Before a licensed therapist or psychotherapist may use AI to record or transcribe a client's therapeutic session for supplementary support purposes, the professional must provide written notice to the patient (or their legally authorized representative) disclosing both that AI will be used and the specific purpose of its use. The patient must then provide written consent. Without both written notice and written consent, AI-assisted recording or transcription of therapeutic sessions is prohibited. This applies only to supplementary support involving recording or transcription — administrative support tasks that do not involve recording sessions are not covered by this provision.

No individual, corporation, or entity may offer, advertise, or provide therapy or psychotherapy services in South Carolina — including through internet-based AI — unless those services are conducted by a state-licensed professional. This effectively prohibits standalone AI therapy products that operate without a licensed professional conducting the services. The prohibition extends to advertising such services, not merely delivering them. Religious counseling and peer support are carved out by the definitions section.

Licensed professionals face four categorical prohibitions on AI use in therapy: (1) AI may not make independent therapeutic decisions; (2) AI may not directly interact with clients in any form of therapeutic communication — a broadly defined term covering virtually any clinical interaction intended to diagnose, treat, or address mental health; (3) AI may not generate treatment plans or therapeutic recommendations without the licensed professional's review and approval; and (4) AI may not detect emotions or mental states. The overall framing limits AI use to administrative and supplementary support roles, with the licensed professional maintaining full responsibility for all AI outputs. The emotion detection prohibition is notably absolute — it applies regardless of whether the professional reviews the output.

All records maintained by a licensed professional — including AI-generated records — and all communications between a client and a licensed professional are confidential. Disclosure is permitted only as required under South Carolina's existing mental health confidentiality statute (§ 44-22-100). While this reinforces existing confidentiality law, it extends the obligation explicitly to cover records created or maintained with AI assistance, creating a data governance obligation in the AI context that practitioners must observe.

Three categories are carved out from the article's AI-in-therapy obligations: (1) religious counseling provided by clergy acting within their religious duties that is not represented as clinical mental health services; (2) peer support services by individuals with lived experience; and (3) self-help materials and educational resources that do not purport to offer therapy. This provision creates no new compliance obligation — it narrows the article's scope.

The appropriate licensing board may assess civil penalties up to $10,000 per violation, scaled by degree of harm and circumstances. Payment is due within 60 days. Licensing boards have investigative authority over actual, alleged, or suspected violations. This provision establishes the enforcement mechanism but creates no independent compliance obligation.