Practice Stories
Psychotherapist, California · former managed-care executive
A former managed-care executive turned California psychotherapist, on the new question showing up in her sessions: whose voice is her client actually listening to?
Lisa Morissette came to healthcare twice, decades apart, through two very different doors. The first was practical: a nursing student who realized partway through her training that she "didn't want to be clinical," she pivoted into healthcare administration and health science, which led to her first job in managed care. "It was really born out of a desire not to be in a clinical setting," she says. She spent the next twenty-plus years on the corporate side of the industry — a world she describes with the precision of someone who lived inside its incentives. "That is really a corporate environment with a lot of very value-based and sales-based goals woven into the performance and the job," she says. "What's really valued is efficiency. Not so much thinking out of the box."
The second door opened much later. "My introduction into the mental health aspect of it came much later, in my mid-40s, after some significant life changes and wanting to make an impact in a different way." That decision sent her back to graduate school and eventually into licensure as a psychotherapist — a career built on the opposite muscle from the one she'd spent two decades training. "On the mental health side," she says, "it's much more of a role that requires you to do a lot of work on yourself and to be fully present." Two completely different skill sets, she's clear, and she's had to build both from scratch.
Morissette's practice today is Lotus Therapy, in California, where she works with couples navigating high conflict and infidelity, with neurodivergent teenagers and young people, and with the trans and LGBTQIA community — populations she says most therapists gravitate toward "born out of their personal experiences." But increasingly, regardless of who's in the chair, a new presence has entered the room with them.
"We are now being faced, as mental health clinicians with deep training and knowledge, with sitting across from our clients and having conversations for the first time where they are actually bringing in things that they may have been talking about with AI," she says. She describes what it sounds like in practice — a client recounting, almost verbatim, a late-night exchange with ChatGPT about whether their thoughts are automatic, then relaying the AI's answer back to her as though it were a second opinion. Her read on the moment is unflinching: "Do we have two providers in the room trying to take care of the same person?"
She's careful not to dismiss what her clients are doing — she notices it skews younger, "much more often with Gen Z" — but she is clear about where she thinks the tool falls short. "The AI, in and of itself, is trying to learn about you and trying mostly to agree with your perspective and your point of view," she says. "So I don't see it as a valid way to get any kind of mental health or psychotherapy service." What she tries to do instead is name the gap out loud with her clients: the difference between a system trained to feel congruent with what you already believe, and a human being with years of training who is willing to push back.
The practice she's built her own name around isn't a rule about AI — it's a rule about attention. "Refrain from picking up your phone for at least the first hour of the day," she tells clients. "Be responsible with your social media and AI use. Track yourself." She's seen the exercise land the same way almost every time: "People are surprised — I don't use it that much." Beyond that first hour, her prescription is almost defiantly physical. "Where we can touch the grass, where we can be among the trees, where we can have connection with a loved one that does not judge us." She asks clients directly: "When was the last time you took your shoes off and put your feet on the grass? When was the last time you breathed the air of a forest?"
It's not nostalgia for its own sake. It's a working theory about what keeps a person tethered to themselves in a landscape that increasingly pulls the other way — and it's the same theory she applies to the birth-rate declines and relationship patterns she's watching shift across the generations she treats.
Asked where she lands on AI — for, against, somewhere in the middle — Morissette doesn't reach for a tidy answer. "I think that life is rarely black or white," she says. "I would like to be part of the ethical use of AI. It's just that there don't appear to be many guardrails around it right now." She points to professional bodies like the APA and state associations that are still drafting position statements, still working out what ethical coexistence with AI is even supposed to look like for licensed clinicians. "Our organizations that guide us as providers are in the process of trying to understand how we ethically coexist with an AI tool," she says. "That's the piece that's missing."
She's not waiting for permission to keep practicing in the meantime — she's just watching the gap between how fast the technology moves and how slowly the guardrails are catching up, and doing what she can, one session at a time, to help her clients notice the difference between a tool that agrees with them and a person who's actually paying attention.
If you want to hear how she navigates that gap in real time — with an actual client, an actual transcript, an actual question about who's really in the room — watch the conversation.