Psychotherapy and Managed Care: Reconciling Research and Reality / Edition 1

Psychotherapy and Managed Care: Reconciling Research and Reality / Edition 1

by Catherine Hartl Chambliss
     
 

ISBN-10: 0205279503

ISBN-13: 9780205279500

Pub. Date: 06/28/1999

Publisher: Allyn & Bacon, Inc.

This book presents an optimistic view of the future of mental health work, while providing a balanced look at both sides of the managed care debate. Managed care is portrayed as part of an evolution requiring the participation of informed therapists. This book is persuasive and practical, providing convenient access to an enormous amount of information clinicians

Overview

This book presents an optimistic view of the future of mental health work, while providing a balanced look at both sides of the managed care debate. Managed care is portrayed as part of an evolution requiring the participation of informed therapists. This book is persuasive and practical, providing convenient access to an enormous amount of information clinicians need in order to communicate productively with managed care companies. The author emphasizes how using research findings can help therapists improve the quality of therapy while meeting the demands of managed care. A concise review of the crises confronting therapists and a discussion of some effective responses to them, this book addresses some of the field's pet, untested and possibly indefensible assumptions about how therapy should operate. Beginning by acquainting the reader with the philosophy and history of managed care and moving on to the pros and cons of the system, the book then provides practical information on how to meet the expectations of managed care organizations. Additional sections review general psychotherapy outcome research; using three general treatment strategies; specialized therapies for particular disorders and future trends and innovative practice directions some enterprising clinicians are pursuing. For practicing clinicans and anyone interested in mental health.

Product Details

ISBN-13:
9780205279500
Publisher:
Allyn & Bacon, Inc.
Publication date:
06/28/1999
Pages:
416
Product dimensions:
7.24(w) x 9.57(h) x 0.98(d)

Table of Contents

Preface x
SECTION ONE Psychotherapy in the Age of Managed Care 1(34)
Protests against Managed Care Practices
2(1)
The Successes of Managed Care Companies
3(1)
Not All Managed Care Companies Are Alike
4(1)
Not All Providers Are Alike, Either
4(1)
Accountability Is Here to Stay
4(1)
A Caveat: Managed Care Won't Affect Private-Pay Clients
5(2)
The End of Psychotherapy As It Was: Evolution or Revolution?
7(16)
Reconciling Research and Managed Care Practice
11(3)
Becoming a Practitioner-Scientist
14(4)
The Hierarchy of Treatment Restrictiveness and Intrusiveness
18(1)
Steps of the Speed Sequence
19(2)
Making Managed Care Work
21(2)
The New Era of Psychotheraphy: What Is Managed Care?
23(12)
Different Managed Care Delivery Systems
24(1)
Appreciating the Variability among MCOs
25(1)
For-Profit versus Nonprofit MCOs
25(1)
History: Why Did Managed Care Emerge?
26(1)
The Evolution of Behavioral Managed Care
27(6)
The Hopes and Dreams: The Rationale for Managed Care
33(2)
SECTION TWO The Managed Care Maelstrom: The Battle, Protests, and Reforms 35(76)
A House Divided: How Managed Care Has Fractured the Field
37(26)
The Despair: The Battle against MBH Problems
37(3)
The Downside for Patients: Cost Cutting Compromises Care
40(5)
The Downside of Managed Care for Providers
45(8)
Reform Efforts: Working toward a Better Balance
53(2)
The Backlash Has Begun
55(3)
Litigation and Legislative Reforms
58(2)
NCQA Regulations and Standards
60(2)
Managed Care's Criticism of Its Critics
62(1)
Being Fair: Looking Critically at Our Nostalgia and Revisiting Assumptions about Therapy
63(22)
Combatting Nostalgia for What Never Was
63(1)
Revisiting Assumptions
64(2)
Is Traditional Psychotherapy Always Therapeutic?
66(6)
The Previous System's Unfairness to Providers
72(3)
Who Knows Best What Clients Need?
75(5)
A Caveat: Clients Don't Always Know Best
80(3)
How Can We Best Facilitate Change in Clients?
83(2)
Making Peace with Managed Care
85(26)
Did Psychotherapists Ask for It?
85(3)
Weighting the Pros and Cons: Better Research Needed
88(3)
The Positive Impact of Managed Behavioral Healthcare
91(6)
Constructive Strategies for Improving Managed Care
97(3)
Developing a Balanced Perspective: Resolving Ambivalence
100(1)
Coping with the Ambiguity: Achieving Commitment
101(4)
Risks of an Adversarial Stance
105(1)
Enjoying Your Work
106(2)
Conscientious Streamlining: Cutting the Right Corners
108(1)
Managed Care: Friend or Foe?
109(2)
SECTION THREE Preparing for the New Demands of Managed Care 111(84)
What Managed Care Expects from Providers
113(21)
The Managed Care Mindset
113(10)
The Heart of Managed Care: Focused Treatment Planning
123(5)
Partnering with Managed Care Companies
128(6)
Joining Managed Care
134(30)
Coping Constructively with New Constraints: Provider Accommodation Research
134(3)
Joining Managed Care
137(4)
A Triage Mentality: Evolving Criteria for Outpatient Treatment
141(3)
Legal and Contractual Issues
144(2)
Providing the New Continuum of Care
146(3)
Delivery Methods and Manpower
149(8)
Using Research to Improve Psychotherapy: Cutting Corners with Savvy
157(5)
Using a Research-Based, Rational Progression
162(2)
Justifying Care as Medically Necessary
164(18)
Working with Utilization Reviewers
165(3)
Medical Necessity: Defining Insurance-Covered Problems
168(2)
Using Diagnoses Most Constructively
170(6)
Impairment Ratings and Severity Ratings
176(1)
The Problems of Jargon and Paperwork
177(2)
Research on the Cost-Effectiveness of Psychotherapy
179(3)
Individualizing Treatment
182(13)
Applying Knowledge about Specific Groups of Consumers
182(3)
Tailoring Treatment
185(4)
Accommodating Cultural Differences
189(6)
SECTION FOUR Justifying Psychotherapy to Managed Care 195(34)
A Review of Relevant Psychotherapy Outcome Research
197(18)
The History of Outcomes Research
197(1)
Outcome Studies
198(12)
Debates about Psychotherapy Outcomes Research
210(5)
Squaring Off: The Specificity Debate
215(14)
Specific Techniques versus Common or Placebo Factors
215(1)
Common Factors and Placebo Effects
216(10)
Applying Empirical Research: Using a Research-Based Rational Progression
226(3)
SECTION FIVE General Psychotherapy Strategies 229(60)
Psychotherapy Based on Common Factors
231(16)
Common/Nonspecific/Universal Therapy Elements
231(3)
Client and Therapist Factors Contribute the Most
234(6)
Therapeutic Conditions: What Constitutes Quality Treatment?
240(4)
Using Common Factors in Individualizing Treatment
244(3)
Solution-Focused Treatment Methods
247(15)
Working Backward and Building on Clients' Strengths
247(1)
Why Managed Care Favors Solution-Focused Therapy
248(3)
Positive Therapist Expectations
251(5)
Solution-Focused Methods
256(3)
Applying Techniques to Challenging Patients
259(1)
Learning to Be Solution-Focused
260(1)
Criticism of the Solution-Focused Approach
261(1)
Brief Problem-Solving Methods: Integrating Outcomes Assessment and Treatment
262(27)
Single-Session Treatment: Once May Be Enough!
263(1)
Many Common Problems Suitable for Brief Treatment
264(2)
Being Brief: How-To Tips for Streamlining
266(12)
Attacks on and Defense of Brief Therapy
278(2)
When Not to Use Brief Treatment
280(4)
"Buying Time" for Those Who Need It
284(1)
Partnering with MCOs for Optimum Patient Care
284(3)
Can Idealism Survive Constraints?
287(2)
SECTION SIX Specialized Psychotherapy Strategies: Empirically Supported Treatment Approaches 289(60)
The Pressure to Specialize
289(1)
Using Treatment Guidelines
290(1)
Using ESTs in Making Managed Psychotherapy Work
290(3)
Summaries of ESTs for Common Serious Mental Disorders
293(23)
Anxiety Disorders
293(11)
Depression
304(6)
Post-Traumatic Stress Disorder
310(2)
Eating Disorders
312(4)
Summaries of ESTs for Severe Mental Illnesses and Serious Refractory Problems
316(14)
Schizophrenic Disorders
316(5)
Borderline Personality Disorder and Suicide
321(3)
Substance Abuse/Chemical Dependency
324(6)
Summaries of ESTs for Problems in Living
330(19)
Marital Therapy
330(5)
Sexual Dysfunctions
335(5)
Parenting/Childhood Problems
340(9)
SECTION SEVEN Summary 349(11)
Conclusions: Meeting the Demands of the Future
351(9)
Thinking about Therapy from a Managed Care Perspective
351(5)
Responding to Managed Care's Demands for Efficiency: Making Less More
356(2)
Future Therapy
358(2)
Glossary: A Primer of Managed Care Terminology 360(4)
Listing of Empirically Supported Psychological Treatments 364(5)
Listing of Pharmacotherapies for Different Disorders 369(4)
References 373(36)
Index 409

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