Jake Cooper on Grow Therapy, Why AI Won't Displace Therapists, and Starting with $20
Grow Therapy's first move wasn't a pitch deck or a beta product. It was a $20 job listing: "Do you want to start your own practice? In exchange for a revenue share, we'll partner with you every step of the way." Fifty therapists applied.
Jake Cooper, co-founder and CEO of Grow Therapy, quit his job at Blackstone three days later. His co-founder Manoj Kanagaraj left medical school, and they started Grow Therapy with Alan Ni.
Jake joined us at Villagers Retreat, a curated, invite-only gathering for founders, GPs, and angels. In a conversation hosted by Ben Casnocha, Village Global co-founder and General Partner, Jake went deep on the lessons behind Grow Therapy and how he built it into a company serving roughly a million patient visits a month.
Key Insights
Resolve disagreements by testing the premise, not arguing the conclusion
When Jake and a co-founder land on opposite answers, his instinct isn't to argue for his side. It's to find what each position assumes and check whether those assumptions hold. "What's more interesting is what are the premises that underpin your point of view, and then can you validate or invalidate any of those premises," he says.
Two people can disagree loudly about a conclusion while agreeing on almost everything underneath it, or agree on a conclusion while resting it on premises that don't hold up. Arguing the conclusion directly skips the step that would resolve anything.
Manager quality predicts retention better than culture or perks
Grow Therapy has some of the best employee ratings in an industry known for weak ones. Jake doesn't credit swag, offsites, or rituals. He points to a single correlation from the company's internal NPS data: what employees think of their direct manager.
The company invests in finding and developing people who can operate with real autonomy and lead well, rather than in the cultural gestures that are more visible and and easier to copy.
Employees join companies, but they leave managers.
Push six layers down, and check what people say against what they've done
Jake's interview method starts with motivation, then keeps going. He asks a candidate to walk through a strategic decision, then asks what they specifically did about it, then keeps asking what's underneath that answer. Most people run out of depth after two or three layers. The ones worth hiring keep going.
He also checks stated values against evidence. Someone who says they don't care about title, but whose career shows a title increase at every step, gets a specific test: what's the actual title on this offer. Motivation is easy to claim and hard to fake once you ask enough follow-up questions. Jake has found that signal from an interview process largely saturates after five or six cumulative hours; more time past that doesn't add much.
Owning the full stack beats splitting into four specialized companies
Grow Therapy could have been four separate businesses: a marketplace, an EHR, a revenue cycle management company, a care delivery platform. Jake's first-principles case for building all four as one company came down to a simple question. "Does it make sense for everyone to independently apply to insurance companies? Does it make sense for everyone to independently build their own revenue cycle management functions?" he says. "There's a real one plus one equals three aspect of being able to own the full infrastructure rails end to end."
That bet wasn't available before COVID pushed mental health care from in-person to virtual. Matching patients to providers on a hyperlocal, in-person basis meant five realistic options. Matching on a state basis meant five hundred. Paper workflows becoming digital ones meant Grow could actually operate the fragmented system it was trying to replace, rather than just describing how the pieces should fit together.
Optimize for expected value, not for how often you're right
Jake points to Meta's roughly $70 billion AR and VR bet as an example worth admiring, not for the bet itself, but for the reasoning behind being willing to make it. A founder operating with intellectual humility, genuine curiosity, and a long enough time horizon doesn't need to be right most of the time. They need the wins, when they come, to be large enough to outweigh the rest.
That framework cuts against the instinct to protect a win rate. Being wrong repeatedly is only a problem if you're optimizing for looking right. If the objective is expected value, being wrong most of the time is compatible with making exactly the right bets.
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About the Guest
Jake Cooper is co-founder and CEO of Grow Therapy, a company he started with co-founders Manoj and Alan during the COVID pandemic to address fragmentation across mental health patients, providers, and payers. Grow Therapy now serves roughly a million patient visits a month across 26,000 providers, passed a billion dollars in top-line revenue last year, and has operated profitably since its second year.
About the Host
Ben Casnocha is co-founder and General Partner of Village Global.
