The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy

Why AI Mental Health Chatbots Fail When It Matters Most: The Hidden Vulnerabilities Stress-Testing Reveals - An Interview with Shirali and Arul Nigam of Circuit Breaker Labs

Shirali and Arul Nigam of Circuit Breaker Labs on why AI mental health chatbots fail, how stress-testing exposes their hidden vulnerabilities, and what therapists need to know.

Curt and Katie talk with Shirali and Arul Nigam, the sibling co-founders of Circuit Breaker Labs, about what therapists tend to get wrong about AI, why the safety infrastructure behind many mental health chatbots is weaker than it looks, and how their team stress-tests these tools to find dangerous failures before real users ever encounter them.

Generative AI is probabilistic, so the same prompt can return a safe answer one moment and a harmful one the next. Shirali and Arul explain how guardrails get bypassed by a misspelled word, a teenager's slang, or the hundredth message in a long conversation, why mental health chatbots tend to fail in the moments that matter most, and what stress-testing hundreds of thousands of simulated conversations actually reveals about model safety.

The conversation closes on what clinicians can do now, why clinical insight is the missing ingredient in AI safety, and why third-party validation is becoming the standard regulators and developers expect. Used well, AI can be a supplement to care or a gateway to a human therapist, but it is not a replacement, and getting there safely starts with building clinical insight in from the foundation.



In this episode, we discuss:

- Why people usually turn to AI in place of no care, not in place of a therapist

- Why generative AI's unpredictability, not a single bad answer, is the real safety problem

- How a misspelling, slang, or a long conversation can slip past chatbot guardrails

- Why AI mental health chatbots tend to fail in the highest-risk moments

- What stress-testing hundreds of thousands of conversations reveals about model safety

- Why clinical insight is the missing ingredient, and what clinicians can do now



Timestamps:

0:00 - Introduction

1:38 - Meet Shirali and Arul Nigam and Circuit Breaker Labs

3:37 - What therapists get wrong about AI

5:28 - Deterministic versus generative AI, and why the risk scales

8:26 - The safety problem in AI mental health: trust, training data, and agreeableness

11:29 - Guardrails, lifeguard models, and the 988 problem

17:30 - Deploying clinical insight at scale and building safety in from the start

21:09 - How stress-testing works: context pollution and adversarial simulation

27:11 - What the stress tests reveal: variance, typos, and bypassed guardrails

30:59 - Regulation, credential hallucination, and third-party validation

36:58 - What clinicians can do, and the missing clinical insight

40:20 - Where to find Circuit Breaker Labs



Guest Bios:

Shirali and Arul Nigam are siblings and the co-founders of Circuit Breaker Labs, which autonomously pressure-tests the AI systems that interact with people to find hidden mental health vulnerabilities before they reach real users. Shirali brings expertise in neuroscience, translational research, and clinical work, with experience at the Howard Hughes Medical Institute's Janelia Research Campus, NIH NINDS, Harvard's Wyss Institute, Johns Hopkins, and Children's National. She holds a BS in Biomedical Engineering from The George Washington University and an MBA from The Wharton School, University of Pennsylvania. Arul has conducted technical and policy research on ethical AI, with a focus on bias and fairness, at Georgetown University and Thomas Jefferson High School for Science and Technology, and holds a BSBA in Operations and Analytics from Georgetown University. Learn more at circuitbreakerlabs.ai.



Full show notes and transcript: mtsgpodcast.com



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AI Ethics Codes for Therapists: What CAMFT, APA, NASW, and AAMFT Now Require

How the CAMFT, APA, NASW, and AAMFT ethics codes now regulate AI in therapy: a CE podcourse on competence, informed consent, data privacy, bias, and human accountability.

Curt Widhalm, LMFT, and Katie Vernoy, LMFT, walk through the recent artificial intelligence updates to the major mental health ethics codes. Centering on the new CAMFT updates and cross-referencing the APA, NASW, ACA, and AAMFT codes, they turn the new language into a practical roadmap for everyday clinical work.

The conversation covers what competence with AI actually requires (closer to safely driving a car than building one), the three CAMFT obligations that travel together (disclosure, informed consent, and informed decision making), and a client's right to opt out. They get specific on data privacy, including business associate agreements and why "HIPAA compliant" is a marketing claim rather than a certification, on spotting demographic and medical-model bias in AI output, and on why the human in the loop still owns and is accountable for anything signed under their name.

This continuing education podcourse is for therapists, supervisors, and clinical educators who want to use AI tools ethically and stay accountable in an automated world.

In this episode, we discuss:

- Why the codes aim for broad, durable AI principles instead of tool-specific rules
- What competence with AI actually requires of a clinician
- The three CAMFT obligations: disclosure, informed consent, and informed decision making
- How to vet data privacy, including BAAs and why "HIPAA compliant" is only marketing
- How to catch demographic and medical-model bias in AI output
- Why the clinician remains responsible for anything produced under their name

Timestamps:

- 0:55 - Why the ethics codes are updating for AI
- 3:30 - Defining artificial intelligence (California AB 2885)
- 9:49 - The four Beauchamp and Childress principles
- 12:28 - Timeline: CAMFT, APA, NASW, and AAMFT updates
- 16:11 - Competence and the "driving a car" metaphor
- 21:09 - Disclosure, informed consent, and the right to opt out
- 33:18 - Data privacy, BAAs, and "HIPAA compliant" as marketing
- 41:20 - Bias, social justice, and reading the output
- 44:52 - The human in the loop and accountability
- 53:12 - Is AI right for this client?
- 1:00:59 - Supervision, education, and the AI vetting guide

1 CE unit is available through the Modern Therapist Learning Community: moderntherapistcommunity.com

Full show notes and transcript: mtsgpodcast.com

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Supporting Conversion Therapy Survivors After Chiles v. Salazar: SOGIECE, Clinical Care, and Community Response - An Interview with Samuel Nieves

Samuel Nieves of the Conversion Therapy Survivor Network on supporting conversion therapy survivors, recognizing SOGIECE, and clinical care after Chiles v. Salazar.

Curt and Katie welcome back Samuel Nieves, a conversion therapy survivor and board member of the Conversion Therapy Survivor Network, for a follow-up to their earlier conversation and to the host-led discussion of the Chiles v. Salazar decision. Rather than re-litigating the legal details, they focus on the clinical and human aftermath for survivors.

Sam shares what he saw the day the ruling came down, how to recognize a conversion therapy survivor on your caseload (including memory loss and shifting narratives), why validation has to come before strengths work, and how to lead with curiosity instead of challenge. He explains SOGIECE, sexual orientation and gender identity or expression change efforts, and why naming it can be the validation that lets a survivor finally call their experience what it was.

The conversation also sits with why reducing these practices to "speech" misses the harm, what licensing boards and clinicians owe survivors, and how survivors and the advocates who serve them stay in the work through firm boundaries and intentional queer joy. This is a grounded, affirming episode for any clinician working with LGBTQ+ clients.

In this episode, we discuss:

- How to recognize a conversion therapy survivor on your caseload

- Why validation has to come before strengths-based work

- How to lead with curiosity instead of challenge with traumatized clients

- What SOGIECE is and why naming it can be profoundly validating

- Why framing conversion therapy as "speech" misses the real harm

- What licensing boards and the profession owe survivors

- How survivors and advocates sustain themselves through boundaries and queer joy

Timestamps:

- 02:00 - Who Sam is and the Conversion Therapy Survivor Network

- 03:14 - The day the Chiles v. Salazar decision came down

- 06:26 - Validation before strengths with survivors

- 09:04 - What well-meaning therapists can miss

- 11:10 - The public "permission" and its harm to survivors

- 18:40 - Why "it's just speech" misses the harm

- 22:10 - SOGIECE, allies, and survivor organizations

- 27:45 - What the profession owes survivors

- 32:21 - Solution-focused therapy, ACT, and queer joy

- 35:01 - How Sam sustains himself in the work

Guest Bio:

Samuel Nieves (he/they) is a board member of the Conversion Therapy Survivor Network, a 501(c)(3) nonprofit supporting survivors of conversion therapy and SOGIECE worldwide. Trained as a marriage and family therapist, Sam advocates online as "CantPrayMeAway" and helps facilitate the organization's weekly survivor support group.

Full show notes and transcript: mtsgpodcast.com

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Should Conversion Therapy Be Protected Speech? What Chiles v. Salazar Means for Conversion Therapy Bans and the Future of the Profession



In Chiles v. Salazar, the Supreme Court ruled 8 to 1 that a therapist's talk therapy is protected speech, putting state conversion therapy bans at risk.

Curt Widhalm, LMFT, and Katie Vernoy, LMFT break down what the March 31, 2026 decision actually says, what it does not say, and what it means for therapists who work with LGBTQ+ clients. The Court did not call conversion therapy safe, effective, or ethical, and it did not make the practice mandatory. It treated talk therapy as speech rather than regulable conduct, and sent Colorado's ban back to the lower courts for stricter First Amendment review.



Curt and Katie walk through the strict scrutiny test at the center of the case, the Kagan and Sotomayor concurrence, and Justice Jackson's dissent, then sit with the harder question: what happens to the profession when the state can no longer set a guardrail on harmful practice before harm has occurred. Released during Pride Month, this is a candid, values-forward conversation about protecting LGBTQ+ clients and practicing affirming, anti-conversion-therapy care out loud.



In this episode, we discuss:

- What the Chiles v. Salazar ruling does, and does not, change about conversion therapy bans

- Why the Court treated talk therapy as protected speech instead of medical treatment

- How the strict scrutiny test decided the case

- Where the concurrence and the dissent point the profession next

- Concrete ways to signal affirming, anti-conversion-therapy care in your practice



Full show notes and resources: mtsgpodcast.com



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Good Enough, Safe Enough: Affirming LGBTQ+ Clients When You're Not a Specialist

Affirming LGBTQ+ clients when you are not a specialist: Curt Widhalm, LMFT, and Katie Vernoy, LMFT on being a good enough, safe enough therapist when you cannot refer out.

Curt and Katie take on a question therapists often avoid: what do you do when an LGBTQ+ client needs care, you are not a specialist, and referring out is not possible, not safe, or not honest? In this Pride Month episode, they make the case that you can be a good enough, safe enough therapist for LGBTQ+ clients even when affirming care is not your declared specialty.

Mental health deserts, narrow insurance panels, long specialist wait lists, and unsafe home environments mean referral is not always available, and sometimes referring out is closer to abandonment than care. Curt and Katie argue that scope of competence is too often used as polite cover for therapist discomfort, and that most clinical work with LGBTQ+ clients is the same work you already do well. Affirming care is the container, not a separate specialty.

They also get practical about being a safe enough stopgap therapist: building a just in time consultation kit, doing the cultural humility work, and reckoning with the invisible labor and consultation tax of allyship, including why you should never bill a client to research their own identity. And they name the specific moments when referring an LGBTQ+ client out is still the right and ethical call.

This is a useful conversation for generalist therapists, rural and solo clinicians, insurance-based practices, and anyone doing the ongoing work of affirming, culturally humble care.

In this episode, we discuss:

- Why "refer out" can be avoidance dressed as ethics, and when it is genuinely the right call

- How to tell a true scope of competence limit from your own discomfort

- What it means to be a good enough, safe enough therapist for LGBTQ+ clients

- How to build a just in time kit so an LGBTQ+ client never lands on you cold

- Why the invisible labor and consultation tax of allyship is yours to carry, not your client's to fund

- The specific signs that mean you should refer out anyway

Timestamps:

00:15 - Why a Pride Month episode on being good enough, not a specialist

02:56 - "Just refer out": sound advice or avoidance?

05:05 - Scope of competence versus therapist discomfort

13:08 - The good enough therapist, and when referral becomes abandonment

16:55 - Meeting clients where they are until specialist care opens up

19:03 - Building a just in time kit for your practice

24:44 - The invisible labor and consultation tax of allyship

32:10 - When you should refer out anyway

Full show notes and transcript: mtsgpodcast.com

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Modern Therapist's Survival Guide Creative Credits

Voice Over by DW McCann: https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano: https://groomsymusic.com/