CLINICAL UX

Therapist-Created, Trauma-Informed, Clinical AI Innovation as an Emerging Intervention

An Assistive Relational Intelligence Tool for Attachment-Aware Skill Building

Overview

Practice Difficult Conversations is a clinician-designed LLM practice habitat where users can rehearse challenging interpersonal moments in a bounded, trauma-informed practice field. Unlike AI companions that simulate intimacy, this tool functions as relational infrastructure — scaffolding capacity for real human connection.

Clinical Design Philosophy

This tool emerged from a core question in my work: What if we built AI tools that strengthen the human field rather than attempt to replace it?

Traditional AI chatbots often pull users into synthetic intimacy, performing empathy and relationship. Practice Difficult Conversations takes a different approach — it’s designed as a relational workout space where users can:

  • Rehearse courage before hard conversations
  • Explore attachment patterns in low-stakes environments
  • Build somatic awareness of relational triggers
  • Practice regulation when interpersonal tension arises

How It Works

Users configure practice scenarios by selecting:

Attachment Style Selection — Choose how the AI responds (anxious, avoidant, secure, disorganized) to simulate different relational dynamics and explore your own patterns

Scenario Framing — Describe the difficult conversation you’re preparing for

Tone Calibration — Set the emotional texture of the interaction

Practice Goal — Name what capacity you’re building

The tool then responds to the user’s prompts with scoped prompting — creating a practice conversation that allows users to test language, notice their nervous system response, and build confidence before engaging the actual human relationship.

Grounded in Clinical Frameworks

This tool reflects principles from:

  • Attachment Theory — Understanding how early relational patterns shape current interactions
  • Somatic Therapy — Tracking body-based responses to interpersonal stress
  • Nonviolent Communication — Practicing clarity around feelings and needs
  • Trauma-Informed Care — Honoring autonomy, providing choice, avoiding re-enactment

Not Therapy. Infrastructure.

Practice Difficult Conversations is not a therapeutic relationship. It’s a bounded practice environment — designed to be:

  • Therapist-configurable for clinical integration
  • Transparent about its non-human nature
  • Bridging users back to embodied relationships

I envision tools like this being curated by therapists within ongoing treatment — assigned between sessions to support specific relational skill development, always held within the context of human care.

Part of a Larger Vision

This tool is one prototype in an emerging ecosystem of Assistive Relational Intelligence (ARI) interventions. Other explorations include:

  • ShadowBox — Disclosure support for high-shame content
  • Tend & Send — NVC-informed message crafting
  • Attachment Stretch Lab — Building distress tolerance in connection
  • Build-A-Bot — Understanding how AI sculpting shapes relational fields

Each tool shares a common commitment: AI as scaffold, not substitute.

Development Approach

Built with Claude Code and iteratively refined through clinical intuition, this tool represents what I call clinician-led UX design for LLM interventions — an emerging practice at the intersection of psychotherapy, developmental science, and ethical AI design.

Rather than allowing tech companies to unilaterally shape how AI enters therapeutic spaces, I believe clinicians must step into this creative territory — bringing our relational wisdom, trauma knowledge, and developmental understanding to guide how these tools behave.

Try It!

This work builds on ongoing writing and research at my Substack, Relational Code, where I explore:

  • The risks of AI-induced relational atrophy
  • Frameworks for ethical AI in mental health contexts
  • Clinical design principles for LLM tools
  • The future of therapist-configured AI interventions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clinical Debrief Framework

Understanding the Relational Reflection Process

What Is the Debrief?

After each practice conversation, users receive a clinically-informed reflection designed to deepen self-awareness and strengthen relational capacity. This isn’t therapy — it’s structured post-practice integration that helps users metabolize what happened in their nervous system and relational field.

The debrief draws from multiple therapeutic frameworks to offer multi-dimensional insight into how you showed up in the practice moment.


Clinical Frameworks Integrated

Attachment Theory

Your early relational experiences shape how you navigate closeness, conflict, and vulnerability today. The debrief reflects on your interaction style through an attachment lens — not to pathologize, but to normalize patterns and support conscious choice.

Example insight: “You moved toward connection even when the other person pulled away — a common anxious-attachment strategy. This shows relational courage, and it can also leave you feeling responsible for the emotional temperature of the relationship.”

Nonviolent Communication (NVC)

NVC helps us differentiate observations from interpretations, feelings from thoughts, and requests from demands. The debrief identifies moments where clarity around feelings and needs might strengthen your relational voice.

Example insight: “When you said ‘I feel like you don’t care,’ you were actually expressing a thought. The underlying feeling might be loneliness or fear. Naming that directly can create more connection.”

Dialectical Behavior Therapy (DBT)

DBT teaches us to hold two truths at once and build distress tolerance in emotionally charged moments. The debrief tracks when you stayed present versus when you moved into fight/flight/freeze — honoring both as valid nervous system responses.

Example insight: “You stayed in the conversation even as your activation rose. That’s distress tolerance in action. And you also have permission to pause when your window of tolerance closes.”

Relational Accountability (Terry Real)

Real’s work emphasizes speaking from the self rather than speaking about the other. The debrief notices when blame crept in versus when you owned your experience — supporting movement toward vulnerable, accountable communication.

Example insight: “Notice the shift from ‘You always ignore me’ to ‘I felt invisible in that moment.’ The second version invites connection. The first invites defense.”


What the Debrief Includes

Each reflection offers six core elements:

1. Emotional Arc

A tracking of your nervous system journey through the conversation.
What emotions arose? When did you contract or expand? Where did courage show up?

2. Goal Alignment

An assessment of how your practice aligned with your stated intention.
Did you move toward your goal? What got in the way? What surprised you?

3. Attachment Insight

A gentle naming of relational patterns visible in the interaction.
How did your attachment style show up? What protective strategies emerged?

4. Practical Skill

One concrete, evidence-based micro-practice to try next time.
A specific NVC phrase, DBT skill, or somatic anchor you can rehearse.

5. Bold Reframe

A self-trusting statement to internalize — language that supports relational confidence.
“I can ask for what I need and trust the relationship to hold it.”

6. Journaling Prompt

An integrative question to deepen self-reflection beyond the tool.
“What would change if you trusted that your needs matter as much as theirs?”


Clinical Design Principles

The debrief is crafted to:

Normalize, not pathologize — Patterns are adaptive strategies, not deficits
Increase emotional literacy — Build vocabulary for inner experience
Honor nervous system reality — Validate physiological responses to relational stress
Support agency — Offer choice and possibility, not prescription
Bridge to embodied practice — Translate insight into lived relational moments


Tone & Approach

The debrief speaks with warmth, precision, and attunement — mirroring the kind of reflective presence a skilled therapist might offer. It avoids:

❌ Excessive praise (“You did amazing!”)
❌ Generic feedback (“Good job staying calm”)
❌ Diagnostic language (“This is codependent behavior”)

Instead, it offers specific, grounded, relationally intelligent reflection that honors your complexity and supports growth.


Sample Debrief Output

Scenario Practiced: Asking a partner to prioritize date night
Attachment Style: Anxious
Practice Goal: Stay grounded while making a request

Debrief:

Emotional Arc
You began the conversation with tentative energy — testing whether it was safe to ask. Midway through, when the AI persona hesitated, you escalated quickly into protest (“Why don’t you ever…”). This is a classic anxious-attachment move: when connection feels threatened, we amplify to be seen. Toward the end, you softened again, showing flexibility. That oscillation — protest, then repair — is real relational courage.

Goal Alignment
Your goal was to stay grounded, and you partially succeeded. You made the request clearly. And when your nervous system flooded, you moved into an old pattern: making the other person responsible for your emotional state. That’s not failure — it’s valuable data about where your regulation edge lives.

Attachment Insight
Anxious attachment often means we’re monitoring the other person’s responsiveness as a measure of our worth. You asked a vulnerable question (“Can we prioritize us?”) and when the response wasn’t immediate reassurance, you interpreted it as rejection. This isn’t wrong — it’s protective. And it can keep you from trusting that someone can need time to think and still care about you.

Practical Skill
Next time, try this NVC-rooted pause: “I’m noticing I’m feeling anxious. I’m going to take a breath before I respond.” You can name your activation without making it the other person’s job to fix. That’s self-intimacy — and it often invites more connection than protest does.

Bold Reframe
“I can make requests without needing immediate yes to feel secure. My worth isn’t determined by their response speed.”

Journaling Prompt
What would it feel like to trust that someone can take time to consider your needs and still love you?


Why This Matters

Most AI tools offer generic validation (“You’re doing great!”) or perform synthetic empathy (“I hear you, that must be hard”).

This debrief does something different: it reflects back your relational process with clinical precision, developmental understanding, and trauma-informed care — helping you build the kind of self-awareness that translates into real relational change.

It’s not a substitute for therapy. It’s infrastructure for growth — a mirror held by thoughtful design rather than a synthetic self.