When Headspace Health laid off 33 of its therapists June 29, patients were told their providers had left the platform.
What they didn’t know was their therapists had lost their jobs. And they suddenly had no way to contact them.
Several therapists who were let go from Headspace, the Santa Monica meditation app and remote mental health care company, have raised alarm over their treatment and that of their patients after the companywide layoff of 181 total employees, which amounts to 15% of the workforce.
After the layoffs were announced in the morning without warning, these therapists said they immediately lost access to their patient care systems. Appointments, they said, were canceled without explanation, potentially causing irreparable harm to their patients and forcing them to violate the ethical guidelines of their profession.
One former therapist, who specializes in working with the LGBTQ+ community, said one of his clients had just come out in a session the day before he lost his job. The therapist requested anonymity because he was still awaiting severance from Headspace and feared retribution.
“I’m the first person they’ve ever talked to about it,” he said. “They’re never going back to therapy. They just had the first person she talked to about it abandon them.”
He didn’t know he had been laid off until 10 minutes after his first appointment was supposed to start and he had been unable to log into the system.
“If any of the clinicians had done this to our clients, we would be losing our licenses tomorrow,” he said. “I assume [Headspace] didn’t allow us to talk to the clients because they didn’t want us to poach the clients. In doing so, they just really screwed over their entire client base.”
In a statement, Headspace said it “promptly notified” members whose providers were affected and provided details on how to switch to a new therapist, prioritizing patients with greater need. The company said most of the individuals scheduled appointments with new providers within 10 days of the notification.
“As a licensed medical provider, protecting the privacy and safety of our members and employees is paramount,” Headspace said. “We keep this commitment at the forefront for both our patients and our former colleagues, including safeguarding confidential patient data and personal details regarding the nature of the impacted employees’ departures.”
The company said it used a “team-based model” that includes psychiatry and behavioral health coaching to ensure continuity of care beyond individual therapists.
Monica Blauner, an officer and past president of the California Society for Clinical Social Work, said that if the layoffs did indeed immediately cut off access to therapists with no explanation, that would constitute a “huge breach of trust” with patients, many of whom may have a history of trauma and loss.
“A lot of what happens in psychotherapy — the most important curative factor in psychotherapy is the relationship with the client,” said Blauner, who’s been a therapist for more than 40 years.
Ending therapy is the end of an important relationship, and it’s crucial to give ample notice so that the therapist can help their patient process their feelings about the change and discuss how to move forward, Blauner said.
“One of the things that can be so therapeutic for people, especially if you’ve had a lot of traumatic loss, is having a different and a better goodbye,” she said.
Jay Hodes, president of healthcare regulation compliance company Colington Consulting, said Headspace acted in line with federal legislation surrounding patient electronic medical records when conducting the layoffs.
Companies are required to terminate a worker’s access to protected health information once employment ends, Hodes said. However, it’s up to companies to decide when or how they notify workers of a layoff or termination.
Beyond privacy, however, the abrupt termination could raise malpractice issues, said Rolf Lowe, a lawyer with Michigan healthcare law firm Wachler & Associates.
“If somebody has a crisis, and harms themselves or another, and they’re no longer seeing that specific therapist, there could be some issues there, if someone were to file a complaint with an individual therapist with the board,” Lowe said. Because each state requires its own license to practice, this would apply to therapists individually across the country.
Lowe said the employer should ideally be able to give patients a way to contact their therapists, with both parties’ permission.
“But the relationship is between the therapist and the patient, not the company and the patient,” Lowe said.
Another therapist laid off from Headspace said she had an active caseload of 67 patients, with her longest continuing client having seen her for two years.
She had eight appointments scheduled June 29 — the day of the layoffs — with seven June 30, and seven more July 1.
At a previous online therapy company that she worked for, Talkspace, she gave the company a month’s notice before leaving the platform. During that month, she was able to have discussions with her patients and talk about moving forward.
“I’ve had former clients who have had other therapists tell me that that’s happened to them before, they feel abandoned,” she said. “It takes a long time for them to go back and try therapy again.”
The ethics code of the American Psychological Assn. outlines the ideal process for transferring patients.
“Ideally, there would be pre-termination discussions and appropriate handoffs to the new therapist,” said Lindsay Childress-Beatty, the association’s chief ethics officer.
The code says that “paramount consideration” should be given to the welfare of the patient, and there should be “orderly and appropriate resolution of responsibility for care,” Childress-Beatty said.
Any termination of care should be “planned for, discussed openly in treatment, and be an essential aspect of the treatment process that assists the client toward effective independent functioning,” Jeffrey Barnett and Caroline Coffman wrote for the Society for the Advancement of Psychotherapy.
Several therapists said that former patients have reached out to them through LinkedIn and Psychology Today, and searched for therapists’ private practices to ask where they went and if they were OK. Some patients were under the impression that the therapists themselves had canceled their appointments at the last minute.
“That’s defaming us,” one former therapist said. “It very much affects our reputation as providers.”
A therapist still employed by Headspace said she was instructed by her supervisor to stick with the messaging that “their previous provider is no longer with the organization” and that they could not share details “for confidentiality reasons.”
She’s already seen her workload increase, with eight new intake patients this week — more than double the usual. One of her colleagues got nine new patients transferred from other providers, she said.
“I’ll be honest, I was already looking for other jobs,” she said. “Definitely not feeling comfortable to stay now.”