UberTherapy is not about Therapy
The Mayor of New York Mamdani, a DoorDash delivery rider, and two UberTherapists from Headspace and HealthAssured walk into a bar and this is what could happen next.
It might be that when they take that sharp intake of breath at the cost of a first round, Mamdani tries to cheer everyone up with stories of his crackdown on wage theft by the delivery platform DoorDash. How NYC won the largest collective settlement for platform food delivery drivers in the US, US$131.5 million for all those stolen hours and late payments, all those lost tips. Just imagine the pedantic technical work to establish the data and algorithmic black-boxes behind 152m payments and 110m hours of deliveries in order to monetize the extraction behind the platform business models.
The DoorDash rider reminds Mamdani that he’s a proud New Yorker but this didn’t happen by accident. It wasn’t just the work of having an actual democratic political leadership in NY. It was also the self-organised groups that convinced platform workers that its safe enough to join the heroic technopolitical efforts required to get the actual data on wage theft. It was the Department for Consumer and Worker Protection (DCWP), working with the Worker’s Justice Project and the Workers’ Algorithm Observatory who designed the compliance software needed to understand the black-box behind the extractive business model of DoorDash.
A sober reminder of the hard slog behind digital collective action, like the ‘UberCheats’ app designed by an UberEats rider to collect the wage theft data. Or the dynamic pay campaign coordinated through Worker Info Exchange for Dutch and UK Uber drivers, and the work to collectivise the international data around dynamic pay models this involves (treat yourself to a subscription to the best substack on this The Gig Economy Project).
The UberTherapist working for Headspace tries to make everyone feel better by offering another round and hands out a leaflet with a 50% reduction of BetterHelp subscription for Lyft drivers as part of their celebration of a half-decent mental health week.
By the time the UberTherapist comes back Mamdani has started to calculate the wage theft of HealthAssured therapists on the back of an e-cigarette packet. Feminized workforce, the standardised behavioural techniques of next generation automated iCBT-lite, the wage theft associated with the ranking and rating and the non-payment of cancelled clients. An hourly rate that only offers a living wage if you work intensely far from the safety of professional regulation. The emergence of predatory pricing that predicts the consumer’s ability to pay a higher rate for the unique text based support offered at 3am.
The UberTherapists’ minds wonder into a dark place about the cost of their shame behind paying for all those high level CPD events on how to understand benefits of AI and the FOMO of Practice Management Companies required to navigate the landscape of private medical insurance.
An awkward silence follows as the penny drops that nobody knows if Uber’s dynamic pay models are already being used by online therapy platforms. Suddenly, nobody wants to talk about money. A doing-my-headspace-in moment I’ve become incredibly sensitive to as my book UberTherapy rolls out and evidences the complexity and shaming involved in just talking about actual money.
An alert pings on someone’s smart phone. Alert: Whatever happened to Andy? Andy Puddicombe, the Buddhist co-founder of Headspace who guaranteed the algorithm behind the first large scale wellbeing platforms available B2B and B2C in the UK. You know Andy, the one whose calm mindful voice is used in the recorded meditations sold to millions of people. Andy, sold the business and was replaced by another white guy, Tom Pickett in 2024.
Tom comes from the platform sector including DoorDash and Crunchyroll. Yup, that Tom Pickett who after Headspace’s $3bn merger with a digital provider of clinical services called Ginger, reconfigured the Headspace business model to providing standardised therapy under the platform logic of DoorDash. Tony was also a senior manager at Crunchyroll when it was bought by Sony in its global takeover of anime and the subsequent restructuring of the e-commercial subscription model.
Which makes you wonder at what point in Tony’s interview power point slides he included the bullet points on moving Headspace Health into a sector of e-commerce with guided self-help subscriptions and automated AI clinical support for the next generation of e-consumers of therapy.
The reshuffling of Headspace Health, now headquartered in California, means that it is dominated by large investors, in this case Spectrum Equity (Tech) and Blackstone (a key investor in Uber Technologies). Investors hold board positions and predictably enough the tech investment press signal an IPO ahead, putting it into direct competition with digital therapy companies like TalkSpace and their new AI Chatbot Tee.
Andy left the company to focus on his family and moved to Portugal. Although his iconic voice remains on the Headspace App it’s maybe a lesson that once something has been extracted there isn’t much you can do about it. Confirming that all of us, even Buddhist founders of platforms, can be automated.
The UberTherapist working for HealthAssured tries to make a joke about how at least we don’t work for BetterHelp, where the gaming of recovery has gotten out of hand, as its parent company Teladoc sees the complaints clock up.
The DoorDash rider cuts them down to size through a rudimentary google of HealthAssured. Reporting on the BBC Radio 4 File on 4 investigation into its practices (referencing my research around UberTherapy) and subsequent suspension of HealthAssured as a credited provider of therapy in the UK. He snorts that at about the same time HealthAssured was renamed WisdomWellbeing. Wisdom plus wellbeing in the face of regulatory scrutiny, you couldn’t make it up.
Taking a mindful 5-2-5 breath he goes on to say that Fred and Peter Done own HealthAssured and Betfred, the online gambling giant. Well connected billionaires, moving in the small circle of investment hell that intersects Lyft, Uber, DoorDash and all the online digital therapy platforms that will survive the immanent definancialisation of care.
Learning from the experience of the Psychotherapy Action Network in the US sued by Talkspace for $40m for asking if this is therapy, the UberTherapists go quiet. And they start to wonder if it’s the same Betfred algorithm designed to extract money from consumers through the shame machines of ecommerce, that is used in BetterHelp.
The penny drops that many of the people accessing HealthAssured will be seeking treatment for gambling. Links are made somewhere in our unconscious that maybe UberTherapy is premised on a model of ecommerce where the worse we feel the more we buy. Buy better, feel better, be better.
Hurling salt into the professional wound, he adds that the ‘free’ mental health questionnaires used across standardised iCBT products are designed by Pfizer. Questionnaires where 80% of respondents end up on prescribed medication. And it is in this naming of names that the DoorDash guy opens up the Pandora’s box of the new business of Digi-thera-ceuticals.
It is only by pulling back the green digital curtain of UberTherapy that we can see the reality of its extractive industry and the ‘super-intelligent’ tech savvy white guys behind it. If we can allow ourselves to see that, we can see the thuggery and violence of the extractive industries and map the financial logic within which we now work. And the yellow-brick road home.
There will be a time that when people say that UberTherapy isn’t about therapy, you will just believe them. But in the meantime do this:
Listen to our podcast series Stories of UberTherapy here
Join our network of UberTherapists here
Read UberTherapy: The New Business of Mental Health here
Follow the story of MuchBetter.Help here
If you’re an UberTherapist join us here