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The decrease of autonomy in social work practice is the result of societal trends that include the rise of technology and massive restructuring of organizations. These trends are reflected in the emergence of managed care as an efficiency movement that has not been monitored. Social work's contribution to intervention is reviewed in relation to the emergence of managed care. Ethical issues, professional practice relationships, fee setting, privacy and confidentiality, supervision issues, professional language, professional status, and professional organizations are explored in the context of increasing control of clinical social work practice dictated by managed care.

This article deals with the role of the supervisor based on gender issues. Issues in supervision of practitioners with a feminist perspective are explored, as well as how supervisors can assist the practitioner who has managerial aspirations. The role of supervision in dealing with stress and gender is explored."Paternalism is male domination without a contract." (Sennett, 1980. p. 54

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