Practicing psychology in the era of managed care: Implications for practice and training.

Abstract

Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed.

Cross-Cultural Assessment of Psychological Trauma and PTSD

“…These diagnostic instruments lead to symptom alleviation with pharmacological and cognitive-behavioral interventions in lieu of long-term, diverse treatment modalities consistent with full spectrum assessment objectives. Assessment training has diminished in quality (Clemence & Handler, 2001) and comprehensive assessment training limitations are recommended (American Psychological Association, 1999;Sanchez & Turner, 2003).…”

Effect of Therapist Color-Blindness on Empathy and Attributions in Cross-Cultural Counseling.

“…Finally, the present practice of psychotherapy reflects guidelines set forth by insurance companies and managed care, which have resulted in an emphasis on time-limited, or briefer, solution-oriented therapy (Averill, Ruiz, Small, Guynn, & Tcheremissine, 2003;Franko & Erb, 1998;Sanchez & Turner, 2003). These therapeutic approaches often emphasize solutions and are less focused on the direct causes of client problems.…”

Culturally competent school assessment: Performance measures of personality

“…In managed care, preferences for clinical diagnosis using brief symptom checklists are now accompanied by severe time restrictions on assessment, contributing to an increasing erosion of standard tests and test batteries (Sanchez & Turner, 2003) consistent with a Division 12 future assessment training model (American Psychological Association Division 12 Presidential Task Force, 1999) deemphasizing projective methods. The Rorschach in particular has been stigmatized as poor science in two influential books (e.g., Lilienfeld, Lynn, & Lohr, 2003;Wood, Nezworski, Lilienfeld, & Garb, 2003) despite a meta-analysis reaffirming a positive history of empirically grounded projective assessment methods (Meyer et al, 2001) and a Society for Personality Assessment White Paper documenting the Rorschach as a legitimate scientific product (Society for Personality Assessment, 2005).…”