12- VC Producing Therapist Farms, AI Therapists, and the Fight to Keep Real Care Alive

The ground under therapy is moving, and we’re naming what so many are feeling but few will say out loud: client flow is down, reimbursements are thin, and VC-backed platforms are reshaping care with opaque billing, captured copays, and fine print that rarely favors clinicians or clients. We trace how convenience becomes control—how credentialing shortcuts turn into lower rates, how private-pay “differences” quietly siphon value, and how the promise of access can mask a transfer of power away from the therapeutic relationship.

We also follow the data: reports of session notes and recordings used to train AI “therapists” raise serious questions about privacy, consent, and the soul of our work. AI can provide information, but it can’t offer attunement, repair, or the lived human presence that healing often requires. When platforms profit from data extracted in care, trust erodes—and without trust, therapy becomes a product instead of a practice. We talk about who carries the heaviest burden in this shift—clinicians of color, adult children of immigrants, and those without generational safety nets—and why that reality demands both honesty and solidarity.

From there, we get practical. If you’re able, consider contracting directly with insurers and keeping more of your value in your hands. If you’re private pay, get visible: build referral relationships, publish useful, specific content, pitch local media, and make your intake process simple. Protect your capacity with real routines, not leftover time. And remember our collective leverage: share rate benchmarks, demand transparent fees, push for clear consent around data use, and coordinate refusals of predatory contracts. We’re not powerless or obsolete; we’re under-organized and often too quiet. Let’s change that together.

If this resonates, follow the show, share with a colleague who needs a morale boost and a plan, and leave a review with one action you’re taking this week. Your voice helps others find honest, sustainable paths in a crowded, noisy landscape.

Credit to Caitlin Archibald, MS, LPC, ACS for providing information about VC's and complaints filed against them. 

Come follow me on instagram @heyangelatam and subscribe to my newsletter here. Looking forward to adventuring with you!

Chapters

• 0:01 Facing a Changing Therapy Landscape
• 0:31 Fears About Job Security and AI
• 0:58 Declining Referrals and VC Priority
• 2:05 Burnout and Data Concerns
• 3:11 How VC Platforms Cut Therapist Pay
• 4:14 Lack of Transparency and Burnout Cycle
• 5:17 Ethics Violations Across Major Platforms
• 7:05 Data Use and AI Training Risks
• 8:18 Uncertainty and What We Can Control
• 9:04 Naming the Money-First System and Inequity
• 10:22 From Apathy to Actionable Hope
• 11:04 Protecting Routines and Capacity
• 12:01 Choosing Values Over Martyrdom
• 12:53 Practical Resistance: Panel Independently
• 14:13 If Private Pay: Get Visible and Network
• 15:21 Being Forward-Facing vs Hiding
• 16:09 The Cost of Avoiding Business Work
• 16:36 AI Is Not Therapy
• 16:53 Courage, Adaptability, and Solidarity
• 17:25 Personal Accountability and Next Steps

Transcript

SPEAKER_00: 0:01

Hi everyone, it's Angela Tam back with the So Now What podcast. This is a really hard episode for me to record, mainly because it's so close to home and it's impacting so many of me and my colleagues who are solo entrepreneurs so much. And this is the topic of what is going on in our therapy landscape? Are our job securities at risk? Are we at risk of losing our jobs in the next five, 10, 20 years because of AI, because of these venture capitalist firms who are producing therapist farms and causing us to get severely even more underpaid than we are right now? A lot of my colleagues and I are experiencing a huge difference in the client volume that we're seeing come in. A lot of folks are not seeing any clients come in. A lot of folks are really noticing that these venture capitalist firms are getting priority in the mental health directories. And also, I don't know if any of us don't know a person who's used better help as a therapist, as a clinician, and has not been burned out. And of course, there's so many reports of people working for better help as clinicians who are overworked and severely underpaid, and clients who have reportedly had their data stolen and unethically collected as a result of these platforms that claim that they are abiding by HIPAA rules but are not. A lot of this changing landscape can create a lot of discouragement and a lot of disheartening, a lot of apathy, a lot of overwhelm, a lot of loss in confidence of our skills, and a lot of questioning our abilities as a clinician because we're seeing nobody come in. Our work is so stressful, and I understand how easy it is for us as clinicians to want to use Headway or Alma or Grow Therapy or BetterHelp as a way to really streamline the process of being paneled with insurances, but without the hassle of dealing with credentialing, the hassle of dealing with processing claims. It is really tempting to just enter this big company and just get clients pretty quickly by being paneled with many insurances and then seeing a very low insurance reimbursement. So a lot of people are paneled with Headway or Alma or Cerebral or Lyra or even Spring Health and are noticing that their reimbursement rates are much lower than what their clients are billed. So their clients are billed copies that Headway or all these venture capitalist aka tech firms receive from the client. The client pays a copay, the client uses their insurance to receive mental health services. But these venture capitalist firms, they keep the copay and they negotiate a rate with the insurance, they take a cut of that rate, and then they keep that difference and they give you a lower rate. And then when the person's insurance runs out of in terms of the number of mental health visits they're allotted a year, and then the client moves to private pay, the client is charged a certain rate, and then the therapist is given a different rate, a much lower rate, sometimes almost half of the amount that the client is charged. And there's no transparency about that on either side, on the client side or the therapist side. And so the client is left paying a lot, and the therapist is left not seeing a lot of that pocketed, which creates a sense of furthermore having the therapist work more hours, contributes to burnout, etc. etc. There's a lot of alarming things that are happening in the venture capitalist world. And there's a lot of companies out there like Headway, Grow Therapy, Alma, Rula, Cerebral, Lyra Health, Spring Health, Modern Health, Talkspace, BetterHelp, Headspace, that are under fire for violating a lot of ethics and legal things. Headway is currently in hot water for not being transparent with clients about the cost of services and overcharging them. They've been caught selling data. And Grow Therapy receives similar clients from clients related to the lack of cost of transparency and overcharging for services. Rula has been complained, has a complaint filed against them for using illegal criteria to perform improperly delegated medical necessity reviews. Cerebal is in trouble with the government for illegal prescriptions. And the employers pay for their service, but Lyra is accused of unethical practices. Spring Health has gotten into trouble for having clinicians operate without a legal license to practice. And the list goes on and on. There's a lot of VC-backed mental health companies that are under fire for creating a lot of harm. And a lot of people are not willing to speak about it. So I imagine that there's a lot going on that we don't even know about. And they are at the part of the force behind creating and training AI therapists. So they use all these records and notes and recordings in the sessions to train AI therapists, quote unquote therapists, to be more like therapists. And so they have been under fire from HIPAA because they're taking the data that's in these sessions and training AI therapists. And it has because it's so new, laws are still murky, and a lot of companies are able to use and collect this data because there aren't a lot of rules out there around and proof that AI is violating HIPAA when it's recording therapy sessions and it's not human. A lot of people are worried that this field is changing. And a lot of us as therapists are worried: is our job security safe? Are we safe? And the answer is, I don't know. I'm recording this podcast and I have a lot of uncertainty around our job and field. I don't know if our field will be obsolete. Are we the next blockbuster and Netflix is gonna come in and completely overrun us? I don't know. It's scary to think about, but all I know is that there are some things that are within our realm of control that we can do. And qualities that we could cultivate in order to face the changes, to face the changing landscape, to take an honest look at what's actually going on and face it. I think a big part of that is to not live in denial that things are changing and that we can adapt this profession has not had us in mind. It's a money prioritized profession. And clinicians of color are definitely the most impacted. Folks with more marginalized identities are the ones that are most impacted. Those that are clinicians of color, specifically adult children of immigrants, who don't have a safety net with their parents, we don't have trust funds, we don't have generational wealth, we don't have backup plans, are really the ones that are hugely affected. We are often the ones supporting our families. We are often our parents' retirement plans, we're often the ones supporting and holding up our nuclear families without much help. And this is where I want to create some hoping. Feeling apathy and feeling withdrawn and distant from the realities of our everyday life could be a great coping strategy. I understand how it's feeling way more safe to rant and complain and scream, but not have any energy to do anything about it. It isn't helpful to stay in that space and not be able to work against it. One of the things that we need to recognize that we have to do is to keep your routines routine. Sometimes it's boring and mundane, but this is where we don't compromise, where we set our intentions to be deliberate, to prioritize our sleep, to prioritize our rest, to prioritize our recreational activities and our social times. And this is something that us clinicians we're not good at. We're really not good at prioritizing us. We are bought into the martyrdom persona, we are bought into the prioritizing other people, a highly empathetic caretaker persona. We're not really thinking about how we can embody to be change agents in the changing landscape of our field. And that requires for us to prioritize our needs first through individual and collective care. And I hate the word self-care because I feel like that is not helpful, but it is practicing the individual level, collective level care that's required to meet the level of violations that are happening to us as a field. And that means that we need to set up structures in our lives that revolve around deepening our commitments to our values. So that might mean that if you are not in alignment with these venture capitalist firms creating therapy farms, it means that if you can, if you are licensed, sign up for insurance, sign up to contract with an insurance panel on your own. That in and of itself is a political act of resistance because it doesn't create more numbers for venture capitalist firms. And that means that you might have to do more work, you might have to do more paperwork, you might have to get more support. But that is possible. It is possible. There are people and professionals out there that their only job is to help people panel with insurance. And I don't might not have those people in your states, but I'm sure that in Washington state where I am, I can give you some names if you just text me through the podcast link for private messages. And that is one thing that one tangible thing that we could do. If you are not willing to panel with insurances, that's totally fine. But it means that you have to be more visible, you have to make yourself more findable, you have to get out there, constantly do the work of marketing, to build your networks, to be forward-pacing, to not hide behind the therapist persona, and to be vulnerable and to share what you know so that other people who are looking for therapists can find you. And this can mean that you are on Instagram. It can mean that you're doing podcasts, but it also could mean that you're building relationships with other health professionals, with other therapists, or you're providing some free consultations via writing editorials in your local newspaper. That is a very effective way to build your clientele base. Provide real-time samples of the work that you would be doing by pitching yourself constantly to others. And that quality internal quality is the quality of being forward-facing, being open and being visible. And that's something that is the opposite of what we've been taught as therapists. We've been taught to be invisible, we've been taught to hide behind the curtain of empathy, been taught to just care for others, don't do paperwork, but sign up with these companies so that you could just focus on what you love to do, which is just to work with people. And that is a huge disservice to us when we hide, when we are unwilling to do the paperwork, the huge cost that it's bearing is that it creates therapy farms, therapist farms, where therapists are hugely underpaid, and it's used to train AI therapists, which will create a huge deletion of our field in the future. And we all know that AI therapy is not really therapy. There's a lot of wisdom that AI can provide, but at the end of the day, it is not therapy. So implore you, I encourage you to do some hard things and to face our changing landscape with adaptability, with courage. And this is a call to me too. I am sometimes shaking at the thought of my field being erased and these therapy farms taking over and moving towards an obsolete direction. And I worry that I might be the next blockbuster. I might be an industry that is like Blockbuster, where we are obsolete, we're no longer relevant. It scares me. I have a belief that we as a therapist are huge in numbers and we can stick together and we could care for each other. We could build our own networks. We can rise up and we can we have the numbers on our side to organize and to say no to these venture capitalist firms. Speak out in truth and in accountability for myself. I am a part of Spring Health and I want to divest from Spring Health myself. I want to make sure that I am not going to stay in Spring Health forever. I want to really limit my interactions with the platform and my dependence on the platform. And it might mean that I will have to take traditional insurance in the future. But I'm really working hard to expand my network and expand findable I am. And I'm working against my own internal forces that call me to be more invisible and to hide. So I hope that you can take some of my encouragement, my transparency, my personal struggles, and my solidarity with you to do the same. Until next time, I'll talk to you soon. Take care. Bye.