A flagship moment on this theme
"I think what I find most often when I talk to either practice owners or individual therapists operating right now, they're so good at looking internally. Right. Especially at the care of their clients. And then beyond that, a lot of them have taken the look at their own business structure and how they're running things, and that feels like a big step. But very few, it's a much smaller number, are looking at what's happening around us in the industry."
Rachel names the exact blind spot the episode is designed to address, and she does it from her own clinical observation rather than as a setup question. It positions the episode for therapists who feel too busy with client care to track industry changes.
Where this is a central topic
5 episodes
When Payers Own the Data: What the CAQH Rebrand Means for Providers
Rachel raises specific questions about who controls provider data, what oversight exists, and whether a governing board made up of insurer representatives can protect provider interests.
Advocacy, Autonomy and the Future of Psychotherapy with Linda Michaels of PsiAN
Dr. Michaels details how practice management companies retain all client data when a therapist leaves, how Headway faces a class action for sharing data with Google (an owner), and how AI scribe tools buried in terms of service route therapy content to third parties.
The 988 Hotline: Three Years In
Awareness is significantly lower among Black, Hispanic, and Asian adults; Southern states show the lowest contact rates nationally; and the LGBTQ specialized line was cut in July 2025 despite LGBTQ youth representing nearly 20% of all texts.
Big Mental Health Stories & Trends to Watch in 2026
Rachel explicitly names tech companies selling protected health information as an ethical breach and argues regulatory bodies are not moving fast enough to establish meaningful guardrails.
Real Change
Headway's documented sale of mental health data and HIPAA violations by platforms like BetterHelp drove a sustained conversation about what community clinicians spend careers protecting and what tech companies routinely discard.
Where this comes up substantially
8 episodes
What Clinicians Need to Know About AI Law with Dr. Nick Shumate
Nick's discussion of informed consent for patient data entering AI systems, and unpublished findings that 80% of seriously ill patients using AI for mental health had not disclosed this to their clinician, grounds a substantive data-rights and ethics thread.
Ethical Marketing Strategies for Mental Health Practices with Adrienne Wilkerson
HIPAA restrictions eliminate IP tracking and limit review solicitation, and paid ad campaigns for medication-related services require specific scripts or Google will blacklist the site, with real legal consequences for practices whose agencies don't know the rules.
Mental Health Access, Telehealth Policy and the Future of Behavioral Health Care with Andrea Fox
Both speakers raise the concern that shared behavioral health data could lead to labeling, denial of services, or inappropriate medication decisions, particularly for young people still developing whose diagnoses may not warrant the treatment they receive.
Tiered Care, Technology, and the Future of Mental Health
Rachel contrasts consumer-level desensitization to data selling with the specific ethical weight of clinical confidentiality, treating it as a live tension the field cannot afford to let drift.
Navigating Tech in Private Practice with Uriah Guilford
Rachel makes a sustained argument about AI scribe data risks: unknown retention policies, the vulnerability of fine print to change over time, and the chilling effect on client disclosure when recordings exist.
Preparing for the AI Shift in Therapy with Dr. Jordan Harris
Rachel raises a substantive distinction between session recording and data mining, challenges whether clients can meaningfully consent to downstream data use, and argues privacy is foundational to therapeutic safety.
When AI Meets Therapy: Risks, Ethics, and Advocacy with Dr. Ajita Robinson
Dr. Robinson explains that Headway is classified as a tech company rather than a healthcare company, which allows it to sidestep HIPAA and potentially sell patient records or use them to train AI.
The Human Side of Elite Athletes | Julie Kliegman of the book, Mind Game
Rachel and Julie examine how perceived confidentiality risk with employer-funded clinicians suppresses help-seeking even when those clinicians genuinely maintain confidentiality.
Looking to go deeper in your own work?
These TSTI trainings build on conversations from the episodes above.