This article reports the first Kaiser-Permanenle study comparing medical services utilized before and after shortand long-term psychotherapy. Findings indicate that persons in emotional distress were signgicantly higher users of medical facilities, that medical care utilization by individuals seen in Psychotherapy declined, and that lhis decline continued and remained constant during the 5 years afier termination of psychotherapy.

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T h e way in which psychotherapy services are delivered, rather than the number of patients served, determines the cost-effectiveness of service. Immediate intervention that avoids lengthy waits f o r appointments and evaluative sessions often relieves emotional distress. A n 8-year follow-up of patients' recollections of their symptoms and treatment is reported.

From physicians' notes and medical charts, a "criterion of psychological distress '' was developed and used as part of the computerized screening of general medical patients fo provide psychotherapy referral recommendations to physicians. In spite of intense efjorts to increase referrals to psychotherapy, the number of H M O subscribers seeking psychotherapy reached an optimal level and remained fairly constant thereafter. The study demonstrated that in spite of increased demand, providing psychological services lowers overall health care costs.