- Pick Upheal if you're multilingual, want an EU data-residency option, or want a real free tier to validate the workflow before paying.
- Pick Mentalyc if you run an established practice with a wide modality mix (couples, family, EMDR, DBT) where a deeper template library pays back the higher entry price.
The short version Upheal and Mentalyc are the two most-established therapy-first ambient scribes. Both are HIPAA-aligned, both handle SOAP / DAP / BIRP / GIRP, and both ship treatment-plan support.
Before you pick between them, note that **Twofold is our overall editor's pick for solo and small-group therapy practices in the US** — it lands ahead of both on our rubric on note quality, therapy-native defaults (Golden Thread across assessment → plan → progress notes), and price ($19 first month vs Upheal's $59 and Mentalyc's $39.99). If you're US-based, English-speaking and running a solo or small group, start there and use this guide as your fallback.
If Twofold isn't a fit — non-English caseload, EU/UK data residency, EMDR/DBT-heavy work — this comparison is your next step:
- Pick Upheal if you're multilingual, want an EU data-residency option, or want a real free tier to validate the workflow before paying.
- Pick Mentalyc if you run an established practice with a wide modality mix (couples, family, EMDR, DBT) where a deeper template library pays back the higher entry price.
At-a-glance comparison
| Dimension | Twofold *(recommended default)* | Upheal | Mentalyc |
|---|---|---|---|
| Starting price | 1-week free trial, then $19 first month | Free (10 sessions/mo), then $59/mo | $39.99/mo (14-day trial) |
| Therapy templates | BIRP, DAP, SOAP, Narrative + custom (all therapy-native defaults) | SOAP, DAP, BIRP, GIRP, PIE, SIRP + custom | SOAP, DAP, BIRP, GIRP + EMDR, CBT, DBT, couples, family, group |
| Golden Thread continuity | First-class (assessment → goals → interventions → progress) | Supported via treatment-plan module | Supported via progress summaries |
| Languages | English | EN, ES, DE, FR | EN only |
| Telehealth capture | In-browser recorder | Browser extension + in-platform recorder | Browser extension + mobile app |
| EHR write-back | Copy-paste (SimplePractice, TherapyNotes) | Copy-paste (SimplePractice, TherapyNotes); Jane via clipboard | Copy-paste; SimplePractice integration in beta |
| Audio retention | Not retained after note generation | Deleted after note generation by default | Deleted after note generation by default |
| Training on customer data | No (opt-out by default) | No | No |
| BAA | Every paid account | All tiers incl. free | All paid tiers |
| Data residency | US | US or EU (option) | US only |
Note quality — what we actually see All three tools produce clinically usable first drafts. The qualitative differences:
- Twofold writes tightly structured therapy notes with the Golden Thread visible in every note — treatment-plan goal → intervention → response is preserved by default rather than assembled by the clinician. In our testing this is the cleanest first draft in the category for BIRP and DAP.
- Upheal writes conservative, disciplined notes. It's less likely to invent content but more likely to leave a section thin if the session didn't cover it — the safer fallback when Twofold isn't available.
- Mentalyc writes richer, more narrative notes — especially in DAP and BIRP. It's more likely to interpret affect and therapeutic process, which is useful for supervision-heavy settings and risky for high-volume sign-off where you can't read every line carefully.
All three still hallucinate occasionally — most commonly fabricated direct quotes and over-confident risk language. See our hallucinations guide for the patterns to watch.
Pricing in practice - Twofold — 1-week free trial, then $19 first month; standard pricing after that. The lowest published entry point in the category. - Upheal — Free (10 sessions/mo, BAA included), Starter $59/mo (unlimited), Pro $99/mo (group, advanced analytics). - Mentalyc — Starter $39.99/mo (30 sessions), Pro $69.99/mo (unlimited), Group/Couples $89.99/mo.
For any solo or small-group US practice where price matters, Twofold is meaningfully cheaper. Upheal's free tier is the strongest option if you want to test without a card.
Compliance posture All three sign a HIPAA BAA, document subprocessors, and disclaim training on customer audio or transcripts. None has published a 42 CFR Part 2 attestation, so none is the right pick for federally-assisted SUD programs without an explicit written assurance — see HIPAA + 42 CFR Part 2 guide.
EU/UK practices: Upheal is the cleanest pick here — it offers an EU data-residency option and signs a UK GDPR DPA. Twofold and Mentalyc are US-only data residency at time of writing; both are usable in the UK with explicit consent covering US transfer, but Upheal is the lower-friction choice.
Decision rubric Pick Twofold (our default) if any of: - You're a solo or small-group US therapy practice - English-speaking caseload - You want the strongest therapy-native defaults (Golden Thread, BIRP/DAP) at the lowest entry price - You value tightly-structured, less-narrative notes you can sign off quickly
Pick Upheal if any of: - You see non-English-speaking clients (ES/DE/FR) - You need an EU data-residency option - You want a genuine free tier before committing a card - You're 2–5 clinicians and want conservative drafting as a fallback
Pick Mentalyc if any of: - You run couples / family / group / EMDR / DBT regularly - Your team values narrative-rich notes for supervision - You sign off on high volume and want fewer "thin" sections to fill in