Co- Op

Basically, a worker cooperative, or co-op, is a non-hierarchical type of business, which is co-owned by the workers. Rather than a business supporting the owner of the company and their vision, a co-op leaves entrepreneurship in the hands of everyone. Business decisions and money are shared by everyone. This model works to challenge systemic norms that perpetuate control over others, racism, sexism, classism, and other forms of marginalization and oppression. 

In what I will call a standard business model under a capitalist society (which is what we have here in the US and is generally how the global economy operates), workers have supervisors, who have managers, big bosses, CEOs, and so on. Hierarchy dictates what power and say the individual workers have in company decisions. One employee’s voice or grievance has little impact, and the higher-ups can choose to ignore issues, hire/fire at will, and pay whatever they want. 

This system is inherently flawed and allows marginalization and oppression in the workplace to stand. Often it ends up looking like women, LGBTQ+ people, poor people, disabled people, and BBIPOC being taken advantage of, even by companies that boast inclusive and otherwise “woke” or “progressive” diversity policies. It often means grievances of those in lower paid positions tend to be ignored, even though it is often those positions that keep a company making profits and keep it running day-to-day. It is also true that lower-level workers have to work longer hours to receive the same benefits as higher-level workers. AND it is often true that marginalized people tend to be chosen for jobs that are at a lower level than their actual experience and education prepare them for, so they end up working harder for the same benefits than peers. 

The power differential increases the lower down the ladder you go, and it becomes more unfair when those at the bottom often do not have anywhere else to go. They are trapped in the system and by the system and cannot afford to stand against it alone. Of course, there are a tiny few who have the experience of rising to the top but, that is not the majority experience and those few do not do it alone. 

In a true co-op, these issues are addressed by having decisions made by the group. Workers make the business decisions democratically and share in the profits. That way, everyone has a say in things like business decisions, job duties, leadership, policies, etc. This can happen in a small company, or on a larger scale. It can look different ways such as by regular meetings, voting, electing leaders, etc.

To be clear upfront, this is NOT a perfect system. To claim this model is where the buck stops is to ignore the importance of individuals and groups continuing to educate themselves, continuing to listen and learn from marginalized people, and making changes to address their own problematic behavior and policies. So, a co-op alone is NOT “the one thing” that will stop marginalization and oppression. That said, the nature of a co-op is one that moves in the right direction when compared to a standard capitalist business model. I will talk about a few here. 

First, by giving everyone a voice and making decisions together democratically, a co-op keeps one person or a small minority of workers from holding all the power and profit and making decisions that are good for them and bad for everyone else. 

Second, by valuing everyone and having decisions around job duties and work expectations and policies be joint decisions, power differentials are reduced significantly. No one person has power or control over another. One person cannot force another to complete extra work under threat of loss of job. This works to prevent situations where marginalized people are overworking for the same pay and benefits. Everyone having a say in things like money distribution also means that every person that does the same job makes the same money. This works to eliminate pay gaps.  

Third, in-office issues, such as harassment, are more likely to be minimized by keeping each person accountable to the rest of the group. One person cannot look the other way and perpetuate these behaviors. Also, when a workplace culture values each person as carrying equal value in success, issues such as harassment are far easier to catch and are less likely to occur to begin with.

Not necessarily. The difference is that in a true co-op model, decisions about money and fair pay rates are made by the whole group. Everyone gets a say in what jobs get what pay. This tends to lead to pay being distributed in a way that is more reflective of the actual amount of labor contributed. Everyone who does the same job makes the same money. It can also lead to a more fair distribution of money within a company so that money is not being stored away for business investments while the workers struggle to meet basic needs. The employee’s success and the company’s success are one and the same.

I am glad to hear it. Some businesses do have policies that offer, within this capitalist system, benefits and work environments that may be better or worse than others. I’m not saying working under this system will always seem terrible in the day-to-day to each person. It may also be true that your company does do a lot to make conditions good for everyone, even the lower-level workers. AND I may feel that I am super informed and able to have a standard business model while being fair to everyone. I may say to myself, “I won’t do unfair things” or “I will have great diversity and informed hiring practices.” BUT I still think this is not good enough. Here is why.

Regardless of how a workplace is and feels under capitalism, the fact remains that those policies and procedures, and the decision to keep those or give them up at any given point, remain with only one person or one small group that holds power over the company. Even if the power holder gives the others a good deal, they still hold the power and can take it away at any time. Benefits can be changed literally by the choice of one person. Pay can change by the decision of one person. This creates an unfair power differential. The fact that one person can choose to exert power and control over another person, or to not, perpetuates big problems. It is inherently unfair.

So, I encourage people to choose to step toward a model that is inherently fairer and empowers the whole group to work toward success together. I maintain that this begins not in the leadership of a company or in motivational training, but in the core work model and values a company starts with. Research shows that when people generally choose to value people for what they do and remove power differentials, we notice increased productivity, increased creativity, increased sense of self-worth, and more. In addition, co-op businesses notice increased profits and the ability to tackle more than they could otherwise. Is it worth it? For me, it is.

Well, let’s get really honest. In the US in mental health, and any other healthcare field, companies are run like the rest of the economy. Like a business. We have program managers, supervisors, medication prescribers or “med docs,” fully licensed providers, associate providers, intake specialists, receptionists, etc. All have different levels and different abilities to access change in the system they work within. All are paid and valued differently, despite all serving critical roles in the wellbeing of those seeking services. 

In a co-op, this would look different. This is way too complex to go over fully, but here are some ideas. First, the roles above would all still exist in the sense that the functions would still need to be met, however, each person would be valued equally both in pay and in voice. For example, an ARNP or psychiatrist and therapist would both be equally valued as members of the team. The receptionists and service providers would be valued equally for their contribution to making the business run. 

Now, what about decisions about healthcare? It is true that there are some decisions about healthcare or treatment models in sessions that need to be made solely by those with this education and experience. For instance, I know that ethically I cannot advise someone on medication because I have limited experience around this. So, I probably should not get an equal say in which medications are prescribed to every client. That would be unsafe. A co-op doesn’t mean that each decision for a particular client’s care must be, or is, shared among everyone. 

That said, there are ways to follow this model AND be safe. For instance, decisions about what model of therapy a provider chooses for an individual client is not shared…BUT decisions about what models of therapy the group promotes and which trainings it provides to clinical service providers can absolutely be shared. Everyone can bring their experience and ideas, things clients have said, and what they have found helpful to the table. We can all learn from each other and share in these ideas. Does that mean each individual provider cannot go out on their own and learn something new? NO! In fact, they are likely to be encouraged to! The group could even decide to allocate a fund for service providers to get their CEUs met and help pay for such trainings. The idea is more freedom, more say, more choice.

Here are some links and brief descriptions of resources to learn more! 

1. ‎1. Worker Ownership – U.S. Federation of Worker Cooperatives (usworker.coop) to see information basics on co-ops that don’t come from me. Also attached to a website with lots of other great info. 
2. The Benefits of Worker Cooperatives | Democracy at Work Institute for more on the benefits of co-ops. 
3. ‎It’s Not Just In Your Head: #022: Worker Cooperative Led By Mental Health Workers! (Tell Your Therapist To Join The Movement) on Apple Podcasts to hear an episode about a mental health worker co-op that already exists in NYC. 
4. The 7 Cooperative Principles (nipco.coop) for more on the 7 principles of cooperatives in general. 
5. ‎It’s Not Just In Your Head: #041: What is capitalism and why should you care? (ft. Richard Wolff) on Apple Podcasts for more on capitalism and the problems it creates. Certainly, an interesting history lesson of different types of government and class systems.  
6. Phoenix Mental Health (phoenix-mental-health.com) the web page of another example of a mental health co-op already in existence.  

1. Voluntary and open membership: This one was perhaps the easiest to uphold. All our contracts include voluntary termination at any time and for any reason by the provider. The contracts explicitely talk about what this means for the provider’s business moving forward (if it will be impacted at all) and about the relationship between the provider and the group moving forward. We also include information on the website and in conversations with providers about what the business model is, how it works, and what they can expect. We have transparency in that we provide copies of all contracts and procedures ahead of signing on new providers and make the “parent” company’s relevant financial information available by request to all contracted providers so that everything is on the table and providers are making informed choices. We are also very transparent about the fact that providers can do all the things the group provides on their own and that they do not have to partner with us to achieve these goals.

2. Democratic Member Control: Because our providers are not technically members of the same business on paper, we had to work around this in a different way. Each provider signs a contract with the “parent” group, Lycan Counseling, at onboarding. On paper this is a provider services agreement wherein both our businesses operate independently. However, our contracts include agreement to abide by our Co-Op Procedures manual and that refusal to or excessive failure to abide by this may be grounds for termination of contract.

The Co-Op Procedures manual details policy and procedure that aligns with democratic decision making process and all the co-op principles. For instance, we have transparency of shared funds and costs and we vote on changes to administrative staffing, changes to the manual, pay for admin staff, decisions around onboarding of new providers and termination of provider contracts if needed. The manual also outlines details on how the group may move forward without Lycan Counseling should they decide to terminate the “parent” company from the group. In this way I am also held accountable.

This is not a perfect system. I don’t think there is such a thing that actually exists in real life. AND this is what we have found to work around legality of our work and do our best to honor this principle.

3. Member’s economic participation: This was another easy one. All of our providers pay a monthly fee to cover an equal share of the agreed-upon expenses. Many things that are considered overhead are cheaper if you buy as a group. It is often true that such an arrangement necessitates a “parent” company to be the official purchaser of several accounts which is difficult when providers operate entirely independently. At times, the more providers we have, the cheaper the cost for all involved. This is how we benefit from working together and meet this principle. The montly fee is re-evaluated semi-annually (unless a change is made to staffing or otherwise) to address changes in value of services provided and keep the costs fair. Lycan Counseling does not make a profit off of any providers and any extra that is collected between cycles is returned to the providers equally at the end of the cycle.

4. Autonomy and Independence: Because we are NOT officially partners or employers, we are legally independent businesses operating completely separately of one another. On paper and in practice this is true, excepting the co-op policies. Each provider owns their own practice that can operate independently should a provider choose to terminate with the group. Each provider legally makes their own decisions around hours worked, clientelle, time off, and their clinical work, etc. Because licensed providers can operate without supervision, there is no power differential between providers to contend with and none is assigned by the contract.

We do work toward shared goals and vote on things such as allocation of shared resources, but each provider could purchase services or otherwise for their own practice outside of the shared group if they chose to or if the group did not vote to adopt it across the board. No provider is held to the group decision for their independent practice, outside of their obligations to follow the Co-Op Procedures manual. Even then, they could choose to leave the group and operate independently with little trouble.

5. Education, training, and information: One of the things the group provides is discounts and opportunities for continued education. We provide the ability to go as a group to CE events which is often cheaper AND provide opportunities to give and receive agency sponsored training by our supervisors around topics they have expertise in. We also provide opportunities through our insurance contracts for free or reduced cos CE opportunities. Additionally, we provide monthly consultation to enhance our learning from one another and work to ensure we are all providing safe and affirming best practice for all our clients.

We also provide education on the co-op model and benefits to all our providers as well as the larger community to present a different way of doing things. We seek opportunities for educating the community through activism, tabling events, and more.

6. Cooperation among cooperatives: One of the things in the Co-Op Procedures manual is a statement of prioritizing, where possible, support of other businesses that operate in a cooperative way or follow cooperative business practices. When we look for services for hire, supplies, or other shared needs, we will work to support such businesses. We also agree that each of our businesses will operate by the co-op model within and outside of the group. This means that if an individual provider hires outside of the group, they agree to operate as close to a co-op as possible and be transparent about this practice with the group. In this way, we are encouraging and supporting one another in our own co-op development as well.

7. Concern for community: This is a main principle for our group as a co-op, but also as mental health providers. We value service to the community and advancing community goals. We believe in marginalization and intersectionality and the need to work to break down oppressive systems. We support BLM, LGBTQIA2+, and neurodiversity safe/accepting/affirming practice in our work and in the general community. We promote equity and justice and work to empower our group and those we serve to use their voice and what privilege they may have to create positive change. We also provide education to providers on what this looks like in their practice and in mental health in general.
We also encourage providers to contract with Medicaid or provide reduced-cost services in some way to support those with the most need and fewest resources in our communities.