# Palimpsest License: Guide for Psychologists

**Audience:** Clinical psychologists, research psychologists, therapists, trauma specialists
**Version:** 0.4

---

## Why Psychology Matters for Palimpsest

Psychology intersects with Palimpsest at multiple points:

1. **Trauma-informed consent:** Understanding what consent means for trauma survivors
2. **Creative expression as therapy:** Art therapy, narrative therapy outputs
3. **Research data:** Psychological research in AI training datasets
4. **AI in mental health:** Chatbots, diagnostic tools, therapeutic AI
5. **Identity and creativity:** Psychological dimensions of creative ownership

---

## Trauma-Informed Consent Design

### Why Standard Consent Fails

Standard consent models assume:
- Rational decision-making
- Consistent preferences over time
- Clear understanding of consequences
- Freedom from coercion

Trauma complicates all of these:

```
TRAUMA AND CONSENT
──────────────────

Rational decision-making:
├── Trauma affects executive function
├── Dissociation may impair processing
├── Hypervigilance → impulsive consent
├── Freeze response → passive consent

Consistent preferences:
├── Trauma responses fluctuate
├── Recovery changes relationship to work
├── What felt safe yesterday may not today
├── Re-traumatization can shift perspectives

Understanding consequences:
├── AI was unimaginable when work was created
├── "Training data" is opaque concept
├── Downstream uses unpredictable
├── Algorithmic reproduction is abstract

Freedom from coercion:
├── Economic pressure to consent
├── Platform power imbalances
├── Social pressure to share
├── Institutional coercion (patients, prisoners)
```

### Palimpsest's Trauma-Informed Features

```
TRAUMA-INFORMED CONSENT FEATURES
────────────────────────────────

1. REVOCABLE CONSENT
   └── Consent can be withdrawn at any time
   └── Mechanism is low-friction
   └── No explanation required

2. GRADUATED CONSENT
   └── Different levels for different uses
   └── "Human viewing OK, AI training not OK"
   └── Separate consent for separate contexts

3. PROXY CONSENT
   └── Community can consent on behalf
   └── Trusted person can manage consent
   └── Estate/descendant provisions

4. CONTEXT PRESERVATION
   └── Work stays in its context
   └── Decontextualization prohibited
   └── Trauma markers travel with work

5. CONSENT REVIEW
   └── Built-in review periods
   └── Technology triggers review
   └── Life event triggers available
```

---

## Art Therapy and Creative Expression

### Therapeutic Creative Work

Work created in therapeutic contexts has special characteristics:

```
THERAPEUTIC CREATIVE WORK
─────────────────────────

Created for:
├── Processing trauma
├── Expressing difficult emotions
├── Therapeutic relationship context
├── Personal healing

NOT created for:
├── Public consumption
├── Artistic evaluation
├── AI training data
├── Commercial use

Special considerations:
├── Therapeutic frame is sacred
├── Therapist-client confidentiality extends
├── Work may contain triggering content
├── Meaning is deeply personal
```

### Licensing Therapeutic Work

```json
{
  "@context": "https://palimpsestlicense.org/therapy",
  "@type": "TherapeuticWork",

  "therapeuticContext": {
    "nature": "art-therapy-output",
    "confidentialityExpected": true,
    "therapeuticRelationship": "protected"
  },

  "consent": {
    "publicDisplay": "client-consent-required",
    "aiTraining": "prohibited",
    "researchUse": "ethics-board-approval-required",
    "therapeuticEducation": "de-identified-only"
  },

  "traumaMarkers": {
    "present": true,
    "categories": ["personal"],
    "handlingRequirements": {
      "triggerWarnings": "required",
      "contextPreservation": "mandatory"
    }
  },

  "apophaticNote": "This work emerged in a therapeutic context. Its meaning cannot be separated from that relationship. Any use outside therapy violates its fundamental nature."
}
```

---

## Psychological Research Data

### Research in AI Training

Psychological research data is being used to train AI:

```
RESEARCH DATA AI USE
────────────────────

Types of data affected:
├── Survey responses
├── Interview transcripts
├── Behavioral observations
├── Therapy session recordings
├── Assessment results
├── Qualitative research data

Problems:
├── Consent was for "research" not "AI training"
├── De-identification doesn't prevent pattern learning
├── Voices can be recognized, synthesized
├── Narrative patterns reveal identity
├── Cultural/demographic patterns preserved

Questions:
├── Did IRB approval cover AI training?
├── Does participant consent extend?
├── What about historical data?
├── Who owns research outputs?
```

### Palimpsest for Research Data

```markdown
## Research Data Palimpsest Addendum

### Original Consent
Participants consented to: [original study purpose]

### AI Training Status
This data [has / has not / may with conditions] be used
for AI/ML training purposes.

Conditions (if applicable):
- [specify conditions]

### Reasoning
[Why this determination was made]

### Review
To be reviewed: [date or trigger]

### Contact
Questions about AI use of this data: [contact]
```

---

## AI in Mental Health

### Therapeutic AI Concerns

AI is increasingly used in mental health:

```
MENTAL HEALTH AI LANDSCAPE
──────────────────────────

Current uses:
├── Chatbots for initial screening
├── CBT-based apps
├── Mood tracking with ML
├── Diagnostic decision support
├── Natural language analysis of notes

Concerns:
├── Training data source (whose therapy?)
├── Cultural competence (whose norms?)
├── Harm potential (suicide risk, etc.)
├── Therapeutic relationship replacement
├── Privacy of mental health disclosures

Palimpsest relevance:
├── Training data consent
├── Patient voice in AI development
├── Protecting therapeutic disclosures
├── Ensuring human oversight
```

### Clinician Guidance

```
CLINICIAN AI GUIDANCE
─────────────────────

When using AI tools:
├── Know the training data source
├── Check for Palimpsest compliance
├── Inform clients about AI use
├── Maintain therapeutic relationship primacy
├── Document AI-influenced decisions

When your client's work may be AI-affected:
├── Discuss AI consent as part of therapy
├── Support autonomous decision-making
├── Process feelings about AI and creativity
├── Help identify consent boundaries
├── Provide resources on protection
```

---

## Psychological Dimensions of Consent

### Consent Capacity

```
CONSENT CAPACITY ASSESSMENT
───────────────────────────

For AI consent, consider:

1. Understanding
   └── Does the person understand what AI training means?
   └── Can they grasp downstream consequences?
   └── Is the explanation accessible?

2. Appreciation
   └── Do they appreciate how it affects them?
   └── Can they connect abstract AI to concrete impact?
   └── Do they understand emotional implications?

3. Reasoning
   └── Can they weigh benefits and risks?
   └── Is their reasoning consistent?
   └── Are they using relevant information?

4. Choice
   └── Can they communicate a choice?
   └── Is the choice stable?
   └── Is it free from undue influence?

Accommodations:
├── Simplified language
├── Visual explanations
├── Time to process
├── Support persons
├── Review mechanisms
```

### Decision-Making Supports

```
SUPPORTED DECISION-MAKING FOR AI CONSENT
────────────────────────────────────────

For people who need support:

Principle: Support, not substitute

Options:
├── Plain language materials
├── Visual consent tools
├── Trusted person assistance
├── Advocate involvement
├── Cooling-off periods
├── Trial periods
├── Review meetings

Never:
├── Assume incapacity
├── Make decisions for someone
├── Rush the process
├── Ignore preferences
├── Substitute caregiver consent when avoidable
```

---

## Psychological Impact of AI Extraction

### When Your Work Is Used Without Consent

```
PSYCHOLOGICAL IMPACT OF EXTRACTION
──────────────────────────────────

Common reactions:
├── Violation / betrayal
├── Loss of control
├── Identity confusion ("Is that still mine?")
├── Powerlessness
├── Rage / grief
├── Dissociation from one's own work
├── Creative paralysis

Aggravating factors:
├── Trauma content extracted
├── Personal narratives used
├── Community stories appropriated
├── No notification
├── Commercial profit by others
├── Unable to stop ongoing use

Therapeutic implications:
├── Validate these responses
├── Support agency restoration
├── Process grief and loss
├── Explore meaning of creative ownership
├── Build coping strategies
├── Support activism if desired
```

### Supporting Affected Creators

```
THERAPEUTIC SUPPORT FOR AI-AFFECTED CREATORS
────────────────────────────────────────────

Assessment:
├── Extent of exposure
├── Content involved
├── Current distress level
├── Coping resources
├── Support system

Intervention:
├── Psychoeducation about AI systems
├── Validation of response
├── Processing loss/violation
├── Restoring sense of control
├── Practical support (documentation, legal)
├── Community connection

Long-term:
├── Rebuilding creative confidence
├── Developing protection strategies
├── Processing ongoing exposures
├── Meaning-making about experience
```

---

## Research Opportunities

### Psychological Research Agenda

Questions for psychological research:

1. **Consent Psychology**
   - How do people understand AI consent?
   - What heuristics do they use?
   - How does framing affect decisions?
   - What supports informed consent?

2. **Impact Assessment**
   - Psychological impact of AI extraction?
   - Moderating factors?
   - Resilience factors?
   - Long-term effects?

3. **Therapeutic Integration**
   - How to discuss AI in therapy?
   - Impact on therapeutic creative work?
   - Clinician training needs?

4. **Trauma-Informed Design**
   - What makes consent trauma-informed?
   - How to design for diverse needs?
   - What accommodations are effective?

5. **Cultural Dimensions**
   - How does consent vary culturally?
   - Community vs. individual consent?
   - Power dynamics in consent?

---

## Clinical Ethics

### Ethical Considerations

```
CLINICAL ETHICS AND AI
──────────────────────

Beneficence:
├── AI can help (screening, accessibility)
├── AI can harm (misdiagnosis, cold care)
├── How to maximize benefit?

Non-maleficence:
├── Training data harm potential
├── Algorithmic bias in mental health
├── Privacy breaches
├── Therapeutic relationship erosion

Autonomy:
├── Informed consent for AI use in care
├── Client control over their data
├── Supporting AI literacy
├── Respecting AI preferences

Justice:
├── Who benefits from mental health AI?
├── Who is harmed?
├── Whose data trains the systems?
├── Who profits?
```

---

## Professional Integration

### APA Ethics Code Alignment

| APA Principle | Palimpsest Connection |
|---------------|----------------------|
| 3.10 Informed Consent | AI use must be disclosed |
| 4.01 Maintaining Confidentiality | AI training exposes data |
| 4.02 Limits of Confidentiality | AI creates new limits |
| 6.02 Privacy | AI privacy implications |
| 8.02 Research Consent | AI training as research use |

### Professional Development

Topics for clinical training:
- AI literacy for clinicians
- Discussing AI with clients
- Assessing AI consent capacity
- Trauma-informed AI consent
- Therapeutic work in AI age
- Research ethics and AI

---

## Resources

### Professional Organizations
- APA: [apa.org](https://www.apa.org)
- BPS: [bps.org.uk](https://www.bps.org.uk)
- APS: [psychology.org.au](https://psychology.org.au)

### AI Ethics in Mental Health
- WHO Digital Health Guidelines
- APA AI Task Force (forming)
- Digital Mental Health ethics literature

### Palimpsest Psychology Working Group
- Contact: psychology@palimpsestlicense.org (planned)
- Focus: trauma-informed consent design, research ethics, clinical integration

---

## Document Review Log

| Date | Reviewer | Status | Notes |
|------|----------|--------|-------|
| 2025-12-08 | AI | Current | Initial creation |

**Next Review Due:** 2026-03-08

