Field Notes
Practice economics, measurement-based care, AI-as-tool, and the operational reality of running a clinical practice in 2026. Written by Matthew Sexton, LCSW.
Practice economics · 14 min read
The Therapist Side-Gig Economy: Why Your Licensing Exam Did Not Prepare You for This
Roughly two in five licensed therapists run a second clinical income stream. Graduate school did not teach you to price supervision, manage a side caseload, or operate a HIPAA-grade tool stack. The market did.
Clinical AI · 14 min read
AI as Clinical Tool, Not Replacement: What the Research Says and Why the Distinction Matters
The strongest evidence base for digital mental health is for guided, clinician-supervised tools. The marketing-driven framing of AI-as-therapist is not where the research points. Here is what the literature actually shows.