Abstract

Four managed care psychotherapists were interviewed about their perceptions of contracting with managed care companies. Two specific questions were asked of each study participant that stressed the positive supportive and non-supportive characteristics and features while working with the contracting organization. Using the phenomenological psychological method, data were reduced to the essential constituents that described the typical, lived experiences of all participants. The intent of the study focused on the participants’ view of organizational support when organizational policy and interactions influenced the practice of psychotherapy. Results show that there is one essential constituent of positive support and four constituents of non-supportive situations. The positive support feature was described as participants learning to foster informal relationships with those affiliated with the organization external to the organizational policy as to benefit clients; frequently in the areas of re-certification and utilization review. It is determined that organizational policy is generally perceived as rigid when it comes to serving clients effectively, particularly when clients issues surface suddenly or when clinical needs dictate additional therapy. This study confirms certain previous research about the general attitudes of psychotherapists and managed care; it also allows the participants to define “effective therapy” as practiced in the real-world setting and generating new information vital to understanding how psychotherapy clients can benefit from managed care organizational improvements and changes.

Chapter 1
INTRODUCTION
1.1 Overview of the Problem