, and a treatment initiated behind his or her back is a foreseeable source of conflict.
What to do in practice?
- **Always ask for the other parent** in the first contact: if you are aware, if you agree, what the personal care scheme is like.
- **Find the signature of both**, even at different times. An e-mailed agreement, documented on the tab, is better than nothing.
- **If a parent does not agree**, it is not up to you to resolve the conflict: the discrepancy must be resolved by adults by the appropriate means. Consult your professional college before initiating or continuing treatment and document each communication.
- **If there is litigation for personal care**, extreme caution: neat record of everything (who brought the patient, what was spoken to each adult, what was agreed), equivalent communication with both and zero improvisation.
Don't become an expert. If a parent (or their lawyer) asks you for a report about the other parent, the answer is no: you can't give clinical opinion about a person you didn't evaluate. Your function is healthcare, not expertise, and mixing them is one of the most frequent sources of ethical sanctions.
## When to breach confidentiality
With minors, exceptions to confidentiality are not just a faculty: in certain cases they are an obligation. The two central scenarios:
- **True and imminent risk** for the adolescent or for third parties: suicidal ideation with plan, serious risk behaviors, concrete threats. The priority is to protect, and that involves involving those responsible and, if necessary, emergency devices.
- **Abuse, abuse or violation of rights**: in the light of knowledge or a well-founded suspicion that the child or adolescent is being harmed, you have an obligation to act to protect him or her. The usual channels are the bodies for the protection of rights in your jurisdiction and, as the case may be, the corresponding complaint. Your professional school can guide you on the local circuit.
Two care that makes a difference:
1. **Warn the patient first, whenever possible.** "This thing you told me forces me to do something to take care of you" preserves the link much better than knowing later.
2. **Record the decision.** What information you received, with whom you consulted, what you did and why. If your decision is reviewed later, that record is your best support. In our guide on [professional secret in psychology](/blog/secreto-profesional-psicologia) we develop the exceptions in detail.
## The medical records of a minor
The medical records of the minor patient follows the general rules of the 26.529 Law, with particularities:
- **Who can ask**: while the patient is a minor, his/her legal representatives can request it. That does not erase the confidentiality pact: what you include in the formal registration deserves a conscious decision. Upon reaching the age of majority, the right of access is the patient.
- **Conservation**: The general term is 10 years since the last performance, but with minors the recommendation of prudence is to keep it well beyond the age of majority, because the periods of claim can be extended. Details are in our [medical records in psychology](/blog/historia-clinica-psicologia) guide.
- **Registration of care**: in contexts of family conflict, a minor's medical records is more likely to be required by the courts. I wrote each entry knowing that a third party could read it.
A clinical management software such as Brauni allows you to settle down who signed the consent, when and in what terms, linked to the patient's file. In cases with conflicting parents, that traceability is worth gold.
## The school and other third parties asking for information
The school asks for a report, health insurance requests records, the pediatrician wants to know how the treatment comes. The rule does not change because it is institutions:
- **Only with written permission from those responsible** (and the adolescent's agreement, depending on age). A school phone call is not an authorization.
- **Informs what is necessary and nothing else.** A school report can give guidance to the classroom without revealing session content or diagnoses that the school does not need.
- **Leave a copy of everything**: what was requested, who authorized it, what was delivered. A minor's health data are sensitive data; in our guide on [personal data protection law for psychologists](/blog/ley-proteccion-datos-personales-psicologos) we explain what that implies.
## Frequent errors
Those we see most in the consultation with colleagues:
- **To have one parent sign** "because the other never appears," without even registering that an attempt was made to contact him.
- **Promise absolute confidentiality to the adolescent.** You cannot fulfill it, and when you have to break it the damage will be double.
- **Tell session content to parents to reassure them.** Reach once for the patient to stop talking.
- **Emitting reports on one parent you never evaluated**, at the request of the other parent.
- **Trying assent as a procedure**: a signed paper that the child did not understand is not assent.
- **Do not update the frame when the patient grows.** The agreement of the 12 years is not the one corresponding to the 16.
## Template: consent for responsible persons and agreement with the adolescent
A basic model to adapt to your jurisdiction and validate with your professional college.
---
### Informed consent for psychological treatment of underage patients
**Professional:** Lic. [Name and Surname] - M. P. [professional license number]
**Patient:** [Name and Surname] - DNI [Number] - Date of birth: [date]
**Responsible:** [Name and Surname] - DNI [Number] (link: [mother/father/guardian]) and [Name and Surname] - DNI [Number] (link: [mother/father/guardian])
---
**1. Proposed treatment**
A psychotherapeutic treatment of orientation [focus] is proposed, with a frequency of [quantity] session/s weekly/s of [duration] minutes, in modality [presential/online/mixta]. General objectives: [describe briefly].
**2: Participation of the child or adolescent**
He/she was informed in a language appropriate to his/her age and agreed to participate. His/her opinion will be heard throughout the process.
**3. Confidentiality**
What is discussed in the session by the patient is confidential. The professional will inform those responsible about the general progress of the process, but not about the content of the sessions. This reservation is granted only in the event of situations of risk to the patient or to third parties, or of violation of his/her rights, in which case the professional will act to protect him/her and inform the appropriate person.
**4. Communication with both parents**
Both officers declare their agreement with the start of treatment and accept that the professional's communication will be equivalent to both. The professional will not issue reports or opinions on persons who have not evaluated.
**5. medical records and personal data**
The clinical records are kept with security measures that guarantee their confidentiality. Those responsible can request access to the medical records according to the regulations in force; upon reaching the age of majority, this right corresponds to the patient.
**6. Fees and cancellations**
The value of each session is $[mount]. Cancellations must be made at least [quantity] hours in advance.
| | Responsible 1 | Responsible 2 | Professional |
|---|---|---|---|
| **Signature** | _______________ | _______________ | _______________ |
| **clarification** | _______________ | _______________ | _______________ |
| **DNI / M. P.** | _______________ | _______________ | _______________ |
| **Date** | ____/____/______ | ____/____/______ | ____/____/______ |
---
**Disclosure agreement paragraph to present the adolescent:**
> This space is yours. What we talk about in session is private: I'm not going to tell your [paps/responsibles] what you tell me. I'm going to tell them how the process in general comes, but not the content. The only exception is if you or someone else is in danger: in that case I'm going to have to do something to take care of you, and whenever I can I'm going to tell you before. If any of this doesn't close you, we talk about it.
---
## Frequently Asked Questions
### Can a 15 teen start therapy without her parents knowing?
In principle yes: between 13 and 16 years you can consent for yourself non-invasive treatments that do not compromise your health, and psychotherapy in general qualifies. That said, if there are no protection reasons to exclude adults, adding them is usually better. If the booking request is linked to a serious risk or family conflict, consult your school.
### What do I do if a father asks me for his son's medical records?
While the patient is a minor, his/her legal representatives can request it. Check the identity and link of the person requesting it, hand over the formal registration and record the request and delivery. If there is a dispute between the parents, consult your school first: the request may be part of the conflict.
### Do I need the signature of the two parents to care for a child?
As a good practice, yes: seek the conformity of both, even if they sign at different times. If one is inubitable or refuses, document attempts to contact and advise with your school before moving forward.
### Can I tell the parents what your son says in session?
No, except risk. The guideline is process yes, content no: information about the course of treatment, not what the patient counts. That limit has to be agreed with everyone in the first interview.
## Summary
- The Civil and Commercial Code (art. 26) recognizes progressive autonomy; the minor is subject to rights, with the right to be heard (Law 26.061).
- Minors of 13: sign those responsible, always with the consent of the child explained in their language.
- From 13 to 16: Teens can themselves consent to non-invasive treatments such as psychotherapy; adding those responsible is good practice.
- From the 16: He is considered as an adult for decisions about the care of his own body.
- Confidentiality with parents: process yes, content no. Pactalo in the first interview, with all present and in writing.
- Separate parents: seek the conformity of both, register everything and do not issue reports on who you did not evaluate.
- Confidentiality gives way to certain and imminent risk or violation of rights: obligation to protect and register the decision.
- medical records of minors: legal representatives may request it; keep it beyond the age of majority.
- In any legal grey area, the reference is your professional school.
---
## Paper session notes or Google Drive: why don't you follow the law and what alternative you have
- **URL**: https://brauni.io/en/blog/notas-sesion-papel-google-drive-vs-software-clinico
- **Category**: Privacy and Security
- **Date**: 2026-01-30
- **Tags**: session notes, clinical history, security, google drive, paper, psychologists
Keeping session notes on paper, notebooks or Google Drive carries the same legal responsibility as using clinical software, but with much less protection. What the law says and why safe software is best option.
"I write everything down in a notebook." "I have an Google Drive with each patient's folders." "I use an Excel spreadsheet."
If any of these phrases ring a bell, this article is for you. Because many psychologists believe that writing on paper or a basic digital file is "simple" or "safer" than using clinical software. Reality is exactly the opposite: **paper and generic tools expose you to more legal risks, not less**.
The law does not distinguish between a notebook, an Google Drive or specialized software. The obligation to protect your patients’ data is the same. What changes is your real ability to fulfill it.
## The law is clear: the responsibility is yours, whatever you use
### Law 26.529 — medical records
Art. 12 defines the medical records as the "compulsory chronological, foliated and complete document" that must record all actions performed on the patient. This definition applies **irrespective of the support**: paper, digital, notebook, Google Drive or specialized software.
Art. 18 states that the medical records is **inviolable** and that you, as a professional, are his **depositary**. You must "instrute the means and resources necessary to prevent access to the information contained therein by unauthorized persons."
The minimum retention period is **10 years** since the last registered action (Art. 18).
### Law 25.326 — Protection of Personal Data
Art. 9 obliges you to take the **technical and organizational measures necessary** to ensure the security and confidentiality of the data, avoiding their adulteration, loss, consultation or unauthorized processing.
Art. 9.2 **prohibits** recording personal data in files that do not meet technical conditions of integrity and security.
These obligations apply whether you use a notebook or using state-of-the-art software. The difference is that with a notebook, fulfilling them is almost impossible.
## The paper problem
### It does not comply with "chronological, foliated and complete" (Art. 12)
In theory, a notebook can be chronological and foliated (if you put numbers on the pages). But in practice:
- What if you need to add information to a past session? You can't insert pages
- What if you're wrong?
- What if you fill out the notebook? You have to start another one and now the medical records is split into two notebooks
### It does not comply with inviolability (Art. 18)
The law requires you to avoid unauthorized access. A notebook on a desk, a drawer with no key or a bag:
- It can be read by anyone who has physical access (cleaning staff, family members, another patient in the waiting room)
- It can be stolen without you noticing until much later.
- It has no record of who read it and when
- No password, encryption or access control
### It does not comply with the conservation of 10 years (Art. 18)
Keeping a paper notebook for 10 years implies:
- Don't get wet, don't get damaged by moisture, don't burn
- Don't throw it away by mistake thinking I was old.
- Don't let the ink deteriorate over time
- Don't move and get lost in a box
- That you can find the information of a specific patient among hundreds of pages
**How many notebooks 10 years ago do you keep in perfect condition?** Probably none.
### Not complying with delivery in 48 hours (Art. 14)
If a patient asks you for a copy of their medical records, you have 48 hours to deliver it, "authenticated by competent authority." With a notebook, that means:
- Photocopy the relevant pages (which may be distributed in several notebooks)
- Authenticate each photocopy
- Make sure the copy is complete
With software, it's a click and a PDF.
### No backup
If it is lost, destroyed or stolen, **there is no way to retrieve the information**. and you are violating the legal obligation to keep the medical records for 10 years.
A fire, a flood, a robbery. Any of these events irrecoverably destroy years of clinical records on paper. And the law does not accept "lost" as an excuse not to comply with the obligation of preservation.
## The Google Drive problem (and similar)
"But I'm digital, I use Google Drive / Dropbox / OneDrive." Better than paper, but it has serious problems.
### Not designed for health data
Google Drive is a generic storage tool. It does not have:
- medical records structure (chronological, foliated)
- Patient access control
- Audit log (who opened which file and when)
- Specific encryption for sensitive health data
- Compliance with [Law 25.326](/blog/ley-proteccion-datos-personales-psicologos)
### Google can access your files
According to Google's terms of service, the company can access the content stored in its services to operate and improve its products, comply with legal obligations and enforce its terms. This is incompatible with the duty of confidentiality of Art. 10 of the 25.326 Law.
### Security depends 100% on you
| Risk | Did it ever happen to you? |
|--------|---------------------|
| By mistake share a folder with "anyone who has the link" | Probably. |
| Do not have two-step verification | Very common |
| Leave the session open on a shared computer | Come in. |
| Someone guesses your password. | If it's "123456," yes. |
| A family member or colleague with access to your Google account | Common |
### No medical records structure
A Google Docs file with session notes is not a medical records in the terms of Art. 12 of the 26.529 Law. For it to be, you would need:
- That is chronological and leafy (consisting page numbers)
- Make it unalterable (someone can edit a Google Doc without leaving any visible trace)
- That informed consents are integrated (Art. 16)
- Recording of all proceedings
Google Docs does not guarantee the **inalterability** required by Art. 13 of the 26.529 Law for computerized medical records, as anyone with access can modify the document without permanent trace.
### The "version history" is not an audit record
Google Docs has version history, but:
- Only shows changes, not accesses (you don't know who read the file)
- It is not an immutable record — the owner can delete the entire document
- It's not designed as legal evidence
- It does not comply with "non-rescribeable storage means" required by Art. 13
## Direct comparison
| Legal requirement | Paper | Google Drive | Safe clinical software |
|----------------|-------|-------------|----------------------|
| **Chronological and foliated** (Art. 12, Law 26.529) | Hard to keep | It has no structure | Automatic |
| **Inviolable** (Art. 18) | No access control | Depends on your configuration | Encryption + access control |
| **Conservation 10 years** (Art. 18) | Very vulnerable (fire, water, theft) | Depends on your Google account | Automatic encrypted backups |
| **Delivery within 48 hours** (Art. 14) | Manual photocopies | Export Loose Files | Export PDF in one click |
| **Unchangeability** (Art. 13) | Visible but not controlled crossovers | Anyone can edit | Unchangeable records |
| **Perdurability** (Art. 13) | Ink is erased, paper deteriorates | Depends on Google | Professional infrastructure |
| **Recoverability** (Art. 13) | Impossible if lost | Google Trash (30 days) | Backups with prolonged retention |
| **Integrity and safety** (Art. 9, Law 25.326) | Nula | Basic | Designed for health data |
| **Duty of confidentiality** (Art. 10, Law 25.326) | Anyone can read the notebook | Google can access | E2E encryption: neither the provider reads |
| **Access Log** | No such thing | Partial | Complete |
| **Integrated consent** (Art. 16) | Attached loose paper | Separate file | Linked to the file |
## "But it was always done that way."
That something has always been done in a way does not mean that it is legal or safe. The 26.529 Law is 2009 and the 25.326 Law is of the year 2000. Both establish clear obligations on the safety, integrity and inviolability of clinical records.
The fact that many professionals continue to use generic paper or tools does not mean that they are complying with the law. It means that **they have not yet been audited**.
### The day a patient asks for your medical records
Can you give him a complete, chronological and authenticated copy in 48 hours? If the answer is "I would have to look in several notebooks" or "I'm not sure it's all," you have a legal problem.
### The day a patient claims you
If a patient initiates a malpractice complaint or an ethical complaint, your medical records is your main defense. What if:
- The notebook was lost or deteriorated
- Google Drive files were edited after the fact
- You can't prove that you registered everything at the time.
An incomplete or unproven medical records is **worse than having no medical records**, because it suggests that there was modification or destruction.
## "But software can also fail"
True. No system is perfect. But safe clinical software has layers of protection that paper and generic tools simply do not offer:
| Protection | Paper | Google Drive | Clinical software |
|-----------|-------|-------------|-----------------|
| Data encryption | No | In transit (HTTPS) | In transit + at rest + E2E |
| Automatic backup | No | Partial (if Google does not close your account) | Yes, daily, in separate location |
| Access Control | No | Basic (Google password) | Granular, per patient |
| Access audit | No | No | Yeah, full. |
| Immutability of records | No | No | Yes |
| Disaster recovery | Impossible | Partial | Designed for that. |
## What should a psychologist who still uses paper do?
### Step 1: Don't destroy what you have
Your paper records are legally valid, don't throw them away or destroy them.
### Step 2: Migrate progressively
You don’t need to digitize 10 years of notebooks overnight. Start with:
1. Active patients first
2. Key data: reason for consultation, diagnosis, treatment plan
3. Session notes from now on
### Step 3: Use software designed for psychology
Not any software works. You need one that meets the requirements of Art. 13 (Law 26.529) and Art. 9 (Law 25.326). Check out our guide on [how to choose safe clinical software](/blog/como-elegir-software-clinico-seguro).
### Step 4: Keep old notebooks
Keep them in a safe place (keyed, protected from moisture and fire) during the legal period of 10 years since the last entry.
## What should a psychologist using Google Drive do?
### Step 1: Evaluate your current settings
- Do you have two-step verification enabled?
- Are there shared folders with "anyone who has the link"?
- Does anyone else have access to your Google account?
- Do you have backup outside of Google?
### Step 2: Understand the limitations
Google Drive may serve as **temporary storage** or as **additional backup**, but not as a main system of medical records. It does not meet the requirements of inalterability, audit or structure of the 26.529 Act.
### Step 3: Migrate to clinical software
Export your relevant files and start using a system designed for clinical practice.
## How Brauni meets where paper and Google Drive cannot
| Requirement | How Brauni Meets It |
|-----------|----------------------|
| **Chronological and leafy** (Art. 12) | Each note is recorded with date and automatic number. |
| **Inviolable** (Art. 18) | End-to-end encryption. Neither Brauni computer can read your data |
| **Conservation** (Art. 18) | Daily automatic backups, encrypted, in separate location |
| **Delivery within 48 hours** (Art. 14) | Export PDF complete in one click |
| **Unchangeability** (Art. 13) | Unchangeable record of each seat. Changes are displayed |
| **Perdurability** (Art. 13) | Cloud infrastructure with redundancy |
| **Recoverability** (Art. 13) | Quick restoration from backups |
| **Security** (Art. 9, Law 25.326) | Encryption, 2FA, access control, complete audit |
| **Confidentiality** (Art. 10, Law 25.326) | Encrypted data that cannot be read by the provider |
| **Data not training AI** | Your clinical information is never used to train models |
| **Integrated consent** (Art. 16) | Linked to patient file |
The detail of how Brauni meets each requirement is in [digital medical records](/funcionalidades/historia-clinica-digital).
## Summary
| | Paper | Google Drive | Safe clinical software |
|---|---|---|---|
| **Legal liability** | Same | Same | Same |
| **Actual capacity to meet** | Very low | Medium-low | High |
| **Risk of loss** | Very high | Medium | Low |
| **Unauthorized access risk** | Stop | Medium | Low |
| **Cost of non-compliance** | Administrative, civil and criminal sanctions | Idem | Idem, but the real risk is much lower |
| **Conclusion** | Not meeting most legal requirements | Partially but with significant gaps | Designed to meet |
---
## High therapeutic: when to give it, how to document it and closing model
- **URL**: https://brauni.io/en/blog/alta-terapeutica-psicologia
- **Category**: Professional practice
- **Date**: 2026-01-26
- **Tags**: high therapeutics, treatment closure, Clinical documentation, clinical history, psychologists, template
Guidance on therapeutic discharge: when to give it, how to work the closure with the patient, what to record in the medical records and model closing note.
In the undergraduate training, a lot of time is spent on how to start a treatment: the first interview, the diagnostic hypothesis, the framing. But almost no one teaches how to finish it well. The high therapeutic is usually left to the intuition of each professional, and that is noted: treatments that stretch by inertia, abrupt closures, cases that are extinguished without any record.
The closure of a psychological treatment is not an administrative procedure. It is a clinical intervention in itself. Well worked, it consolidates what was achieved and gives the patient an experience of end care. Mismanaged, it can disarm part of the process or leave a feeling of abandonment.
In this article we review the types of closure, the signs that a treatment is ready for discharge, how to work the end in sessions, what to do before abandonment and how to record everything, with a closing note template ready to adapt.
## The various endings of psychological treatment
Not all closures are the same, and it is important to distinguish them: each involves a different clinical work and record.
### High agreed by achieved objectives
The ideal scenario: the patient and you evaluate together that the objectives were achieved and agreed to the closure. It is the high therapeutic in the strict sense, and is usually worked through several sessions.
### Derivation clearance
The treatment with you ends, but the attention continues with another professional: a specialist in a specific problem, a group device, a psychiatrist who takes the case. Here the closure includes preparing the transition. On this we write in detail in our [Responsible Derivation](/blog/derivacion-responsable-psicologia) guide.
### Interruption by decision of the patient
The patient communicates that he or she does not want or cannot continue. Sometimes he or she says so in session and you can work a short closure. Other times he or she simply stops coming, which is known as abandonment. Below we see how to handle that scenario.
### Interruption by decision of the professional
You decide not to continue: because of the limits of your competence, because of a conflict of interests that arose, because you shut down clinical practice or reduce your practice. In these cases you have the ethical responsibility to offer concrete alternatives and not leave the patient without attention overnight.
### External closures
Moves, economic changes, loss of health insurance coverage, working hours that make it impossible to hold sessions. They are not a high clinic or abandonment: they are interruptions by context, and they should be recorded as what they are.
Distinguishing the type of closure in the registry is not a bureaucratic detail. If the patient returns, another professional asks for a background or a claim arises, the difference between "high for fulfilled objectives" and "abandoning without response to contact attempts" changes the reading of the case completely.
## When is a treatment for high therapeutics ready?
The discharge in psychology is not defined by a number of sessions or a period of time: it is defined by clinical criteria. That being said, there are signs that should be looked at together.
### The objectives of the treatment plan were met
If you first defined clear goals, discharge becomes much easier to evaluate: there is something to compare against. That’s why we insist so much on working with an explicit [treatment plan](/blog/plan-de-tratamiento-psicologico). When the reason for consultation was resolved or became manageable, it’s time to talk about closure.
### Patient gained autonomy
Beyond the specific objectives, look at the process: does the patient solve only what he previously needed to work in session? Do he face new situations with his own resources? Do he come to sessions more to "tell how it went" than to work something? They are indications that the function of treatment is running out, in the good sense.
### Clinical criteria confirm this.
The two above points are guidance, not automatic. There are patients who meet goals and need to follow something else that emerged along the way. There are processes where spacing sessions is more appropriate than closing. The final decision is clinical and is yours, along with the patient: no tool, no protocol and no AI can take it for you.
A useful question to ask you every now and then: if this patient came to your clinical practice today with his current condition, would you tell him to start a treatment? If the answer is no, it's time to talk about discharge.
## How to work the closure of treatment in sessions
Closing is not the last session: it is a stage. These are the best practices.
### Anticipate it in time
I put the subject on the table several weeks earlier: "I see that you are very well with what you came to work with. I would like us to think together how to close this process." That gives the patient time to elaborate what the end generates.
### Spacing frequency
Moving from weekly to fortnightly sessions, and from fortnightly to monthly sessions, works as a gradual transition: the patient verifies in the facts that he can sustain longer periods without session.
### Review the route
It devotes part of the last sessions to rebuilding the process: how it came, what was worked, what changed, what tools it takes. This review consolidates the learnings. Having good session notes makes this task much richer than rebuilding by memory.
### Name what is open
No treatment solves everything, and it's okay to say it. Name the pending, and the signs to pay attention to if it reappears, is more honest and more useful than a triumphalist closure.
### Leave the door open
The therapeutic discharge is not a definitive farewell. I explicitly say: if in the future you need to return, you can do so. Knowing that the door is open reduces the anxiety of the closure and makes it less likely that the patient will return as a matter of urgency.
## When the patient stops coming without warning
Abandonment is the most frequent end and the worst documented. The patient fails, does not respond, and the case is left in limbo: neither closed nor active.
### How many attempts at contact are reasonable?
There is no rule that sets an exact number, but a reasonable professional pattern is this: two or three attempts, through the usual channels of the link (message, call, email), spaced over time and with a tone that invites without pressing. Something like: "Hello, I noticed that you couldn't come to the last sessions. I wanted to know how you are. If you want to resume or prefer to close the process, let me know so we talked about it."
### Record every attempt
Every message sent, every call without reply, with date, goes to the medical records. It is what allows you to show that you did not abandon the patient: you made a reasonable follow-up and the decision not to continue was from the other side.
### When to consider the case closed?
If after these attempts there is no response within a reasonable period of time, the closure will be recorded by abandonment: date of the last session, attempts to contact, absence of response and clinical status known to the last contact. The case is formally closed, not hung.
### WHAT NOT TO DO
- To insist beyond reasonable: repeated messages, calls to relatives, appear through other channels. The insistence that invades violates the patient's autonomy.
- Reprove your absence if you respond: the tone of claim closes doors.
- Decommission the record without recording anything, as if the treatment had never existed.
One special case: if the patient who stopped coming had risk indicators (suicide ideation, violence, decompensation), the follow-up must be more active and documented with special care. Faced with the doubt, he or she supervises with a colleague and will also register that consultation.
## The closing note in the medical records
Close the treatment in practice and close it in the registry are two different things, and both are necessary. The closing note gives formal record of the end of the treatment.
### What to register
- Reason for closure: discharge due to objectives met, referral, patient decision, abandonment, external cause.
- Status of the patient at close: how is it regarding the original reason for consultation. There is no need for an extensive report, yes an honest synthesis.
- Recommendations: care guidelines, warning signs, suggestion to resume if a given situation appears.
- Derivation, if any: to whom, why, and if derivation note was given.
- Date of last meeting and date of closing note.
### Why It Protects You
The medical records is your main professional support, and a story without a closing note is an incomplete story. Faced with a claim, a health insurance audit or a court order, the closing note shows that the treatment ended in an orderly manner, that the patient was not abandoned and that the decisions were clinically based. His absence leaves the door open to interpretations: did you stop taking care of him without further delay? Is the case still your responsibility?
The Code of Ethics of FePRA is clear regarding not prolonging treatments that no longer benefit the patient and not interrupting the care in a way that harms him. The closing note is the record that the end was handled within those limits.
In Brauni, the closing note is generated from a template with patient data and the history of sessions already loaded, so documenting discharge takes minutes. The clinical content, as always, you define it.
## What about the medical records after discharge
The 26.529 Patient Rights Act states that the medical records must be kept for a minimum period of 10 years since the last recorded performance. The history of a patient who discharged today must remain available and complete for at least a decade.
This has practical implications: on paper, you need a secure physical file for all those years; in digital, a system that guarantees preservation and integrity. In our [medical records in psychology](/blog/historia-clinica-psicologia) guide we develop the obligations of registration, conservation and access in detail.
## Returning patients: reopening or new history?
It's more common than it seems: the patient you discharged two years ago makes an appointment again. Do you take back the previous medical records or do you open a new one?
Our recommendation is to prioritize the continuity of the registry: it is the same person, and its previous history is valuable clinical information. It is reasonable to reopen the registry with a re-entry note that marks the restart: date, new reason for consultation, relationship (or not) with the previous process, and new objectives. Thus, it is clear where one treatment ended and where the other began.
The two extremes should be avoided: to keep scoring as if nothing had ever been closed (the process structure is lost) or to start from scratch as if the patient were unknown (history is lost). The well documented closure of the previous treatment is what makes this orderly continuity possible.
## Common errors in closing a treatment
### Do not record closure
The most common of all. Treatment ends in the facts but the medical records remains open indefinitely. Without a closing note there is no record of the reason, the patient’s condition or your attempts to contact if there was abandonment.
### Discharge from one day to another
Even if the patient is well, an abrupt closure misses consolidation work and can be lived as a rejection. Discharge is anticipated and work is done.
### Holding inertial treatments
The opposite error: processes that follow for years without goals or direction, because no one puts the issue on the table. Check periodically what each patient is coming for. If you cannot answer it, that is the pending conversation.
### Taking abandonment as a personal failure
If a patient stops coming, it hurts, but does not always talk about your work: there are economic, vital and personal reasons that you will not control. What is in your hands is to make a reasonable follow-up, record it and, if the pattern repeats a lot, take it to supervision.
## Closing note template / therapeutic high
Copy it and adapt it to your practice.
---
### Treatment closure note
**Date of note:** ________________
---
**Professional:** Lic. [Name and Surname] - M. P. [Number]
**Patient:** [Name and Surname] - DNI [Number]
**Start of treatment:** [Date]
**Last session:** [Date]
**Frequency and modality:** [Week / fortnightly - face-to-face / online]
---
**1. Type and reason for closure**
[Mark and base:]
- High for therapeutic objectives achieved
- Referral closure to [professional/service]
- Interruption by decision of the patient (communicated in session / by message)
- Abandonment closure (detail point contact attempts 4)
- Interruption by decision of the professional (founding and detailing alternatives offered)
- External closure: [movement / economic motive / coverage / other]
**2. Status of closure with respect to the reason for consultation**
[Synthesis of the current clinical status in relation to the original consultation and the objectives of the treatment plan. What was achieved, what remains open.]
**3. Recommendations to the patient**
[Careers, warning signs to consult, suggestion to resume treatment if applicable. Register that you were informed that you can consult again.]
**4. Derivation/contact attempts (if applicable)**
- Referral to: [Name, specialty, contact] - Referral note delivered: [Yes / No]
- Contact attempts: [Date and channel of each attempt, and if there was an answer]
**5. Observations**
[Any additional information relevant to closing the case.]
---
**Signature:** _____________________ **Seal:** _____________________
---
## Frequently Asked Questions
### Should I release her or is the patient asking for her?
Ideally, neither of them remembers. If the patient asks to close and you do not see fit, you can propose your criteria, but the final decision to continue or not is the patient’s. If it is you who proposes it, anticipate it and work it, never impose it from one session to the other.
### Do I have to make a discharge report?
The closing note in the medical records is mandatory as part of the registry. A separate report as a document is only necessary if someone requests it: the patient, a health insurance, another professional or a judicial instance. In that case they apply the same rules as for any [psychological report](/blog/informe-psicologico-modelo): relevant information, substantiated and respectful of professional secrecy.
### What do I do if the patient comes back in two years?
I re-opened your previous medical records with a re-entry note: date, new reason for consultation and new objectives. The continuity of the registration is valuable, provided the processes are well defined.
### Does abandonment count as high?
No. The discharge involves an evaluation and an agreement; the abandonment is a unilateral interruption. In the registry they have to appear as different things: in the abandonment you document the last session, your attempts to contact and the known clinical status, not a discharge that never occurred.
### How long do I have to keep my medical records after closing?
A minimum of 10 years from the last recorded act, according to the 26.529 Law. The closure of the treatment does not shorten that period: it initiates it.
## Summary
- The closure of a psychological treatment is a clinical intervention, not a procedure: well worked, consolidates the process.
- Not all finals are the same: agreed discharge, referral, patient decision, professional decision and external causes are recorded differently.
- The therapeutic discharge is evaluated against the objectives of the plan and the patient's autonomy, with clinical criteria and without universal prescriptions.
- The closure is anticipated: space the frequency, review the route, name what is open and leave the door open.
- Faced with abandonment: two or three reasonable attempts at contact, all registered, and formal closure of the case if there is no response.
- The closing note records motive, closure status, recommendations, referral if there is and last session. It is your legal and ethical support.
- The medical records is kept at least 10 years from the last performance (Ley 26.529), even after discharge.
- If the patient returns, I re-opened his story with a re-entry note: continuity of the registry, with the processes well defined.
---
## Confidentiality agreement in psychology: when to use and model to download
- **URL**: https://brauni.io/en/blog/acuerdo-confidencialidad-psicologia
- **Category**: Professional practice
- **Date**: 2026-01-22
- **Tags**: confidentiality agreement, professional secrecy, professional ethics, clinical supervision, psychologists, template
Complete guidance on confidentiality agreement in psychology. When necessary, what to include, differences with professional secrecy and template ready to use.
Professional secrecy is a pillar of psychology. But what happens when you share clinical information with a supervisor, a colleague of the interdisciplinary team or an administrative assistant? Professional secrecy binds you as a psychologist, but not necessarily the other people who access that information.
This is where the **confidentiality agreement**: enters a formal document extending the obligation of reservation to third parties directly or indirectly involved in the care.
## What is a confidentiality agreement?
A confidentiality agreement (also called NDA, *Non-Disclosure Agreement*) is a **contract** between two or more parties that undertake not to disclose sensitive information to which they have access.
In the context of psychology, it protects **patient clinical information** when it is shared with people who are not directly reached by professional secrecy.
Professional secrecy is a legal and ethical obligation of the psychologist. The confidentiality agreement is an instrument that extends this protection to other persons who access patient information.
## Professional Secret vs. Confidentiality Agreement
These two concepts complement each other, but they are not the same:
| | Professional secrecy | Confidentiality agreement |
|---|---|---|
| **Who is obliged?** | The registered psychologist | Anyone who signs the agreement |
| **What regulates it?** | Law 26.529, codes of ethics, provincial laws | Civil and Commercial Code (contracts) |
| **Since when does it apply?** | Automatically when exercising the profession | Since the signing of the agreement |
| **What does it protect?** | All things known in professional practice | The specific information defined in the agreement |
| **Consequences of non-compliance** | Ethical sanctions + civil and criminal liability | Contract civil liability |
## When do you need a confidentiality agreement?
You don't always need one. These are the scenarios where it is necessary or highly recommended:
### 1. Clinical supervision
When you present clinical material to a supervisor, you are sharing sensitive patient information. While in practice it is usually anonymized, a confidentiality agreement formalizes that:
- The supervisor cannot disclose the information of the case
- Clinical material cannot be used outside the scope of supervision
- Recordings or transcripts (if any) must be destroyed at the end
Many codes of ethics recommend that the patient know that his or her case will be presented under supervision. Ideally, this is mentioned in informed consent.
### 2 Interdisciplinary teams
When working with psychiatrists, social workers, phonoaudiologists or other professionals who do not share the same legal framework:
- Each professional has its own secrecy regime
- A unified agreement guarantees a minimum standard of protection
- Defines what information is shared, for what purpose and to what limits
### 3. Administrative staff and secretaries
The person answering the phone, scheduling appointments and handling the reception has access to:
- Patient Names
- Meeting times
- Sometimes reasons for consultation or emergency contact details
This staff is not reached by professional secrecy. A confidentiality agreement is **must**.
### 4. Virtual assistants or technical support staff
If someone helps you with the digital management of clinical practice (social networks, invoicing, software support), they may have indirect access to sensitive data.
### 5. Institutions and health centres
When you work in a mental health clinic or facility, the agreement is usually included in the employment contract. If you are not, request it.
### 6. Research and teaching
If you use clinical material for publications, classes or presentations at congresses:
- The agreement must specify that the material will be anonymized
- Ideally, the patient also gives his or her specific consent for this use.
## What should a confidentiality agreement include?
A confidentiality agreement for the psychological field should contain:
### Key elements
| Element | Description |
|----------|-------------|
| **Parties** | Complete identification of the person who reveals and receives the information |
| **Definition of confidential information** | What type of data are protected (clinical data, patient identity, session material, etc.) |
| **Recipient obligations** | Do not disclose, do not copy, do not use outside the agreed purpose |
| **Exceptions** | When confidentiality can be broken (judicial order, life risk) |
| **Duration** | How long the obligation applies (generally indefinite for health data) |
| **Consequences of non-compliance** | Civil liability, termination of the employment relationship, ethical complaint |
| **Signature and date** | Of all parties involved |
### Recommended elements
- **Procedure for return or destruction** of confidential material upon termination of the relationship
- **Security measures** to be adopted by the recipient (do not leave files in sight, use passwords, etc.)
- **Survival clause**: the obligation of confidentiality survives the termination of the link
## Confidentiality agreement template
Then we leave you an adaptable model. **Remember to consult with a lawyer** to adjust it to your specific situation and jurisdiction.
---
### Confidentiality agreement
**City:** [City], [Province]
**Date:** ___________________
---
**ENTRE:**
**Developing party:** Lic. [Name and Surname], M. P. [Number], with professional address in [address], hereinafter "EL/LA PROFESSIONAL".
**Receiving Party:** [Name and Surname], DNI [Number], as [clinical supervisor/| member of | interdisciplinary team administrative staff | another], hereinafter "EL/LA RECEPTOR/A".
---
**PRIMER — Object**
The purpose of this agreement is to establish the conditions under which EL/LA RECEPTOR/A accesses confidential information related to the professional practice of EL/LA PROFESSIONAL, including but not limited to patient data, clinical records, sessional material and any other information related to psychological care.
**SEGUNDA — Definition of confidential information**
Confidential information shall be deemed to be any information that EL/LA RECEPTOR/A is aware of in connection with EL/LA PROFESSIONAL, including:
a) Personal and patient identification data
(b) Clinical information, diagnoses, treatment plans and medical records
(c) Contents of therapeutic sessions (notes, recordings, transcripts)
d) Contact and invoicing data of patients
(e) Any information that, by its nature or context, should be treated as a reserve
**TERM — EL/LA RECEPTOR/A obligations**
EL/LA RECEPTOR/A undertakes to:
(a) To maintain strict confidentiality of all confidential information
(b) Failure to disclose, reproduce, copy or transmit such information to third parties
c) Use the information only for the specific purpose of [write: clinical supervision/teamwork/administrative tasks/etc.]
(d) Take the necessary security measures to prevent unauthorized access
(e) Notify EL/LA PROFESSIONAL immediately of any security breach or accidental disclosure
**FOURTH — Exceptions**
The obligation of confidentiality does not apply when:
(a) Information is required by written court order
(b) There is an imminent risk of harm to the patient or third parties
(c) Information already in the public domain without breach of this agreement
**FIFTH — Duration**
The obligation of confidentiality is **undefined** in nature and remains in force even after the termination of the professional, labour or contractual relationship between the parties.
**SIXTH — Return and Destruction**
At the end of the relationship, EL/LA RECEPTOR/A shall return or destroy any confidential material in its possession (physical or digital), confirming in writing that it does not retain copies.
**SEVENTH — Non-compliance**
Failure to comply with this Agreement shall result in:
(a) Immediate termination of the professional/labour link
(b) Civil liability for damages
(c) Legal actions that correspond to the law in force
**OCTAVA — Jurisdiction**
For any dispute arising out of this agreement, the parties submit themselves to the jurisdiction of the ordinary courts of [City, Province].
---
| | Professional | Receiver |
|---|---|---|
| **Signature** | _________________ | _________________ |
| **clarification** | _________________ | _________________ |
| **DNI / M. P.** | _________________ | _________________ |
*Two copies of the same wording are signed for one effect only.*
---
## Models according to context
The previous template is general. These are key settings according to the scenario:
### For clinical supervision
Add in clause 3rd:
> "The clinical information will be used exclusively for the purpose of supervision and professional training. EL/LA RECEPTOR/A undertakes not to use the material in publications, presentations or academic activities without prior written permission from EL/LA PROFESSIONAL and the patient."
### For administrative staff
Add specifically:
> "EL/LA RECEPTOR/A does not access clinical content of the sessions. The confidential information you access is limited to contact details, appointment schedule and patient invoicing data."
### For interdisciplinary teams
Add:
> "The parties agree to share only the clinical information strictly necessary for the patient's therapeutic goal. Any communication on the case will be made in the framework of team meetings and should not be discussed in informal settings."
## Frequent errors
### Have no written agreement
"We are colleagues, we know each other, we don't need to" — is the most common mistake. If there is a problem, you have nothing to support that the other person was obliged to reserve.
### Too generic agreements
An agreement that says "commits to maintaining confidentiality" without defining what information, for how long or with what consequences, does not serve much legally.
### Not including administrative staff
It is one of the most frequent blind spots. The secretary or receptionist handles sensitive data every day and often does not have a signed agreement.
### Do not renew or update the agreement
If conditions change (new software, new monitoring modality, change of functions), the agreement should reflect those changes.
### Confused with informed consent
Informed consent is between you and the patient. The confidentiality agreement is between you and a third party who accesses patient information. They are complementary documents, not interchangeable.
Do you also need an informed consent? We have a full template guide in our article on [informed consent in psychology](/blog/consentimiento-informado-psicologia).
## How to manage confidentiality agreements with Brauni
Brauni lets you centralize all the legal documentation of your clinical practice:
1. **Agreements templates**: Creates reusable models for each type of relationship (supervision, team, administration)
2. **Digital Signing**: Send the agreement to the receiver for signature from your device
3. **Safe storage**: Agreements are linked to the profile of the professional with encryption
4. **Maturity Alerts**: If you set up a duration, Brauni will let you know when it's time to renew
5. **Access Log**: Controls who accesses each patient's information
## Summary
| Concept | Description |
|----------|-------------|
| **Professional secret** | Legal and ethical obligation of psychologist — automatically applies |
| **Confidentiality Agreement** | Contract extending the reservation obligation to third parties |
| **When to use it?** | Supervision, interdisciplinary teams, administrative staff, technical support, research |
| **Recommended duration** | Undefined for mental health data |
| **Required complement** | Informed consent (with the patient) and confidentiality agreement (with third parties) go together |
---
## Psychological treatment plan: how to put it together and model to use
- **URL**: https://brauni.io/en/blog/plan-de-tratamiento-psicologico
- **Category**: Professional practice
- **Date**: 2026-01-17
- **Tags**: treatment plan, therapeutic objectives, Clinical documentation, psychologists, template
Practical guide to put together a psychological treatment plan: components, evaluable objectives, review, frequent errors and ready-to-use template.
"We're watching session-to-session" sounds like clinical flexibility, but many times it hides something else: the lack of an explicit course. A psychological treatment plan is just that, a course. It doesn't guarantee results or shrink the process: it defines where you're working with that patient and how you're going to realize if you're getting closer.
Without explicit goals there is no way to know if treatment progresses. You may have the feeling that "it's going well", but a feeling cannot be reviewed, compared or shown. And there is a practical reality: private health insurance and health plans are increasingly asking for more documentation to justify the initiation and continuity of treatments, and the plan is the central part of that justification.
In this guide we tell you what is (and is not) a psychological treatment plan, what components it has, how it adapts to your theoretical orientation, when to review it and what mistakes to avoid. In the end we leave you a complete template to copy and adapt.
## What is a psychological treatment plan (and what is not)
A psychological treatment plan is a written working hypothesis. From what you evaluated in the first interviews, you formulate what happens to the patient, what objectives will guide the process, how often and approach you will work, and with what criteria you will review the course or discharge.
The key word is hypothesis, which is why it should be clear what it is not:
- It is not a rigid script. It does not force you to follow a step-by-step sequence or ignore what the patient brings every week: it orders the process, it does not replace it.
- It is not a promise of results. The plan formulates where you work, not what is guaranteed: committing to a change within a certain time frame is clinically irresponsible.
- It is not a procedure for health insurance. The administrative version can be derived from the plan, but the plan is written for you and the patient, not for the audit.
- It is not the framing contract. Fees, schedules and cancellation policy are part of the framing; the plan is the clinical dimension of the process.
The treatment plan is not an isolated document: it is part of the [medical records](/blog/historia-clinica-psicologia). The 26.529 Law (Art. 15) requires recording the presumptive diagnosis, the indicated treatment and the patient's evolution, and the plan is the most orderly way to comply with that.
## What's the point of having a plan?
Beyond the obligation to document, a good psychological treatment plan performs four specific functions:
1. Clinical direction. It allows you to distinguish between a session that "was interesting" and one that brought the patient closer to what they came to work. When the process stagnates, the plan is the reference to think about why.
2. Continuity if there is referral. If the case exceeds your field of competence and you have to make a [responsible referral](/blog/derivacion-responsable-psicologia), a clear plan allows the next professional to know what was worked, what objectives and how far it was reached.
3. When health insurance requests to justify the continuity of treatment, a plan with objectives, frequency and review criteria answers that question without improvising reports of distress.
4. Communicating with the patient. Agreeing objectives aloud orders expectations: the patient knows what to expect from the process and you have an explicit agreement to return to when doubts arise.
## Components of a psychological treatment plan
There is no mandatory single format, but a complete plan usually includes these six components.
### Reason for consultation and demand
The starting point is what you did in the [first interview](/blog/primera-entrevista-psicologica): what does the patient bring in his own words and what do you read about that demand? They don't always agree: someone can consult "for work stress" and the underlying demand be another. Registering both separately allows you to see, months later, how the initial consultation was transformed.
### Presumptive diagnosis or problem description
Here is an important nuance: presumptive is not the same as definitive. Initial diagnosis is a hypothesis that can (and usually) be adjusted with the progress of the process. 26.657 law reinforces it: a mental health diagnosis alone does not authorize the presumption of risk of harm or disability (Art. 5), and the patient has the right not to be identified or discriminated against by a current or past condition (Art. 7).
If your orientation does not work with diagnostic categories, this component may be a description of the problem or a formulation of the case: what happens to the patient, how it is sustained in its history and context, and what hypothesis you have about its functioning.
### General and specific objectives
It is the heart of the plan and where it fails the most. The key is to write measurable goals without falling into bureaucracy. Evaluatable does not mean measurable with a numerical scale: it means that anyone (you, the patient, a colleague who receives the case) can recognize whether it was fulfilled or not.
Compare:
- Vague: "Improving the emotional well-being of the patient."
- Valuable: "That the patient can resume the activities he left from the beginning of the anxiety crises (on-site work, social meetings)."
The first cannot be revised: it can always be argued that there was "something" of improvement. The second contrasts with the reality of the patient at any time.
The general objectives mark the overall direction of treatment (they are usually two or three). The specifics are observable steps that emerge from each general objective. There is no need for many: a plan with fifteen objectives does not guide anything.
### Estimated frequency and duration
Weekly, fortnightly or the corresponding frequency, with justification if it departs from the usual. With the duration, be honest: if you can estimate a range, estimate it ("between six and twelve months, to review"); if your approach does not work with deadlines, leave it explicit instead of inventing a number.
### Approach and techniques
What theoretical framework guides treatment and what tools you plan to use: cognitive restructuring, exposure, work with transfer, family interviews, psychoeducation, according to your orientation. It is not a list of everything you know to do: it is what this case needs according to your hypothesis.
### Review and discharge criteria
Two questions that need to be answered in advance: how are you going to know that the plan needs adjustments, and how are you going to know that the treatment can end? The discharge criteria are not a date: they are conditions ("that the crises have yielded and the patient has own resources to manage them"). Defining them at the beginning avoids both treatments that stretch for no reason and quick closures.
## How it varies according to your orientation
The treatment plan is not the property of any school, although each one formulates it in its own way:
- Behavioral cognitive therapy is the most formalizing one: operationalized objectives, protocolized techniques, estimated number of sessions and measurement of advances. For many cases and funders, this level of structure is an advantage.
- Psychoanalysis does not work with behavioral objectives, but it has its own concept of planning: the direction of the cure. There is a reading of demand, a strategy regarding transfer and a position on where the analysis points: that can also be documented, in its own record.
- Systemic therapy usually builds the goals with the family or partner: what they want to change and how they will realize that it changed. The plan is, to a large extent, an agreement between the parties.
The point is that all orientations have some version of "where this treatment is going"; what changes is language. I wrote your plan in the record of your theoretical framework, not that of another.
If you use a clinical software, look for one that doesn't impose a structure beyond your orientation. In Brauni the templates are dynamic: build your own plan model with the fields of your theoretical framework, and the tool adapts to your way of planning, not the other way around.
## The plan is reviewed: when and how to update it
A plan that is written once and is not played anymore is almost as useless as having no plan. Here are the typical signs that it touches to review it:
- The patient consulted for one thing and the work resulted in another: it is expected, but the plan has to reflect it.
- Tables. Several weeks without noticeable movement can be part of the process or indicate that the initial hypothesis no longer reaches: the plan is where you ask that question.
- Crisis or vital events. A loss, a medical diagnosis, a separation: what was a priority can stop happening overnight.
- Objectives met. The best reason to review: what was sought was achieved and it is necessary to decide whether the work is redefined or the discharge is directed.
To review the plan, the raw material is your [session notes](/blog/notas-soap-dap-birp-psicologia): contrast what you come to record with the written objectives and ask yourself which ones progressed, which ones did not and which ones stopped making sense. Update the document with date, without deleting the previous version: the revision sequence tells the treatment story.
Many professionals also set up a periodic review (every three or four months, for example): it is a practical way for the review not to depend on it being "raised".
## Treatment plan and patient: how much to share
The plan is not a secret document, but it is not necessary to deliver the complete technical formulation. What is good is to agree on the objectives in a shared language: what we came to work, how we are going to realize that it progresses, how much we are going to talk about it.
This agreement strengthens the therapeutic alliance, organizes expectations and gives the patient an active place in their treatment. It also avoids a frequent misunderstanding: the patient asks "how long does this last?" after three months without ever having talked about it.
With children and adolescents, the agreement has two levels: what is discussed with the adults responsible and the version that works with the patient in a language according to their age. Both are registered.
To agree on objectives is not to put them to a vote. If the patient proposes something clinically unworkable (or asks for guarantees of result), your responsibility is to reframe it, not to please it. The plan is a work agreement, not a commercial contract.
## Frequent errors
- Vague objectives. "Improving well-being", "working self-esteem", "strengthening resources": they do not guide the work or allow to evaluate anything, and they say nothing about the case.
- Plans copied between patients. If your anxiety plans are all the same, they are not plans: they are templates without case. The structure can be repeated; the content comes from the evaluation of that patient.
- Never review it. The session plan 4 cannot remain intact in the session 40. A plan without revisions documents that you stopped looking at.
- Confused with the framing contract. Frequency and fees are not a treatment plan. If your "plan" only says "weekly sessions of 50 minutes", the entire clinical dimension is missing.
- Write it for audit only. A plan written in administrative jargon to conform to health insurance, which you do not use to think about the case, is duplicate work: you end up carrying the actual treatment of memory.
## Psychological treatment plan template
We leave you a base model to copy and adapt. Adjust it to your theoretical orientation and, if you work with health insurance, check if the funder asks for additional fields.
---
### Psychological treatment plan
**Patient:** [Name and surname] - **file number:** [Number]
**Professional:** Lic. [Name and surname] - M. P. [Number]
**Date of elaboration:** ___________________
**Revision No.:** [1, 2, 3...] - **Date last revised:** ___________________
---
#### 1.
**In the words of the patient:**
[Textual record of the query]
**Professional reading of the claim:**
[Your formulation of what the patient asks for and what is at stake in that demand]
#### 2. Presumptive diagnosis / description of the problem
[Diagnostic hypothesis with the criterion used, or case formulation if your orientation does not work with categories. Clarify that it is presumptive and reviewable.]
#### 3. OBJECTIVES
**General objectives:**
1. [General objective 1]
2. [General objective 2]
**Specific objectives:**
| Specific objective | Linked to General No. | State (pending/in progress/enforced) |
|---------------------|-------------------------|------------------------------------------|
| | | |
| | | |
| | | |
#### 4. TREATMENT FIGURE
- **Frequency:** [Week / fortnightly / other, with justification if applicable]
- **Modality:** [Present / online / mixed]
- **Estimated duration:** [Estimated range, or "to be reviewed according to evolution"]
#### 5. ADVANCEMENT AND TECHNICAL
- **Theoretical framework:** [Guidance]
- **Intended strategies and interventions:** [The main ones for this case]
- **Interconsultations or planned joints:** [psychiatry, school, family, other professionals]
#### 6. REVISION AND HIGH CRITERIA
- **Plan review:** [Agreed periodicity and events triggering a review]
- **Registration criteria:** [Observable conditions indicating that treatment may be terminated]
#### 7. PATIENT AGREEMENT
- **Objectives discussed and agreed on:** ________________
- **Comments:** [Adjustments requested by the patient, disagreements, version agreed for children/adolescents]
#### 8.
| Date | What was changed | Reason |
|-------|-----------------|--------|
| | | |
| | | |
---
**Professor's signature:** _____________________
---
If you prefer not to boot from a blank document, in Brauni you can load this structure once as a dynamic template and reuse it with each patient: fields are completed on a case-by-case basis, revisions are automatically dated and the plan lives in the same file as the medical records and evolution notes.
## Frequently Asked Questions
### Is it mandatory to have a treatment plan?
No law requires a document entitled "treatment plan." But the 26.529 Act (Art. 15) requires that presumptive diagnosis, indicated treatments and patient evolution be recorded in the medical records. A plan is the most orderly way to comply with this, and in practice many health insurances require it to authorize or renew sessions.
### How often is the plan reviewed?
There is no legal deadline. It is appropriate to combine a periodic review (every three or four months is a frequent habit) with reviews triggered by events: change of demand, prolonged plateaus, crisis or fulfillment of objectives. The important thing is that each review is dated and documented.
### What do I show health insurance?
The pertinent and nothing more: presumptive diagnosis, objectives in general terms, frequency and estimated duration. The content of the sessions is protected by the professional secrecy and confidentiality of sensitive data (Law 26.529, Art. 2). You can derive an administrative report from your plan without transcribing clinical material.
### Is the treatment plan the same as the medical records?
No. The medical records is the complete and chronological document of all attention; the plan is one of its components, along with the initial evaluation, the notes of evolution and closure. You can see the detail in our [medical records in psychology](/blog/historia-clinica-psicologia) guide.
### What do I do if the patient doesn't agree with the targets?
First, listen to it: the disagreement is clinical material and sometimes points out that your reading of the demand needs adjustments. If it persists on something clinically central, it will refocus the work and document the conversation. To agree is not to give in at all: it is to leave explicit what is worked and what is not.
## Summary
- A psychological treatment plan is a reviewable work hypothesis: it is not a rigid script, nor a promise of results, nor the framing contract.
- It serves four things: giving clinical direction, ensuring continuity before a referral, supporting you in health insurance audits and ordering the agreement with the patient.
- Components: reason for consultation and demand, presumptive diagnosis (non-definitive label), general and specific evaluable objectives, frequency and estimated duration, approach and techniques, review and discharge criteria.
- Each orientation is formulated in its own way: the CCT operationalizes it, the psychoanalysis works the direction of the cure, the systemic one agrees objectives with the family.
- The plan is reviewed in response to changes in demand, plateaus, crises or objectives achieved, and with an agreed periodicity. Each revision is dated, without deleting the previous ones.
- Errors to avoid: vague goals, plans copied between patients, never review, confuse plan with framing and write only for the audit.
- The plan is part of the medical records (Ley 26.529, Art. 15) and presumptive diagnosis is treated as a hypothesis, not as a label (Ley 26.657, Art. 5 and 7).
---
## Informed consent in psychology: what is it, when to use it and downloadable model
- **URL**: https://brauni.io/en/blog/consentimiento-informado-psicologia
- **Category**: Professional practice
- **Date**: 2026-01-14
- **Tags**: informed consent, professional ethics, Clinical documentation, patient rights, psychologists, template
Everything you need to know about informed consent in psychology. What should include, when mandatory, difference with informed consent and ready-to-use template.
Informed consent is one of the ethical pillars of psychological practice. It is not just a role that the patient signs before starting therapy — is a communication process that ensures that the person understands what will happen, what his or her rights are and how his or her data will be handled.
In this article we explain what it is, what it should include, when it is mandatory, how it differs from informed consent (for minors) and we leave you a template ready to adapt to your clinical practice.
## What is informed consent?
Informed consent is the **voluntary agreement** given by a patient after receiving clear and sufficient information about the psychological treatment to be initiated. It is not a procedure: it is a right of the patient and an obligation of the professional.
In simple terms, the patient should know:
- **What** is to be done (type of therapy, focus, techniques)
- **Why** this approach is proposed
- **How long** the process takes approximately
- **What risks or limitations** may have
- **What alternatives** exist
- **How** your personal and clinical data are handled
Informed consent is not an accession contract. The patient may revoke it at any time, without needing to explain.
## Is it mandatory in Argentina?
Yes. Informed consent is supported by multiple legal frameworks:
### National Mental Health Act 26.657
**Art. 10** establishes as a principle that governs **informed consent for all types of interventions**, with the only exceptions and guarantees established by law. Art. 7.j recognizes the right to be informed in an adequate and understandable manner of everything inherent in its health and treatment, "according to the rules of informed consent." Art. 7.k recognizes the right to be able to make decisions related to its care and treatment within its possibilities.
### Patient Rights Act 26.529
This law specifically regulates informed consent in the field of health:
- **Art. 5 — Definition**: It is the patient's sufficient declaration of will, issued after receiving clear, accurate and adequate information about his or her state of health, the proposed procedure, the expected benefits, risks, alternatives and consequences of not doing so.
- **Art. 6 — Mandatory**: Any professional performance in the medical-health field requires the prior informed consent of the patient
- **Art. 7 — Form**: Consent is **verbal** by default. It should only be **written** in cases of: hospitalization, surgical intervention, invasive diagnostic and therapeutic procedures, procedures involving risks according to regulation, and revocation. Psychotherapy is not on this list, so legal verbal consent is sufficient.
- **Art. 10 — Revocability**: The patient may revoke his decision at any time
- **Art. 9 — Exceptions**: The professional is exempted from requiring consent when there is a serious danger to public health, or an emergency situation with serious danger to the health or life of the patient
Although the law does not require written consent for psychotherapy, **in practice it is highly recommended** to document it in writing. Written consent protects you from complaints, serves as evidence that you informed the patient and remains part of [medical records](/blog/historia-clinica-psicologia) (Art. 16, Ley 26.529).
### Personal Data Protection Act 25.326
Health data are **sensitive data** (Art. 2). While Art. 8 empowers health professionals to collect and process health data of their patients respecting professional secrecy, Art. 6 requires that the patient be informed beforehand about the purpose of the treatment, the existence of the archive and its rights of access, rectification and suppression.
### Codes of professional ethics
Both the Code of Ethics of FePRA and provincial codes (CPPC, COLPSIBA, etc.) include informed consent as a fundamental ethical requirement.
The absence of informed consent constitutes a serious breach (Art. 21, 26.529 Law), and may result in ethical sanctions by the professional college and in civil and criminal liability. Art. 11 bis exempts from liability a professional who has acted in accordance with the provisions of the law.
## What should an informed consent include?
According to Article 5 of the 26.529 Law, the patient should receive clear, accurate and adequate information on:
- (a) Your health
- (b) The proposed procedure, specifying the objectives pursued
- (c) The expected benefits of the procedure
- (d) The foreseeable risks, discomfort and adverse effects
- (e) Alternative procedures and their risks, benefits and harms
- (f) The foreseeable consequences of failure to perform the procedure
Applied to psychology, full informed consent should cover these points:
### 1.
- Full name and registration
- Specialty or training
- Contact details
### 2. Patient data
- Full name and DNI
- In the case of minors: data on the father, mother or legal guardian
### 3. Treatment information
| Element | Description |
|----------|-------------|
| **Type of therapy** | Theoretical approach (cognitive-behavioral, psychoanalytic, systemic, etc.) |
| **General objectives** | What Treatment Seeks to Achieve |
| **Frequency and duration** | Number of meetings per week, estimated duration |
| **Modality** | Face-to-face, online or mixed |
| **Honors** | Amount per session, method of payment, cancellation policy |
### 4. Limits of confidentiality
This point is critical. The patient should know that confidentiality has legal exceptions:
- **Life risk** of the patient or third parties
- **Abuse or abuse** of minors or vulnerable persons
- **Requirement of the court** with order of the judge
- **Involuntary intervention** in crisis situations
### 5. Handling of personal data
- Where clinical records are stored
- Who has access to them
- How long they are preserved
- If any digital tool is used (management software, electronic medical records)
### 6. Patient's rights
- Revocation of consent at any time
- Access your medical records
- Request rectification or deletion of your data
- Request referral from another professional
### 7. Signature and date
- Patient signature (or legal representative)
- Professional signature
- Date
- Clarification that a copy was delivered to the patient
## Informed consent vs. informed consent
When you work with **underage** (under 18 years), you need two documents:
| | Informed consent | Informed consent |
|---|---|---|
| **Who signs it?** | Parent or legal guardian | The minor |
| **Is it legally binding?** | Yes | It has no legal force, but it is ethically necessary |
| **From what age?** | Not applicable (it is the adult responsible) | Generally since 12-13 years |
| **What does it contain?** | All treatment information | Explanation adapted to the level of understanding of the child |
Assent does not replace consent. You need both: the consent signed by the responsible adult **and** the consent of the minor who demonstrates that he or she understood and agrees to participate.
### How to write an informed assent?
Language should be **simple, direct and age-appropriate**:
- Avoid technical terms
- Use short sentences
- Explain what they're going to do together in the sessions
- Make sure you can say if you don't want to talk about something.
- Make it clear that what counts is private, unless it is in danger.
**Example of fragment for adolescents (13-17 years):**
> "Sesions are a space for you. What we talk about here is private — I am not going to tell your parents what you tell me, unless you are in danger or someone is hurting you. In that case, I will seek help to protect you. If at any time you do not want to keep coming, we can talk about it."
## Special situations
### Online therapy
If you attend to video call, consent should include:
- Platform used and its security measures
- Specific risks (connection cuts, patient environment privacy)
- Remote Emergency Protocol
- Applicable jurisdiction
### Couple or family therapy
When multiple people participate:
- Each participant signs its own consent
- It is clarified that information from joint sessions is not individual
- What happens if you want to stop treatment?
### Psychodiagnosis evaluations
The consent must specify:
- Which tests or techniques are to be applied
- Who's gonna get the report?
- What information will the report contain?
## Informed Consent Template
Then we leave you a basic model that you can adapt to your practice. **Remember that it is a general guide** — consult with your professional college to bring it into line with the rules of your jurisdiction.
---
### Informed consent for psychological treatment
**Professional:** Lic. [Name and Surname] — M. P. [professional license number]
**Patient:** [Name and Surname] — DNI [Number]
---
**1. Treatment information**
The Lic. [Last name] informs you that the proposed treatment consists of orientation psychotherapy [theoretical approach], with a frequency of [quantity] session/s weekly/s of [duration] minutes each. The modality will be [presential / online / mixed].
The general objectives of the treatment are: [describe briefly].
**2. Expected benefits and limitations**
Psychotherapy can contribute to improving emotional well-being, interpersonal relationships, and coping strategies. However, the results are not guaranteed and the process may involve moments of emotional discomfort as part of therapeutic work.
**3. Confidentiality**
Everything shared in session is confidential. Exceptions to confidentiality include:
- Imminent risk of harm to the patient or third parties
- Suspected of abuse or ill-treatment of children or vulnerable persons
- Legal requirement by written order
**4. Handling of personal data**
The clinical records are stored in a [digital/physical] manner with the security measures that guarantee their integrity and confidentiality (Art. 9, Law 25.326). The patient has the right to access, rectify or request the deletion of his data (Art. 14 and 16, Law 25.326). The deletion does not apply when there is a legal obligation to keep them (Art. 16.5).
[If you use Brauni or other software:] The platform [name] is used for the management of the digital medical records, which complies with [mention certifications or security measures].
**5. Fees and cancellations**
The value of each session is $[mount]. Cancellations must be made at least [quantity] hours in advance; otherwise, the session is deemed to have been made.
**6. Patient rights**
You have the right to:
- Revocation of this consent at any time
- Ask for information about your treatment
- Access your medical records
- Request referral from another professional
**7. Declaration**
I declare that I have read and understood the information provided. I have had the opportunity to ask questions and these have been answered satisfactorily. I give my free and voluntary consent to begin treatment.
| | Patient | Professional |
|---|---|---|
| **Signature** | _________________ | _________________ |
| **clarification** | _________________ | _________________ |
| **DNI** | _________________ | M. P. ________________ |
| **Date** | ____/____/________ | ____/____/________ |
*A copy of this document is given to the patient.*
---
With Brauni, you can generate informed consent directly from the profile of each patient. The professional and patient data are automatically completed, and the document is linked to the digital medical records.
## Informed consent template (for minors)
### Informed consent
**For:** [Name of minor]
**Date:** ___________________
---
Hello [Name]. My name is [Professional name] and I am a psychologist.
Your [paps/mom/papa/tutor] asked me to meet you to talk. I want to explain how these meetings work:
- **What are we going to do?** We are going to have talks where you can tell me how you feel, what happens to you and what things worry you. Sometimes we will use games, drawings or other activities.
- **Is it mandatory?** No. If at any point you don't want to keep coming, we can talk about it.
- **What we talk about is private?** Yes. What you tell me is between us. I am not going to tell your [paps/mom/pah] what we talked about, **except** that you or someone is in danger — in that case, I am going to seek help to take care of you.
- **Can you ask questions?** Yes, whatever you want. Now or anytime.
---
**Do you agree that we should start meeting?**
- [ ] Yes, I agree.
- [ ] I prefer not to participate for now
**Signature or name:** _____________________
**Date:** ___________________
---
## Frequent errors in implementing informed consent
Here are the problems we see most frequently:
### Using a generic model without adapting
A copied consent from the internet that does not reflect your approach, modality or the services you offer does not comply with the spirit of the norm.
### Do not explain verbally
The written document complements the verbal explanation, does not replace it. You have to take the time to explain to the patient what is signing and why.
### Do not include exceptions to confidentiality
If the patient did not know that there are situations in which you are going to break professional secrecy, he may feel betrayed and you have an ethical and legal problem.
### Do not update consent
If you change the mode (from face-to-face to online), incorporate a new software or modify the fees, the consent must be updated.
### Do not save a signed copy
Always keep a copy signed by both parties. If you use digital medical records, the document must be linked to the patient's file.
## How to manage informed consent with Brauni
Brauni allows you to manage the entire informed consent flow digitally:
1. **Customizable templates**: Create your own consent model with the fields you need
2. **Autocompleted Data**: Professional and patient data are automatically loaded
3. **Digital signature**: The patient can sign from his device
4. **Safe storage**: The document is linked to the medical records with end-to-end encryption
5. **Versed**: If you update the consent, the previous versions are retained
## Summary
| Concept | Description |
|----------|-------------|
| **Informed consent** | Voluntary agreement of the adult patient after receiving clear information on treatment |
| **Informed consent** | Explanation adapted for minors (usually from 12 years) — complements the consent of the responsible adult |
| **Is it mandatory?** | Yes, by Law 26.529 (Art. 6), Law 26.657 and codes of professional ethics |
| **Written or verbal?** | Verbal by default (Art. 7). Written only for hospitalization, surgery, invasive procedures. In psychotherapy it is verbal, but it is recommended written as good practice |
| **Can it be revoked?** | Yes, at any time (Art. 10, Law 26.529) |
| **Exceptions to confidentiality** | Risk of life, child abuse, court order |
---
## Psychological report: how to write it well and model to use
- **URL**: https://brauni.io/en/blog/informe-psicologico-modelo
- **Category**: Professional practice
- **Date**: 2026-01-09
- **Tags**: psychological report, Clinical documentation, model, reports, psychologists, template
Guide to write a psychological report in Argentina: structure, types according to recipient, frequent errors and complete model ready to adapt.
Of all the documents you produce in your practice, the psychological report is probably the one that generates the most anxiety. And it makes sense: it is one of the few clinical writings that come out of clinical practice. It is going to be read by a judge, a school, a doctor or a health insurance, and every word you put is supported by your signature and your tuition.
A poorly drafted report can harm the patient, engage you professionally, or be rejected by the person who asked for it. A well done report the right thing, protect the privacy of the consultant and leave your work well standing before third parties.
In this guide we explain how to write a correct psychological report: what structure to follow, how to adapt the language according to the recipient, what mistakes to avoid and what the Argentine regulations say. In the end we leave you a complete psychological report model to copy and adapt.
## What a psychological report is and how it differs from the medical records
The psychological report is a professional document in which you communicate, in writing and to a particular recipient, the results of an evaluation or the state of a therapeutic process. It always responds to a request: someone requests it with a specific objective, and that objective defines what goes inside and what does not.
The most common confusion is to treat it as an extension of [medical records](/blog/historia-clinica-psicologia). They are distinct documents with opposite logics:
| | medical records | Psychological report |
|---|---|---|
| **Where it lives** | Stays in clinical practice, in your custody. | Out of clinical practice, read by third parties |
| **Content** | Everything relevant in the process, no filter | Only relevant to the purpose of the order |
| **Destination** | You (and the patient if requested) | A specific third: judge, school, doctor |
| **Register** | Working notes, assumptions, raw material | Careful writing, informed conclusions |
Practical rule: the medical records records everything that happened, the report communicates only what the recipient needs to know for its purpose. If a data does not contribute to that objective, it does not go in the report, even if it is in the medical records.
## Types of psychological report by recipient
The base structure is maintained, but the content, the level of detail and above all the language change according to who will read it.
### School report
It is requested by the school, the guidance team or the parents for an inscription, an external companion or a curricular adaptation. It is read by teachers without clinical training: the language has to be descriptive and oriented to the functional (what the child can do, what it costs, what supports it needs in the classroom). The family dynamics and the session material do not take place here.
### Judicial or expert report
When requested by a court, the requirement goes up: everything you affirm can be questioned by the parties, so every conclusion has to be based on what is evaluated and the methodology used. The expertise itself has its own rules that go beyond this guide, but the principle applies to any report that ends up in a file: maximum accuracy, zero speculation.
### Labour Report
It appears in aptitude assessments, reincorporations or ART processes. The risk here is the use that an employer can give to the information: extreme data minimization. Inform about what was asked and nothing more.
### Report for health insurance or private health plan
It is usually brief: it bases the continuity of treatment or the authorization of more sessions. Health insurance needs diagnosis, frequency and general evolution, never the content of the sessions.
### Interconsultation report
Addressed to a psychiatrist, neurologist or other health professional, this is the only case where technical language is fully justified, because the reader has clinical training. However, communicate only what the colleague needs for his intervention.
The question that orders everything: who will read this and what do you need it for? I wrote for that person, for that purpose.
## Structure of a psychological report, section by section
Beyond the type, a well-armed psychological report follows a recognizable structure:
### 1.
Full name, title, professional registration and contact details. Registration is not a detail: it is what enables the document before any institution.
### 2.
Full name, DNI, date of birth and age. Enough to identify who you're talking about, nothing more.
### 3. Reason for the report and who requests it
Two or three lines that frame everything that follows: who asked for the report, with what objective and in what context. For example: "This report is prepared at the request of School X, with the aim of providing information about the ongoing treatment process." This frame is your best defense: it makes clear that the content responds to a specific request and not to a spontaneous dissemination of clinical information.
### 4. Methodology
What you did to get to what you're going to say: number of interviews, period evaluated, techniques and instruments managed. This section gives weight to your conclusions: it's not the same as an interview impression as an evaluation of five encounters with specific techniques.
### 5. Diagnostic results and appreciation
The body of the report. I described what was observed and what was evaluated, ordered by areas if it helps the reading (cognitive, affective, binding). If you include a diagnosis, clarify the degree of certainty: "presumptive", "compatible with", "impressive". Diagnostic rotundity without sufficient foundation is one of the most expensive errors paid for.
### 6. Conclusions and suggestions
The synthesis that responds to the reason of the report. If the request was about a school support, the conclusion speaks of that. Suggestions have to be concrete and be within your purview: suggest a psychiatric interconsultation yes, indicate medication no.
### 7. Place, date and signature
Every report closes with place and date of issue, signature, clarification and registration. Without this, the document does not compromise anyone and therefore is worthless.
## The Guiding Principle: Reporting Only Relevant
If you have a single idea of this guide, let it be this: in a psychological report it only goes the information relevant to the objective for which it is requested. What is not needed, does not go.
It is not just a good practice: it is a legal and ethical obligation based on three pillars:
- **Act 25.326 on the Protection of Personal Data**: health data are sensitive data, and the law requires that the information processed be adequate, relevant and not excessive in relation to its purpose. A school report with intimate details of the child's parents violates this principle in full.
- **Professional secrecy**: issuing a report is an exception limited to the duty of confidentiality, enabled by the patient's consent or by a court order. The exception covers the pertinent to the request, not everything you know. About its scope and limits we write in [this guide on professional secrecy](/blog/secreto-profesional-psicologia).
- **FePRA's Code of Ethics**: requires that reports be clear, accurate and rigorous, and that information shared with third parties be limited to what is necessary.
Before closing any report, I reread with this question: does each data contribute to the purpose of the order? What does not contribute, is deleted.
## Patient consent
Except for a court order, do not issue a report without the patient knowing and accepting that you are going to do it. Ideally in writing, leaving record of three things: that authorizes the issuance of the report, to whom it will be delivered and for what purpose.
The patient is the holder of his health information and has the right to know what is said about him and to whom. In addition, documented consent protects you: if someone questions why you disclosed clinical information, you have the support of the express authorization of the holder of that data. If you work with [informed consent](/blog/consentimiento-informado-psicologia) from the beginning of treatment, you can include a general clause on reports and supplement it with a timely authorization for each issue.
In the case of children and adolescents, authorization is given by their legal representatives, without losing sight of the child ' s right to be informed according to his or her degree of maturity.
It is not the same a report that goes to the school guidance team as one left in the hands of a parent in conflict of divorce. The real recipient conditions what you write and how.
## The language: technical but understandable
A psychological report is not a session note or academic paper. Some writing guidelines make a difference:
- **I wrote for the recipient**: if read by a teacher or a judge, the jargon does not communicate, obscures. Technicalities are justified only among colleagues.
- **Described before you qualify**: "There are difficulties in sustaining attention during the interview" reports; "it is a scattered child" tag. Valor judgments do not take place in a report.
- **I distinguished the observed from the inferión**: what you saw and what you interpret are different things and the text has to reflect it. "During the interviews he was withdrawn" is observation. "Which could be linked to the recent moving episode" is inference, and it is appropriate to present it as such.
- **Matify diagnoses according to real certainty**: "compatible with a picture of anxiety" is not professional weakness, it is precision. The firm statement remains for when the evaluation sustains it.
- **Short Phrases, Active Voice, Zero Filling**: The best report is understood at first reading.
## What you sign commits you
Your signature turns the text into a document with consequences: everything that a signed report says can be used in a judicial process, an audit or a complaint to the professional college, for or against you.
That's why the rule is simple: don't sign anything you can't hold with your evaluation and your records in the medical records. If a lawyer asks a hearing where a conclusion came from, the answer has to be in your documentation, not in your memory.
Keep a copy of each report issued, with date and record of who it was delivered to, as part of the patient’s medical records. In Brauni the reports are generated in PDF with a digital verification code: any third party can verify that the document is authentic and was not altered after your signature, as we count in [this note on digital verification of reports](/blog/informes-clinicos-verificacion-digital).
## Frequent errors in drafting a psychological report
### Copy and paste from other reports
The most tempting and most noticeable shortcut. Generic phrases that could apply to anyone, data from another patient that remained undelete, conclusions that are not connected to the described methodology. Whoever reads reports often detects recycling immediately, and your credibility resents.
### Resounding diagnostics where presumption corresponds
To affirm "the patient has X disorder" after two interviews, without instruments to support him, is to be exposed free of charge. Use the conditional and presumption formulas when the evaluation does not enable more than that.
### Think about people you didn't evaluate
The classic of reports in family conflicts: the patient talks about his ex-partner, and the report ends by stating that "the father presents violent traits", when you never evaluated him. You can record that the consultant refers to certain situations, making it clear that it is his account. Emitting clinical judgment on someone who never went through your clinical practice is a serious ethical misconduct and a frequent source of complaints.
### Excess intimate data
Include session material, details of sexual life, third party information or background information that do not contribute to the purpose of the order. Each unnecessary data is a potential violation of the patient's privacy and the principle of relevance of the 25.326 Law.
## Model psychological report for copying
We leave you an adaptable base template. Adjust to the type of report and consult with your professional college about the requirements of your jurisdiction.
---
### PSYCHOLOGICAL REPORT
**Place and date:** [City], ________________
---
#### PROFESSIONAL DATA
- **Name and surname:** Lic. [Name and surname]
- **professional license:** M. P. / M. N. [Number]
- **Professional contact:** [Telephone / Email / Address]
#### CONSULTANT DATA
- **Name and surname:** [Name and surname]
- **DNI:** [Number]
- **Date of birth:** ______/__________ - **Age:** [Age]
#### GROUNDS FOR THE REPORT
This report is prepared at the request of [person / institution requesting it], with the aim of [specific purpose of the order]. [the consultant / legal representatives] is authorized to issue and deliver it to [addressee].
#### METHODOLOGY
- **Period evaluated/treatment:** [From - to]
- **Quantity of interviews:** [Number and type]
- **Technicals and instruments administered:** [List interviews, tests, scales, techniques]
#### Results and diagnostic appreciation
[Description of what was observed and evaluated, sorted by areas if applicable. Distinguish what was observed from what was inferred. If a diagnosis is included, indicate the degree of certainty: presumptive, compatible with, confirmed by specific evaluation.]
#### Conclusions and suggestions
[Synthesis that responds to the reason for the report. Concrete suggestions, within professional competence.]
It is noted that the present report is prepared for the purposes requested and that its content is limited to information relevant to that purpose.
---
**Signature:** _____________________
**Clarification and registration:** _____________________
---
File a copy of each report issued in the patient's medical records, together with the authorization to issue it and the record of who it was delivered to. That trio solves almost any future controversy.
## Frequently Asked Questions
### Can the patient read your report?
Yes. The patient is the holder of his health information (Law 26.529) and has the right to access what is written about him. Beyond the law, it is good practice: to show him the report before handing him over avoids misunderstandings and strengthens confidence.
### Can I refuse to make a report?
It depends on who asks. If requested by the patient or a third party with his permission, in principle it is appropriate to do so, although you can set reasonable deadlines and agree on the scope. If ordered by a judge, unjustified refusal can bring legal consequences. What you can always do is delimit the content: find out more about what you evaluated, not what you are being asked to speculate about.
### How much do you charge for a psychological report?
It is an independent sessional benefit and it is appropriate to collect it as such: it takes time to write and carries with it legal responsibility. Many professional colleges publish guidance fees that include it: consult the gazetteer of your jurisdiction and agree the honorarium with the patient before writing.
### Can I send the report by email or WhatsApp?
Carefully. The report contains sensitive data and the 25.326 Act obliges you to protect them in the shipment as well. If you send it digitally, let it be to the agreed recipient, in PDF and through a channel that you can document. Avoid groups and intermediaries that you will not control.
## Summary
- The psychological report comes out of clinical practice and is read by third parties: the medical records records everything, the report only communicates the pertinent to the request.
- The recipient defines the language: descriptive and functional for schools, rigorous and informed for courts, technical only among colleagues.
- Minimum structure: professional and professional license data, consultant data, reason and applicant, methodology, results, conclusions, date and signature.
- Guiding principle: to report only what is relevant to the objective (Law 25.326, professional secrecy, Code of Ethics of FePRA). What is not necessary, does not go.
- Except for a court order, he issues reports with the patient's consent, knowing who he surrenders to and for what.
- I distinguished the observed from the inferión, nuanced the diagnoses according to the real certainty and never emitas clinical judgment on people you did not evaluate.
- Your signature commits you: keep a copy of each report in your medical records, along with the authorization and the record of delivery.
---
## Personal Data Protection Act for Psychologists: What You Have to Know About Law 25.326
- **URL**: https://brauni.io/en/blog/ley-proteccion-datos-personales-psicologos
- **Category**: Privacy and Security
- **Date**: 2026-01-06
- **Tags**: data protection, Act 25326, sensitive data, habeas data, privacy, psychologists
Practical guide on Law 25.326 on Protection of Personal Data applied to psychological clinical practice. Sensitive data, obligations, habeas data, penalties and how to comply without complicating you.
Every time a patient gives you their name, their phone, their diagnosis or tells you something in session, you are handling **personal data protected by law**. and not any data: mental health data are the most sensitive category that exists in Argentine legislation.
The 25.326 Personal Data Protection Act regulates how these data are collected, stored, used and shared. It applies to any psychologist working in Argentina, whether you keep your records on paper, in an Excel spreadsheet or in a clinical software.
In this article we explain to you what the law says, what obligations you have and how to fulfill them without complicating you.
## What is the 25.326 Law?
The 25.326 law, passed in the year 2000, is the norm that regulates the **integral protection of personal data** in Argentina. It is the Argentine equivalent to the European GDPR (although earlier and less strict in some respects).
Its objective is to guarantee the right to honour and privacy of persons, regulating the processing of personal data recorded in archives, records, data banks or other technical means.
The control body is the **Agency for Access to Public Information (AAIP)**,, which replaced the former National Directorate for the Protection of Personal Data.
The protection of personal data has constitutional rank in Argentina. Article 43 of the National Constitution enshrines the action of habeas data.
## Key concepts you need to know
### Personal data
Any information concerning a particular or identifiable natural person. In your clinical practice, this includes:
- First name, last name, DNI
- Telephone, email, address
- Date of birth
- Health insurance data
- Emergency contact
### Sensitive Data
Personal data revealing racial and ethnic origin, political opinions, religious, philosophical or moral convictions, trade union membership and information concerning health or sexual life (Art. 2). They are the category with **greater legal protection**.
In your clinical practice, **almost everything is sensitive**:
| Data | Why is he sensitive? |
|------|-----------------------|
| Diagnosis | Health information |
| Reason for consultation | Health information |
| Contents of meetings | Health and privacy information |
| Medication | Health information |
| Sexual orientation | Sexual life |
| Religious beliefs | Religious convictions |
| History of substance use | Health information |
| Suicide ideation | Health information |
### Data holder
The person to whom the data refer. In your case: the patient.
### Responsible for archiving, recording, database or database
The natural person or person of ideal existence, public or private, who owns a file, register, database or database (Art. 2). In your case: you as a professional.
### Data processing
Systematic operations and procedures, whether electronic or not, that allow the collection, preservation, management, storage, modification, relationation, evaluation, blocking, destruction and in general the processing of personal data, as well as their transfer to third parties (Art. 2).
### Data dissociation
Any processing of personal data in such a way that the information obtained cannot be associated with a specific or identifiable person (Art. 2). This is relevant when you share clinical material in supervision or research.
## What duties do you have as a psychologist?
### 1. Consent to data processing
The general rule (Art. 5.1) is that the processing of personal data is unlawful when the holder does not give his consent **free, express and informed**, which must be recorded **in writing, or by other means permitting it to be equated**..
However, Art. 5.2.d establishes a **important exception for psychologists**: consent is not necessary when the data " derive from a contractual, scientific or **professional** relationship of the data holder, and are necessary for its development or compliance."The therapeutic relationship is a professional relationship, so the data necessary for clinical care are covered by this exception.
In addition, **Art. 8** specifically empowers health professionals to collect and process data relating to the health of their patients, respecting the principles of professional secrecy.
**In practice:** Although the law allows you to process data without additional consent for the professional relationship, it is a good practice to include a section on data handling in your [informed consent](/blog/consentimiento-informado-psicologia). This fulfills the duty of information (Art. 6) and generates transparency.
Art. 7 of the law states that, as a general rule, the formation of files that store sensitive data is **prohibited**. But Art. 8 creates the specific exception: health facilities and health professionals may collect and process data related to the health of their patients, provided that they respect professional secrecy.
### 2. Data quality (Art. 4)
The Act lays down strict principles on data quality:
- They should be **certain, appropriate, relevant and not excessive** in relation to the scope and purpose for which they were obtained (Art. 4.1)
- Collection **cannot be done by unfair or fraudulent means** (Art. 4.2)
- **Can't be used for different purposes** or incompatible with those that motivated their obtaining (Art. 4.3). If a patient gave you their email to coordinate appointments, you can't use it for newsletters (unless you consent separately)
- They should be **exact and updated** when necessary (Art. 4.4)
- Incorrect or incomplete data should be **delete and replaced** when the person responsible is aware (Art. 4.5)
- They should be **destroyed** when they are no longer necessary or relevant to the original purposes (Art. 4.7)
### 4. Security (Art. 9)
The controller must adopt the **technical and organisational measures** necessary to ensure the security and confidentiality of personal data so as to prevent their adulteration, loss, consultation or unauthorised processing, and to detect deviations, whether intentional or not (Art. 9.1).
The law also **prohibits** the recording of personal data in files that do not meet technical conditions of integrity and security (Art. 9.2). This includes:
- Access control (who can see the data?)
- Safe storage (where are the data?)
- Protection against loss or destruction (is there backup?)
- Protection against unauthorized access (is there a password, encryption?)
- Deviation detection (can you detect if someone accessed without permission?)
As you handle sensitive health data, the required safety standard is high.
### 5. Duty of confidentiality (Art. 10)
The controller and the persons involved in **any stage** of the data processing are bound by professional secrecy in relation to the data. This obligation **subsists even after the end of the relationship** with the data file holder (Art. 10.1).
This duty may only be relieved by a court decision or if there are substantial reasons relating to public security, national defence or public health (Art. 10.2).
If you have administrative staff, you need a [confidentiality agreement](/blog/acuerdo-confidencialidad-psicologia).
### 6. Duty of information (Art. 6)
When you collect personal data, you must inform the patient expressly and clearly beforehand:
- The **finality** for which they will be treated and for whom they may be addressed (Art. 6.a)
- The **existence of the file** and the identity and address of the person responsible (Art. 6.b)
- The **mandatory or optional** nature of the replies (art. 6.c)
- The **consequences** of providing data, refusal or inaccuracy (Art. 6.d)
- The possibility of exercising **rights of access, rectification and deletion** (Art. 6.e)
### 7. Transfer of data to third parties (Art. 11)
The data may only be transferred for the performance of purposes directly related to the legitimate interest of the assignor and the assignee, and with the **subject to the consent** of the holder (Art. 11.1). Consent for the assignment is **revocable** (Art. 11.2).
Consent is not required for the assignment in the case of health data and is necessary for reasons of public health, emergency or epidemiological studies, provided that identity is preserved by appropriate dissociation (Art. 11.3.d).
**Important:** The assignee is subject to the same obligations as the assignor, and both respond **solidary and jointly** (Art. 11.4). This applies if you share data with a supervisor, colleague or software provider.
## Patient's rights to their data
The law recognizes the following rights:
### Right of information (Art. 13)
Any person may request from the control body information on the existence of personal files, records or databases, their purposes and the identity of their controllers. This record is for consultation **public and free**.
### Right of access (Art. 14)
The patient, subject to accreditation of his identity, has the right to request and obtain information from his personal data. You have a period of **10 days** to respond from the reliable intimation (Art. 14.2). If you do not respond or the answer is insufficient, the action of habeas data is enabled.
Access is **free** at intervals not less than 6 months, except for legitimate interest (Art. 14.3). In the case of deceased persons, the right corresponds to their universal successors (Art. 14.4).
The information should be provided in **clear, uncodified** form and in accessible language (Art. 15.1), and should address the **totality of the record** belonging to the holder (Art. 15.2).
### Right to rectify, update or delete (Art. 16)
Everyone has the right to have their personal data rectified, updated and, where appropriate, deleted or subject to confidentiality (Art. 16.1). You have **5 working days** to do so from receipt of the claim (Art. 16.2).
**On deletion:** It does not apply when it could cause damage to the legitimate rights or interests of third parties, or when **there is a legal obligation to keep the data** (Art. 16.5). This is key to [medical records](/blog/historia-clinica-psicologia), since the 26.529 Act requires you to keep it for 10 years. In practice:
- **Administrative data** (telephone, email, health insurance): may be deleted
- **medical records**: is preserved for the legal term, but access may be blocked
- **Data on digital systems**: is anonymized or deleted for what is not a medical records
The data must be kept within the time limits provided for in the applicable provisions (Art. 16.7).
The rectification, update or deletion is **free of charge** for the person concerned (Art. 19).
When a patient exercises any of these rights, he or she documents the order and your response in the medical records. This protects you from a possible claim. If you gave data to a third party, you must notify him or her of rectification or deletion within 5 business days (Art. 16.4).
## What is habeas data?
Habeas data is the **judicial action** that anyone can initiate to:
- Know what your data is in a database
- Request the rectification, deletion or updating of incorrect data
- Require the confidentiality of sensitive data
In the context of your clinical practice, a patient could initiate a habeas data if:
- You deny him access to his medical records.
- You don't correct incorrect data after I ask you to
- You share your data without consent
**Procedure:** The patient first makes the claim to you (extrajudicial). If you do not respond or you do not satisfy it, he can initiate the legal action before a judge.
## Database registration
### Do you have to search your database?
Art. 21 states that any file, record, database or public data bank, and **private to provide reports**, must be registered in the Register. Art. 24 adds that individuals who form files **other than for personal use only** must register in accordance with Art. 21. In practice, this applies to:
- **individual clinical practice**: if you keep patient records (paper or digital), technically you should register the basis
- **Institutions and centers**: is mandatory without exception
- **Clinical Software**: the software provider must register its own database
**Reality vs. theory:** Many independent professionals do not register their database, and AAIP rarely controls individual clinical practices. However, registration is free and online, and protects you from complaints. It is advisable to do so.
### How to register?
1. Enter the AAIP website ([www.argentina.gob.ar/aaip](https://www.argentina.gob.ar/aaip))
2. Look for the "National Database Register"
3. Complete the form with your database information (what data, for what purpose, what security measures, etc.)
4. Registration is free and renewed annually
## Penalties for non-compliance
### Administrative sanctions (Art. 31)
The control body may apply: **warning, suspension, fine from $1.000 to $100.000, closure or cancellation** of the file, record or data bank (Art. 31.1). The penalties are graduated in relation to the gravity of the violation and the resulting damages (Art. 31.2).
*The amounts are those of the original law (year 2000) and are updated by regulation.*
### Criminal sanctions (Art. 32)
The Act incorporated two articles into the Criminal Code:
- **Art. 117 bis CP**: Prison from 1 month to 2 years for anyone knowingly inserting false data into a personal data file. The penalty goes up to 6 months to 3 years if you provide false information to a third party. It is increased by half if damage is caused
- **Art. 157 bis CP**: Prison from 1 month to 2 years for anyone who unlawfully accesses a personal data bank, or discloses information whose secret he is obliged to preserve by law
In addition to criminal and administrative sanctions:
- **Civil liability**: The patient may sue for damages
- **Ethical sanctions**: of the professional college
## Common situations in clinical practice
### "A relative calls and asks for information"
You cannot give information without the patient’s consent. Not even confirm that that person is your patient. The exception is whether the relative is the legal representative of a minor or a person with restricted capacity.
### "Health insurance calls for detailed diagnosis"
You are only required to report the diagnostic code (CIE/DSM), the session frequency and the general plan. Not the content of the sessions or detailed clinical information.
### "I share cases with colleagues for supervision"
The law provides for **dissociation of data** (Art. 2): the processing of data in such a way that the information cannot be associated with a determined or determinable person. If you dissociate correctly, the data ceases to be personal. If the dissociation is not complete (because the case is identifiable), you need the consent of the patient for the assignment (Art. 11) and a [confidentiality agreement](/blog/acuerdo-confidencialidad-psicologia) with the supervisor.
### "Use Google Drive to keep medical records"
Google Drive is a generic storage tool, not a clinical software. The main problem is not where the servers are, but that Google Drive does not offer a medical records structure, does not guarantee the unalterability required by Art. 13 of the 26.529 Law, and according to its terms of service, Google can access the stored content. You should check that your account has the corresponding security measures (two-step verification, encryption, restricted access).
### "I accidentally erased a patient's medical records."
If you don’t have backup, you have a serious problem. The law obliges you to keep the data and the 26.529 law obliges you to keep the medical records for 10 years. Not having backup is not just a technical problem — is a legal breach.
### "A patient asks me to erase everything"
You can delete the administrative data, but the medical records must be kept for the legal period (10 years). Explain this legal limitation to the patient and offer to block access if he or she is not going to continue treatment.
## Compliance Checklist
Use this list to check if your clinical practice complies with the 25.326 law:
### Consent and transparency
- [ ] Your informed consent includes a section on handling personal data
- [ ] The patient knows what data you collect, for what and where you keep them.
- [ ] Consent is in writing or otherwise comparable (Art. 5.1)
### Security
- [ ] Paper records are locked
- [ ] Digital records have password and, ideally, encryption
- [ ] Your computer has access password
- [ ] You use two-step verification on your digital accounts
- [ ] You have backup of your clinical records
- [ ] Your WiFi network has a secure password (not "123456")
### Access
- [ ] Only you (and authorized personnel) access patient data
- [ ] Administrative staff have a signed confidentiality agreement
- [ ] If you use clinical software, you checked its security measures.
### Patient rights
- [ ] You know how to respond to an access request (10 days running)
- [ ] You know how to respond to a rectification request (5 business days)
- [ ] You have a procedure to deliver a copy of the medical records
### Registration
- [ ] You registered your database to the AAIP (recommended)
- [ ] Renewed annual registration
## How Brauni helps you comply with the 25.326 Law
Brauni was designed taking into account the 25.326 law from day one. You can see how that translates into practice in [digital medical records](/funcionalidades/historia-clinica-digital); in short:
1. **End-to-end encryption**: Sensitive data are encrypted at rest and in transit
2. **Grenular access control**: Only you access the information of your patients
3. **Integrated consent**: Informed consent includes the data protection section
4. **Auto-Backups**: You will never lose a medical records
5. **Access Log**: Full audit of who accesses what and when
6. **Patient rights provided**: Exports, corrects or blocks patient data in seconds
7. **Data not training AI**: Your clinical information is never used to train models
## Summary
| Concept | Description |
|----------|-------------|
| **What does it regulate?** | Collection, storage, use and sharing of personal data |
| **Does it apply to psychologists?** | Yes. Art. 8 empowers health professionals to process health data of their patients, respecting professional secrecy |
| **Consent** | Free, express and informed, in writing or equivalent means (Art. 5.1). It is not necessary when deriving from the professional relationship (Art. 5.2.d) |
| **Patient's rights** | Information (Art. 13), Access — 10 straight days (Art. 14), Rectification/Removal — 5 working days (Art. 16) |
| **Habeas data** | Action for non-compliance (Art. 33-43) |
| **Sanctions** | Administrative: warning of a fine of $1.000-$100.000 and closure (Art. 31). Penalties: imprisonment from 1 month to 3 years (Art. 32) |
| **Key** | Comply with the duty of information (Art. 6), adequate safety measures (Art. 9) and respond when the patient exercises his rights |
---
## Professional secrecy in psychology: scopes, exceptions and what to do if you are summoned to testify
- **URL**: https://brauni.io/en/blog/secreto-profesional-psicologia
- **Category**: Professional practice
- **Date**: 2025-12-28
- **Tags**: professional secrecy, professional ethics, confidentiality, court order, psychologists, legal framework
All about the professional secrecy of the psychologist in Argentina. What it protects, what are the 4 legal exceptions, what to do before a court order and how to document correctly.
Professional secrecy is probably the most important ethical obligation of a psychologist. It is what makes it possible for a patient to speak freely, without fear that what he says will come out of clinical practice. Without professional secrecy, there is no possible therapeutic alliance.
But the secret is not absolute. There are situations where you are legally obliged to break it, and others where someone will pressure you to do it without proper. Knowing how to distinguish between the two is fundamental.
## What is professional secrecy?
Professional secrecy is the **legal and ethical obligation not to disclose information** you know in the exercise of your profession. In psychology, this includes:
- Everything the patient tells you in session
- Your clinical observations, diagnoses and interventions
- Just the fact that that person is your patient.
- Information about family members or other persons in session
- Data in the medical records
Professional secrecy protects the patient, not the professional. It exists to ensure that the person can speak freely in a safe space.
## Legal framework in Argentina
The professional secrecy of the psychologist is protected by multiple rules:
### Criminal Code — Article 156
> "He shall be punished with a fine of one thousand five hundred pesos to ninety thousand pesos and a special disqualification, if any, for six months to three years, who, by reason of his state, office, employment, profession or art, is informed of a secret whose disclosure may cause harm, shall reveal it without just cause."
This means that the violation of professional secrecy is a **criminal offence**, not just an ethical misdemeanour. The penalty includes a fine of $1.500 to $90.000 plus special disqualification from 6 months to 3 years.
### Civil and Commercial Code — Article 1770
It establishes civil liability for breach of privacy. The patient may claim damages if his or her confidential information was disclosed.
### Law 26.529 — Rights of the Patient
Article 2.c enshrines the right to **intimacy** and the confidentiality of the patient's sensitive data. Article 2.d establishes the right to **confidentiality**: any person who participates in the preparation or has access to clinical documentation must keep the necessary reservation, except as provided by the competent judicial authority or authorization of the patient himself.
### Law 26.657 — Mental Health
Art. 7.i recognizes the right to **not be identified or discriminated against** by a current or past mental condition. Art. 7.l establishes the right to treatment with **protection from privacy** and full respect for his private life. Art. 7.j guarantees the right to be informed in an adequate and understandable manner, according to the rules of informed consent. Art. 5 states that the existence of a mental health diagnosis **does not authorize to presume risk of harm or incapacity**.
### Law 25.326 — Protection of Personal Data
Health data are **sensitive data** with enhanced protection.
### Codes of professional ethics
All codes of ethics (FePRA, provincial codes) include professional secrecy as a fundamental principle. Their violation may result in penalties ranging from warning to suspension of registration.
### Professional Activity (Provincial) Act
Each province has its own law on the exercise of psychology that regulates professional secrecy.
- **Buenos Aires**: Law 10.306
- **CABA**: 153 Law and CPPC Regulations
- **Cordoba**: Law 7.106
## What does professional secrecy achieve?
### WHAT IS PROTECTED
| Information | Example: |
|-------------|---------|
| **Content of sessions** | Everything the patient says, thinks, feels, or relates |
| **Clinical observations** | Your hypotheses, notes, formulations |
| **Diagnosis** | The diagnostic hypothesis and the criteria used |
| **Patient identity** | Just the fact that that person consults you |
| **Third party data** | What the patient tells you about other people |
| **medical records** | All the contents of the file |
| **Communications** | Messages, calls, emails with the patient |
### What Is NOT Protected
- Information that the patient makes public voluntarily
- Data that you tell the patient about himself (it's not secret to him)
- Information you need to share with another care professional (with patient consent)
## The 4 exceptions to professional secrecy
Professional secrecy is not absolute. There are situations where not only can you but you **must** break it:
### 1. Imminent risk of harm
When the patient represents a **concrete and imminent danger** to himself or to third parties.
**Examples:**
- Suicide ideation with structured plan and means available
- Specific threats of harm to an identifiable person
- Patient driving under substance effects and putting others at risk
**What to do?**
- Assess the severity and imminence of the risk
- Try first that the patient will voluntarily accept help
- If the risk is imminent, contact emergency services or a relative
- Document everything in your medical records: what you evaluated, what you decided and why
The key is **imminence**. A patient who says "sometimes I think of dying" is not the same as one who has a plan, a date, and means. Risk assessment must be rigorous and documented.
### 2. Abuse or abuse of children and vulnerable persons
When you have **founded knowledge or suspicion** of physical, sexual, emotional, or negligent abuse of minors or persons in vulnerable situations.
**Legal framework:**
- **Law 24.417** (Protection against Family Violence), Art. 2: Health professionals **are obliged to make the complaint** when the victims were minors, incapacitated, elderly or disabled
- **Law 26.061** (Integrated Protection of Children and Adolescents): Strengthens the reporting obligation for health professionals
- International conventions with constitutional status
**What to do?**
- You don't need certainty, just a reasonable suspicion.
- The complaint is filed with the protection body of your jurisdiction or with the prosecution
- Document the indicators observed in the medical records
- Do not confront the alleged aggressor
The obligation to denounce of Art. 2 of the 24.417 Law prevails over professional secrecy. Health professionals are expressly mentioned as obliged to denounce. Failure to do so may have legal consequences.
### 3.
When a **judge** specifically orders disclosure of information through a well-founded court decision.
**Important:**
- It must be a **judge's order**, not a simple request from a lawyer.
- You must specify what information is requested
- You have the right to deliver only what is strictly relevant to the case.
- You can raise your objections with the judge if you consider the request excessive.
**What to do?**
- Verify that it is a formal court order (not a lawyer's letter)
- Read carefully what information is requested
- Deliver only the pertinent, not "all medical records"
- If you have doubts, consult a lawyer before responding.
- Documenting in the medical records what information you provided and under what order
### 4. Involuntary detention
When the patient requires **mental health internation** and does not consent.
**Legal framework (Law 26.657):**
- **Art. 14**: Internation is a therapeutic resource of a **restrictive** nature.
- **Art. 20**: Involuntary hospitalization only occurs when it mediates a situation of **certain and imminent risk** for itself or for third parties, and outpatient approaches are not possible. It requires an opinion signed by **two professionals from different disciplines**, one of whom must be a psychologist or psychiatrist
- **Art. 21**: Involuntary internment must be **mandatoryly notified within 10 hours** to the competent judge and the review body. The judge has 3 days to authorize, require expanded reports or deny
**Important:** It is not prior judicial authorization. The internment is performed first in the face of the certain and imminent risk, and the judge is notified afterwards, who can confirm or deny it.
**What to do?**
- Evaluate whether the criteria of Art. 20 are met (true and imminent risk, no ambulatory alternative)
- Obtain opinions from two professionals from different disciplines (Art. 20.a)
- Notify the judge and the review body within 10 hours (Art. 21)
- Add all records within 48 hours (Art. 21)
- Document exhaustively in medical records (Art. 15: evolution must be recorded daily)
## Grey situations: when you are pressured to speak
### Relatives Asking
"How's my son? What's wrong with him? What are you talking about?"
**Answer:** Article 4 of the 26.529 Act is clear: health information can only be provided to third parties **with the patient's permission**. In case of incapacity or impossibility, it can be provided to the legal representative, spouse/cohabitant or family members up to the fourth degree of consanguinity. With minors, general information about the process can be given without revealing session contents.
### Lawyers requesting reports
An attorney contacts you asking for a report on your patient for a divorce, tenure or employment trial.
**Answer:** Without written consent of the patient or without a court order, it is not appropriate to provide information. If the patient asks you to make a report, you can do so but remember that you can only report what you observed clinically, not issue legal opinions.
### health insurance and private health plans
They ask you for session notes, detailed clinical content or the "complete" diagnosis to authorize sessions.
**Answer:** You are only required to report:
- Diagnosis (CIE or DSM code)
- Frequency of meetings
- General treatment plan
- Estimated duration
**No** are allowed to access the content of the sessions and the complete medical records.
### Employers
An employer contacts you because the patient is his employee and wants to know "what's wrong with him."
**Answer:** Not applicable. Not even confirming that that person is your patient.
### Colleagues commenting on cases
At a congress, a training or even a luncheon among colleagues, someone mentions a case with identifiable data.
**Answer:** Even among professionals, sharing clinical information without anonymizing and without purpose of formal care or supervision is a violation of professional secrecy.
In the face of any doubt, the golden rule is: **don't disclose information unless you have a clear legal justification.** If you don't have it, the answer is no.
## What to do if you're summoned to testify?
This is one of the most stressful situations for a psychologist. Step by step:
### 1. Read the subpoena carefully
- Who issues it? (judged, prosecutor, lawyer)
- In what character do they quote you? (witness, expert, treating professional)
- What information do you require?
### 2. Distinguish between subpoena and disclosure order
- **Citeion to declare**: You must introduce yourself, but you may invoke professional secrecy not to answer questions about the content of the attention.
- **Order to disclose information**: the judge specifically orders you to deliver information. This applies the exception nro 3
### 3 Invoking professional secrecy
If you are summoned as a witness, at the time you testify you can (and in many cases you must) invoke professional secrecy to refuse to answer questions about the content of the sessions.
The formula is simple:
> "With all due respect to the court, I am obliged to invoke the professional secrecy provided for in article 156 of the Penal Code and the codes of ethics of my profession, so I cannot answer that question."
### 4. Determine what you can report
There's information you can share without violating the secret:
- **Yes**: that you served that person, during what period, how often
- **With care**: general diagnosis, if requested by the judge
- **No**: session content, what the patient said, your clinical notes
### 5. Consult with a lawyer
If the situation is complex, consult with a lawyer specializing in health law **before** declaring. Your professional college can guide you.
### 6. Document everything
It records in the medical records:
- That you were summoned, by whom and in what cause
- What information was asked of you
- What did you answer and what did you invoke?
- If you submitted documentation, which documentation
## The professional secrecy after the death of the patient
The professional secrecy **survives death** of the patient. Death does not free the psychologist from his obligation to reserve.
**Exceptions:**
- Forced heirs may request medical records with the patient's permission, or when the patient is unable to give them (Art. 19.b, Law 26.529)
- A court order may require post-mortem information
- If the patient left an express authorization in life
## Professional secrecy in the digital age
Technology poses new challenges:
### Electronic communications
- WhatsApp messages, emails or patient chats are protected by secrecy
- Use secure and encrypted channels
- Avoid discussing cases by courier with colleagues informally
### Clinical Management Software
- The system you use for your medical records must comply with the 25.326 law.
- Encryption, access control and backups are minimum requirements
- Checks that the provider does not access clinical content
### Social networks
- Do not publish information that can identify a patient, even indirectly
- Do not confirm or deny therapeutic relationships in networks
- Be careful with the "clinical cartoons" that can be identifiable
### Online monitoring
- If you do video surveillance, make sure the platform is secure.
- Do not share unencrypted clinical material by email
- Consider a [confidentiality agreement](/blog/acuerdo-confidencialidad-psicologia) with your supervisor
### Complaints of irregularities in mental health institutions
Article 29 of the 26.657 Law states that the members of the health team are responsible for informing the review body and the competent judge of any suspicion of irregularity involving unworthy or inhuman treatment of persons under treatment, or undue limitation of their autonomy. The law expressly clarifies that this communication **will not be considered a violation of professional secrecy** and may be made subject to a reservation of identity.
## Consequences of breach of professional secrecy
### Criminal
Article 156 of the Criminal Code: fine of $1.500 to $90.000 and special disqualification from 6 months to 3 years. It is a **private action**, offence which means that the patient must initiate the complaint.
### Civilians
The patient may sue for damages (article 1770 of the Civil and Commercial Code). Compensation depends on the damage proven.
### Ethics
The professional college may apply penalties ranging from:
- Warning
- Warning
- Suspension of registration (temporary)
- Cancellation of registration (in serious cases)
### Professionals
Beyond formal sanctions, breach of professional secrecy destroys trust. A psychologist who does not respect confidentiality loses professional credibility irreversibly.
## How Brauni Protects Professional Secret
Brauni is designed with confidentiality as an architectural principle:
1. **End-to-end encryption**: Not even the Brauni team can read your clinical records
2. **Restrictive Access Control**: Only you access the information of your patients
3. **No data training**: Clinical information is never used to train AI models
4. **Access Log**: You know exactly who agreed to what and when
5. **Safe storage**: Encrypted data at rest and in transit
6. **Confidentiality Agreements**: Generate and manage agreements with your team directly from the platform
And if a court or health insurance asks for a report, you can issue it with [digital verification](/funcionalidades/informes-verificables): any third party can check that it was not altered.
## Summary
| Concept | Description |
|----------|-------------|
| **What does it protect?** | Everything known for the professional exercise: session content, diagnosis, patient identity |
| **Is it absolute?** | No. It has 4 exceptions: risk of life, child abuse, court order, involuntary internment |
| **What if I raped him?** | Criminal consequences (art. 156 CP), civilians (damage and damage) and ethics (punishments of the school) |
| **Does He Survive Death?** | Yes. The obligation to reserve continues after the death of the patient |
| **If I am summoned to testify** | Introduce yourself, invoke professional secrecy, deliver only what the judge specifically orders |
| **Golden rule** | If you have no clear legal justification, the answer is no. |
---
## medical records in psychology: what it should contain, how much it should be kept and how much it should be downloaded
- **URL**: https://brauni.io/en/blog/historia-clinica-psicologia
- **Category**: Professional practice
- **Date**: 2025-12-19
- **Tags**: clinical history, Clinical documentation, Act 26529, clinical records, psychologists, template
Complete guide on medical records in psychology in Argentina. Legal requirements according to Law 26.529, mandatory content, digital format vs paper, retention time and ready-to-use template.
The medical records is the most important document of your professional practice. It is not only a record of what happens in session — is a legal, clinical and ethical instrument that supports your work, protects the patient and can be decisive in a judicial process or an audit of the professional college.
Despite this, many psychologists in Argentina are not clear what should contain, how long to keep it or what format to use. In this article we explain everything you need to know.
## What is the medical records?
The 26.529 (Patient Rights) Act defines the medical records as:
> "The mandatory chronological, foliated and complete document in which all actions performed to the patient by health professionals and auxiliaries are recorded."
In psychology, this translates into the **systematic registration of everything relevant** for patient care: from the initial reason of consultation to the notes of each session, through diagnoses, interventions, referrals and discharge.
The medical records is a right of the patient, not a property of the professional. The patient can request a copy at any time and you are obliged to deliver it.
## Legal framework in Argentina
### Law 26.529 — Rights of the Patient
It is the main law governing medical records (Chapter IV, Art. 12-21). It establishes:
- **Art. 12 — Definition**: Document **mandatory, chronological, foliate and complete** in which all actions performed to the patient are recorded
- **Art. 14 — Ownership**: The patient is the **holder** of the medical records. At his simple request he must be provided with an authenticated copy within **48 hours** of request.
- **Art. 18 — Inviolability and deposit**: The medical records is **inviolable**. The professionals are **depositaries** and must implement the means to avoid unauthorized access. Minimum retention time: **10 years** since the last recorded performance
- **Art. 13 — HC Computerized**: Can be made in magnetic support guaranteeing: integrity, authenticity, unalterability, durability and recoverability
- **Art. 15 — Seats**: Defines the minimum mandatory content
- **Art. 16 — Integrity**: The informed consents, medical indications, protocols, prescriptions and studies carried out are part of the HC.
### Law 26.657 — Mental Health
Strengthens the protection of patient rights in the field of mental health:
- **Art. 5**: The existence of a mental health diagnosis **does not allow the presumption of risk of harm or disability**, which can only be inferred from an interdisciplinary assessment of each particular situation
- **Art. 7.i**: Right to **not be identified or discriminated against** by a current or past mental condition
- **Art. 7.g**: Right of the patient, his or her lawyer, a relative or relative to **access to his or her history, records and medical records**
- **Art. 7.l**: Right to treatment with **the protection of privacy** and full respect for his private life
- **Art. 15**: In hospitalization, the evolution and each intervention of the team should be **registered daily** in the medical records
### Law 25.326 — Protection of Personal Data
Health data are **sensitive data** (Art. 2). Art. 8 specifically empowers health professionals to collect and process data relating to the health of their patients, respecting the principles of professional secrecy. This implies:
- Duty of information to the patient (Art. 6): purpose, existence of the archive, rights
- Technical and organisational security measures to ensure integrity and confidentiality (Art. 9)
- Right of the patient to access (Art. 14 — 10 straight days), rectification and deletion (Art. 16 — 5 working days)
- Deletion does not take place where there is a legal obligation to keep the data (Art. 16.5)
### Provincial regulations
Some provinces have additional regulations, for example:
- **Buenos Aires**: 15.464 Law on Electronic medical records
- **CABA**: 153 Law (Basic Health Law) with provisions on registries
- **Córdoba, Santa Fe, Mendoza**: own regulations that complement national law
Check with your provincial professional college to learn about the specific regulations of your jurisdiction. Some provinces have additional requirements about formatting and content.
## What should the medical records contain?
### Data required under the 26.529 Act (Art. 15)
The law provides that at least:
- (a) The **start date** of its manufacture
- (b) **Patient identification data** and its family nucleus
- (c) **Professional identification data** involved and its speciality
- (d) **Clear and precise records** of acts performed by professionals
- (e) **Genetic, physiological and pathological background** of the patient, if any
- g) Any medical act performed or indicated: prescriptions, treatments, studies, presumptive and certain diagnosis, prognosis, procedure, evolution, income and high
In addition, Art. 16 states that informed consents, medical indications, surgical protocols, prescriptions and studies performed, rejected or abandoned **are part of the medical records**:.
### Recommended content for psychology
Beyond the legal minimum, a complete medical records in psychology should include:
#### Opening section
| Element | Description |
|----------|-------------|
| **Patient data** | Full name, DNI, date of birth, address, telephone, email, health insurance |
| **Professional data** | Name, registration, specialty, contact details |
| **Opening date** | When the attention was started |
| **Source of referral** | Whoever derived it (if applicable) |
| **Reason for consultation** | In the words of the patient and professional reformulation |
| **Informed consent** | Signed and dated |
#### Initial evaluation
| Element | Description |
|----------|-------------|
| **Personal background** | Previous treatments, current medication, hospitalizations |
| **Family records** | Relevant psychiatric/psychological family history |
| **Life Story** | Significant biographical data for the understanding of the case |
| **Initial mental state** | Clinical observations from the first interview |
| **Applied assessments** | Tests, scales or psychodiagnosis instruments (with results) |
| **Diagnostic hypothesis** | Presumptive diagnosis with criteria used |
#### Treatment plan
| Element | Description |
|----------|-------------|
| ** Therapeutic approach** | Main theoretical and technical framework |
| **Objectives** | General and specific, ideally measurable |
| **Frequency** | Weekly/fifty/monthly meetings |
| **Modality** | Face-to-face, online or mixed |
| **Estimated duration** | If possible estimate |
| **Registration criteria** | What needs to be achieved in order to complete |
#### Development notes (per session)
| Element | Description |
|----------|-------------|
| **Date and session number** | Timely registration |
| **Assistance** | Present, absent with notice, absent without notice |
| **Content of the session** | Topics worked, relevant clinical material |
| **Interventions** | Techniques applied, markings, interpretations |
| **Emotional state** | Observations on the patient's condition |
| **Plan for next session** | Tasks, outstanding issues |
#### Attached documents
- Reports of other professionals
- Results of psychodiagnosis evaluations
- Interconsultations
- Derivation notes
- Relevant communications (with the patient, family members, institutions)
#### Closure
| Element | Description |
|----------|-------------|
| **Date of closure** | When the attention ended |
| **Reason for closure** | Therapeutic high, abandonment, referral, patient decision |
| **State at close** | Final patient evaluation |
| **Post-high indicators** | Recommendations, suggested follow-up |
## Digital or paper?
### medical records on paper
**Advantages:**
- No technology required
- Some professionals prefer it by habit
**Disadvantages:**
- You may lose, damage, or deteriorate
- Hard to organize and search for information
- It occupies physical space.
- Cannot be accessed from another location
- Difficult to meet the "foliate" requirement if not rigorous
### Digital medical records
**Advantages:**
- Access from anywhere
- Quick search for information
- Automatic backups
- Easily meet the chronological and foliated requirement
- Facilitates delivery of copies to the patient
- Better security with encryption
**Disadvantages:**
- Requires reliable software
- You need to ensure data security
Article 13 of the 26.529 Law explicitly accepts the computerized medical records. It must determine all means that ensure the preservation of its **integrity, authenticity, unalterability, durability and recoverability** data. To this end, the use of restricted accesses with identification keys, non-rescribeable means of storage and field modification control must be adopted.
### Requirements for digital medical records (Art. 13)
If you choose the digital format, the system must guarantee the five requirements of Art. 13:
- **Integrity**: that data cannot be altered without recording
- **Autentity**: that can be verified who made each record
- **Unchangeability**: that the records already registered cannot be modified
- **Perdurability**: that data is stored over time without deterioration
- **Recoverability**: that data can be accessed in time and form
To achieve this, Art. 13 requires: restricted accesses with identification keys, non-rescribeable storage means and field modification control.
## How long do you have to keep your medical records?
### The legal minimum: 10 years
Article 18 of the 26.529 Law provides that the obligation of custody and custody must apply for a minimum period of **10 years of prescription for the release of contractual liability**, calculated **from the last recorded act** in the medical records. If you served a patient until 2026, you must keep his or her medical records at least until 2036. After that period, the depositary shall have it as determined by the regulations.
### Professional recommendation: keep indefinitely
Many professional colleges and ethics experts recommend keeping medical records indefinitely, especially in digital format where storage is not a problem. Reasons:
- **Legal claims**: limitation periods may be extended in certain cases
- **Continuity of care**: The patient may return years later
- **Research**: material may be useful for research (anonymized)
- **Professional protection**: against an ethical complaint, the medical records is your main defense
### What about minors?
The 26.529 Act does not make an explicit distinction for minors as to the period of retention. Article 18 states that 10 years are counted from the last recorded act. However, since the limitation periods for civil liability for damages to minors may be extended (the Civil and Commercial Code establishes that the statute of limitations does not apply to minors), it is prudent to retain the medical records at least until the minor reaches the age of majority plus the applicable statute of limitations.
The premature destruction of a medical records can have serious legal consequences. Faced with doubt, it retains.
## Who can access the medical records?
### The patient (Art. 14 and 19.a)
Always. The patient is the **holder** of the medical records (Art. 14). At his simple request must be provided authenticated copy within **48 hours** of request, except in case of emergency. If you refuse access, the patient can exercise the action of habeas data (Art. 20).
### Legal representative (Art. 19.a)
In the case of minors or persons with restricted capacity, their legal representatives may apply for a medical record.
### Spouse, cohabitant and forced heirs (Art. 19.b)
The spouse or person living with the patient, and the forced heirs, may access **with the consent of the patient**, unless the patient is unable to give it (e.g. by death or disability).
### Other health professionals (Art. 19.c)
Physicians and other professionals in the art of healing may access **with the express consent of the patient** or their legal representative. Ideally, with a signed [confidentiality agreement](/blog/acuerdo-confidencialidad-psicologia).
### Judicial authorities
Article 2.d of the law states that the confidentiality of clinical documentation must be respected unless "expresses a provision to the contrary emanated from the competent judicial authority." Upon a judicial request, you have the right to deliver only what is relevant to the case.
### health insurance and private health plans
They may access administrative information (diagnosis, frequency, duration of treatment) but **not the content of the sessions**. Art. 2.c protects the privacy and confidentiality of the patient's sensitive data.
## Frequent errors
### Do not have a medical records
The most serious and most common error. Some psychologists rely on their memory or carry "loose notes" that do not constitute a formal medical records. This leaves you completely unprotected from a claim.
### Incomplete or irregular records
Dateless sessions, single-line notes, months without records. If the medical records has gaps, it loses value as a legal document.
### Do not record absences
Patient failure (with and without notice) is part of the medical records. Documenting them is important for clinical follow-up and as support for eventual discontinuation of treatment.
### Mixing personal opinions with clinical observations
medical records is a professional document. Expressions such as "this patient is unbearable" or non-clinical value judgments do not take place. Record objective observations and clinical formulations.
### Do not include informed consent
Article 16 of the 26.529 Act states that [informed consents](/blog/consentimiento-informado-psicologia) **are part of the medical records**. If they are not, a legally binding component is missing.
### Do not protect information
Leaving medical records on paper on the desk, in drawers without a key, or in digital files without a password is a violation of the 25.326 Law.
## medical records template
Then we leave you an adaptable base model. **Check with your professional school** to match the requirements of your jurisdiction.
---
### Psychological medical records
**file number:** [Number]
**Opening date:** ________________
---
#### PROFESSIONAL DATA
- **Name:** Lic. [Name and Surname]
- **professional license:** M. P. [Number]
- **Speciality:** [Focus/speciality]
- **Professional address:** [Address]
- **Telephone/Email:** [Contact]
#### PATIENT DATA
- **Full name:** [Name and Surname]
- **DNI:** [Number]
- **Date of birth:** ________________
- **Age:** [Age]
- **Civil State:** [State]
- **Occupation:** [Occupation]
- **Domicile:** [Address]
- **Telephone:** [Number]
- **Email:** [Mail]
- **Health insurance/private health plan:** [Name and Affiliate number]
- **Emergency contact:** [Name, link, telephone]
#### GROUND FOR CONSULTATION
**In the words of the patient:**
[Record textually what the patient refers to as a reason for consultation]
**Professional reformulation:**
[Your clinical reading of the reason for consultation]
**Delivered by:** [Name of the professional / institution / spontaneous consultation]
#### BACKGROUND
**Previous psychological treatments:**
| Period | Professional | Approach | Reason | Outcome |
|---------|-------------|---------|--------|-----------|
| | | | | |
**psychiatry treatments:**
| Period | Professional | Medication | Current dose |
|---------|-------------|------------|-------------|
| | | | |
**relevant medical records:**
[Medical conditions, surgeries, hospitalizations]
**relevant family records:**
[Family history of psychological/psychiatric disorders]
#### INITIAL ASSESSMENT
**Mind state:**
| Area | Observation |
|------|-------------|
| Overview | |
| Orientation (time, space, person) | |
| Attention and concentration | |
| Memory | |
| Language | |
| Thought (form and content) | |
| Affect | |
| Sensoperception | |
| Trial and Self-Criticism | |
| Basic functions (dream, appetite) | |
**Applied instruments:**
| Date | Instrument | Outcome |
|-------|-------------|-----------|
| | | |
**Diagnostic hypothesis:**
[Presumptive diagnosis with criteria or theoretical framework used]
#### TREATMENT PLAN
- **Theoretical approach** [Theoretical framework]
- **General objectives:** [List]
- **Specific objectives:** [List]
- **Frequency:** [Week/fifth]
- **Modality:** [Present/online/mixed]
- **Estimated duration:** [If possible to estimate]
- **Release criteria:** [What needs to be achieved]
#### EVOLUTION NOTES
**Session N°:** [Number] — **Date:** ________________
**Assistance:** [ ] Present [ ] Absent with notice [ ] Absent without notice
**Worked topics:**
[Clinical content of the session]
**Interventions made:**
[Applied techniques, markings, interventions]
**Clinical observations:**
[Emotional status, observed changes, relevant material]
**Plan / Next session:**
[Tasks, topics to be taken up, agreements]
---
[*Repeat the Evolution Notes section for each session*]
---
#### CLOSURE
- **Date of closure:** ________________
- **Motivation:** [ ] High therapeutic [ ] Derivation [ ] Patient decision [ ] Abandonment [ ] Other: _____
- **State at closure:** [Final assessment]
- **Indications:** [Post-high recommendations]
---
**Professor's signature:** _____________________
**Seal:** _____________________
---
## How to manage your medical records with Brauni
Brauni is designed specifically to make the management of the medical records simple, safe and legally sound. The complete detail is in [digital medical records](/funcionalidades/historia-clinica-digital); these are the key points:
1. **Dynamic Templates**: Customize the structure of your medical records according to your theoretical approach and needs
2. **Automatic chronological record**: Each note is automatically dated and numbered
3. **Linked consent**: Informed consent is attached to the patient's file
4. **End-to-end encryption**: Your clinical records are protected with the highest safety standards
5. **Controlled access**: Only you access the information of your patients
6. **Auto-Backups**: You will never lose a medical records
7. **Export**: Generates a complete copy in PDF when requested by the patient
## Summary
| Concept | Description |
|----------|-------------|
| **What is it?** | Mandatory, chronological, foliated and complete document (Art. 12, Law 26.529) |
| **Is it mandatory?** | Yes, by law 26.529 |
| **Titleality** | The patient is the holder (Art. 14). The professional is the depositary (Art. 18) |
| **How much do you keep?** | Minimum 10 years since last performance (Art. 18). Recommended: indefinitely |
| **Digital or paper?** | Both are valid. Art. 13 accepts magnetic support guaranteeing integrity, authenticity, unalterability, durability and recoverability |
| **Copying delivery** | Within 48 hours of application (Art. 14). If refused, the patient may exercise habeas data (Art. 20) |
| **Who can access?** | Patient (Art. 19.a), legal representative (19.a), authorized spouse/heirs (19.b), licensed professionals (19.c), judicial authority (Art. 2.d) |
---
## Your clinical data does not train any AI: how and why we guarantee it
- **URL**: https://brauni.io/en/blog/tus-datos-no-entrenan-ia
- **Category**: Privacy and Security
- **Date**: 2025-12-12
- **Tags**: artificial intelligence, privacy, vertex ai, clinical data, security
We explain with technical transparency why your patient data in Brauni is never used to train AI models. Vertex AI, contracts and architecture.
"If I use AI for my session notes, do these data end up training the model?" It's the first question psychologists ask us. And it makes all the sense in the world: you're putting sensitive clinical information into a tool that uses artificial intelligence. You need to know exactly what happens to that data.
The short answer: **your clinical data is never used to train any AI models. Neither ours, nor Google's, nor anyone's.**
The long answer requires explaining how architecture works inside. That’s what we’re going to do here, with total transparency.
## The difference between using AI and training AI
First, a fundamental distinction that is often confused:
**Use AI** is to send a text to a language model, receive an answer and ready. The model processes your text, generates an answer and discards everything. It is like asking a question over the phone: the person answers you, but does not record the call or learn from it.
**Training AI** is a completely different process. It involves taking large volumes of data, feeding the model with them for weeks or months of intensive processing, and modifying the internal parameters of the model to "learn" from that data. It is an expensive, deliberate and planned process.
Brauni **use** AI. Not **training**. Your clinical information is sent as a temporary context to generate a response, and then disappears.
To think that using ChatGPT or any AI trains the model is like thinking that finding something in Google modifies the search algorithm. They are completely separate processes.
## Google Vertex AI: the platform we use
Brauni does not have its own language model. We use **Google Vertex AI**, Google Cloud's corporate artificial intelligence platform. Specifically, we use **Gemini** models through the Vertex AI API.
Why Vertex AI and not the public API of Gemini or ChatGPT? For a fundamental reason: **contractual privacy warranties**.
### Vertex AI vs Public APIs: the difference that matters
| Aspect | Public API (Gemini, ChatGPT) | Google Vertex AI |
|---------|-------------------------------|------------------|
| **Do they train with your data?** | They can do it (depends on the terms) | No. Contract guaranteed |
| **Do you store your prompts?** | They can be stored temporarily | Not stored after processing |
| **Is there a human revision?** | You can review conversations to improve service | No human review of your data |
| **Contract coverage?** | General Service Terms | Specific Data Processing Addendum (DPA) |
| **Certifications?** | Variables | SOC 2, ISO 27001, HIPAA selectable |
This table summarizes why we choose Vertex AI. It is neither cheaper nor easier. It is safer.
## The contractual guarantees of Google Cloud
When you use Vertex AI through Google Cloud, you are covered by three levels of contractual protection:
### 1. Google Cloud Terms of Service
The terms of service of Google Cloud explicitly state that Google **does not use customer data to train its AI models**. This is different from Google's consumer products (such as Gmail or Google Search), where data can be used to improve services.
### 2 Data Processing Addendum (DPA)
The DPA of Google Cloud is a legal agreement that defines:
- Google acts as **data processor**, not as a controller
- Data is processed **only to provide the requested service**
- Google **cannot use data for any other purpose**
- Confidentiality obligations apply to Google staff
- Google should **delete data** when requested by the client
### 3. Vertex AI Specific Terms
The specific terms of Vertex AI add:
- **Customer training data** - Google does not acquire any rights
- **Custom models trained by the customer are from the customer** - Google cannot use them
- **Prompts and answers are not stored** after processing (unless the client explicitly configures it)
These warranties are not marketing words. They are legally binding contractual clauses that Google Cloud must comply with. If it violated them, it would be breaching a contract with specific legal consequences.
## How your data flows: step by step
Let's see exactly what happens when you use the AI wizard in Brauni to complete a session note:
### 1. You send an audio describing the session
The audio is uploaded to the Brauni servers. It is transcribed to text using the Google Cloud voice-to-text service.
### 2. The context is armed
Brauni take:
- Your therapeutic orientation (from your profile)
- Basic patient data (name, age, diagnosis)
- The structure of your session note template
- The transcribed text of your audio
And put together a **structured prompt** that's sent to Vertex AI.
### 3. Vertex AI processes and responds
The Gemini model receives the prompt, generates the completed fields of your session note and sends them back to Brauni. This processing occurs in **volatile memory** - it is not saved to disk.
### 4. Response reaches Brauni
Brauni receives the completed fields, shows them to you for review and, when you approve them, saves them **Fernet (AES-128)** in the database.
### 5. In Vertex AI there is nothing left
Once the response was generated and sent, **there is no record of the prompt or response on Google servers**. There is no log of your clinical content. There is no temporary storage. There is no data queue waiting to train a model.
## What about audio?
A specific concern is audio. When you record a session summary:
- The audio file is sent to **Google Cloud Speech-to-Text** for transcription
- The service processes audio, generates text and returns it
- Audio **is not stored** on Google servers after processing
- Google Cloud Speech-to-Text has the same contractual guarantees as Vertex AI: **data are not used to train models**
- In Brauni, the original audio is not saved - only the encrypted session note you approved is retained
Never use free or generic transcription tools for clinical audio. Services such as the free version of Whisper, Otter.ai or similar can store and use your data to improve your models. Brauni uses business services with explicit contractual guarantees.
## Google Cloud Certifications and Compliance
Google Cloud (the infrastructure where Vertex AI runs) maintains the following security certifications:
- **SOC 1, SOC 2 and SOC 3**: independent audit of security, availability and confidentiality controls
- **ISO/IEC 27001**: Information security management
- **ISO/IEC 27017**: security controls for cloud services
- **ISO/IEC 27018**: protection of personal data in the cloud
- **ISO/IEC 27701**: Information privacy management
- **HIPAA**: Eligibility for Protected Health Information Processing (PHI) - the world's most demanding health standard
- **FedRAMP**: U. S. government authorization for cloud services
These certifications are not granted by Google. They are granted by **independent auditors** who verify that security controls comply with international standards.
## Why we don't use the public ChatGPT API
OpenAI offers a public API that is excellent for many use cases. But for clinical data, it has limitations:
- OpenAI API terms allow you to use data for **abuse detection**, which means that someone (or an automated system) could review your prompts.
- OpenAI has changed its privacy policies multiple times - what is safe today may not be tomorrow
- It does not offer the same level of DPA as Google Cloud for business customers
- No HIPAA eligibility in your standard API
This does not mean that OpenAI is generally insecure. It means that for **mental health clinical data**, we need stronger and more stable guarantees.
## What Brauni does besides Vertex AI
The Google Cloud guarantees are the floor. Brauni adds additional layers:
### Encryption before and after
- Clinical data are **cyphered with Fernet (AES-128)** before being stored in the database
- The infrastructure of Google Cloud and AWS add **rest encryption** and **TLS 1.3 in transit**
- The prompt sent to Vertex AI is armed in memory and **never saved in plain text**
- The AI response is encrypted immediately when saved as a session note
### Minimum data exposure
We don't send the entire patient's medical records to AI. We send him only what is necessary for the task:
- To complete a note: your audio/text + template structure + basic patient data
- For a chat query: your question + relevant notes found by semantic search
- Never send information to other patients
### No intermediate storage
We do not save the prompts that are sent to Vertex AI. We do not save raw responses. We only save the final result (session note) encrypted in the database.
### Full audit
Each interaction with AI is recorded in the audit log: who made it, when, for what patient. But the **content** of the prompt and the response are not made - only the metadata.
## Frequently Asked Questions
### Can Google read my session notes?
No. The data is automatically processed by the AI model. There is no human revision. Furthermore, the data in the Brauni database is encrypted with a key that Google does not have.
### What if Google changes its policies?
The contractual terms of the DPA are legally binding. Google cannot unilaterally change them for existing customers. If in the future Google would modify its terms in such a way as to affect privacy, we would migrate to another provider before accepting those terms.
### Can I use Brauni if I attend to patients with judicialization?
Yes. The data is encrypted, not shared with third parties and each action is audited. The clinical reports have [cryptographic verification](/blog/informes-clinicos-verificacion-digital) that demonstrates its authenticity and integrity.
### What if Brauni closes?
Your data is yours. You can export it at any time. And as it is encrypted, if the service ceases to exist, the data in the database would be unreadable without the encryption key.
### Does this comply with the 25.326 Law?
Brauni complies with the principles of the 25.326 Law on Protection of Personal Data of Argentina. Article 8 empowers health professionals to process health data of their patients respecting professional secrecy. The data are entered at rest and in transit according to Art. 9, and the patient can exercise his rights of access, rectification and suppression (Art. 14 and 16). For more details, I read our article on [Law 25.326 for psychologists](/blog/ley-proteccion-datos-personales-psicologos).
## Trust is built with transparency
We know that entrusting clinical data to an AI tool is a serious decision. We do not ask you to trust blindly. We ask you to verify:
- Los [términos de servicio de Google Cloud](https://cloud.google.com/terms) son públicos
- Las [certificaciones de Google Cloud](https://cloud.google.com/security/compliance) son auditadas por terceros independientes
- Our [security page](/seguridad) details all protective measures
- This article explains exactly how your data flows
If after reading all this you have questions, email us at [soporte@brauni.io](mailto:soporte@brauni.io). We have nothing to hide.
---
*Brauni uses Google Gemini through Vertex AI in Google Cloud. Clinical data are processed under the terms of Google Cloud Data Processing Addendum and are never used to train artificial intelligence models. Clinical fields are encrypted with Fernet (AES-128) and also operate on secure infrastructure with rest encryption and TLS 1.3 in transit. Brauni complies with the principles of Personal Data Protection Law 25.326.*
---
## Security and privacy in Brauni: how we protect your patients' data
- **URL**: https://brauni.io/en/blog/seguridad-privacidad-brauni
- **Category**: Privacy and Security
- **Date**: 2025-12-05
- **Tags**: security, privacy, HIPAA, patient data, encryption
Meet the 15+ safety layers that Brauni uses to protect your patients' clinical information: military encryption, multifactor authentication, and more.
If you are a psychologist, you know that confidentiality is not optional. It is the basis of the therapeutic relationship. Every session note, every medical records, every personal data of your patients deserves the maximum possible protection.
In Brauni we take this very seriously. It is not a slogan: it is engineering. In this article we show you, with total transparency, the safety layers that protect clinical information within the platform.
## Data encryption: your information is unreadable without the key
All sensitive data from your patients is encrypted **before** being stored in the database. We use **AES-128 in CBC mode with HMAC authentication** (Fernet encryption) for clinical fields, and the platform also has **rest encryption** administered by the cloud provider and **TLS 1.3 in transit**.
What does this mean in practice? If someone accessed the database directly, they would see incomprehensible text strings. Without the encryption key, the data is useless.
### What data are encrypted?
- Patient names and surnames
- Dates of birth
- Document numbers
- Session notes and medical records
- Telephones and invoicing data
- Uploaded files (encrypted before being sent to storage)
Encryption applies field by field. Even within our own technical team, no one can read the clinical data of your patients.
In addition, each file uploaded to the platform is checked with a **SHA-256 hash**, a unique fingerprint that detects any alteration. If a file was modified - by mistake or by an attack - the system detects it automatically.
## Authentication: more than a password
### Passwords protected with Argon2id
We do not save your password. We save a mathematical derivative generated with **Argon2id**, the winning algorithm of the Password Having Competition and considered the safest in the world today.
Why does it matter? Other systems use older algorithms like bcrypt or SHA-256. Argon2id is designed specifically to be resistant to attacks with specialized hardware (GPUs and ASICs), because it requires a lot of RAM for every attempt at divination.
### Multifactor authentication (MFA)
Brauni offers **four methods** of authentication in two steps to choose the one that suits you best:
- **Authentication App (TOTP)**: Google Authenticator, Authy or another app generates 6 digits that change every 30 seconds.
- **Email code**: You receive a temporary code of 6 digits in your mail.
- **Security key (WebAuthn/FIDO2)**: you can use a YubiKey or other physical key. It is the safest method that exists.
- **Backup codes**: 10 single-use codes for emergencies if you lose access to your second factor.
We recommend activating authentication by app or security key. These are the safest methods and do not depend on an email coming to you.
### Protection against brute force attacks
If someone tries to guess your password, Brauni responds in multiple layers:
1. **Account Lock**: after 5 failed attempts, the account is locked for 15 minutes.
2. **Immediate Notification**: You receive an email informing you that someone tried to access your account.
3. **Speed limits**: the system limits the number of login attempts, registration and IP password recovery.
In addition, the system is designed to **not disclose if an email is registered**. If someone tries to sign in with an email that does not exist, the answer is identical to that of an incorrect password. This prevents the enumeration of users.
## Tokens and sessions: controlled access at all times
### Short duration tokens
When you sign in, Brauni generates a **access token** that expires in 15 minutes. This minimizes the exposure window if someone intercepts the token.
So you don't have to sign in every 15 minutes, we use **one-use soft drink tokens**. Every time your session is renewed, the previous token is invalidated. If someone tries to reuse an already used soft drink token, the system detects the attack, overrides the entire session, and records the incident.
### Instant revocation
You can close all your active sessions with a single click. The system uses **versioned tokens**: when you revoke, change the version and all tokens previously issued cease to be valid instantly.
## File protection: deep defense
Uploading files to a clinical platform is a common attack vector. Brauni implements **6 validation layers** before accepting any file:
| Layer | What's he doing? |
|------|----------|
| **1. Extension** | Only supports known formats (PDF, DOCX, images, audio) |
| **2. Magic Bytes** | Verify that the actual content matches the extension (detects disguised files) |
| **3. In-depth inspection** | Scan PDFs for hidden JavaScript code or malicious automatic actions |
| **4. Image reprocessing** | Re-code images to remove hidden metadata (EXIF, GPS, etc.) |
| **5. Size limits** | Documents: 10 MB max. Audio: 25 MB max. Protection against decompression pumps |
| **6. Secure name** | Removes dangerous characters and assigns a unique random name |
Never trust a platform that only validates the file extension. An PDF may contain malicious code. Brauni inspects the actual content of each file before accepting it.
## Prevention of unauthorized access (IDOR)
One of the most common attacks on web applications is the **IDOR** (Insecure Direct Object Reference): one user tries to access data from another user by changing an ID in the URL.
In Brauni, **each operation on patient data validates that the professional making the request is the owner of that data**. If a psychologist tries to access a patient that does not belong to him, the system responds with a generic error that does not even confirm if that patient exists. Zero leaks of information.
## Activity log: full audit
Brauni automatically records any relevant action in an **unchangeable audit log**:
- Who agreed, when and from where (IP, browser)
- Which patient was consulted or modified
- What type of operation was performed (reading, creation, modification, elimination)
- Security events (failed login attempts, password changes, MFA activation)
This record cannot be deleted or modified. It meets the traceability requirements that require health data protection regulations.
## Security headers: network-level protection
Each server response includes security headers that protect against common attacks:
- **HSTS**: forces the use of HTTPS at all times (2 years of validity, includes subdomains)
- **CSP**: blocks the execution of unauthorized scripts
- **X-Frame-Options**: prevents clickjacking attacks (nobody can embed Brauni in an iframe)
- **X-Content-Type-Options**: prevents the browser from misinterpreting files
- **Permissions-Policy**: disables access to camera, microphone and geolocation from the browser
## CSRF protection: safe forms
Brauni implements the **double cookie CSRF** (Double-Submit Cookie) pattern. Each sensitive operation requires a cryptographically signed token that is validated against a cookie. This prevents a malicious site from running actions on your behalf if you visit a dangerous link.
CSRF tokens expire at 1 time and use **HMAC-SHA256** for signature, making it impossible to falsify them.
## Identity verification (KYC)
To ensure that only real professionals use the platform, Brauni offers **identity verification** through Stripe Identity. The process includes:
- Photo ID (DNI, passport or license)
- Real-time selfie to verify that the person matches the document
- Safe processing by Stripe -Brauni never stores the document photos
## Google OAuth with PKCE: secure login with Google
If you prefer to sign in with Google, Brauni uses the **Authorization Code with PKCE** (Proof Key for Code Exchange), the safest standard for OAuth. This prevents interception attacks from the authorization code, even on compromised connections.
## Secret management: nothing in the code
Encryption keys, external service credentials and sensitive configurations **never in the source code**. In production, a service specifically designed to store secrets safely and audited is obtained from **AWS Systems Manager Parameter Store**,.
When starting, the system validates that the keys meet minimum safety requirements. If it detects a weak or development key in a production environment, **refuses to boot**.
## Why so many layers?
In computer security there is a principle called **in-depth defense**: you never depend on a single protective measure. If one layer fails, the following ones continue to protect the data.
Brauni implements this principle at each level:
- **Data at rest**: Fernet encryption (AES-128) field by field + rest encryption administered by cloud provider
- **Data in transit**: HTTPS mandatory with HSTS
- **Authentication**: Argon2id + MFA + Account Lock
- **Authorization**: validation of ownership in each transaction
- **Archives**: 6 validation layers before accepting a upload
- **Sessions**: Short duration tokens + single-use soda
- **Auditry**: Unchangeable record of any activity
- **Red**: security headers in each response
## Your responsibility as a professional
The platform does its part, but security is shared. We recommend:
- **Activate authentication in two steps** (MFA) from your account settings
- **Use a unique password** for Brauni that you do not use for other services
- **Don't share your session** -each professional must have his own account
- **Session closed** when using a shared computer
## Transparency commitment
Safety should not be a black box. We believe that health professionals deserve to understand how their patients’ data is protected. That’s why we publish this article and will continue to share updates on the safety measures we implement.
If you have questions about security or privacy, please write to [soporte@brauni.io](mailto:soporte@brauni.io). We are here to help you.
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*Brauni complies with the principles of Argentina's Personal Data Protection Act 25.326 and is aligned with the international standards of HIPAA for the management of protected health information (PHI).*
## Legal information and contact
- soporte@brauni.io
- https://brauni.io/en/privacidad
- https://brauni.io/en/terminos
- https://brauni.io/en/cookies
- https://brauni.io/sitemap.xml