Exploring The Latest Tech Innovations in Counseling, with Nick Fuller of iTherapy: Ep. 30

Episode Overview

• Episode Topic:
  In this engaging episode of Mastering Counseling, we welcome a tech-savvy entrepreneur, Mr. Nick Fuller. He is a master in his field who serves as the Chief Executive Officer of not just one but two companies, iTherapy, and Shire Digital Solutions. Join us as we delve into the world of mental health practice management and explore the transformative impact of technology on counseling education.
• Lessons You’ll Learn:
  In this episode, we will take a peak into Nick’s journey from web development to mental health practice management, emphasizing the intersection of technology and mental health. Nick shares strategies for driving growth while maintaining a personal touch at iTherapy, a one-stop solution for therapists willing to learn about the latest trends in counseling education. We discuss challenges and opportunities in ownership transition, the role of digital solutions like iTherapy in adapting to client needs, and insights into the future of mental health technology. Aspiring entrepreneurs in mental health tech will find valuable advice from Nick.
• About Our Guest:
  Our guest, Mr. Nick Fuller, is the Chief Executive Officer of iTherapy, a leading practice management platform for mental health providers. With a background in web development and a passion for mental health, Nick’s journey epitomizes the potential of technology in revolutionizing counseling education and its practice management.
• Topics Covered:
  Nick discusses his transition from web development to mental health practice management, highlighting the strategies behind iTherapy’s remarkable growth and the challenge of balancing efficiency with personal attention. He also explores iTherapy’s one-stop solution for therapists, and individuals specializing in counseling education including key features, ownership transition challenges, and the role of digital solutions in adapting to evolving counseling needs. Nick discusses the synergy between Shire Digital Solutions and iTherapy, shares insights on the future of mental health technology, and offers advice to tech-savvy entrepreneurs looking to impact mental health through technology.

Episode Transcript

Nick Fuller: Another area that is perpetually underserved is helping therapists start their own practices. Because if you think about if you’re a therapist, you went to school, you went to a lot of school. But how much of that school actually taught you how to run a practice or run a business? Because a practice is a business, probably not much of it, if at all.

Becky Coplen: Welcome to Mastering Counseling, the weekly business show for counselors. I’m your host, Becky Coplen. I’ve spent 20 years working in education in the role of both teacher and school counselor. Each episode we’ll be exploring what it takes to thrive as a counseling business owner, from interviews with successful entrepreneurial counselors to conversations with industry leaders on trends and the next generation of counseling services, to discussions with tech executives whose innovations are reshaping counseling services. If it impacts counseling, we cover it on mastering counseling.

Welcome listeners to another captivating episode of Mastering Counseling, your window into the world of counseling, therapy and the businesses that make it all happen. I’m your host, Becky Coplen. Today, we are really honored to have a true tech-savvy entrepreneur with us, Mr. Nick Fuller. He is the chief executive officer of iTherapy, a practice management platform that’s changing the game for mental health providers. We talk to many therapists on this show, and today I feel like we’re really going to get a lot more on the business end and so welcome, Nick. Go ahead and introduce yourself.

Nick Fuller: Thank you for having me, Becky. Like you said, I’m Nick Fuller. I’m the CEO of iTherapy, also the CEO of another small business, Shire Digital Solutions, we’ll talk about that. My role is to make life easier for therapists. I’m one of those people in the industry that’s not a therapist myself, but got pulled into this and love helping therapists do the important work that they do.

Becky Coplen: Thank you for being here today. I know that it’s personally therapeutic to me when someone fixes my tech issues or opens my world into easier life in business. So I think you are a partial therapist even if you don’t have the exact title. So can you share with us how your experience in web development led you to the world of working in mental health and practice management?

Nick Fuller: Yeah, it’s kind of an interesting story. I was on the other end sitting on the couch talking with a therapist, and I’d been talking with the therapist for a while and was doing work building websites. That’s been my day job for many years now. And she put me in touch with iTherapy. She knew of the people, the founders of iTherapy were looking for someone a little bit more tech-savvy. And they we got in touch and started working down that road and the rest is history.

Becky Coplen: That’s amazing. I love that you were working with a therapist and that’s what got you into it. So you were seeing it from the client side and what they might need from trying to get a therapist. And then you were able to help us hopefully make that easier. In my searching of you, we see that iTherapy has undergone impressive growth under your leadership. Can you tell us more about your role in doubling its user base and the systems you’ve designed to streamline operations both internally and then also for the clients?

Nick Fuller: Sure. I’m lucky in that a lot of it with the clients has been pretty streamlined to begin with. But yeah, I mean, some of it’s boring stuff like setting up a client relationship management system so that we can just keep track of our clients and our leads and that sort of thing. But the important thing has been maintaining our close working relationship with all the therapists that we work with and making sure that we maintain that human touch. The two co-founders of iTherapy are Couple Forest and Carol Pulley, and Carol is a clinician and Forest is a businessperson. And they always were, Forest, especially. this was his baby. And he would talk with every single person that was getting signed up and make sure that he helped them along and as much as possible. We’ve tried to maintain that personal touch the whole way through, and I think that’s what makes our therapy different.

Becky Coplen: When did they start the iTherapy business? So when was it originally founded?

Nick Fuller: Yeah, good question. Originally, if I’m remembering because it’s gone through a couple of iterations over their history, but they really got it started back in I think 2012 or 2013 and they were way ahead of the game. Again, she’s a clinician, Carol Pulley, and they both live out in rural North Carolina. And she was like this driving everywhere for these appointments. This is for the birds. There’s this Internet. I bet I could do this better. So she again, like 2013, who had heard of Zoom back then, but she was getting it working so that she could do HIPPA-compliant video sessions. And then her friends were going, how are you doing this? What are you doing? And more people were asking her the same question. She’s like, I should really start helping people do this. So initially they had it set up like a group practice, but that was a giant bear to manage. And so at some point, the business model of therapy shifted to where instead of doing that, it’s more about getting the tools for therapists to run their own practice.

Becky Coplen: Good to know the background of everything. You also own Shire Digital Solutions, which specializes in website development and SEO. How has this additional venture enriched your approach to supporting mental health professionals through iTherapy?

Nick Fuller: Yeah, it’s funny because it turns out Shire Digital Solutions was the business that preceded iTherapy for me because I established a Shire Digital SolutionsT to do web development prior to working with the therapist that got me involved with iTherapy. But the two do coexist still and work well together helping each other out.

Becky Coplen: Let’s talk about iTherapy, is known for being a one-stop solution for mental health providers. What are some specific key features and services that make it stand out? And how have they benefited therapists with their practices?

Nick Fuller: When I first came on board with iTherapy and first started working with them, what stood out was the fact that therapy bundled together all the different services you need to work online. Again, like 2016, that was pretty novel again, even in 2016, like who had heard of Zoom. But there’s certainly more competition these days. There’s lots of different places where you can at least have video chat. But the first thing that we do that’s unique is we bundle more than just that. We have solutions. We have HIPAA compliant video chat services, we have HIPAA compliant phones. So you can talk or text to your clients, which is a great backup in case someone’s internet goes down or there’s a problem with Zoom, that sort of thing. And we have HIPAA compliant email. So all those things we bring together so that you can effectively work online in a HIPAA compliant way, you’re not going to have to worry about it, right? That’s number one, is bundling all those things together. Number two, what really again, sets us apart is what I was mentioning earlier, that personal touch with everyone that signs up with iTherapy. We provide one-on-one training for all of these tools, like so you’re actually talking with a live human being to via a video call to understand how to use these things, how to be effective. There’s also great support. In addition to that, the video in particular has 24/7 support for you and your clients.

So if either of you are having trouble connecting, that support, phone number is available and they are able to get that sorted out, usually within just a few minutes, very few cases where it’s going to be more than like just a couple minutes to make sure that you’re able to connect effectively. So bundling everything together, that personal touch, that one-on-one training. The other thing that we do provide is a clinical consult peer group. So one of the few things that’s a downside of working online is it can potentially be isolating. You don’t really get to go down the hall of the group practice and have that water cooler talk. But our answer to that is to have an online peer group. So it meets twice a month and it’s all other licensed professionals. Of course, you would want to maintain client anonymity, but it’s still an opportunity to talk in a safe and HIPAA compliant way about I have this one client, they’re dealing with this challenge and I’m really just not sure. And there’s different people there that know different modalities may be able to give you some insight and a different approach and certainly an ear to listen, if nothing else. Yeah, and it’s been really helpful. Those things set iTherapy apart and really bring a lot to the table for all of our we call them therapy providers, mental health providers that are working with us.

Becky Coplen: Those things are amazing. What stood out to me is how, yes, we can connect all around the nation and the world, but then we really do value that personal connection and not just talking to an operator or AI, but a real person to help guide us, because I think everyone probably has their own little questions that aren’t always on the FAQs. So I love that you guys provide that personal support, and the peer meetings is a great tool as well. We’ll talk a little more about how you ended up taking over the business of iTherapy because they retired in 2020 and it was sold to you, What a year to have that happen. I just have to ask to start what month of 2020 did that occur?

Nick Fuller: And this had been a long time coming. I mean, this was part of the reason why they wanted to bring me on board in the first place because they were really looking, mean, Forest is into his 70s. He’s much more into gardening and golfing these days. And this was like their third or fourth career together. But this it wasn’t news, but things were finalized in the beginning of 2020. But even then, like, I mean, I told Forest through the process of developing our agreement that like, I don’t want you to be gone, so what could I do to make sure that you’re going to still be here in some capacity? And we worked out something where he’s not certainly these days, not involved in the day-to-day so much, but still helpful and offering some guidance and that sort of thing. But boy, 2020, it was not quite the retirement that he thought it was because I was going, hell! and March and April were challenging months for us just to keep up with the demand. But everyone put in long hours and did great work. So their superstar team that got working with us with iTherapy.

Becky Coplen: Well here we are in 2023. I think it’s like the rest of the world caught up with you guys and now hopefully it’s a little more balanced. So in this field of mental health, technology has played a significant role, really before. I would say I knew with all the work that you were doing. Can you share some insights into the importance of digital solutions like iTherapy in today’s counseling landscape, and how is it helping therapists adapt to the client’s ongoing changing needs?

Nick Fuller: Yeah, things are going more and more online, I think, and it’s making therapy more and more accessible, which is great. It seems like therapy is not a dirty word like maybe it was many years ago. It’s okay to talk about mental health in a way that it wasn’t okay, not even that many years ago. But I think the accessibility of things online really helps the privacy of things online. You don’t need to go to an office. You don’t need to be at an office. You can be wherever you’re comfortable, you can be in your own home or you can be if you have a private office, you could be at your office, wherever it is. You can have your session on your terms, wherever you need to be, wherever it’s comfortable, and of course, depending on the therapist and their availability. But at ours, that may be very different than traditional business hours, and think that that’s the biggest change. Just technology has helped make it all more accessible and bring things out into the open a little bit more.

Becky Coplen: This episode is brought to you by mastersincounseling.org. If you’re considering enrolling in a master’s level counseling program to further your career, visit mastersincounseling.org to compare school options via our search tool that allows you to sort by specific degree types tuition, our costs, online flexibility, and more. You mentioned a couple of times about the privacy and how that’s a big part of your guys’ company that people can follow HIPAA and feel safe about what they’re sharing, which is extremely important, and also being able to connect even in different time zones. I talked to someone yesterday in California and it was better for me later, but for her, it was better earlier in the day and we can still connect. So those are some really great things to connect from farther and farther away. Let’s talk a little bit about Shire Digital Solutions, which focuses on custom website development and SEO. And I think maybe just for our listeners before I finish the question, clarify for us what SEO is.

Nick Fuller: Sure. Search Engine Optimization. So any time you go and search something online, you Google something. There’s of course the results on that search engine. And there are things that someone like me can do to try to make it so that your website is more prominent in the search results higher up on those search results. That search engine optimization.

Becky Coplen: All right. So a big part of marketing online. So how does your business with Shire compliment your work with iTherapy and what unique benefits would it bring to mental health professionals?

Nick Fuller: Yeah, great question. So iTherapy is great for giving you the tools and giving you the support to run your practice. It’s all about the clinical tools. Again, that HIPPA-compliant video, the notes, the phone, the fax, and then we have the one-on-one training, the clinical consult group. That’s what iTherapy does. Shire Digital Solutions helps you bring your service, your practice to other people. So of course, we do. As you mentioned, custom web development. I like to think of those as business cards, but much better. I also refer to websites as a conversion machine. If you get eyeballs on your website and if your website’s doing a good job, your ideal client is going to look at that website and go, wow, this therapist understands me and the issues that I’m dealing with. I want to work with this therapist. So then how do you get eyeballs to the website?

Well, that’s other parts of the work that we do, including search engine optimization, trying to make sure that when someone’s looking for your services, your website shows up, then they get to that conversion machine, then you’re talking to that client, and then you’re using all the tools that kind of go along with therapy to first have that initial consultation and then work with that client. So that’s how they work together. Again, like therapy helps you get going and provides the clinical tools. Charging solution helps you grow that practice.

Becky Coplen: Great explanation. How many employees are working in your two businesses and do any of them work in both as well?

Nick Fuller: Yeah, there’s definitely a lot of interplay between the two businesses, and these days, so there’s four full-time employees. Forest is still around when I need him. There’s other people that are providing support for the phone systems and the video systems, all that. So there’s a few different pieces going on.

Becky Coplen: Yeah, absolutely. Let’s talk a little bit about the future. And you guys were so far ahead of everything in the tech world. How do you see the future of mental health technology evolving and what trends do you think will shape the industry in the coming years?

Nick Fuller: One of the trends that is clearly here is things have gone more online. Covid made Zoom, a household name. There’s been a lot of return to office and a lot of return to person to person, but it’s also not gone away. I’ve seen a lot more hybrid practices also where people may have an in-person office, but they may also offer online, which I think is the best of both worlds. Because again, if you want to come into the office, you have that option. But if you have a client that’s potentially just sick with the flu, they might still be able to come but not have to come to the office. So that’s again, I think that’s going to continue. The other big development that’s got its pros and cons, like so many other pieces of technology, is AI or artificial intelligence. I’ve already heard from certain therapists that are trying to use AI like ChatGPT to help them with their notes writing.

So at the end of a session, particularly therapists that are doing things like evaluations where the writing is pretty formulaic and follows a very specific structure, sometimes those tools can help save time from having to write all the same words over and over. So I think there’s merit there, but I absolutely understand that there’s also a lot of concern about the safety of your sessions and your client’s notes. It’s not something that we’re getting into at this point because we just don’t feel like our providers are comfortable with that and completely understand. And but I think that looking five, ten years in the future, I think that is going to be significant. Changes mean even big companies like Microsoft are trying to do that sort of thing for doctors and that sort of thing. So it’s definitely coming.

Becky Coplen: So fascinating. So what advice? Ice would you give to aspiring entrepreneurs looking to make a positive impact in the mental health field, specifically through technology?

Nick Fuller: So great question. If you’re a therapist and you have an entrepreneurial mindset, first of all, you have a superpower as a therapist, as an entrepreneur, in that you have empathy. You are able to speak with your ideal clients and speak their language and the things that move them, right? If you apply that in your entrepreneurial work, you’re going to have a lot of success to the point that you were making earlier of how there’s certainly opportunities between connecting different things. Yeah, I mean, enough said. There’s opportunities there. But lastly, another area that is perpetually underserved is helping therapists start their own practices. Because if you think about if you’re a therapist, you went to school, you went to a lot of school, but how much of that school actually taught you how to run a practice or run a business? Because a practice is a business, Probably not much of it, if at all. So there’s a number of different people out there that provide coaching for this skill, but again, think there’s just so much room for that. So if you’re a therapist with an entrepreneurial mindset, that might be something to look into. If you’re a technologist wanting to work in the mental health space, what I would recommend is talk with therapists about their clients pain points and their struggles and also the solutions that the therapists are bringing. And then think about the ways that technology can help with those therapists and help with those solutions.

Nick Fuller: One kind of simple example that I really like, my wife found an app for my phone. It’s called “Paired” and I wish I’d made this app because it’s genius. All it does is provide like conversation prompts for me and my wife every day. They’re not complicated conversation prompts. Usually, some of them are a little more like, oh, that’s deep. And some of them are very like frivolous. But it gets us talking. And especially the ones that are like deep, they may start a conversation that’s maybe even a difficult conversation that maybe we’ve been avoiding. Paired is a great example where those questions are populated and formed through the help of relationship therapists. They’ll even have like sometimes little video vignettes from relationship therapists talking about why is this important. Why is this helpful for your relationship? Why is this a question that we thought to ask and think that there’s a ton of opportunity for that sort of thing where my wife and I are in a good place with our relationship. But like anything, we can be in a better place, right? There’s always that room for growth. And if you’re able to as a technologist, if you’re able to think about those situations where you can be therapy adjacent, but with that skill set that that training from the therapist, definitely opportunities there.

Becky Coplen: Good to know. I actually have a senior this year, so I’m always telling him about new job opportunities. So I’ll be like, Hey, maybe he’ll want to have a practice with me one day. Don’t know. There you go. He can do the tech side. It will not be me. I guess one thing, I just wanted to branch out on that. If someone was wanting to be more of a technologist, what type of maybe more specific major would you encourage if they were going more that route? They were like, I don’t want to be a therapist, but I would love to support them. Would it be like a computer science, or how do you see that in the education world?

Nick Fuller: Great question. Definitely. Computer science is a great place for someone that’s interested in technology, but I would just encourage anyone that’s interested in technology. But like with a business mindset, sprinkle in some business classes there too. It’s going to be really helpful and then honestly think anyone that is interested in technology, you probably already know the vast amount of things that you can learn online. It’s crazy how much you can learn on just YouTube these days, much less places like masterclass. But there’s also org I think, and it has courses that are from major universities like MIT and Harvard and that sort of thing. Some of them are computer science, but in particular, has some classes on entrepreneurship that years ago I found particularly useful. So stuff’s out there. It doesn’t need to be formal, but in chair university training it could be your own learning. There are so.

Becky Coplen: Many things being learned that don’t require paying tuition, but I like what you shared about getting courses in a variety of things. Is there anything else in our whole conversation that you either want us to know about your platform, your companies, or any more advice you wanted to share for people interested in a master’s in counseling? Any other wrap-up details that maybe we might have missed?

Nick Fuller: I think if you’re thinking about a master’s in counseling, we need more counselors in the world for sure. If you’re thinking about starting a practice, I’d encourage you to take a look at iTherapy. It’s the letter I the word therapy.com. We try to make it real easy for you, provide that training along the way. If you’ve been established for a while, we can still certainly help you. Similarly with digital solutions, the websites shire-digital.com. We make websites that I personally think are beautiful. And I can say that because it’s not just tooting my own horn, it’s mostly the another person on my team that does a lot. The website work. We can help you grow your practice and we just try to be a resource. So if you have questions and if we have answers or we know someone that does. Don’t hesitate to send a contact message. If it’s something that we’re able to help you with reasonably, then we absolutely are going to.

Becky Coplen: Thank you so much. I feel like we really got to branch out and hear more about business practices and just putting the way our world has changed so much into the world of therapy and counseling, which is going to be so important for the future. And so really appreciate you being here today. We are grateful to Nick Fuller for sharing both of his companies with us and his predecessors who were so ahead of their time. To our listeners, I hope that these insights help you and even inspire you and maybe even a different realm of this type of fields. As always, let’s continue the conversation online. We want to hear feedback from you, questions, comments, opinions, all of that is well received. We will say goodbye for today and we will talk soon on Mastering Counseling.

You’ve been listening to the Mastering Counseling podcast by mastersincounseling.org. Join us again next episode as we explore what it takes to be a business success in the counseling industry.