Therapists At Mental Health Startup Resilience Lab Vote To Unionize

Therapists at the start of mental health Resilience Lab voted to unionize on Wednesday, one of the first successful unionization efforts at a digital health company.

The move follows widespread concern among employees after the company fired 12 therapists, changed how it was paid and introduced third-party software to track patient progress, according to five current and former employees who requested anonymity for fear of retaliation. The petition to hold union elections and layoffs was first reported by Gothamist.

The New York-based startup, founded in 2019 by chief clinical officer Christine Carville and her husband, CEO Marc Goldberg, claims to be “the largest and most diverse New York-based therapeutic collective.” As the company grew, employees said it increased its emphasis on technology and software and began hiring former executives from WeWork, Uber and Airbnb, leading up to a $15 million Series A funding round led by Viewside Capital Partners and Morningside in November.

After publishing a story on corporate venture financing, Forbes study Resilience Lab has, three days before, fired 12 of 200 therapists, giving one week to transition 271 patients, according to documents seen by Forbes. Three administrative employees were also fired, according to current and former employees involved in union organizing. He also said the majority of the fired employees have segregated identities, including people of color, queer people, trans people and people with disabilities.

Carville and Goldberg did not respond to multiple email requests for comment and phone calls to the Resilience Lab office for this story.

Resilience Lab employees were elected to be represented by AFSCME District 37 Council, the union that mostly represents public sector employees in New York, by a vote of 79 to 13, according to Kayla Blado, a spokeswoman for the National Labor Relations Board, which oversees the election. Blado confirmed 15 ballots were challenged and not counted.

By 2022, about 1.2 million health care workers will be union members, accounting for 13 percent of the total health care workforce — down half a percent from the previous year, according to the U.S. Bureau of Labor Statistics.

“Work now begins to secure contracts for our new members — the first in the state for a telehealth company,” said Henry Garrido, executive director of District 37 Council in a statement. “All workers deserve union support, whether they do business online or in person.”

Up until four months ago, current and former employees said Resilience Lab was the prospect of a stable, salaried job in what could be an exploitative training period for early career therapists. In order to become a fully licensed therapist, people with a master’s degree in mental health counseling or social work must complete thousands of hours of supervised clinical training, which is one of the problems Carville and Goldberg previously mentioned. Forbes they try to solve it.

Resilience Lab hires therapists under supervision in a way that will receive a percentage of the fees from patient sessions. If it reaches 100 patient sessions in consecutive months, the company offers the possibility of achieving “resident” status – a $67,000 salary job with benefits and potential bonuses, according to employees and documents seen by Forbes. That’s interesting, because the average salary for social workers is $50,390 per year or $24.23 per hour, according to the US Bureau of Labor Statistics.

In June, Resilience Lab announced a partnership with a Boston-based startup called Mirah to deploy “measurement-based care,” which it described in a press release as “founding clinical care practices on client data collected during treatment.” Patients began receiving weekly assessments to complete outside sessions with therapists.

There’s been pushback from therapy groups that say the way the company implements the software is “unethical,” according to a letter signed by more than 60 employees sent to Resilience Lab management in July. The group wrote that they were concerned that frequent assessments and the idea that “progress” in linear therapy could be harmful to patients. The letter also asked for more information about what patient data is collected and how it is used.

In August, Resilience Lab announced new hires from other tech startups to expand operations. Patrick Morselli, former head of global expansion at WeWork, becomes chief operating officer. John Hamby, former regional manager of community engagement at Uber, was named general manager, and Alyssa Lin, former director of portfolio strategy for Airbnb Luxe, became head of growth. Goldberg previously told Forbes the company “has no interest in building Lyft or Uber for therapy.”

In mid-October, the therapist was given a new contract. The “resident” position with a salary of $67,000 was eliminated. In the space, all therapists will receive a base salary of $1,300 per month – $15,600 per year – plus 15% of the patient’s session fee for the first 49 sessions per month. The percentage shows for increased therapy above 50 sessions.

When the company announced its series A funding the following month, the press release hyped its software products: an online training program for therapists, a “proprietary software infrastructure” for billing, reimbursement and tracking of patient outcomes, and client-matching software.

Current and former employees say the focus on technology and software is another blow to the morale of the company’s mental health workers. “They have not been transparent that this is a mental health technology platform in the hiring process so far,” Tanya Tripi-Weiss, one of the fired therapists who is on the union’s organizing committee. Forbes. “Until now, we’ve been involved as if this were a larger private practice in New York City.”

Another former employee described it as a bait-and-switch: “I feel like they’re using all the doctors as guinea pigs to see what they can do. [with the technology].”

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