The cost of psychotherapy.

Abstract

This article examines the relationship between psychotherapy funding policies and concepts of mental health. Three levels of mental health-necessity, improvement, and potentiality-are proposed. Necessity represents basic adaptation, the current dominant level illustrated by brief psychotherapy funded through managed mental health care. Improvement is the phase beyond necessity aimed at prevention and heightened quality of life, and potentiality is the ideal. The latter two now receive limited funding and emphasis. At question are both economic and social policies that endorse a narrow rather than a broad conception of mental health.

Quality of life in social phobia

“…Historically, studies of the efficacy of treatments of mental disorder have focused on symptom reduction, while emphasis on the promotion of life satisfaction has been rare (Cowen, 1991;Herron et al, 1994;Strack et al, 1991). However, there is growing consensus that psychologists should assess quality of life or life satisfaction in evaluating both mental health and treatment outcome (Frisch, 1994b;Hollandsworth, 1987;Howard et al, 1993;Kazdin, 1993;Seligman, 1995).…”

Quality of life in social phobia

“…Self-perceived quality of life (also referred to as life satisfaction), a person's judgment of whether his or her goals, needs, and wishes have been fulfilled, is an important aspect of psychological well-being (Frisch, 1994a;Frisch et al, 1992;Lewinsohn et al, 1991). Historically, studies of the efficacy of treatments of mental disorder have focused on symptom reduction, while emphasis on the promotion of life satisfaction has been rare (Cowen, 1991;Herron et al, 1994;Strack et al, 1991). However, there is growing con-sensus that psychologists should assess quality of life or life satisfaction in evaluating both mental health and treatment outcome (Frisch, 1994b;Hollandsworth, 1987;Howard et al, 1993;Kazdin, 1993;Seligman, 1995).…”

Professional psychologists in general health care settings: A review of the financial efficacy of direct treatment interventions.

“…Psychologists are also being used more frequently because of new behavioral technologies, broader training of psychologists, political advocacy, and increasing research demonstrating the financial efficacy of psychological interventions (Cummings, 1985, 1990, 1991a; Jacobs, 1987). However, this increased use of psychologists is also being threatened by progressive efforts to reduce health care costs (Eckert, 1994; Herron, Javier, Primavera, & Schultz, 1994; Holder & Blose, 1987; Olfson & Pincus, 1994), particularly through restrictions resulting from managed care (Austad & Berman, 1991; Karon, 1995; Stern, 1993). Indeed, there is a distinct lack of federal legislative recognition that psychosocial interventions can actualize significant cost-savings to the health care system, particularly in reducing overreliance on medical–surgical services.…”