Mental health workers at Resilience Lab, a Manhattan startup that matches people with therapists to offer remote counseling, may be the first to unionize in the booming teletherapy sector.
The company’s employees filed a petition with the National Labor Relations Board earlier this month to get it approved to join DC 37. DC 37 is the city’s largest municipal workers union and union representing public hospital employees. According to DC 37 officials, DC 37 is the first telemedicine company to be organized in the country.
The filing comes after the company laid off more than a dozen mental health therapists in mid-November and gave several days’ notice to the 271 clients they worked for that their care would be suspended. The ethical guidelines of the American Counseling Association and the American Psychological Association state that ending a patient-client relationship involves processing the client’s complex emotional reactions, ensuring that they are not harmed, and understanding the goals and progress of treatment. It states that it should be done with sufficient time to review the situation. The layoffs come just days before the company announced the raising of his $15 million venture investment round.
A company representative declined to answer questions about why the 12 therapists were fired.CEO and co-founder Mark Goldberg said patients should continue to see therapists outside of the Resilience Platform. is allowed.
In a statement, Goldberg said unionization would hurt the company’s development and was not necessary. However, we do not believe that this model will provide the flexibility needed at Resilience Lab’s current stage of development to continue to provide our clients with the best possible treatment and support. ” he said.
Talk therapy was once offered primarily by non-profits and clinicians operating private practices in physical stores, but in recent years it has increasingly moved into the world of tech startups. One of his biggest companies, BetterHelp, has been around since his 2013. Other companies have followed suit, and the COVID-19 pandemic has further increased telemedicine acceptance among both patients and practitioners. Last year, a startup offering digital mental health services raised his $4.8 billion investment, reports The Wall Street Journal.
These companies can help therapists build their own practices or supplement their income from other jobs. But they also have a significant downside. Due to low wages at some companies, therapists may take on more cases and be understaffed. This reflects some of the labor challenges found in the tech-fueled gig he economy.
Founded in 2019, Resilience Lab sought to differentiate itself from its competitors in the increasingly crowded field of telemedicine. The company claims that half of its 230 or so therapists identify as people of color or part of the LGBTQ community, allowing it to appeal to a more diverse clientele.
At a time when the country is facing a shortage of mental health professionals, Resilience Lab also emphasized allowing new therapists who are not yet licensed to work under clinical supervision as private practitioners. By doing so, they can amass the hours of counseling needed to become fully licensed.
About half a dozen current and former Resilience Labs employees who spoke with Goshamist said they were drawn to the opportunity to build a customer base and the company’s message of inclusivity. But some have criticized the company for hiring board members from outside the healthcare sector. Union organizers also said the new employment deal means pay cuts for some therapists, and some say it’s not in the best interests of patients, including layoffs and patient assessment tools that management tried to introduce over the summer. He criticized the management’s decision, which he believed.
“[Resilience Lab] An employee of Resilience Labs, who is on the union’s organizing committee, spoke on condition of anonymity for fear of retaliation. by management. “The group’s private practitioner says he doesn’t hire people from Uber to teach therapists how to work.”
CEO Goldberg said the company has hired executives from both the tech and healthcare industries. His wife and co-founder Christine Carville is the company’s chief clinical officer and licensed therapist.
After being laid off in November, one of the company’s supervisors left due to a transfer. In a lengthy memo shared with Gothamist, he said the company did not give therapists and patients more time to transition and how the move violated professional ethical guidelines. was quoted.
At least one of the dismissed therapists, Tanya Tripi-Weiss, remains on the union organizing committee. She was already considering leaving her company for her new contract when she was fired in a lawsuit in November.
“The people I work with to help unionize deserve far better than what they are getting,” Tripi-Weiss said.
Aside from the recent layoffs of therapists, another issue for some workers is the Resilience Labs initiative to measure patient progress through new assessment tools. The company claims that the tool will allow therapists to receive feedback from their patients and improve their results. However, a letter to management, signed by 60 employees, countered that patient surveys “are devoid of trauma-related information and do not meaningfully assess clients’ individual goals.”
On December 14, Michele Moorman, Vice President of Resilience Lab, sent an email about the employee’s letter to industrial relations consultant Jason Greer. The email was shared with Gothamist Resilience, whose lab did not respond to questions about her relationship with Greer.
Casey Pierce, an assistant professor of informatics at the University of Michigan, studies how the rise of teletherapy companies is impacting the work of mental health professionals. She said many therapists choose to work with these companies because of the flexibility they offer, but to make the gig worthwhile, they have to work with a larger case load than they can handle. Some people feel the pressure to undertake
“One of the biggest issues is that you get rewarded for getting more customers, but you don’t always feel like you have the ability to do that,” Pierce said. say.
But her research shows that not all teletherapy companies have the same model. Some are designed primarily to connect networks of insurance companies and therapists, allowing therapists to retain most or all of the fees they earn per session.
Similar to BetterHelp, Resilience Lab’s pay scale encourages therapists to take on as many clients as possible.
Resilience Lab sets the base salary at $1,300 a month, according to a contract released in October shared with Gothamist. The therapist earns a portion of what the patient or their insurance company pays for each session. Starting at 15% for his first 49 monthly sessions, then increasing in increments.
Why telemedicine is hard to organize
At most teletherapy companies, mental health professionals are independent contractors, not employees, Pierce said. This classification means that Resilience Lab’s union activities are likely difficult to replicate elsewhere in the industry.
The problem is also occurring in other parts of the gig economy, such as ridesharing and delivery services, said James Parrott, director of economic and financial policy at the New School’s Center for New York City Affairs. Some companies argue that organizing by independent contractors is an antitrust violation.
“They are ostensibly independent businessmen, and banding together to deal with third parties, such as ostensible employers, can be construed as anti-competitive behavior,” Parrott said. .
But instead of unionizing, New York City delivery workers form political alliances and have been successful in changing local laws about the industry, he noted. We want to set the standard in the telemedicine field that encompasses patient care.
DC 37 executive director Henry Garrido said in a statement: “We intend to secure a strong deal with Resilience Lab, which sets high standards for the entire telehealth industry.”