Doing the Work: Therapeutic Labor, Teletherapy, <br> and the Platformization of Mental Health Care

Event ⋅ May 9 2024

Doing the Work: Therapeutic Labor, Teletherapy,
and the Platformization of Mental Health Care

Databite No. 159

Linda Michaels
Melody Li
Mei Wa Kwong
Livia Garofalo

Read the report

“When corporations prioritize profit over people, there’s a dehumanization that happens…It’s about getting as many people onto these platforms as possible, as many clinicians onto these platforms as possible, without considering the wellness of the folks on there, the experience of why people are joining.”
– Melody Li

“It’s really not just about the technology — that’s just the tool or the medium. It’s really the first time [therapists and providers] are confronting the entry of big money, private equity, investors, and a corporate mindset into the mental health space, and [they’re] bringing their incentives, their values, and their orientation into the work that we’re doing.” – Linda Michaels

“I tell [mental health] providers, ‘You need to get involved.’ Because I’m a policy person and I’m a JD, and I can write the perfect policy, but if it does not work in practice for the provider and the patient, it’s useless.” – Mei Wa Kwong

Increasingly, online therapy has become one of the main ways that people seek and engage in psychotherapy in the US, especially since the COVID pandemic. While this represents a significant shift for those on the receiving end of care, it has also transformed the work of mental health providers — as they interact with more digital tools, provide care in the virtual space, and see and find clients through direct-to-consumer platforms. Even as teletherapy and platform therapy have enabled more people to access and benefit from these services, for providers, this increased availability has often meant intensified labor.

Data & Society’s report, Doing the Work: Therapeutic Labor, Teletherapy, and the Platformization of Mental Health Care, by Livia Garofalo, explores how these new arrangements of therapeutic labor are affecting how therapists provide care and make a living in the US. By focusing on the experiences of providers who practice teletherapy and work for digital platforms, our research examines the fundamental tensions that emerge when a profession rooted in clinical expertise, licensing, and training standards meets the dynamics of platformization, productivity incentives, and algorithmic management.

In this conversation, we reflected on how technology is changing the conditions of how therapists do their work, on the consequences for the present and future of therapeutic labor, and on how this might be changing our understanding of therapy itself.

Speakers

Linda Michaels

Linda Michaels, PsyD, MBA is a psychologist with a private practice in Chicago. She is chair and co-founder of the Psychotherapy Action Network (PsiAN), a grassroots nonprofit that advocates for therapies of depth, insight, and relationship. She is a consulting editor of Psychoanalytic Inquiry, clinical associate faculty at the Chicago Center for Psychoanalysis, and a fellow of the Lauder Institute Global MBA program. Michaels is author and co-editor of Advancing Psychotherapy for the Next Generation, and has published, presented, and been interviewed by The New York Times, The Wall Street Journal, NPR and other national media on the value of psychotherapy, the therapeutic relationship and technology, and the public narrative about therapy. Her former career was in business, and she has over 15 years of experience consulting to organizations in the US and Latin America.

Melody Li | Instagram: @melodyhopeli @inclusivetherapists

Melody Li, LMFT (they/佢) is the founder of Inclusive Therapists, a liberation-oriented mental health directory, resource hub, and community centering intersectionally marginalized identities (e.g., Black, Indigenous, and people of color, 2SLGBTQIA+, neurodivergent, and disabled communities). They also founded Mental Health Liberation, a non-profit ecosystem bridging BI&POC with free, quality therapy services, and empowering students and clinicians of color.Their activism focuses on decolonizing mental health care and mobilizing for collective liberation. As a colony-born migrant and settler on Turtle Island, Li advocates for Landback, Indigenous sovereignty, and Black liberation as priority.

Mei Wa Kwong

Mei Wa Kwong, JD has over a decade of experience in state and federal policy work. She is currently the executive director for the Center for Connected Health Policy (CCHP), the federally designated National Telehealth Policy Resource Center. She has written numerous policy briefs, crafted state legislation, and led coalition efforts on a variety of issues. Kwong has published articles on telehealth and telehealth policy in peer-reviewed journals and is the co-author of CCHP’s 50 State Medicaid Telehealth Reimbursement Survey. She is recognized as an expert on telehealth policy and has been consulted by state and federal lawmakers.

Editorial: Eryn Loeb

Additional support provided by Data & Society’s Engagement and Accounting teams.