Evan Dumas

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co-host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and electronic health record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients remotely, create rich documentation, schedule appointments and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Evan Dumas 

Hello and welcome to Episode 544: The Big Stories of 2025 Impacting Mental Health Practices.

 

Liath Dalton 

2025 was really a significant year in both some really positive ways and some challenging ways for the majority of mental health practitioners and mental health practice leaders. So we’re going to just kind of do a like high level Year in Review, here are the big stories and what their implications were, and continue to be for you as a practitioner navigating this whole landscape and like operational context.

 

Liath Dalton 

So, I mean, in a nutshell, 2025 was pretty seismic year for most mental health practice operations, in terms of compliance requirements, insurance, for those of you that are insurance based practices, some of the new insurance requirements or changes to reimbursement rates, the whole Medicare debacle and just the, like, business of therapy in general. So, instead of going through the whole frame of panic or hype, we’re just going to talk about what actually mattered and what these shifts mean for you as a practice leader trying to create a sustainable, ethical and connected practice.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

So Evan, like just headline overview, what were the main stories that we were getting the most questions around and trying to support folks in navigating.

 

Evan Dumas 

Yeah, well, there were six big ones this year and sort of categories. Like the security rule change panic at the start of the year. Let’s see, the proliferation of AI, this new concept of a practice management as a service, sort of boom. Some, also therapists, sort of are claiming clinical work that feels grounding, thankfully, we’re getting back to that.

 

Liath Dalton 

I’m especially a fan of that one.

 

Evan Dumas 

Totally. And, you know, cross-jurisdictional, as always, I feel like that’s a yearly, yearly trend, but progress this year, progress.

 

Liath Dalton 

Mhm.

 

Evan Dumas 

And also sort of some shaky things with Medicare and the uncertainty around that.

 

Liath Dalton 

Exactly. So we’re just going to go through kind of each of these main six stories, and talk about what happened, what the kind of key clarifications and then takeaways are for each of you with regards to those.

 

Evan Dumas 

Mhm.

 

Liath Dalton 

So, as Evan said at the beginning of the year, there was this massive panic around proposed HIPAA Security Rule changes. And essentially that proposed new language and rulemaking caused widespread alarm. And a lot of misinformation spread really quickly by both vendors who were kind of, you know, leaning into how to utilize that as a marketing angle. And then, of course, social media, right?

 

Evan Dumas 

Mhm, yeah.

 

Liath Dalton 

So a lot of practices felt like they were suddenly going to have to overhaul everything overnight, when, in reality, that was not the case. So essentially, at this point there, these proposed changes are just dead in the water, and they aren’t going to go into effect.

 

Evan Dumas 

Nope.

 

Liath Dalton 

But, but they all were really common sense.

 

Evan Dumas 

Yeah, yeah, they’re good.

 

Liath Dalton 

So Evan and I, like you know, from our risk management lens and trying to support practices in making sure that they have their risks shored up, and all of that, we’re going, oh my gosh, all of these changes are so good.

 

Evan Dumas 

Yeah, yeah.

 

Liath Dalton 

And like, 99.9% of them are already reflected in the way PCT approaches things, because, again, they’re really common sense, in terms of protecting against what the kind of current threat landscape issues are.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

But what the takeaway is, is that anytime there is a big hype around proposed rulemaking changes when it comes to, federal especially, but also state laws, it is slow moving.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Very slow moving.

 

Evan Dumas 

Very.

 

Liath Dalton 

So there, when you see proposed changes, that doesn’t mean it’s going to go into effect overnight. There will always be an implementation period. It does not need to cause panic.

 

Evan Dumas 

No, not at all.

 

Liath Dalton 

Right? And so it was kind of challenging to see everyone starting the year having that, that panic, right? Because it wasn’t, it wasn’t necessary, and it’s not necessary now. But even though the way that things are with the current HHS and OCR sort of leadership and staffing and what their focuses are, and how that is very much not centered on the HIPAA and regulatory compliance aspects.

 

Evan Dumas 

No.

 

Liath Dalton 

That doesn’t mean that these really common sense changes cannot be incorporated into how you’re managing your practice.

 

Evan Dumas 

Mhm, yeah.

 

Liath Dalton 

So really the main takeaway is, in terms of what we want to support practices in managing are going to center around device security guidance, ensuring that every third party service provider, so every vendor or additional platform that you are using in your practice to handle client info, is one that will provide a HIPAA Business Associate Agreement, and then having really explicitly defined written policies and procedures that essentially are the foundation for how your practice is going to operate.

 

Evan Dumas 

Yeah, yeah.

 

Liath Dalton 

So this is, like we always say, compliance is a process, not a product, and so that there is always going to be the need for ongoing engagement, but we we know that you as a intentional practice owner, are looking at how to manage things, and we’ll always be on hand to help support you in managing things effectively and navigating the kind of weird nuances that come up.

 

Evan Dumas 

Yeah, yeah.

 

Liath Dalton 

So the next big story was most certainly, and not that this is all like sequential either, because this has been going on for a while, but I feel like 2025, was really the year that this took off, which is the proliferation of AI.

 

Evan Dumas 

Oh yeah.

 

Liath Dalton 

And that brought about all kinds of impacts in terms of, you know, some practice pitfalls, maybe some productivity benefits as well. We saw that nearly every vendor or service platform rolled out an AI assistant.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Many of which were not compliant,

 

Evan Dumas 

Nope, no.

 

Liath Dalton 

transparent, or actually helpful.

 

Evan Dumas 

No, not at all.

 

Liath Dalton 

Evan, how much do you hate the prompts that we get?

 

Evan Dumas 

Well to me, AI is like introducing fast food to writing. Like you, if you eat normal, good, healthy food, great, and you always have the choice of cheap, fast and not so good for you. And AI is like that for thinking, it feels like. Where you’re like, oh, wow, this is faster. Is it better? No. Is it cheaper? Yes. Is it making us dumber? Yes. So I find it just, you know, it perfectly fits into our insecurities of our own intelligence. And that’s not a good thing. That is not a good thing in my mind.

 

Liath Dalton 

No, that’s a really valid point. And I think, you know, there’s this, like, push and pull right?

 

Evan Dumas 

Mhm.

 

Liath Dalton 

Where folks in our just modern reality are overwhelmed and burnout,

 

Evan Dumas 

Yeah.

 

Liath Dalton 

And just want to do things, right. So if, if there’s this tool that makes it seem like, oh, I can, I can do more than I’m actually

 

Evan Dumas 

Capable of?

 

Liath Dalton 

personally capable of,

 

Liath Dalton 

Yeah.

 

Liath Dalton 

okay, great. I’ll utilize that. I will deploy it in in all the ways I can, to be better at life, and,

 

Evan Dumas 

Yeah.

 

Liath Dalton 

be a better human and all of those things.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

So, I mean, I will say that there are some areas where AI can bring about benefit when it comes to maybe marketing draft templates or that sort of thing. But I also want to push back against all of this, and this kind of connects to one of the other stories about therapists finding what is most sort of clinically grounding for them.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Because I think that’s where there’s an opportunity for distinction and differentiation on a, on a really meaningful level. Like what what do you as a therapist provide to clients that is, cannot be replicated by AI?

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Well, it’s, I mean, first and foremost, the therapeutic alliance, right?

 

Evan Dumas 

Well, of course, of course, yes.

 

Liath Dalton 

So, but what is that based on? Part of what that’s predicated on is the, like, co-regulation, like two human beings with nervous systems.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Right? So I think that, as there is a lot of concern about like existential threat to the profession because of client utilization of AI, that where therapists can really differentiate and distinguish themselves is based on those really person centered, human centered, and nervous system regulation oriented components of practice, right? Doesn’t that feel a lot more resonant and appealing than just interacting with a bot who’s authentic?

 

Evan Dumas 

Yeah, yeah, it’s far easier to say, hey, this tool will give me the right answer, than blowing your mind and realizing maybe there’s no right answer and we can let live and sit with uncertainty.

 

Liath Dalton 

So, yeah, exactly. So I mean, I guess the big takeaway there is that AI is really a tool, but it’s not a clinician. It’s not a human.

 

Evan Dumas 

No.

 

Liath Dalton 

And it most certainly is not a compliance solution.

 

Evan Dumas 

No, it’s just a sort of magic eight ball for what people have written on the internet.

 

Liath Dalton 

That’s actually a perfect summation of what it is. So with that, I would say it’s, it’s something that always, always must be centered in your ethics, your transparency with clients. And we’ve seen that transparency component reflected in all of the ethics codes updates that have occurred over this year, and then, of course, being founded in actual security.

 

Liath Dalton 

And that sort of leads us, segue to the next piece, which is, and maybe this is actually the most dominant or impactful piece, because I feel like so many new clinicians, like newly licensed clinicians, are going this route, because it sounds so fantastic, and what we’re talking about here is the proliferation of platforms that are offering practice management as a service.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

So not just like a practice management system, which is what we’ve often referred to EHRs, or electronic health record systems, so your Therapy Notes, Simple Practice, Jane App, Theranest, etc., where they’re providing like a suite of services that provide the functionality to primarily client care delivery, but also some internal operations pieces, right?

 

Liath Dalton 

So, those are your classic practice management platforms, but now we’re seeing this proliferation of practice management services where they’re both providing all of the like EHR components and credentialing and saying that they’ll market you and that, just like a whole host of things, kind of positioning themselves as a one stop shop, right?

 

Liath Dalton 

And they are so problematic because their business models are really increasingly undermining clinician autonomy when it comes to clinical decisions and like quality control and even addressing clients that have high acuity, that sort of thing. So some of the risks that really came into focus as we were evaluating these different platforms were, I mean, first and foremost, the lack of Business Associate Agreements, HIPAA Business Associate Agreements, where they were taking on, were willing to any HIPAA responsibility or liability. And kind of weird positioning of we’re all one covered entity, and it’s fine because we’re also healthcare providers, and so it doesn’t really matter. And just very hand wavy. Like, these aren’t the droids you’re looking for. This isn’t the Business Associate Agreement you’re looking for.

 

Liath Dalton 

So we honestly have a lot of concerns about these platforms because of how they put the risk onto clinicians, but are still exerting all kinds of factors of control. So as the profession kind of moves forward, I would love to see you know group practices position yourselves, as you’re trying to onboard and hire new clinicians, as, what you offer that’s an alternative that’s different to these platforms, right?

 

Liath Dalton 

And part of that is a practice culture and professional support and a sense of belonging and and so many different things that these platforms could never provide. And so I think it’s not just about the benefits package or those pieces, but but the other components of what makes someone want to be part of your practice and feels compelling, right?

 

Evan Dumas 

Right.

 

Liath Dalton 

And then, Evan, I’m going to actually let you take the lead on this one, because I know it, you know, sort of is, is one of the areas where you feel most connected, or what feels most resonant to you, which is all about the trend that we’ve seen around clinicians returning to their clinical roots and trying to reclaim some identity and regulation and and figure out where where they land, and what makes being a therapist sustainable for them.

 

Evan Dumas 

So something that we’ve seen this year, which I’m just really pumped about, is people finally talking about how burned out they are and overwhelmed, and the pressures to commodify their their work and speed up, etc. You know, this is a perfect shoehorn for the previous two, of AI and platform as service. I’m just really pumped that we’re getting rid of the shame of talking, rid of burnout, etc. And how, you know, we’re having more trainings about, oh, how can you do documentation more easily? And how can you deal with insurance and Medicare more easily? And how a lot of this, like you can change your workflow to make it more meaningful and grounding, and we can do this not by ourselves, but together.

 

Evan Dumas 

So really, this focus on clinical presence and client connection, I feel as a very natural sort of pushback and swing back from all this tech proliferation and whatnot, and I’m just really here for it, and looking forward to seeing what happens in 2026 as we continue to value the relationship with our clients and the work that we do, and just sort of see how tech can support that, not focusing on the tech.

 

Liath Dalton 

That’s such a beautiful way to put it, Evan, because I feel like that’s become more and more PCTs focus as well.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Right, like we try to be responsive to the professional community that we have the privilege of serving, and you know our purpose has always been to be person-centered in that. But in in the sort of current context and all of the tech overwhelm and concern and so on, I feel like we’ve had more opportunity to provide supportive and responsive resources to folks that are really meaningful over this past year.

 

Liath Dalton 

And I’ll say like once upon a time, like pre-2020, pre-covid, that PCT existed to serve clinicians who are just trying to navigate how to incorporate tech into their practice to meet client needs, and do so in a secure and appropriate way. And then that what that actually entailed shifted so much during the pandemic.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

And it felt really meaningful. Like, oh, wow. We now have this opportunity to help clinicians manage what is incredibly stressful, and to then have a ripple effect by then, through providing support to clinicians also be supporting the clients that they serve.

 

Evan Dumas 

Mhm.

 

Evan Dumas 

Oh yeah, that’s far more rewarding. That’s why I made the switch from IT to counseling and then, now this.

 

Liath Dalton 

Right. So, so here we are, kind of like reflecting back to you, that was a little bit of a sidebar, but reflecting back to you our listeners and all of the folks in the professional community that we serve, that we really appreciate all of you and the work that you do, and it truly is a privilege to get to support your practices in meaningful ways. And I think part of what 2025 has highlighted for me is that the ways that we get to help support practices become even more meaningful. So anyway, that’s that’s my thought on that.

 

Liath Dalton 

And I feel like we have a new kind of even more impactful opportunity in that area now, because some of the concerns that have been brought to us over the course of this last year, are ones around how to really, truly safeguard client info when we’re talking about the most sensitive level of Protected Health Info, of PHI. So, things around reproductive health care, gender identity, immigration status, etc. And yes, the reality that we’re having to think so, kind of, explicitly about each of those areas of risk exposure is distressing, on like an individual and collective level. But the fact that there are solutions and that we can help providers manage those things, feels feels even more meaningful to me, honestly, than being able to help folks get set up with being a telehealth provider.

 

Liath Dalton 

Okay, so last two, not to brush over them. But we definitely have seen some great progression of the cross jurisdictional practice like mobility. When it comes to the compacts going into effect. So previously, we just had PSYPACT, so for licensed clinical psychologists. Now the Counseling Compact has gone into effect, although like minimally so. But we’re seeing progress, and that that makes me really happy, because it means that there is clear guidance. And I feel like we’ve kind of reached a marker where where folks are more understanding of what the actual requirements are to navigate cross-jurisdictional practice, legally and ethically.

 

Liath Dalton 

And then last, but not least, certainly not least, is the Medicare uncertainty.

 

Evan Dumas 

Oh yeah, yeah, a lot of last minute shenanigans.

 

Liath Dalton 

Oh, my goodness. I feel like we got dozens of panicked emails every day for the last few months regarding this. Because, understandably, it’s like very, very impactful. But also there was kind of not misrepresentation, but the focus was on so many in terms of media coverage, was on a lot of other aspects that weren’t specific to behavioral health.

 

Liath Dalton 

So based on the coverage and the way things were being reported, folks were feeling like there was a telehealth cliff, because there were literally, like media articles saying telehealth cliff. So, you know, that that concern was very understandable. But the good news is that at the time of recording, all of the extension, extensions, like the additional telehealth flexibilities for Medicare, have been expended, extended through the end of January.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Which is great, and that, I think in all likelihood, they will get extended again. There is a lot of, you know, political will and impetus for that to occur, so we’re thrilled to see that.

 

Liath Dalton 

But in the, in the meantime, and just wanting to try and prevent January from being deeply stressful for folks that that that are Medicare credentialed, if you are taking on new clients and the extension ends, then you would have to do an in-person visit. If you are just seeing existing clients, which means anyone that you have seen in the time prior to when the flexibilities end, which hopefully they won’t, in January, like hopefully Congress can get their shit together, then that that means that you are good for an entire year, right? So that’s plenty of time to plan things and plenty of time for them to actually extend things again. So don’t disrupt your entire operational flow just to try and meet something that very likely is not going to be applicable by the time you’re like ready to execute your plan.

 

Liath Dalton 

So those, those are the main stories that have been really impactful to mental health providers over this past year that we’ve been been tracking. We’ll continue tracking all of those in the new year as they sort of shift and change. But as always, what our goal is is to provide clarity and confidence and support and just grounding around how to manage your practice effectively.

 

Liath Dalton 

So thanks for joining us on this journey, and we will talk to you good folks next week.

 

Evan Dumas 

Yeah, talk to you next week everybody.

 

Liath Dalton 

This has been Group Practice Tech. You can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.