The Health Maintenance Organization: II. Implications for psychotherapy.

Austad, Carol Shaw; Kisch, Jeremy

doi:10.1037/h0085369

Cited by 14 publications

(13 citation statements)

References 11 publications

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“…While discussing ways to make treatment delivery compatible with health maintenance organization benefit structures, Austad et al (1988) pointed out that 'it has never been established empirically that a psychoanalytic or psychodynamic time schedule is best' (p. 451). Alexander and French (1974) maintained that the frequency of appointments should be regarded as relative.…”

Section: The Psychodynamic Perspectivementioning

confidence: 98%

“…Pressures to optimize time and financial resources are experienced internationally (Barkham, Shapiro, Hardy, & Rees, 1999). Waiting lists in the United Kingdom (see, e.g., White, 2000), and managed care's reimbursement restrictions (see, e.g., Mueller & Pekarik, 2000) as well as limitations by Health Maintenance Organizations (Austad, DeStefano, & Kisch, 1988) in the United States are some of the factors exerting pressure for an effective, efficient service. To maximize gains and minimize costs the frequency and duration of treatment sessions should be an important consideration.…”

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confidence: 99%

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Can patients specify treatment parameters? a preliminary investigation

Carey

2005

Clin Psychology and Psychoth

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In this paper I provide data that were obtained when patients made decisions regarding the scheduling of treatment sessions. I outline relevant information from the literature and describe Perceptual Control Theory as the theoretical basis of this work. The implications and limitations of the data are discussed as well as suggestions for future research. The data are interpreted as preliminary evidence that patients can take responsibility for decisions made during psychological treatment programs.

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Section: The Psychodynamic Perspectivementioning

confidence: 98%

mentioning

confidence: 99%

Can patients specify treatment parameters? a preliminary investigation

Carey

2005

Clin Psychology and Psychoth

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“…To do so abrogates a therapist's most basic professional responsibility to his or her patient. Some of the psychologists most strongly identified with the managed care movement (e.g., Austad et al, 1988;Budman & Gurman, 1988;Cummings, 1986Cummings, , 1988Cummings, , 1990 have justified their endorsement of a universal brief therapy model by comparing it with the model of primary care medicine. The idea is that rather than thinking of psychotherapy as a onetime, once-and-for-all, continuous episode of care (which it almost never is), we should think of it as a series of discrete time-limited episodes in which the patient may return to the same "doctor" at different points in the life-span when different discrete problems arise.…”

Section: Organized Psychologymentioning

confidence: 99%

Managed care, brief therapy, and therapeutic integrity.

Stern

1993

Psychotherapy: Theory, Research, Practice, Training

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A major cost-containment strategy of managed mental health care is the mandating of short-term psychotherapy via session limits, dollar caps on mental health benefits, and utilization review mechanisms. It is argued here that while brief therapy is a widely useful treatment modality, when it is mandated by a third party it violates the fundamental integrity of the therapeutic relationship. The construct of therapeutic integrity is defined, and the parameters vulnerable to managed care intrusions are identified. The article then examines the implications of this analysis for: (a) the practice of brief therapy; (b) training in brief therapy; (c) managed care; and (d) organized psychology.

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“…Concern for clients' welfare should always be primary and override any competition among practitioners. Austad et al (1988) suggested that mental health services might become better coordinated within these settings, since numerous professionals are available through one base of operation. They added that this coordination and integration of services can improve the quality of care.…”

Section: Professional Interactionsmentioning

confidence: 99%

The ethical practice of psychology in a managed-care framework.

Bilynsky¹,

Vernaglia²

1998

Psychotherapy: Theory, Research, Practice, Training

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With the rise of managed healthcare, psychologists face new challenges to their professional ethics. This article examines the dilemmas posed by managed care in three areas: client care; the handling of patient data; and issues surrounding membership in a managedhealthcare organization. Case examples of ethical dilemmas and strategies for dealing with these challenges are presented. In an attempt to summarize the strategies used to cope with the ethical dilemmas presented in the case examples, global solutions for the ethical practice of psychology in a managedcare framework are also reviewed. These strategies include: understanding managed-care policies, clear communication with the client, additional training, increased advocacy by clinicians, and ultimately, psychologists' involvement in the formation of these organizations.Within the United States, there has been a proliferation of managed-care insurance providers and it is believed that the number of subscribers and providers will continue to increase in the future (Austad & Hoyt, 1992). As outlined by Blum (1992), managed-care systems generally have three goals: (1) to eliminate unnecessary services, (2) reduce cost, and (3) maintain or even increase effectiveness.

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The Health Maintenance Organization: II. Implications for psychotherapy.

Cited by 14 publications

References 11 publications

Can patients specify treatment parameters? a preliminary investigation

Can patients specify treatment parameters? a preliminary investigation

Managed care, brief therapy, and therapeutic integrity.

The ethical practice of psychology in a managed-care framework.

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