mental health therapist

therapist

psychiatric nurse practitioner

scheduler

senior customer support representative

Talkspace

It is with deep regret and sadness that we must now speak up publicly. We’ve already taken our grievances to you directly, but you offered scripted responses, retaliated by withholding client referrals, or ignored our concerns. 

We used to love contracting with Talkspace: Morale was high, community was cohesive, and there was a team of highly talented, passionate, and supportive staff that made Talkspace feel like an exciting and rewarding adventure in modern mental health treatment. 

In June 2019, however, you instituted the “reply by” button on the platform which enabled clients to demand up to three lengthy messages within restrictive time frames, overriding the former  agreement we had with you for up to two asynchronous responses per day, depending on our schedules and the clients’ needs, which ensured appropriate boundaries and up to 50 minutes or more of therapy per week (just like face to face therapy). You decided to withhold fees pre-paid by clients for therapy if theses unreasonable deadlines are missed and withhold referrals from therapist who declined to take clients in these new plans.  

When you announced the addition of this “reply by” feature, therapists by the hundreds to thousands expressed discontent and concerns communally to you in our consultation platform on Slack or in private emails. We explained that your new feature raises issues around poor boundary modeling and distress intolerance for clients and created scheduling conflicts and burnout for clinicians. You refused to listen to us when we told you that this timed response feature is contraindicated for clients with certain diagnoses and generally models a pattern of unrealistic expectations. 

An inability to set healthy boundaries with our clients can leave both clients and therapists feeling exhausted and depleted, and seriously damage the therapeutic relationship. We saw the consequences of your clinically untested technological feature in our Interactions with our clients; the work began to look like “chatting” vs psychotherapy because we were expected to conduct psychotherapy on a timer (Few therapists can afford to work solely for Talkspace because the pay is low and inadequate as a sole source of income. As independent subcontractors, it is both imperative and our right to set our own schedules. We flooded you with emails begging you to rethink the policy, and you told us that we were free to leave if we didn’t like it. You instituted new scheduling parameters that limited our options. With clients already on our caseload, we couldn’t just leave, due to legal and ethical obligations to our clients, yet you unilaterally changed the agreement. You shut down our open consultation channel, because you didn’t like our feedback and then thousands of our colleagues began to phase out and give notice to clients. 

We felt like we were being disrespected and undervalued as therapists when you repeated your inane mantra “Change is hard.” Your persistence in using this phrase for the next several months, as you continued to implement newer and equally misguided policies made it obvious that you put greed and profit before the welfare of therapy clients or the working conditions of the contracted professionals who provided the service your company advertised. 

You hired Mark Hirschhorn as president, chief financial officer and chief operating officer in early 2020; a man with a questionable history who left your biggest competitor under dubious circumstances. Hirschhorn was formerly the executive vice president, chief operating officer and chief financial officer of Teladoc Health and BetterHelp, where he’d allegedly had an inappropriate [censored] relationship with his subordinate. The two also engaged in insider trading, according to investigative reports. After accusations surfaced in December 2018, Hirschhorn stepped down from his position at Teladoc on January 1, 2019 before coming to Talkspace. Immediately following Hirschorn’s hire at Talkspace, his team implemented changes financially and logistically unfavorable to the therapists and clinically questionable for the clients.

Your myopic focus on creating and implementing technology-based features that are intended to automate therapy (and therefore increase your profits) are wholly untested in clinical practice and show a complete deficit in understanding about the therapeutic process and the necessarily strict and ethically bound guidelines that the discipline encompasses. You chose to conduct experiments on the public and with your subcontractors without any semblance of transparency or disclosure. 

Under the guise of customer satisfaction, you implemented a star-rating feature that allowed clients to anonymously express transference or any dissatisfaction about sessions with non-clinical personnel who then read the rooms. This is a breach of confidentiality, but technically a right you abrogated in your user agreements for customers use of the application, a detail the majority of the clients are completely unaware of because it is in stark contrast to the consent for treatment provided by your company. 

To add further injury and insult, your “Quality Management”  forwarded these complaints to a coaching team who would compel “coaching” or “consulting” stating it was “voluntary,” but resulted in a cessation of referrals if we turned these sessions down. Any time spent on these so called “voluntary coaching sessions” was uncompensated, as were multiple coaching sessions that were sometimes required to stay on the referral list; this basically amounted to requiring licensed clinicians to engage in supervision. 

We are fully licensed and accredited mental healthcare professionals who have subcontracted to provide services on your platform, but you’ve treated us like employees by micromanaging how we practice therapy and constantly creating new rules and requirements, while failing to provide the requisite benefits, breaks, vacation time and sick pay which actual employees are entitled to by law. This is a direct violation of labor law in many states, and the withholding of fees paid by clients for clinical services is tantamount to billing fraud. 

As independent contractors, we are responsible for practice expenses, including liability insurance, licensing renewal (sometimes in several states to be compliant with the law,) , continuing education required for continued licensing, and  technology and telecommunications costs, just to name a few items. Telehealth through the Talkspace platform already only paid about 25% of full in-person therapy fees, but many of us made that sacrifice to reach more clients and populations who were marginalized or otherwise would not have received services. The parameters and boundaries that were initially set up for the text based and video session therapy allowed quantity and quality both, with a minimally acceptable compensation for services that most of us used as an ancillary revenue stream. The new schedules and gimmicks were set up in a way that prohibited flexibility with our full time jobs and practices and decreased income to less than half of minimum wage per hour, so no longer viable as an additional source of income. Both therapists and clients lose with what Talkspace has become. 

We refuse to sacrifice our time, talent, resources and training to line the pockets of a company who has set up a system where we carry all the liability, but are denied adequate compensation for our labors. Nor will we jeopardize our licenses, livelihood, or values for a company that so completely ignores the legal and ethical considerations of our profession, and eschews any responsibility for the welfare of the population we serve; they may just be Talkspace app “customers” to you, but they are our therapy clients, people seeking help, and we take that seriously. We are seriously done with Talkspace and condemn their founders, their board and their practices.

Talkspace used to be a nice side gig. You can't really thrive financially if this is your FT job, and it can be very draining when you have a high caseload. Even though Talkspace has increased subscription prices for clients and increased pay in June for therapists, we are still paid much less than 50% of what TS charges clients. Clients with the basic monthly subscription pay $65/week. The therapist gets about $23.12/week per client; we're paid less than that if the client is paying quarterly or biannually. 

Clients can require the therapist to respond within certain timeframes/deadlines 3 times per day at a certain minimum word count. If the therapist misses the deadline twice in one week and does not write enough, the therapist is docked the week's pay. If a client requires therapist to respond 3xs/day, five days per week, the therapist is earning around $12.50/hour. 

This company is making a lot of money and keeps growing. It prides itself on making therapy more accessible to potential clients. But at what cost to the health and well-being of their therapists? It's incredibly disrespectful to pay so little to professionals who often owe around $200K in student loans and are required to purchase their own professional liability insurance and pay to renew their license yearly or every 2 years, and pay to take numerous trainings per year to keep their license. Therapist are also required to purchase ipads or iphones, use all of their own resources. We don't get paid for sick days or holidays. We're required to take notes and do treatments plans in our own time, unpaid. It's like a therapist sweat shop! 

Clients are able to demand same-day video sessions without much notice. I'm usually booked out for a week--so when a client does this to me, I have to stay up late or skip a meal or skip my daily shower/bathing. 

Talkspace has also implemented a new rating system. Clients can anonymously rate their therapists at any time and numerous times without being required to explain their rating so the therapist can make adjustments to ensure the client is happy and receiving the support they need. Many clients see us as bots or avatars. They don't know how hard we are working, how much we care, how much time we're spending, how little we're paid, and how high the burnout. We don't come to this work for the money. The money is terrible. They see us the way drivers often view other drivers--not as humans but as cars they can flip off when they're unhappy with how slow we're driving or any little thing. It tends to become abusive. 

Therapists aren't permitted to tell clients if we are not trained or skilled to help them with a particular issue. We cannot screen clients. This is unethical. I've had to treat people with eating disorders, something I have zero experience with or know-how. 

If a client is matched with me on my day off and they're unhappy that I haven't written or messaged them, they often leave me one star. When that happens, the complaint goes to a coach who contacts the therapist to find out the therapist's side of the story about the complaint. The coaches seem to care and are patient and nice. But why do I get called out and have to explain myself for something that isn't my fault?

I've also been accused of not introducing myself to a client and only writing scripts. I told the coach who contacted me that I ALWAYS introduce myself in a video. The coach apologized and said the video cannot be seen by them. But it's on my record now anyway.

If a client schedules a live video session but does not show up (which happens frequently), Talkspace does not reimburse the therapist. They call this a "therapeutic issue" that must be addressed between therapist and client. They do not get involved. So my clients can schedule live video sessions whenever they please and show up only if they feel like it. They're permitted to waste my time and interfere with my self-care routine with no repercussions. 

I feel like I'm walking on egg shells all the time as a Talkspace therapist. I feel like someone is always looking over my shoulder waiting for me to mess up. I do not feel comfortable with the fact that every time a client complains, someone is permitted to look into the therapist-client "room" and investigate. 

There have been times I've reached out to the therapist feedback email to let them know how I feel and to advocate for myself. I've been told more than once that if I'm not happy, I can leave. The therapists are the reason Talkspace exists and how the founders and administrative staff have an income! How can they go to sleep at night knowing they treat us the way they do?

I now wake up every day exhausted, burned out, and sick in my stomach at the thought of working on Talkspace. I've stayed for as long as I have because therapists make so little money on one FT job. I need the extra income to pay for health insurance and health care. But that's all that it covers. I have so much anxiety all of the time that I have to get a therapist too! I hope some day I can leave. I know that I'm a good therapist. The people I work with face to face tell me that often. I've always received awards and positive feedback from supervisors. I've always given my work my all. We therapists deserve so much more than this.

I worry Talkspace will set you up for failure. Their contract, which was recently updated, includes unethical noncompete clauses where you have to agree to be billed $750 if you do something that results in a client leaving the platform. Talkspace is not the right place for all clients, and there are times where other providers are better, or being able to provide care outside of the platform with less restrictions can better meet a client's needs. This also means that if you are directly in-network with a client's insurance and need to continue care, but the client's insurance is not covered on Talkspace (such as from a policy change), you cannot continue care outside the platform without risking this payment. It also makes it a financial risk to connect clients with other therapists and psychiatrists outside the platform that may be able to better meet their needs, creating bias and serious ethical concerns.

There are also strict restrictions on speaking to clients outside the platform or keeping any forms of records on clients, which can create liability concerns. 

Their payment structure is a poor representation of what therapists should be paid for the work we do, and it just got updated to significantly reduce payments due to removal of the current bonus structure. The new structure focuses on bonuses for new clients, but nothing for existing clients or clients that maintain beyond 12 sessions. The prior bonus structure, which paid based on productivity, was barely financially feasible for me, but enough to make ends meet. This will result in a significant loss of income and require me to maintain a 35-40+ client caseload to pay the bills. That is unrealistic and sets practitioners up for failure.

Furthermore, you are very limited in the types of clients you get. I have been inappropriately matched multiple times and had to discourage clients by asking them to connect with a provider better trained in treating their specific concerns, which I intentionally did not include on my profile for matching. In addition, you are obligated to do asynchronous messaging with clients if that's their preference, which pays about half as much as a 60 minute session, even if written/audio exchanges exceed 60 minutes. It also isn't a great fit for some clinical presentations or therapy models, but you must provide asynchronous messaging sessions per the contract.

As for no-shows, clients reported to me that they are billed over $100 for each no-show. As a provider, you see $10 of that. You get less than 10% of the no-show charge and miss an entire hour of therapy that cannot be replaced. The charge amount makes no sense if the disbursement is less than a typical copay. Based on those charges, Talkspace could easily pay providers the full session amount for the hour they can't make up for.

Talkspace had potential to be a good middle ground for providers supplementing income and getting their feet under them in private practice with care that is easily accessible to clients. Because of their payment structure changes and unethical policies, I think it puts providers at significant risk for being forced to provide inadequate care in order to meet financial needs. Talkspace needs to reward client outcomes with use evidence-based practices; not high caseloads and unrealistic burnout-inducing practices.

Working as a therapist at Talkspace has revealed significant shortcomings in how the company approaches psychotherapy and the overall well-being of its therapists. Psychotherapy is inherently a sacred practice involving deep, human connections where one person holds space for another's healing. Unfortunately, at Talkspace, this essence seems overshadowed by a rigid focus on solution-based therapy, numbers, and standardized scripts.

Workload and Hours:
Talkspace requires a minimum of 30 clinical hours per week. This might sound reasonable, but the reality is quite different. Insurance defines a 60-minute session as up to 53 minutes, a 45-minute session as up to 38 minutes, and a 30-minute session as up to 16 minutes. Despite these variations, Talkspace's reviews and expectations are based on the actual number of hours worked, not the session length. This discrepancy means therapists often see double the number of clients to meet the 30-hour requirement, leading to overwhelming caseloads—sometimes exceeding 100 clients, far above the suggested 60-70.

Impact on Work-Life Balance:
This demanding schedule severely impacts work-life balance. Therapists are essentially working 40 hours, with 30 hours dedicated to client sessions and the remainder for administrative tasks. This includes responding to messages twice daily, five days a week, and completing documentation—often while still in session with clients. Failure to meet the 30-hour target results in micromanagement from the administration.

Quality of Therapy:
The business model at Talkspace prioritizes quantity over quality, treating therapy like a factory line. This approach is detrimental to the therapeutic process and contributes to high client turnover. Moreover, therapists are not given the flexibility to choose their preferred modalities for delivery (audio, video, or chat) which would significantly enhance the therapeutic experience for both the therapist and the client.

Client Surveys and Ratings:
Another issue is the client feedback system. Clients can complete multiple surveys from a single session, and a single low rating can disproportionately affect a therapist's overall score. Factors like lack of immediate access over weekends can unjustly result in poor ratings, misrepresenting the therapist's quality of care.

Compensation and Benefits:
While the pay at Talkspace is competitive, the workload makes it unsustainable for maintaining mental health and peace of mind. The company offers some decent benefits, such as paid time off, a $50 wellness stipend and recognizing Juneteenth plus other days as mental health days. 
However, these perks are overshadowed by the immense pressure and unrealistic expectations placed on therapists.

Conclusion:
If Talkspace continues to operate with a factory-like mentality, prioritizing quantity over quality, it risks not only the well-being of its therapists but also the integrity of the therapeutic process itself. Providing therapists with the flexibility to choose delivery of therapy modalities (audio, video, or chat) and ensuring reasonable workloads would be steps in the right direction. Without such changes, the company's current trajectory seems unsustainable, risking the downfall of what could otherwise be a valuable mental health service.

Proceed with caution when considering employment with this company. In my experience, it was a complete waste of time and money. I applied to work with Talkspace and purchased individual liability coverage (a requirement) in November 2018 and heard several months later (February 2019) that I had finally been approved and passed their qualification requirements. 
After receiving approval to move forward in February, I completed the next steps (various paperwork), and in March 2019, I was instructed to complete Orientation which consists of 2 phases. I was told it would be a "short wait" before I could join the next group of therapists. 9 WEEKS LATER in mid-May, I finally received an email alerting me that I could begin my Phase 1 orientation within 30 days. 
I’ll note that NONE of this lengthy wait was ever explained to me prior to applying. Had I known it would take 6 months for me to begin orientation, I would’ve rethought applying in the first place. While I appreciate the thoroughness of vetting, training and preparing potential providers, there is NO reason it should take ~ 6 months to on-board a professionally qualified and certified mental health clinician. 
I began Phase 1 of orientation in mid-May and unexpectedly, had a family event that I needed to attend to for several weeks. This left little time for me to work on my orientation outside of my 9-5 job. I’ll be honest and admit that I lost track of my 30 days which came and went without me being able to commit as much time as I would normally have several months prior. When I logged in to my account shortly before the 30-day expiration date, I messaged one of the trainers and asked about an extension. I was told no extensions would be granted and that I could complete a “drop out” form and reapply later. Another trainer messaged me and told me to not worry and that if I finished my training in a timely fashion, I would be fine. I asked for clarification on these two conflicting and never received a response.
The next day, I decided to devote several hours to working through some of the course in hopes that I might finish the remaining lessons in time, only to discover that my account had been deactivated. This led to several messages back and forth between the orientation manager and myself who informed me that I would have to wait another 6 MONTHS and reapply- basically start all over. 
All I can say to that is, what a joke. My whole experience with Talkspace has been incredibly disappointing. A company that would make such an arbitrary rule and make eligible providers who have been approved and credentialed wait 6 MONTHS before reapplying is ridiculous and makes me seriously question their values/ethics related to provider quality and retention and client care. The only thing Talkspace is doing by implementing such a policy is keep people in need from receiving quality mental health care.  
I would highly recommend avoiding this company altogether if you are a licensed professional looking for employment or opportunities to supplement your income by providing a much this much needed service. There are plenty of other platforms to share your time, money and skills with.

I have been working for Talkspace for over a year now. It's a contract position, so I supplement it with my private practice. It is interesting and can be a different kind of experience. The best situations involve clients who pay for videos. They often feel more comfortable and connected to the therapist. 

They don't screen people well, and there is a chance of getting someone who is suicidal. I have had to explain to people that this is not an appropriate forum and offer to refer them to in-person people. I have also had to go above and beyond when people needed psych evals and outside referrals. I do this in my practice, and I wouldn't feel right about not doing that for one of my online clients too. 

You are your own boss and get to make your own schedule. The pay is not great. They recently increased it, however it still feels frustrating when you only get paid once a month. It's a requirement that you check messages 2 x per day, 5 days per  week. Sometimes this has felt like a lot. 

You may get a new client at some random time of day, and it may not be a good time to reach out to the new client. They push you to talk with them immediately, and this can be difficult. Recently they have added an option for people to request a response within a certain time frame. If you don't respond, then Talkspace takes that out of your pay. It is frustrating, and there have been times when I thought it wasn't worth it. 

I like doing it at times. I think it does force me to think outside the box and try to be a better therapist. I have clients from all over the world and that's kinda fun. I also like doing video and audio with people. I like being able to provide a service for people who can't easily access healthcare. I don't know how long I will be able to continue this, but for now I am going to continue doing online therapy. It's good to supplement. I would not recommend this as your only job. It's definitely something on the side that is nice, especially if I have a slower month in my private practice.

When I first started with talkspace I loved it. I had flexibility, no pressure and really enjoyed working with my clients. We responded to our clients twice a day with a meaningful response. As the company grew, they started engaging in some really unfair practices toward us therapists. They completely changed the structure of the program and the way it worked, without being transparent with us providers. The new structure completely changed the way we were expected to work on the platform, we suddenly had unrealistic deadlines and word limits and our pay was penalized if we did not meet them. We were forced to start counting words and making sure to respond by a deadline during our other jobs, really reducing the quality of our work with clients.   Talkspace proclaimed they were providing us a 15% pay increase but failed to mention we were expected to do twice the work under these new constraints ( the new time deadlines now required us to respond to our clients three times a day, which would have been fine except talkspace NEVER told us that). We had to find out on our own after they upgraded the platform. Many of us contract with talkspace on the side of a full time job (what they pay is not something you could support yourself on full time if it’s your only job)  and the new expectations to respond by a certain time are just not attainable. When you reach out for suggestions, they are not helpful and basically tell you to leave your clients and move on. I stay because I feel that is unfair to do to clients I have been treating for over a year. Also, they claim the platform is confidential but they actually do random audits of clients therapy rooms. I have nothing to worry about, I have sound clinical skills however I can see where this could be upsetting to clients to know that some stranger is coming in and reading their conversation with their therapist. The base pay is also really weird-they offer different plans with different base pay rates which is fine- but then some people receive vouchers which affects the therapist compensation. For example they offer discounts to clients, but then reduce the therapist pay to compensate for the discount. So the discounts offered to clients directly come out of therapist pay.

Cons of Working with Talkspace:

1) No flexibility in work schedule: The company recently started a new policy, where therapists have to respond to every client's messages within a certain strict timeframe. If a therapist replies outside of the allotted timeframe, her pay will be reduced immediately! 
   - Related to this, therapists are now then required to respond to clients as much as 3 times a day. 

2) Very low pay: They started a new policy in April of 2020, where therapists get compensated by the number of words they write. At the time of this writing, the compensation is $10 for 1,000 words that therapists exchange with their clients. If one gets a client who does not write very much, then the compensation would be drastically reduced due to the small number of total word counts exchanged between a therapist and the client. 

3) Demoralizing work:  Most of the clients will only purchase the services that come with only text messaging, meaning no live video sessions. How effective can therapy be when therapists and clients only "meet" and communicate via writing?  
    - Talkspace will cite research on the effectiveness of Telehealth and Online therapy to persuade the potential clients and therapists that what Talkspace is selling, in terms of their services, is effective. However, let's not forget that almost all the research done in the field of telehealth therapy involves live, face-to-face, video chat with clients!  Simply writing messages to one's clients has severe limitations and is probably not very effective! 

4) Frequent changes in pay and work policy without listening to the inputs of their therapists. And worse of all, they don't even ask your consent. Therapists basically have to comply with new policies or they could no longer take on new clients (meaning you will be phased out quietly). 

Pros of working at Talkspace:

1) Therapists could technically work at any location and travel. However, therapists are required to meet strict response time to their clients' messages. So international travel to different time zones will probably be impractical.

I've worked in a variety of settings as a Psych NP, and this company has an interesting setup and has a lofty goal. They succeed only partially, and there are significant barriers to the success of their mission that they seem unable to work through, especially since they became publicly traded. 

Positives: 
- Flexible work schedule - you set your hours
- Better pay than *some* companies
- No controlled substances
- Clients are all 18+
- They will reimburse you for licensure in other states if they need a prescriber there
- Meeting clients where they are, supporting people who might have trouble accessing mental health help otherwise

Neutral:
- You're a 1099 employee (no benefits)
- EMR that's pretty different than others
- Pay is only 1x/month, not biweekly

Negatives:
- Lack of collaboration with therapist your client sees (even on Talkspace itself)
- Their support is often horribly understaffed, and lacks any ability to help with the many technical issues I've had on the platform in the >1 year I've been with them
- Compared to what you *could* earn in outpatient psych, the pay is low
- No screening of patients (you could have a floridly psychotic client abusing alcohol or attempting SI during your session and there is no screening to manage this, prevent this, and the associated liability)
- There is no way to order labs at all
- If someone requests records - you have to figure out a way to get them to your patient, there is no assistance with this
- I have personally had to help clients with the mess that is their patient support system (without pay)
- They have many technical issues with writing notes, which they have failed to address

All in all, there are some real positives of the model, but if they aren't able to fix the challenges (and thus far it does not seem that they are particularly motivated to do so), they won't retain the professionals they've hired.

Top Job Titles	Average Salary
Mental health therapist 19 salaries reported	$79.26 per hour
Therapist 46 salaries reported	$71.30 per hour
Psychiatric nurse practitioner 36 salaries reported	$110 per day
Scheduler 16 salaries reported	$67.90 per hour
Senior customer support representative 3 salaries reported	$22.33 per hour

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