The Psychotherapists' Guide to Managed Care in the 21st Century: Suriviving Big Brother and Providing Quality Mental Health Services

By Jeri Fink, Sondra Tuckfelt, and Muriel Prince Warren

From the Prologue

Psychotherapy is changing. It was once a professional practiced by highly trained, caring individuals. It is becoming an industry operated by business administrators.

This book describes the changes brgough by managed mental health care and tells how to adapt to them, whether by choosing to work within managed care, outside of managed care, or in a combination of the two. It addresses the essential issue faced by psychotherapists today: how to maintain professional integrity while protecting income in a world of managed care.

This book is not an indictment of the managed health care system. Managed care will continue to evolve under the pressures of national and state legislation, of litigations, and of concerns about responsibility, confidentiality, and accountability. Many of the problems that clinicians face relate to the business approach to psychotherapy practiced by managed care organizations (MCOs). The delivery of mental health services is being orchestrated by people who specialize in business management, economics, and administration. Their goal is to make money by reducing costs while offering the most commercially attractive product possible. Financial, legal, technological, and governmental mechanisms, all relatively invisible to practitioner and patient, affect the ways in which MCOs choose to implement cost control and quality assurance. This business approach to health care may be a shock to professionals whose goal has been to earn a living by healing people in an ethical and responsible manner. Many psychotherapists have experienced difficulty making the ideological leap to a business perspective. Conversely, many managed care administrators have difficulty understanding the ideology of traditionally autonomous, professional clinicians in private practice.

The intent of the authors is to present the conflicts between MCOs and psychotherapists in as fair and useful a manner as possible. For this book we interviewed managed care providers, independent professionals, administrators, investment analysts, attorneys, technological experts, political activists, people in business, people in government, and patients throughout the country.

Table of Contents

Part I: Meet Big Brother

1. Where did it all come from?
2. The impact of managed care
3. Doublethink
4. Who's lurking?
5. From the halls of justice

Part II: Inside the Treatment Room

1. Look before you leap
2. The managed care practice
3. Computerizing your practice
4. Time-limited psychotherapy

Part II: Finding Solutions

1. Coordinate solutions with special people
2. Coordinate solutions with special techniques
3. New directions
4. Flight
5. Fight
6. Psychotherapy in the 21st century
7. Conclusion

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