Rethink Wellbeing’s Year 2 Update: Foster Sustainable High Performance for Ambitious Altruists

By Inga, Báo, carysj @ 2024-12-08T14:32 (+43)

In a period of increasing existential risks and growing political instability, it can be hard to stay focused and passionate about working toward humanity’s flourishing. Many members of this community have told us they feel worried, hopeless, and burnt out. At Rethink Wellbeing, we have made it our mission to empower those doing the most good, by giving them tools to improve their mental health and well-being, and thereby their executive functioning and productivity, to increase their positive impact on the world.  

TL;DR

This post is about:

• Highlights, & learnings from 2024
• Our goals & plans for 2025
• Ways you can join our mission 

In 2024, we successfully delivered and evaluated 3 guided mental health programs teaching evidence-based psychotherapeutic techniques, tailored to the EA and adjacent communities (N~150). We also searched for and tested some potential fundraising options: focusing on writing federal grant applications and building our EA supporter and donor community.  

In 2025, we aim to deliver our most cost-effective and proven flagship program, the iterated “CBT Lab Peer Support” to 150 to 200 ambitious altruists in 3 cohorts. We’d also like to develop and pilot at least one of two potentially impactful programs: 

1. An LLM-guided version of the CBT Lab to test whether similar results can be achieved with lower costs of human guidance.
2. The Social Lab Peer Group Support, which teaches social skills to connect, support, manage conflicts, form meaningful social roles, assert oneself, and build relationships. This program aims to serve those ~30% of program applicants who we were unable to invite to the CBT Lab due to too low social scores, which have been shown to be a risk factor for mental health treatments not working.

Three key ways to support our mission:

1. Follow us (LinkedIn, EA Forum, newsletter), AND recommend our program to a friend, or share our donation campaign with 1-3 potential supporters.

2. Donate to our campaign this season if you're able to. Even if just a little (every dollar counts!), or more if you feel as confident in our program outcomes as we do after our successful replication this year. Every $350 supports 1 ambitious altruist, saves ~2 WELLBYs, and ~2 months FTE of productive hours.

3. Contact us about supporting our research, i.e., publishing our data in a journal.

Highlights & Insights from 2024

Main achievements

1. We scaled our services to support 3x more members of the EA community.^[1] Our participants included employees at 80,000 Hours, CEA, and the Future of Life Institute, just to mention a few. 85% of participants would recommend the program to a close friend or colleague.

    

2. We replicated the positive pre-post outcomes of our flagship program, the CBT Lab Peer Support, within a registered Clinical Controlled Trial (CT). This year, after 12 weeks, the program again showed similar improvements as 1:1 psychotherapy in RCTs but at a fraction of the costs.

   • Positive Mental Health: ~ +1 point on the 0-10 personal well-being scale (ONS-4, p<.05), which is greater than the increases seen from becoming partnered (+0.59) or finding employment (+0.70) (see (11).
   • Mental Health Burden: Decrease in mental health-related suffering by ~20% (GAD7, PHQ8, BSI, p<.05), including symptoms of anxiety, depression, and executive dysfunction, i.e., on average moderate suffering goes down to mild suffering.
   • Productivity: Participants gained ~7.8 (~8) working hours per week on average - calculated as the sum of 2.7h worked more plus ~19% self-assessed subjective productivity increase (converted to 5.2h) during the working hours (WAI:GH, p<.05). The self-assessment of productivity during these hours might be overestimated due to participants feeling better, which could artificially inflate the perceived effect. What speaks against this type of bias being likely is that the outcomes of the CBT mini-support version show significant improvements in mental health scores, but no corresponding ones in productivity scores. This would be the case though if feeling better equated to reporting overestimated effects where there are none or small ones. To make sure, we overall guessed more conservatively, we removed ¼ of the effect (2 hours) to account for potential assessment biases and settled on likely ~6 productive hours per week being gained per participant.
   • EA community commitment: 30% of participants reported an increased commitment. This will likely contribute to preventing some of the future value attrition, and allow those affected to stay in the community, thereby doing good better, for longer.

    

3. As part of our goal to increase the cost-effectiveness and reach of our services even more, we developed and tested two additional programs: the IFS Lab and the CBT Lab Minimum Guidance. Both show promising mental health benefits but lack a significant pre-post effect on productivity. We will publish dedicated reports for each of these program versions soon. Those pilots indicated that the effort we put into the standard guidance is worth the incremental benefits and that IFS doesn’t improve mental well-being aspects significantly after 12 weeks in the guided self-help format.
   Additionally, we cut our operational costs in half.

    

4. We launched a pay-what-you-can model for program fees to diversify our funding sources. This, combined with invaluable support from a member of the Mental Health Funding Circle and three smaller amounts donated by EA individuals, enabled us to offer over 50 program places at little to no cost this year.

We are running our first-ever Giving Season campaign to help another 25 altruists access our programs for free in 2025. Donate an hour of mental health support here, or contact us to discuss dedicating your support to a specific cause area. It’s even possible to gift the program to a specific person! Which of the ambitious altruists in your network might benefit most?

Impact

Overall, our three programs:

• Amplified the well-being and the productive hours of the participating ~150 ambitious altruists, gains equivalent to ~123 WELLBYs and 13 additional FTEs for an entire year.^[2] What participants might do with their extra time (not mutually exclusive):
  • ~50% working for EA organizations unlock a day of productivity every week. We expect this gain to benefit their cause area directly. Imagine what your organization could achieve with 20% more capacity.
    • On average, participants gain ~6 hours per week, and 2 months FTE over 1.5 years.
    • If they worked at a GiveWell-recommended charity, we estimate that these 2 months would be worth $6000 or ~1.3 lives saved.
    • We assume most of those we support might not work on projects as cost-effective as those of the GiveWell-recommended charities. If they’re just ~50% as cost-effective, their productivity gain would be worth ~0.65 lives saved, equivalent to ~$3,000 donated to a GiveWell-recommended Charity.
    • We assume most of those we support might not use all of their productive hours to work on the EA cause but rather ~50%. This means ~0.33 lives saved per participant.
    • Therefore, donating $1,050 to cover the cost of the RW program for 3 of those working on an EA cause could be worth 3 months FTE of unlocked productivity, or 1 life saved.
• ~30% earning to give: These are often the ones paying for their attendance anyway, so rarely have the need to be covered using EA donations, but rather contribute to cover the costs of those who can’t afford it. For those who have benefitted from a funded place, we estimate the following return on investment ($350 donations provide a free place):
  • Freelancing. Likely ~half of those earning-to-givers are freelancers (World Bank, 2024). For freelancers, productivity and earnings have a stronger correlation. Many who earn-to-give commit to donate in proportion to their income so we expect their charitable giving to increase. For example, if they earned $6,000 in those 2 months of extra time, and they usually donate 10% of their income, the $350 covering their space in the program would bring $600 in expected donations. This way, you’d save a life for $2,450 supporting 7 earning-to-givers by covering their program costs, leading to $4,200 donations which roughly helps to save a life when people donate to one of the GiveWell-recommended charities. Moving forward, we feel confident to use EA donations to cover the program costs for freelancers who don’t work on EA causes.
  • Employees: The impact for employees not working on EA causes is harder to predict. Work performance improvements don’t guarantee a raise, so we can’t be sure these participants will be in a position to increase their donations to EA causes. The program might help them unlock more time to volunteer for EA causes, but this isn’t something we currently measure. Given that the expected cost-effectiveness is lower for this group, we might consider prioritizing EA-donated program places for those freelancing or working directly on EA causes.
• ~33% pursuing EA-aligned careers–mostly students. This segment has the highest demand for funded places but the exact impacts and cost-effectiveness are the hardest to quantify. Let us know should you have any ideas on how to solve this. 
  We expect a larger future prevention effect for these often younger participants. Successful and early prevention leads to fewer and milder mental health issues when faced with challenging life situations. They might secure an EA job quicker and be more likely to persevere with applications due to resilience and the raised commitment to the EA community.
• Delivered with just $31 per session hour per person, compared to $65-$250 usually paid for an hour of 1:1 therapy.^[3][4]

We share the results of each program version in dedicated additional EA Forum posts:

• How the CBT Lab Amplifies Effective Altruists’ Impact (CBT Lab Peer Support, our main program).
• CBT Minimum Guidance report, including the Simple Support and Buddy Support versions (coming soon).
• Internal Family Systems (IFS) Lab report (coming soon).

The diagram contains and compares the main effects of the different program versions.

We are also proud to have contributed to the science of cost-effective mental health interventions, including: 

• Finding effective tailoring and engagement criteria, dropout predictors, and optimal program components and duration.
• A proof of concept (PoC) for a regular monitoring system to support optimizations based on the most relevant drivers of engagement and effectiveness throughout the programs.
• PoC for a peer-guided online group format with strong retention, i.e., the CBT Lab Peer Support. The hard-to-solve problems were the too-low program and session attendance especially free guided mental health interventions using an online group format. Our CBT Lab Peer Support shows similar attendance rates as those reported for 1:1 psychotherapy in RCTs.

In 2025, we’d like to publish our 2024 results in scientific journals, together with a university partner.  Interested? Reach out to us.

To round off the impact overview, we’d like to share two heart-warming testimonials with you. We are aware that qualitative feedback isn’t suitable for assessing the quantitative relevance of effects, but we hope these quotes give you a “feel” for what it is like to attend the programs:

Also. check out this recent EA forum post: we liked the case study describing how productivity and mental health were intertwined and how CBT helped.

How the team has developed

We are a globally connected team, united by our passion to do good and support those who do good. While working remotely, we value open communication, diverse perspectives, and accountability to empower each other. We walk our talk: we embrace a work-life balance, ownership, and trust.

This year, we were very fortunate to welcome several outstanding new team members:

• Dr. Rengin Isik Akin grounds us with her decades-long expertise in therapy, research, and education.
• Alcea de Jesus enriches us with 5+ years of experience as principal architect and non-profit founder.
• Carys John is an operations ace with 5+ years of experience in delivering multi-million-dollar performance improvements.

• As part of our extended team, we collaborated with our growing network of volunteers and experts and trained >25 volunteer facilitators to deliver the program sessions to groups.

At the same time, we saw a shift in roles for Dr. Sam Bernecker and John Drummond, whose invaluable contributions have left a lasting impact on Rethink Wellbeing. Sam has transitioned to pursuing an exciting professional dream related to meta-science, while continuing to contribute to our work in a reduced capacity. Meanwhile, John moved on as we evolved our hiring strategy to prioritize opportunities for team members from regions where our resources can make a more meaningful difference.

The other two founding members, Inga Großmann and Robert Reason, are still part of the team.

This transition, coupled with the need to support triple the number of participants and programs without a proportional team increase, has driven us to significantly enhance our internal efficiency. Altogether, we have been able to halve our operational expenses.

Some important learnings in 2024

Our 2025 Objectives

• Deliver our cost-effective flagship program, the CBT Lab Peer Support, to 150-200 ambitious altruists, with tweaks to improve engagement and effectiveness once again, employing the pay-what-you-can model.
• Increase reach and impact, plus lower the costs of our programs, by potentially supporting other non-profits to take over and run our program for their target group, and by testing at least one  new program:
  • 1. LLM-model-guided CBT Lab to reduce human efforts needed to support..
  • 2. the Social Lab Peer-Support to cover the deselected 30% of CBT Lab applicants whose social scores were low, being a risk factor for CBT not to work for them.
  • 3. An in-person RISE retreat, as a condensed, experience-focused version of our 3 Lab programs, containing the selected best contents and tools.
• If we can secure the federal grant that we are currently applying for that would cover 50-70% of our funding needs for 3 years, we plan to develop and test program versions tailored to students. The corresponding grant has a 75% acceptance rate for those who made it to the stage we are in the application process. In case we don’t receive that funding, we would like to apply for other non-EA grants.

The objectives above are aligned with our product vision to build a varied, balanced, sustainable, and effective range of services.

How You Can Contribute Right Now

We’d love for you to become part of our community and the Rethink Wellbeing journey. 

How you can help those ambitious altruists in need of mental health support:

• Apply to join a program in 2025, if you think it will benefit you and your cause area
• Help us raise at least $10,000 in 2024 to help another 25-28 ambitious altruists working on EA causes who can’t afford or access it otherwise get access to our CBT Lab programs for free in 2025. How?
  • 1. For $350, make the program a present to an ambitious altruist you know. 
    For Christmas maybe? This can e.g., be an employee, a colleague, a friend, or a talented person you mentor. Someone who you know might benefit but who can’t afford it or who wouldn’t consider taking action on their own and might need a little push. Contact us, to get the lovely gift voucher which can be used by your chosen person once program applications are open again. Which shall be your present? The IFS Lab, the CBT Lab, or the facilitator training.
  • 2. Consider adding Rethink Wellbeing to your list of “trusted, cost-effective charities worth donating to”. Evaluate why this might or might not be a good idea. Should you have any questions or concerns about that, please definitely reach out to us, ask, and let us know what you think. We’d like to learn. inga@rethinkwellbering.org Below´, we collected pros and cons for you in a table.
  • 3. Donate to Rethink Wellbeing in December 2024, ideally setting up a yearly donation amount that fits your strategy best, examples:
    • $2,000 helps a whole peer group of 6 ambitious altruists, save one complete FTE for a year of productive hours, which will likely partly be used to do good better.
    • $350 helps 1 ambitious altruist, giving them 2 WELLBYs and the productive hours of 2 extra months working as a FTE and this way, generate extra resources, part of which are potentially used to do good better.
  • 4. Share your donation decision and the reasoning behind it with your networks, including on LinkedIn, Facebook, and with your colleagues. We’d love you to snap and post a picture of yourself with a plant,(our symbol for flourishing this year (see below) with this. 
    
     

How you can join the RW community & stay in the loop

• Connect with us on social media: This way, you can easily learn about and reshare the content that you find should spread more. Take a minute now to follow us on LinkedIn, add the EA Forum Post Rethink Wellbeing tag to get reminders about related posts, and sign up to receive our monthly newsletter here.  This newsletter contains organizational updates, interesting insights from our ongoing work, the latest developments in the field and science results that inspired us, and our opportunities for ambitious altruists, e.g., when participant applications are open, when we train more facilitators, or when we have open job offers.
• Share your and our story and Giving Campaign on your social media, with your professional, personal, and EA networks. For example, just repost something we post in December, that helps us to get the support we need to keep helping more ambitious altruists. Then just tag the Rethink Wellbeing profile (LinkedIn), and link this post or our website. Other more complicated options:
  • 1. Share a quote from the RW website or this EA forum post with a call to action such as “This year, consider donating to support those that do lots of good to do so better”,
  • 2. write about which 1-2 key points related to our ideas, impacts, or others seem most interesting to you, or
  • 3. discuss how you see mental health as a potentially highly impactful area.
• Get in touch if you’re a researcher interested in using and publishing our data, via a thesis or a scientific journal, and would like to work with or for us. 

Thank You

… to Justis Millis for the helpful comments and feedback on this post. They severely contributed to its depth and quality!

…to all our participants, for trusting us with their well-being journeys and providing generous feedback to help us continually improve.

…to all donors and our funders, for their trust and support.

…to our dedicated and talented team, including volunteers, facilitators, and experts, without which none of this would be possible. Special thanks go to Charlie O’Donohue and Sofie Meyer, our two most active volunteers, and Robert Reason, Nicolas Báo Zingerle, and Sadaf Rasheed.

We Wish you Growth & Flourishing 💜

Nourish to flourish! The Rethink Wellbeing Team with a plant theme this year.

1. ^{^}

   150 people participated in our programs in 2024, compared to 42 in 2023.

2. ^{^}

   The CBT Lab Peer Support (N=48) and CBT Mini (N=27) improved participants’ wellbeing by ~2 and ~1 WELLBYs, respectively, totalling 123 WELLBYs (2×48 + 1×27). Additionally, the CBT Lab Peer Support and IFS Lab (N=24) increased participants’ weekly productive hours by 8 and 6 hours, respectively, amounting to 25,300 hours over 48 weeks. This equates to 13 FTEs (25,300 ÷ 1,900 hours per FTE).

   While ~150 people participated, we based calculations on N=99, excluding dropouts and non-completers of week 12 surveys. These exclusions may thus slightly underestimate the total gains, as other participants likely also benefited to some extent.

3. ^{^}

   According to a large US psychotherapy directory.

4. ^{^}

   As the range and quality of teletherapy services, such as BetterHelp, have increased, we plan to re-benchmark ourselves against these services in our next impact report.