Every transcription service works by sending your audio to a server, which is why most therapists who would gain most from dictation do not use it at all. Session Notes ships the speech models inside the download, so you speak and the words appear on the machine in front of you, and nothing a client said goes anywhere. Around it sits the rest of a practice: your caseload, your week, a mental status exam and standardised measures, and a written record encrypted with a passphrase only you know. The application makes no network requests of any kind, and it costs fifteen dollars once.
One payment. No subscription, no account, no per client pricing, no renewal.
Three speech models ship inside the download, so you can trade speed against accuracy without connecting to anything. The audio goes to a process on your own computer and never anywhere else, and you decide whether it is kept.
Not a setting you can leave switched on. There is no code in the application that opens a network connection, and the build refuses to compile if any is added.
AES-256. The key is derived from your passphrase and nothing else, so a stolen laptop is a stolen brick without it.
No subscription, no account, no per client fee. There is no meter to raise later and nobody who can change the terms.
Four things and no more: the people you see, the appointments you keep, the notes you write, and the documents you attach. Everything else a practice management subscription sells you is deliberately absent, and the price reflects that.
This is the part no cloud product can copy honestly. Otter, Rev, Word dictation and every other transcription service works by uploading your audio to somebody else. You cannot do that with a session, which is why most practitioners who would benefit most from dictation do not use it at all.
Session Notes ships three speech models inside the application. When you dictate, the audio goes to a process on your own computer and comes back as text. Nothing is uploaded, because there is nowhere for it to be sent and no code that could send it.
A note takes a few seconds to transcribe, faster than it took to say. You can send the window to a small strip in the corner of the screen while you talk, the way a screen recorder does, so you can look at something else without wondering whether it is still listening. That strip deliberately carries no name and no clinical detail, because it floats above whatever else is on screen.
The recording is kept, encrypted with the same passphrase as the notes, because the transcript is a draft and the only way to settle what was really said is to hear it again. That is a thing only local software can offer you. A cloud service holding a year of your session audio is a liability for both of you, which is why the honest ones delete it and the careless ones do not. Here it is a file on your own disk: play it, delete that one, or sweep everything older than a month in one go. You can also turn it off for a single note from the dictation row, or for good in settings.
If you have an accent that transcription software usually mangles, this is the part that matters. There is no accent setting here, because no such thing exists: one model covers every English accent and the only thing that changes is how much of it the model can hold on to. So the application ships three, from a fast one that is fine on clear speech in a quiet room to a slow one that gets difficult audio right, and you pick. It starts you on the middle one, which is still faster than you spoke. They are all in the download and none of them needs a connection.
Speech to text gets names, numbers and the word "not" wrong, and those are exactly the words that matter in a clinical record. A dictated note is marked as an unchecked draft until you edit it. Read it through every time. Anybody who tells you their transcription is accurate enough to sign unread is selling something.
It is built for therapy, and the mental status exam, the impressions and the standardised measures are there because a therapist needs them. But the record underneath is the same shape for anybody who sees the same people repeatedly and writes something down afterwards. Pick your trade on the first screen and the words, the note format, the default appointment length and the fields all change to match. A physiotherapist never sees a mental status exam, and a counsellor never sees a body chart.
The words are the least of it. A physiotherapist records the body area treated, and that belongs to the appointment rather than to the patient, because it is a shoulder this week and a knee next week. A tutor records the subject and a table of topics with the homework set against each. Whatever your trade needs and nobody thought of, you can add yourself: a field on the person, a field on the appointment, or a table that repeats. Everything is searchable, and none of it is a different version of the application.
If yours is not on the list, choose Something else. Nothing is missing, you just keep the neutral words.
The honest comparison, including the places where the subscription wins. If you bill insurance electronically, take card payments through your notes software, or need a client portal, the cloud product is doing work this does not do and you should keep it.
| Feature | Paper or Word | Cloud practice software | Session Notes |
|---|---|---|---|
| Notes stay on your own machine | Yes | NoOn their servers, by design | Yes |
| Encrypted at rest with a key only you hold | No | PartlyEncrypted, but they hold the keys | Yes |
| Searchable across every note | No | Yes | Yes |
| Dictation without uploading the audio | No | No | Yes |
| Works with no internet connection | Yes | No | Yes |
| Price stays where it started | Yes | NoRaised for existing customers | Yes |
| Keeps working if the maker disappears | Yes | No | Yes |
| Insurance claim submission | No | Yes | NoNot built and not planned |
| Card payments and client portal | No | Yes | NoNeeds a server, so no |
| Reaches you on your phone | Partly | Yes | NoOne Windows computer |
All of these are deliberate. Most of them follow directly from the notes never leaving your computer, and none of them are going to change in version 1.
Practice management subscriptions for solo practitioners run from about 50 to 100 dollars a month, plus a percentage of every card payment and a fee per claim. This is fifteen dollars, once, and then nothing. There is a free edition to try it on real work first: it holds three people on your caseload, has every feature switched on, and never expires. If you buy the full edition later, the practice you have already built opens straight up in it and nothing needs moving or re-entering.
A major version 2 with substantial new work would be a new purchase, and it would be optional. That is said here rather than discovered later, because a perpetual licence with unlimited free work behind it is how small software companies quietly die, and a product that dies is worse for you than one that charges again in three years.