Click on the image above to download UberTherapy.


This eBook is part of seven years of activities and writings as and as an academic looking at working conditions in the mental health sector.  In 2017 I carried out a national survey of mental health workers, the results of which are free to access, and subsequently wrote a series of articles, book chapters and blogs about the ‘Uberisation’ of therapy. What follows is a series of blogs produced in the summer of 2019 as the crisis in services continued to unfold.


The lack of data about the workforce and understanding about the industrial relations context within which they are working is a convenient gap in the mental health debates. It has allowed us to waste a good crisis as services and jobs are strategically downgraded.


The argument presented in this eBook about the emergence of Ubertherapy is as follows.

  • Downgrade the service through standardization, manualisation and digitalization
  • Collect performance data that acts as an ‘evidence base’ for a downgraded model of sub-therapy
  • Sell it to the public as a value-for-money service
  • Enforce performance management based on targets and recovery rates that nobody can challenge
  • Downgrade the jobs to reduce clinical roles and working conditions
  • Silence any dissent from people accessing and delivering mental health services by threatening sanctions on both sides
  • Firmly lodge open the healthcare door to digital providers and platforms
  • Voila UberTherapy


There are some benefits of hitting a crisis such that difficult things become easier to hear and the many specters at the feast who have been critical of the IAPT model are increasingly amongst friends. We’ve started to see a series of critical readings being published and self-organised groups of workers joining the now established radical mental health and survivor networks that have so far led the radical rethink that needs to take place.


The co-option  of mental health services into austerity policies and sanctions has re-drawn the political line in the mental health debates. No longer can we restrict ourselves to talking about mental health services as if they are simply-benign-needing-more-funding. Increasingly therapists are not considered the good guys and many activists do not see the NHS as a safe place for therapeutic work to take place. This also means that increasingly the ‘defend the NHS’ campaign strategy doesn’t work when neither the people using or delivering mental health services are prepared to fight to the last if it just keeps the IAPT juggernaut on the road.


Several years ago I stopped going to mental health events, tired of the priority given to saying clever stuff over the ordinary organizing work that needs to take place for us to challenge what’s happening to services. Increasingly, as our political debates degenerate into spats that can only be explained by too much vino or a real lack of understanding on how to use technology, I wonder at the wisdom of saying anything at all on social media. As a woman, with opinions and no institution to hide behind I’ve learned to focus my energy in the daylight hours and to circumnavigate the full-time preoccupation of personal grievances that, along with porn, suck 99% of the online oxygen available for genuine exchange.


This is just an eBook but the end sections offer an introduction to the organizing challenge and some methods used in workers’ education. I write about and use these emancipatory methods in my everyday working life and hope that you can use them too. I’m not preaching at you because after working in and for trade unions for much of my life there’s not one romantic bone left in my body about the prospects of working collectively. But I am trying to encourage you to think and act in any way you can with the people you work with, both in the workplace and more broadly across the mental health sector.


Surviving Work will be spending the summer writing her new book UberTherapy: Working in the Therapy Factory and will be back in the Autumn.


To sign up to the Surviving Work blog go here

To follow us on twitter go here @survivingwk

To read about the future of therapy go here

To get some resources on surviving work in healthcare go here

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