Texas Family Therapy Board to Weighs Rules That Would Reach Therapists’ Use of AI

The nine-member board that writes the ethics rules for Texas marriage and family therapists will meet Sept. 25 to recommend a rewrite that would, for the first time, put a therapist’s use of artificial intelligence under the same rule as therapy delivered by video. Written comment to the board closes at 5 p.m. Sept. 24.

The current rule defines technology in therapy narrowly: electronic communication between a licensee in one place and a client or supervisee in another. The proposed definition replaces that with “technology-supported services,” covering artificial intelligence, wearable devices, machine learning or analytics, and applying “regardless of whether directly experienced by the client.” It names record keeping, treatment planning, note taking and diagnostic decision-making as covered uses.

The practical effect is that a therapist running an AI scribe over a session note, or a diagnostic tool the client never sees, would fall under the competence, informed-consent and state and federal privacy requirements that now govern online therapy. Nothing in the proposal bans a tool; it pulls the tools inside the rulebook. The agency’s own explanation describes the package as bringing “greater clarity, consistency, and efficiency” and does not single the change out. Public comment on the rules themselves closed Sept. 6.

Six other rules move with it, among them a wider bar on encouraging drug or alcohol use so that it covers supervisors and supervisees rather than only clients, advertising restrictions extended to any medium, and a new requirement that research follow state and federal human-subjects law. One line would also disappear from the telehealth rule: a therapist treating a client in another state must currently follow both Texas rules and that state’s, and the proposal would leave only the other state’s. The published explanation does not describe that as a change of substance.

The board only recommends. Under state law the Behavioral Health Executive Council must either adopt a practice or ethics rule as the board proposed it or send it back, and the council takes that vote Oct. 27. Also on Sept. 25: the annual election of a vice chair, the choice of a new professional delegate to the council — a seat the council’s own roster shows as unfilled — and a rework of the board’s committees that has been under discussion since May without any published rationale.

Meeting at a glance

Board members

• Lee A. Hampton Jr. — presiding member; Bellaire; public member, former city commissioner.
• Jodie Elder — vice chair; Dallas; licensed marriage and family therapist.
• Russell “Russ” Bartee — Fort Worth; therapist, Texas Wesleyan faculty member.
• James S. Castro — San Antonio; licensed counselor and marriage therapist.
• Misti K. Neilsen — Houston; therapist; appointed August 2026.
• Nicole M. Richardson — Austin; therapist; chairs the rules committee.
• Barbara “Barbie” Ezell — Portland; public member.
• William R. “Will” Price — Houston; public member.
• Elvira Reyna — Little Elm; public member, former state representative.

Roster from the council’s board page, checked September 17 and cross-checked against the governor’s appointment releases. The council calls Hampton presiding member and the agenda calls him board chair; the chair is a gubernatorial designation, and the Dispatch found no release naming him to it. Lisa V. Merchant, who chaired two committees as recently as the May 29 agenda and held the board’s professional seat on the executive council, appears on neither the September agenda nor the current roster; the reason is not published, and the board posts no minutes of any meeting. The governor named Misti Neilsen to a professional seat on August 25. The Sept. 25 agenda lists the licensing standards and outreach committee chairs with no names. Meeting contact: Sarah Faszholz, board administrator, (512) 305-7700.