Latest / The Mental Health Evolution / Ep 6: Navigating Tech in Private Practice with Uriah Guilford

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Ep 6: Navigating Tech in Private Practice with Uriah Guilford · The Mental Health Evolution

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(Transcribed by TurboScribe. Go Unlimited to remove this message.) This podcast is part of the Frederick Podcast Network.
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Learn more at listenfrederick.com.
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Welcome to Mental Health Evolution, a podcast about what's changing in mental
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health and why it matters.
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I'm your host, Rachel Harrison, inviting you into honest conversations with
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people from all perspectives in the field, clinicians, tech founders,
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investors, insurance companies, and all the folks in between.
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Let's explore what's working, what's not, and what's next.
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Welcome back, everyone, to the Mental Health Evolution podcast, where we are
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talking about how the landscape is quickly evolving in the mental health
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industry.
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And today we are talking to a colleague who is the owner
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of The Productive Therapist, a former group practice owner, and someone who
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is always on the lookout for new things in our industry and
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in tech.
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Uriah Guilford is a speaker as well and offers all kinds of
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business support to therapy practices.
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As always, I want to give a little background here to set
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the stage for our conversation so that you have some information about
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the topics that we're addressing.
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So here are a couple of things in the news recently from
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the Truik team that the article title is 27 Top Mental Health
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Startups to Watch in 2025.
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Now, this might surprise you that we are actually narrowing down the
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top 27, and that should tell you something.
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There are a lot of mental health startups to watch and to
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be curious about.
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So these are the top 27.
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And in this article, I thought it was really interesting how they
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summarized what was happening.
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They say mental illness impacts millions of people worldwide, yet mental health
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care has lagged behind other areas of medicine and health services.
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With outdated approaches still commonplace, innovative startups are aiming to
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transform this industry and have emerged as beacons of hope.
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This article lists 27 tech mental health companies from MSOs to AI
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chatbots to apps designed to increase happiness.
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The tech industry has framed themselves as the solution to outdated approaches
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offered in traditional therapy practices.
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And then another article from Forbes is titled Why Psychiatry May Be
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the Last Frontier for AI Disruption.
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And this article by Amanda Marlar, she says, for health care leaders
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and innovators, there is a broader lesson here.
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In the rush to scale AI across every corner of the system,
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we must also ask which problems require precision and which require presence,
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which challenges are best met by algorithms and which still demand attunement,
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context, and human care.
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This article talks through some of the nuances that are required in
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psychiatric care and that these nuances cannot be addressed by AI.
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In addition, the presence of another person as a way to provide
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connection and healing, they say, cannot be replicated by a chatbot.
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And then lastly, to set the stage, I want to highlight an
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article by BeeKey.
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And this article is called Mental Health Tech in 2025, Consolidation,
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Personalization and the Uneven Reality of Access.
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And in this article, they talk about the current status of innovation
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in mental health care and they state the following trends and observations,
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which I found interesting.
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Number one, they say apps are out, integrations are in.
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Number two, AI works best to augment therapy, not to provide it.
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Number three, equity needs to be addressed.
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Number four, regulatory pressure is growing.
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And number five, validated research outcomes are not robust, so more is
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needed.
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And many companies operate in silo, this is number six, without good
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follow up.
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This author advocates for the following, transparency, clinical integrity,
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inclusivity by design, and seamless integration.
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This article also says that so many things such as the trends,
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but also some of the limitations and shortcomings of the tech boom
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in mental health care.
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It seems to give some balance to the need to have human
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interaction and oversight, as well as integrating these tech systems.
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I have to say, with these more recent articles coming out, I'm
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actually seeing a more even keeled assessment.
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It seems like the press cycle is less about AI being the
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greatest, latest, greatest solution and maybe some understanding that there are
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some limitations and that we have to think through things a little
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bit, which I think is great for this conversation.
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So now I want to turn toward our guest, Uriah, for some
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of his thoughts and perspectives.
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Uriah is one of those people always looking into the new things
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and talking to a lot of folks in the therapy world.
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And I thought his take on these things would be really helpful
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for all of us to hear.
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So thank you, Uriah, for being here.
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Absolutely.
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I'm thrilled to talk about all these things.
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I'm so excited.
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It's hard to know where to start.
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I know, right?
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Okay, so I want to dig in to maybe a little bit
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about AI, not the general AI, but as I dig in more
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and more, and I am a novice, and you know more about
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this, and I'm actually taking your course very soon, which I am
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super psyched about, but I think AI requires a different kind of
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thinking.
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So I would love to hear from you.
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Like, the more I learn, the more I'm like, this is just
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a different conceptualization than how a lot of us are thinking about
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our businesses and the process of mental health care.
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So I would just love to hear from you a little bit
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about how does AI require us to think differently?
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Yeah, the context matters a lot here in terms of thinking about
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AI, but I find that there is a mindset shift that happens
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for the average person, as well as the business owner, in terms
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of going from, this is an interesting tool, to this is a
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game-changing technology, whether that's in a clinical space or, like I
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said, in a business space.
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And I had that sort of transition, if you will, I'd say
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about six months ago or so, when I thought that I was
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using AI and integrating it into my life and my work in
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sort of, you know, interesting ways.
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And then I realized that I was barely scratching the surface.
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So I think, yeah, this is such a new technology.
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It's only in, you know, most consumers' minds, it's only about three
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years old, right?
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It actually goes back a couple of decades.
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Turns out folks have been working on these things, computer scientists and
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whatnot have been working on this for decades, but only now has
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it gotten incredibly powerful and incredibly useful.
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So I think it is a mindset shift from like, this is
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kind of a new Google search tool to like, this is something
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that can level up my health, my mental wellbeing, my business, like
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on down the line, right?
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So what was that shift for you?
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What did you notice or how are you thinking about it differently
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now?
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So the shift was really about two things.
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I would say the power of giving AI tools context about you
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and whatever it is you wanted to give it.
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For me, it was in a business context, right?
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So giving my AI tools all the knowledge and information about me
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and my business operations and my goals and what I'm trying to
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accomplish.
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And then realizing that the output that I'm getting is dramatically better.
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So that was one.
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And then the second one was just sort of changing how I
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interact with AI on a daily basis to being sort of, you
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know, the first place that I go to, to get questions answered.
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So like commonly now, like this morning, literally I was driving to
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my office coming in to talk to you today and I had
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an issue that I had to deal with.
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And I turned on voice mode on chat GPT and I had
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a whole conversation on my drive to work about California law and
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jury duty and paid time off and sick time and et cetera.
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And I got my questions answered and I got some guidance.
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So there was a switch from when I was using it occasionally
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to where now I'm using it much more often.
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Wow.
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And so what do you think about the world of mental health
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care?
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Like how do we need to be thinking about AI or do
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you have any opinions or kind of stances on this?
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I think it's a whole big question out there.
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It's fascinating and I think scary too.
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I think anybody you talk to, everybody has an opinion about AI,
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you know, whether they're anti or they're all in or they're sort
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of somewhere in between.
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I think anybody who's really looking at all the information will be
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somewhat skeptical and somewhat concerned.
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And that certainly has a place.
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I know a lot of therapists are concerned about how AI is
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being used and what are the safety sort of issues.
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I would say I'm about 80% optimistic and excited about it.
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And then about 20%, you know, I listen to some people talk
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about how it's, you know, it's going to have some incredibly negative
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impacts on the environment and on humanity and on existence.
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So I do like to spend a little bit of time learning
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about and listening to smart people about those things.
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But about 80% of my time and my mindset is like,
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this is revolutionary and it's going to be incredibly helpful.
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So yes, and I do have a, I have a couple of
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predictions of my own.
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Oh, I'd love to hear.
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Yeah.
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As I listen to smart people though, including like Jeffrey Hinton, one
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of the godfathers of AI or, you know, Sam Altman, the founder
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of OpenAI.
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Basically when they get down to it and people are really grilling
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them about what's going to happen and how this is going to
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unfold, their most honest answer is this, nobody knows.
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That's the truth, right?
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Even the smartest people, even the people who have built these tools
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and these systems, they don't know.
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Yeah.
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So what are your predictions though?
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Well, if we're talking about mental health, I think that a large
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part of the population is going to use it for mental health
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purposes.
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And guess what?
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They already are.
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A lot of therapists don't realize that their clients are already using
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AI for, you know, in between sessions.
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And so I think that accessibility to mental health support is going
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to broaden dramatically.
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And that's mostly good, is my thought.
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That's mostly a good thing because we have a shortage of providers,
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both in healthcare and in behavioral health.
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And then I also think that most therapists at some point are
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going to have their own AI avatar that will be available to
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clients and that will assist them in their clinical work.
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So there's the business, the AI assistants that are going to be
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helping therapists with their private practice.
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And then there's the clinical avatars that they're going to have, that
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they're going to make available to clients.
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So when you come to see, I don't see clients anymore, I'm
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retired, but if someone was to come to see Uriah as the
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therapist, you would also get access to Uriah AI, right?
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So that would be an AI avatar that has absolutely everything that
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I've ever said or written or produced or put out there available.
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And so I'll just give you an example, like in a context
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of like, I, most of my career was working with adolescents and
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families.
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So family therapy, you know, sort of parent coaching and those kinds
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of things.
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So if I was working with parents who are having a hard
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time with their teenager, they would have sessions with me.
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And then in between sessions, they would have questions because things come
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up every single day.
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And then they would be able to chat with, by voice and
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by text, Uriah AI to get my feedback and my guidance 24
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-7.
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So that's not a crazy prediction, but I think that's very likely
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going to happen.
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So not going to replace therapists, but going to augment the work
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that we do.
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Yeah, yeah, I like that.
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I'm also wondering about this idea.
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I've heard, I've read a lot about the current status quo of
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therapy.
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And then one of the articles today highlighted this being sort of
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a cottage industry, like kind of outdated, all of those things.
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And the tech companies are definitely positioning themselves to come in and
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save the day.
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I'm just curious your thought about the pros and the cons of
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this kind of tech wildfire that we're experiencing right now.
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Yeah, so interesting.
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Did you see this coming?
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I certainly didn't.
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Not at all.
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Yeah.
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I mean, yeah.
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I know you have been around a long time.
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So have I.
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This is by far, I mean, part of what motivated me to
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start this podcast was that, number one, these changes are happening so
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fast and every, almost every single practitioner or even business person that
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I'm talking to doesn't have a clue that it's happening or is
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not really tuned in to how much this is going to impact
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us.
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And then the second part, which you already said, nobody knows where
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this is going to go.
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So the combination of those two things made me say, I want
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to just elevate this conversation.
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Let's just start talking about it at least so we can be
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informed.
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Yeah, it's fascinating to see how much has changed in my 25
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year career, you know, but and there's pros and cons to this
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quote unquote disruption, right?
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This innovation, if you will.
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Accessibility is one of them.
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One of the positive things, whatever your opinion is of, some people
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call it big therapy, right?
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These venture backed companies that are providing big therapy, big pharma.
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Yeah, yeah, I got that.
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I mean, guess what?
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It's got a lot of downsides, but a lot more people are
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getting therapy because of the marketing dollars, the ad spend and the
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visibility and the brand awareness and all of these things.
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So is that good overall?
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I think so.
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I think so.
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But it's definitely changing the game for solo private practice owners and
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for group practice owners and for other people who are in the
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mental health space.
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I remember not that long ago, maybe it was like a year
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ago, I was talking to a good friend of mine and he
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has a group practice in the San Francisco Bay Area as well.
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And I said to him, I said, do you feel like you
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own a small bookstore?
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And it's like Amazon is just really, really ramping up.
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And he said, actually, yes, I do feel like that way.
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So that's interesting, right?
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I have likened it to like Walmart coming in and moving out
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the Main Street store, right?
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It's kind of same idea.
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Sure.
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I think there's a lot to be said for what therapists can
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do to, you know, create a unique brand and to kind of
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protect themselves and protect their offerings and to pivot what they're doing
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so that like it's not something that can be easily replicated by
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like a corporation.
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So I think like, you know, for one thing, family therapy is
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hard to do.
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It's hard to do virtually and it's and it's harder to do.
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It's just better in person, I think.
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I know that makes me sound very old school, but I'm right
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there with you.
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Yeah.
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So I can think of other examples, too.
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But there's, I think, a lot more, well, competition, honestly.
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Yeah, I agree.
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I agree.
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And I think in some ways we haven't had to face that,
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at least not at this level.
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And same as you starting, what, like 27, 28 years ago doing
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this work?
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Like we, there hasn't been this level of, we've been this, like,
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we really have been a little kind of protected industry where when
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COVID hit, that was like one of the biggest changes moving everything
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to telehealth and all of that.
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And that was, I think the start of this, honestly, kind of
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where the light shone in our industry and everybody said, huh, we
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could take a piece of that.
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COVID and then telehealth and then AI.
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It's like, it's just been this sort of onslaught of changes.
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Yeah.
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I wonder what it was like to be like therapist or a
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psychiatrist in like the 70s or 80s, you know, like where people
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came to see their therapist multiple times a week.
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There was no managed care.
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There was no insurance coverage.
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It was all out of pocket.
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And you just had to put an ad in the yellow pages
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and then, you know, network a little bit, have a business card.
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I had a listing in the yellow pages when I first started.
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Okay.
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So yeah, that's crazy.
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And yeah, things have changed so dramatically.
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And on that note, so I'm wondering your thoughts on this.
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If therapists or practices or businesses are open to utilizing technology, what
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are some of the systems and programs that you would recommend people
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considering?
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I mean, most of us have EHRs already at this point.
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Right.
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But what else would be good pieces for either the business side
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or the clinical side?
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Yeah.
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I mean, really, you can just try to think of a problem
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or a pain point and then you can find an AI tool
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or an application.
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So we could just go down the list, but certainly almost every
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modern electronic health record or electronic medical record system has an AI
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scribe feature.
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Right.
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So that is pretty much built in to almost all of them
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now.
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So that's an option.
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It's funny.
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I was thinking about it the other day.
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I had one client many, many years ago who recorded every session
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and it was fine with me.
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I didn't mind because they wanted to listen to it and kind
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of like process it afterwards.
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Right.
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I can tell you, I don't know.
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I would be curious to know your answer, Rachel, but like if
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I was going to see clients again, I would 100% want
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to use the AI scribe feature because it would make my life
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so much easier.
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Right.
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Like it would make note writing so much faster.
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But when I think about me going to see a therapist and
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if they asked me as a client, if I want, if I'm
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okay with them turning on AI to listen to our session, I
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think my answer would be no.
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My doctor?
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Fine.
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I'm talking about my elbow hurts, you know, or I've got a
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flu or something like that.
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But I don't think I would want my therapy, you know, listened
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in on and recorded by AI.
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What do you think?
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I agree.
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I have two different areas of concern.
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The one is that it's recorded.
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And I know I've talked to a lot of different AI people
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who do offer these services and they will all say, you know,
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some of them will say it's not saved.
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A lot of it is data mined though.
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So they are definitely taking the data.
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But there's that question that no one can answer is where does
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that exist?
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And even if an organization starts out as highly ethical, good intentions,
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we're destroying everything.
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At what point is the offer so good that we're going to
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switch our policy and nobody's necessarily really that where that gets lost
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in the fine print.
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Right.
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I think that's a risk.
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I think when you think about like attorneys wanting to get a
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hold of client records, like if if a verbal recording exists, like,
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yikes.
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Right.
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There's and I think therapy works because we can guarantee that confidentiality
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with exceptions of safety issues for the most part.
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Right.
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And that is what makes people able to open up.
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So I think we lose potentially a piece of our highest offering.
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But the even bigger piece, I think, for me, is the idea
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of critical thinking.
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So when you look at what a therapist does, like putting that
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note is like it's a reflection.
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It's a synthesis.
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It's a plan for that client.
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And I honestly feel like we're not providing as good of care
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as we could if we're not putting that critical thinking work into
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our clients.
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Because if AI just records it and summarizes it, hopefully therapists are
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at least reviewing that to make sure there's no inaccurate information, which
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is a whole other potential issue there.
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But even if all that is happening, I think you're likely not
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spending the time to do the critical thinking about your client in
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the way that would provide optimal care if you're doing that.
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So I guess I'm kind of.
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That's an interesting perspective.
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Against it for those reasons or definitely not jumping on that bandwagon.
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Now, AI for back-end processes.
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Sign me up.
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It's a totally different story, right?
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I mean, I think some therapists will differentiate themselves by the fact
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that they don't use AI.
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So if almost everybody is using AI, but some percentage of people
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are looking for a therapist who's going to do it the old
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school way, that's going to be a thing too.
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So that'll be interesting.
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And like, as far as digital security and privacy goes, nothing is
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actually secure.
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Everything is, every system is hackable.
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I give the FBI and the DOJ and every, every other company
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can be hacked.
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So, so can we.
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So it's nothing is truly safe unless it's you and me in
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a room that's protected and nobody's listening.
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Right.
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Like that is confidentiality between a provider and a, and a patient,
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right?
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Yeah.
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I definitely hear that.
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But the other applications in terms of business operations and even
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administrative support are really, really key.
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So one of the things that I've been teaching therapists how to
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do is how to build their AI advisory team.
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So how to use certain tools to create an HR department and
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a marketing department and a business coach and, you know, you name
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it.
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And that has been really a game changer for myself and for
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the folks that I'm working with.
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So that's exciting.
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And then also the other thing we can get into if you
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want to, but is I have been building AI receptionists for therapists
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so that the phone can be answered 24, 7, 365.
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But the beautiful thing is, and this is one of my beliefs
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is that humans still matter and it's, it's still the relationship that
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heals and all those things.
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So it's about AI helping on the front end and then doing
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a handoff to the human.
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So in this case, an intake coordinator who can then schedule, you
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know, provide some real human connection, empathy, and then schedule with a
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real human therapist.
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But the AI receptionist answering the phone 24, 7, I've already got
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it turned on for both of my businesses and it's actually so
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good.
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I read your newsletter about that last week and I was sending
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it to my intake team, my practice manager.
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I was like, these are some of the things we've kind of
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been talking about as well.
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So I love that.
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Yeah.
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And my, my perspective on that too is does, does anybody really
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want to have a long extended chat with an AI voice, you
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know, agent?
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Not really.
21:41
Although there's this whole sub niche of, you know, AI companions, that's
21:45
the whole thing, right?
21:46
But most people don't really want to just chat with AI most
21:50
of the time.
21:51
However, if that AI agent or tool or bot or whatever you
21:54
want to call it actually helps them solve their problem and get
21:57
them one step closer to getting their water heater fixed, getting a
22:01
therapist for their daughter, you know, fill in the blank.
22:03
I don't think any of us are going to mind.
22:04
And if that's faster and easier, we're going to be like, okay,
22:07
sure.
22:08
Yeah.
22:08
It's kind of like those automated phone systems, right?
22:11
If you're calling your pharmacy or whatnot, I think people are somewhat
22:14
used to that.
22:15
Definitely.
22:15
Definitely.
22:16
Yeah.
22:17
So yeah, I'm optimistic about those things and I'm finding that it's
22:20
a huge benefit to me.
22:22
And at the end of the day, I'm actually able to create
22:25
more content that's helpful.
22:26
I'm able to help more people in various different ways that I
22:29
do that.
22:30
I'm able to just kind of like broaden and expand my, you
22:34
know, my offerings, I guess.
22:36
Yeah.
22:36
And that feels awesome to me because it's not like I'm not
22:39
replacing Uriah.
22:40
I'm just expanding Uriah.
22:43
We always say like if we could clone ourselves, right?
22:46
And then we could get more done.
22:48
Maybe this is a sort of version of that.
22:50
It is, for better or for worse.
22:51
For better or for worse, I know.
22:53
All right.
22:55
Well, we are running up on the end of this podcast.
22:58
But what is one thing that you think both consumers of mental
23:03
health care and practitioners need to know about the current state of
23:08
what's going on?
23:09
What would be your one nugget for people to take away?
23:13
That is a hard question to answer.
23:14
I know.
23:15
I mean, you know, it's interesting when I talk to my two
23:18
daughters, 17 and 19, funny enough, one of them is using AI
23:24
all the time to learn about colleges, to do college applications.
23:29
You name it.
23:30
She's using it every day.
23:31
And then my older daughter is quite anti-artificial intelligence.
23:37
And so she more or less refuses to use it and wants
23:40
to like, you know, feels like that's like a soul, like a,
23:43
like a meaningful choice for her to not use it.
23:46
And to be honest with you, I respect both of them.
23:48
Even though I have like tried to convince my older daughter that
23:52
she should use it to help her with her college work.
23:56
But I guess the thing that comes to mind, if I'm talking
24:00
to anybody, whether they're, you know, a therapist, a business owner or
24:03
my own family, I'm excited about the specific use cases for individual
24:09
people where it really makes a difference.
24:12
And so if someone's listening to this, I would say AI is
24:15
powerful.
24:16
If you use it thoughtfully and use it wisely, it can really
24:19
help you accomplish your goals.
24:21
So consider that.
24:22
And then of course, if you are someone like me, who's, you
24:25
know, early adopter, tech enthusiast, just be mindful of how you're using
24:29
it and what you're putting into it too, because we don't know
24:32
how this is going to shake out.
24:33
Absolutely.
24:34
Well, on that note, I just want to thank you for being
24:37
here and sharing all of your perspective on these trends.
24:40
Uriah's contact information will be in the show notes so you can
24:44
reach out to him, find out more about what he does and
24:47
what his offerings are.
24:48
But I hope you will join us next time as we take
24:51
a look from another view at the changes in the mental health
24:54
industry.
24:55
Bye for now.
24:57
Thanks for listening to the Mental Health Evolution podcast.
25:01
Join the conversation, find us on social, send us your thoughts and
25:05
tell us what you are seeing in your corner of the mental
25:08
health world.
25:09
Until next time, stay curious and keep evolving.
25:19
Live radio, local podcasts, the Frederick Podcast Network and listenfrederick
25:24
.com.