VIABILITY OF BEHAVIORAL AND PSYCHOANALYTIC THERAPIES IN THE
Definition of Managed Care and Trends in Managed Care
Managed care consists of diverse prepaid health plans or insurance programs in which enrollees receive medical services in a manner designed to eliminate unnecessary services and their attendant costs (Raffel & Raffel, 1994). A key factor in managed care that highlights it as radically different from the traditional doctor-patient approach to treatment is that cost-effectiveness goals increasingly involve health care purchasers (e.g., employers, government, insurance companies) in treatment decision-making---a fact that has lead to the charge that it is not maximal treatment that is the major concern in managed care programs for the ill in general and the mentally ill in particular but rather the minimization of treatment costs (Stanhope, 1994).
Given the foregoing, the question can be asked as to what constitutes maximal or optimal treatment decisions regarding the selection of psychotherapy models and modalities for mentally ill patients? In particular, it seems reasonable to wonder as to the viability of two major contemporary psychotherapy approaches to the treatment of the mentally ill, approaches that differ in structure, underlying theory, and treatment strategies. These are the approaches of psychoanalysis and behavioral therapy? Regarding the judgement of viability, three dimensions can be considered: treatment efficacy, time constraints, and costs.
Treatment Efficacy Considerations. According to many behavioral scientists and researchers, behavioral therapy is to be preferred over psychoanalytic approaches in the managed care setting because, unlike the psychoanalytic approach, behavioral treatment has concrete and measurable outcomes for success (Sue, Sue & Sue, 1994). In other words, for behavioral therapies and not psychoanalytic therapies, treatment efficacy can be specified and assessed...