Navigating Tech in Private Practice with Uriah Guilford

welcome to Mental Health Evolution, a podcast about what's changing in mental health and why it matters. I'm your host, Rachel Harrison, inviting you into honest conversations with people from all perspectives in the field. Clinicians, tech founders, investors, insurance companies, and all the folks in between. Let's explore what's working, what's not, and what's next.

Welcome back everyone to the Mental Health Evolution podcast where we are talking about how the landscape is quickly evolving in the mental health industry. And today we are talking to a colleague who is the owner of the Productive Therapist, a former group practice owner, and someone who is always on the lookout for new things in our industry and in tech. Uriah Guilford is a speaker as well and offers all kinds of business support to therapy practices. As always, I want to give a little background here to set the stage for our conversation so that you have some information about the topics that we're addressing. So here are a couple of things in the news recently from the TRUIC team that the article title is 27 Top Mental Health Startups to Watch in 2025. Now this might surprise you that we are actually narrowing down the top 27 and that should tell you something. There are a lot of mental health startups to watch and to be curious. So these are the top 27. And in this article I thought it was really interesting how they summarized what was happening. They say mental illness impacts millions of people worldwide, yet mental health care has lagged behind other areas of medicine and health services. With outdated approaches still commonplace, innovative startups are aiming to transform this industry and have emerged as beacons of hope. This article lists 27 tech mental health companies. From MSOs to AI chatbots to apps designed to increase happiness, the tech industry has framed themselves as the solution to outdated approaches offered in traditional therapy practices. And then another article from Forbes is titled why Psychiatry May be the Last Frontier for AI Disruption, and this article by Amanda Marlar. She says for healthcare leaders and innovators, there is a broader lesson here. In the rush to scale AI across every corner of the system, we must also ask which problems require precision and which require presence, which challenges are best met by algorithms and which still demand attunement, context and human care. This article talks through some of the nuances that are required in psychiatric care and that these nuances cannot be addressed by AI. In addition, the presence of another person as a way to provide connection and healing, they say, cannot be replicated by by A chatbot. And then lastly to set the stage I want to highlight an article by Beekee and this article is called Mental health tech in 2025 consolidation, personalization and the Uneven Reality of Access. And in this article they talk about the current status of innovation in mental health care and they state the following trends and observations which I found interesting. Number one, they say apps are out, integrations are in. Number two, AI works best to augment therap, not to provide it. Number three, equity needs to be addressed. Number four regulatory pressure is growing and number five validated research outcomes are not robust so more is needed and many companies operate in silo. This is number six without good follow up. This author advocates for the following transparency, clinical integrity, inclusivity by design and seamless integration. This article also says that so many things such as as the trends but also some of the limitations and shortcomings of the tech boom in mental health care. It seems to give some balance to the need to have human interaction as end oversight as well as integrating these tech systems. I have to say with these more recent articles coming out, I'm actually seeing a more even keeled assessment. It seems like the press cycle is less about AI being the greatest, latest, greatest solution and maybe some understanding that there are some limitations and that we have to think through things a little bit, which I think is great for this conversation. So now I want to turn toward our guest Uriah for some of his thoughts and perspectives. Uriah is one of those people always looking into the new things and talking to a lot of folks in the therapy world and I thought his take on these things would be really helpful for all of us to hear. So thank you Uriah for being here.

Absolutely. I'm thrilled to talk about all these things. I'm so excited. It's hard to know where to start.

I know, right? Okay, so I want to dig in to maybe a little bit about AI. Not the general AI, but as I dig in more and more and I am a novice and you know more about this and I'm actually taking your course very soon, which I am super psyched about. But I think AI requires a different kind of thinking. So I would love to hear from you. Like the more I learn, the more I'm like this is just a different conceptualization than how a lot of us are thinking about our businesses and the process of mental health care. So I would just love to hear from you a little bit about how does AI require us to think differently.

Yeah, the context matters a lot here in terms of thinking about, but I find that there is a mindset shift that happens for the average person as well as the business owner in terms of going from this is an interesting tool to this is a game changing technology, whether whether that's in a clinical space or like I said, in a, in a business space. And I had that sort of transition, if you will, I'd say about six months ago or so when I thought that I was using AI and integrating it into my life and my work in sort of, you know, interesting ways. And then I realized that I was barely scratching the surface. So I think, yeah, this is such a new technology, it's only in, you know, most consumers minds. It's only about three years old. Right. It actually goes back a couple of decades. Turns out folks have been working on these things, Computer scientists and whatnot have been working on this for decades, but only now has it gotten incredibly powerful and incredibly useful. So I think it is a mindset shift from like this is kind of a new Google search tool to like this is something that can level up my health, my mental well being, my business, like on down the line. Right.

So what was that shift for you? What did you notice or how are you thinking about it differently now?

So the shift was really about two things. I would say the power of giving AI tools context about you and whatever, whatever it is you want to give it. For me it was in a business context. Right. So giving my AI tools all the knowledge and information about me and my business operations and my goals and what I'm trying to accomplish and then realizing that the output that I'm getting is dramatically better. So that was one. And then the second one was just sort of changing how I interact with AI on a daily basis to being sort of, you know, the first place that I go to to get questions answered. So like commonly now, like this morning, literally I was driving to my office coming in to talk to you today and I had an issue that I had to deal with and I turned on voice mode on ChatGPT and I had a whole conversation on my drive to work about California law and jury duty and paid time off and sick time and et cetera. And I got my questions answered and I got some guidance. So there was a switch from when I was using it occasionally to where now I'm using it much more often.

Wow. And so what do you think about the world of mental healthcare? Like how do we need to be thinking about AI or do you have any opinions or kind of stances on this? I think it's a whole big question out there.

It's fascinating and I think scary, too. I think anybody you talk to, everybody has an opinion about AI, you know, whether they're anti or they're all in, or they're sort of somewhere in between. I think anybody who's really looking at all the information will be somewhat skeptical and somewhat concerned. And that certainly has a place. I know a lot of therapists are concerned about how AI is being used and what are the, you know, safety sort of issues. I would say I'm about 80% optimistic and excited about it, and then about 20%. You know, I listened to some people talk about how it's, you know, it's going to have some incredibly negative impacts on the environment and on humanity and on existence. So I do like to spend a little bit of time learning about and listening to smart people about those things, but about 80% of my time and my mindset is like, this is revolutionary and it's going to be incredibly helpful. So, yes, and I do have a. I have a couple of predictions of my own.

Oh, I'd love to hear.

Yes. As I listen to smart people, though, including like, Geoffrey Hinton, one of the godfathers of AI or, you know, Sam Altman, the founder of OpenAI. Basically, when they get down to it and people are really grilling them about what's going to happen and how this is going to unfold, their most honest answer is this. Nobody knows. That's the truth. Right. Even the smartest people, even the people who have built these tools and these systems, they don't know.

Yeah.

Yeah.

So what are your predictions, though?

Well, if we're talking about mental health, I think that a large part of the population is going to use a for mental health purposes. And guess what? They already are. A lot of therapists don't realize that their clients are already using AI for, you know, in between sessions. And so I think that accessibility to mental health support is going to broaden dramatically. And that's mostly good, is my thought. That's mostly a good thing because we have a shortage of providers both in healthcare and in behavioral health. And then I also think that most therapists at some point are going to have their own AI avatar that will be available to clients and that will assist them in their clinical work. So there's the business, the AI assistants that are going to be helping therapists with their private practice, and then there's the clinical avatars that they're going to have that they're going to make available to clients. So when you come to see. I don't see clients anymore. I'm retired. But if someone was to come to see Uriah as the therapist, you would also get access to Uriah AI. Right. So that would be an AI avatar that has absolutely everything that I've ever said or written or produced or put out there available. And so I'll just give you an example. Like in a context of like I. Most of my career was working with adolescents and families, so family therapy, you know, sort of parent coaching and those kind of things. So if I was working with parents who are having hard time with their teenager, they would have sessions with me and then in between sessions they would have questions because things come up every single day. And then they would be able to chat with, by voice and by text, Uriah AI to get, you know what to, to, to get my feedback and my guidance 24 7. So that's, that's not a crazy prediction, but I think that's very likely going to happen. So not going to replace therapists, but going to augment the work that we do.

Yeah. Yeah, I like that. I'm also wondering about this idea I've heard, I've read a lot about status quo of therapy and then one of the articles today highlighted this being sort of a cottage industry, like kind of outdated all of those things. And the tech companies are definitely positioning themselves to come in and save the day. I'm just curious your thought about the pros and the cons of this kind of tech wildfire that we're experiencing right now.

Yeah, so interesting. Did you see this coming? I certainly didn't.

Not at all.

Yeah.

I mean, yeah, I know you have been around a long time, so have I. And this is by far, I mean, part of what motivated me, motivated me to start this podcast was that number one, these changes are happening so fast and every, almost every single practitioner or even business person that I'm talking to doesn't have a clue that it's happening or is not really tuned in to how much this is going to impact us. And then the second part, which you already said nobody knows where this is going to go. So the combination of those two things made me say, I want to just elevate this conversation. Let's just start talking about it at least so we can be informed.

Yeah, it's, it's fascinating to see how much has changed in my 25 year career, you know, but, and there's pros and cons to this quote, unquote disruption. Right. This innovation, if you will. Accessibility is One of them, one of the positive things, whatever your opinion is of. Some people call it big therapy. Right. These venture backed companies that are providing big therapy. Big pharma.

Yeah, yeah, I got that.

I mean, guess what? It's got a lot of downsides, but a lot more people are getting therapy because of the marketing dollars, the ad spend and the visibility and the brand awareness and all of these things. So is that good overall? I think so. I think so. But it's definitely changing the game for solo private practice owners and for group practice owners and for other people who are in the mental health space. I remember not that long ago, maybe it was like a year ago, I was talking to a good friend of mine and he has a group practice in the San Francisco Bay area as well. And I said to him, I said, do you feel like you own a small bookstore? And it's like Amazon is just really, really ramping up. And he said, actually, yes, I do feel like that way. So that's interesting. Right?

I have likened it to like Walmart coming in and moving out the main street store. Right. It's kind of same idea.

Sure. I think there's a lot to be said for what therapists can do to, you know, create a unique brand and to kind of protect themselves and protect their offerings and to pivot what they're doing so that like, it's not something that can be EAS easily replicated by like a corporation. So I think, like, you know, for one thing, family therapy is hard to do. It's hard to do virtually and it's. And it's harder to do. It's just better in person, I think. I know that makes me sound very old school, but I'm right there with you. Yeah, so I can think of other examples too, but there's, I think, a lot more, well, competition, honestly.

Yeah, I agree, I agree. And I think in some ways we haven't had to face that, at least not at this level. And same as you starting what, like 27, 28 years ago doing this work. Like we. There hasn't been this level of. We've been this, like, we really have been a little kind of protected industry where when Covid hit that was like one of the biggest changes, moving everything to telehealth and all of that. And that was, I think, the start of this, honestly, kind of where the light shone in our industry and everybody said, huh, we could take a piece

of that Covid and then telehealth and then AI. It's like it's just been this sort of, sort of onslaught of changes. Yeah. I wonder what it was like to be, like, therapist or a psychiatrist in, like, the 70s or 80s, you know, like where people came to see their therapist multiple times a week. There was no managed care. There was no insurance coverage. It was all out of pocket. And you just had to put an ad in the yellow Pages and then, you know, network a little bit, have a business card. I must have been.

I was in the yellow Pages when I first started. Okay. So, yeah, that's crazy. And, yeah, things have changed so dramatically. And on that note, so I'm wondering your thoughts on this. If therapists or practices or businesses are open to utilizing technology, what are some of the systems and programs that you would recommend people considering? I mean, most of us have EHRs already at this point.

Right.

But what else would be good pieces for either the business side or the clinical side?

Yeah, I mean, really, you can just try to think of a problem or a pain point, and then you can find an AI tool or an application. So we could just go down the list. But certainly almost every modern electronic health record or electronic medical record system has an AI Scribe feature. Right. So that is pretty much built in to almost all of them now. So that's an option. It's funny, I was thinking about it the other day. I had one client many, many years ago who recorded every session, and it was fine with me. I didn't mind because they wanted to listen to it and kind of like process it afterwards. Right. I can tell you, I don't know. I would be curious to know your answer, Rachel. But, like, if I was going to see clients again, I would 100% want to use the AI scribe feature because it would make my life so much easier. Right. Like, it would make note writing so much faster. But when I think about me going to see a therapist and if they asked me as a client if I want, if I'm okay with them turning on AI to listen to our session, I think my answer would be no. My doctor fine. I'm talking about my elbow hurts, you know, or I've got a flu or something like that. But I don't think I would want my therapy, you know, listened in on and recorded by AI. What do you think?

I. I agree. I have two different areas of concern. The one is that it's recorded and I know I've talked to a lot of different AI people who, who offer these services, and they will all say, you know, some of them will say it's not saved a lot of it is data mined though, so they are definitely taking the data. But there's that question that no one can answer is where does that exist? And even if an organization starts out as highly ethical good intentions, we're destroying everything. At what point is the offer so good that we're going to switch our policy and nobody's necessarily really that where that gets lost in the fine print. Right. I think that's a risk. I think when you think about like attorneys wanting to get ahold of client records, like if, if a verbal recording exists, like yikes, right. There's. And, and I think therapy works because we can guarantee that confidentiality with exceptions of safety issues for the most part. Right. And that is what makes people able to open up. So I think we lose potentially a piece of our highest offering. But the, the even bigger piece I think for me is the idea of critical thinking. So when you look at what a therapist does, like putting that note is like it's a reflection, it's a synthesis, it's a plan for that client. And I honestly feel like we're not providing as good of care as we could if we're not putting that critical thinking work into our clients. Because if AI just records it, summarizes it, hopefully therapists are at least reviewing that to make sure there's no inaccurate information, which is a whole other potential issue there. But even if all that is happening, I think you're likely not spending the time to do the critical thinking about your client in the way that would provide optimal care if you're doing that. So I guess I'm kind of interesting perspective against it for those reasons or definitely not jumping on that bandwagon now. AI for backend processes. Sign me up. It's a totally different story. Right.

I mean I think some therapists will differentiate, differentiate themselves by the fact that they don't use AI. So if almost everybody is using AI, but people, some, some percentage of people are looking for a therapist who's going to do it the old school way, that's going to be a thing too. So that'll be interesting. And like as far as digital security and privacy goes, nothing is actually secure. Everything is, is every system is hackable. Like if the FBI and the DOJ and every, every other company can be hacked, so so can we. So it's nothing is truly safe unless it's you and me in a room that's protected and nobody's listening. Right, Exactly. Like that is confidentiality between a provider and a, and a patient. Right? Yeah, I definitely hear that. But the other applications in terms of business operations and even administrative support are really, really key. So one of the things that I've been teaching therapists how to do is how to build their AI advisory team. So how to use certain tools to create an HR department and a marketing department and a business coach and, you know, you name it. And that has been really a game changer for myself and for the folks that I'm working with. So that's exciting. And then also the other thing we can get into, if you want to but is I have been building AI receptionists for therapists so that, that the phone can be answered 24 7, 365. But the beautiful thing is, and this is one of my beliefs, is that humans still matter and it's, it's still the relationship that heals and all those things. So it's about AI helping on the front end and then doing a handoff to the human. So in this case an intake coordinator who can then schedule, you know, provide some real human connection, empathy and then schedule with a real human therapist. But the AI receptionist answering the phone 24 7, I've already got it turned on for both of my businesses. And it's, that's actually so good. Amazing.

I read your newsletter about that last week and I was sending it to my intake team, my practice manager. I was like, these are some of the things we've kind of been talking about as well. So I love that.

Yeah. And my perspective on that too is does anybody really want to have a long extended chat with an AI voice agent? Not really. Although there's this whole sub niche of AI companions. That's the whole thing.

Right.

But most people don't really want, want to just chat with AI most of the time. However, if that AI agent or tool or bot or whatever you want to call it actually helps them solve their problem and get them one step closer to getting their water heater fixed, getting a therapist for their daughter, you know, fill in the blank. I don't think any of us are going to mind. And if that's faster and easier, we're going to be like, okay, sure, yeah,

it's kind of like those automated phone systems, right. If you're calling your pharmacy or whatnot, I think people are somewhat used to that.

Definitely. Definitely.

Yeah.

So yeah, I'm optimistic about those things and I'm finding that it's a huge benefit to me. And at the end of the day I'm actually able to create more content that's helpful. I'm able to Help more people in various different ways that I do that I'm able to just kind of like, broaden and expand my, you know, my offerings, I guess.

Yeah.

And that feels awesome to me because it's not like I'm not replacing Uriah, I'm just expanding Uriah.

We always say, like, if we could clone ourselves right, and we could get more done, maybe this is a sort of version of that.

It is. For better or for worse.

For better or for worse. I know. All right, well, we are running up on the end of this podcast. But what is one thing that you think both consumers of mental health care and practitioners need to know about the current state of what's going on? What would be your one nugget for people to take away?

That is a hard question to answer.

I know.

I mean, you know, it's interesting. When I talk to my two daughters, 17 and 19, funny enough, one of them is using AI all the time to learn about colleges, to do college applications. You name it, she's using it every day. And then my older daughter is quite anti artificial intelligence, and so she more or less refuses to use it and wants to, like, you know, feels like that's like a soul, like a, like a meaningful choice for her to. To not use it. And to be honest with you, I respect both of them, even though I have, like, tried to convince my older daughter that she should use it to help her with her college work. But I guess the, the thing that comes to mind if I'm talking to anybody, whether they're, you know, a therapist, a business owner, or my own family, I'm excited about the, the specific use cases for individual people where it really makes a difference. And so if someone's listening to this, I would say AI is powerful. If you use it thoughtfully and use it wisely, it can really help you accomplish your goals. So consider that. And then, of course, if you are someone like me who's, you know, early adopter, tech enthusiast, just be mindful of how you're using it and what you're putting into it too, because we don't know how this is going to shake out.

Absolutely. Well, on that note, I just want to thank you for being here and sharing all of your perspective on these trends. Uriah's content contact information will be in the show notes so you can reach out to him, find out more about what he does and what his offerings are. But I hope you will join us next time as we take a look from another view at the changes in the mental health industry. Bye. For now,