Abstract
This article reports the results of an exploratory study to determine how managed care is influencing mental health practice from an inter-disciplinary perspective. Using two case vignettes, respondents were asked about how they would classify presenting problems and treatment strategies within the context of two scenarios: (1) managed care and its limitations, and (2) fee-for-service/private pay. Findings suggest that managed care has a significant influence on case assessment and treatment planning across the mental health disciplines. Although respondents did not favor adjusting treatment approaches to meet managed care expectations, they nevertheless did so. Findings also substantiate managed care's negative impact on earnings and job satisfaction. These preliminary results begin to address discipline-related cost effectiveness from the perspective of practitioner treatment choices and preferences and highlight the perceived incompatibility between preferred practice and the dictates of managed care.
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REFERENCES
Barker, R.L. (1999). Social work dictionary, 4th ed. Washington, DC: NASW Press.
Buckloh, L.M.,& Roberts, M.C. (2001). Managed mental health care: Attitudes and ethical beliefs of child and pediatric psychologists. Journal of Pediatric Psychology, 26(4), 193–202.
Cooper, C.C.,& Gottlieb, M.C. (2000). Ethical issues with managed care: Challenges facing counseling psychology. Counseling Psychologist, 28(2), 179–236.
Corcoran, K.,& Vandiver, V. (1996). Maneuvering the maze of managed care: Skills for mental health practitioners. New York: Free Press.
Davidson, T., Davidson, J.R.,& Keigher, S.M. (1999). Managed care: Satisfaction guaranteed... Not! Health&Social Work, 24(3), 163–171.
Duska, R.G. (2000). Managed care and insurance: Some ethical considerations. Journal of Financial Service Professionals, 54(5), 68–77.
Emenhiser, D., Barker, R.,& DeWoody, M. (1995). Managed care: An agency guide to surviving and thriving. Washington, DC: Child Welfare League of America.
Epstein, A.M. (1997). Medicaid managed care and high quality: Can we have both? Journal of the American Medical Association, 278(19), 1617–1621.
Galambos, C. (1999). Resolving ethical conflicts in a managed care environment. Health&Social Work, 24(3), 191–197.
Gibelman, M.,& Schervish, P. (1996). The private practice of social work: Current trends and projected scenarios in a managed care environment. Clinical Social Work Journal, 24(3), 321–338.
Gibelman, M.,& Whiting, L. (1999). Negotiating and contracting in amanaged care environment: Considerations for practitioners. Health&Social Work, 24(3), 180–190.
Gordon, S. (2000, June 15). Commentary: Perspectives on health care; HMOs fight the sick instead of the sickness. Los Angeles Times, p. B11.
Kadushin, G. (1998). Adaptations of the traditional interview to the brief-treatment context. Families in Society, 79(4), 346–357.
Kontosh, L.G. (2000). Ethical rehabilitation counseling in a managed-care environment. Journal of Rehabilitation, 66(2), 9–13.
Mechanic, D. (1997). Managed care as a target of distrust. Journal of the American Medical Association, 277(22), 1810–1811.
Mechanic, D. (2000). Managed care and the imperative for a new professional ethics. Health Affairs, 19(5), 100–111.
Mechanic, D.,& McAlpine, D.D. (1999). Mission unfulfilled: Potholes on the road to mental health parity. Health Affairs, 18(5), 7–21.
Mitchell, C.G. (1998). Perceptions of empathy and client satisfaction with managed behavioral health care. Social Work, 43(5), 404–411.
Moss, S. (1995). Purchasing managed care services for alcohol and other drug treatment. Technical assistance publication series, No. 16, Vol. III. Rockville, MD: U.S. Department of Health and Human Services Publication No. (SMA) 95-3040.
Padgett, D. (1998). Qualitative methods in social work research. Thousand Oaks, CA: Sage.
Regestein, Q.R. (2000). Psychiatrists' views of managed care and the future of psychiatry. General Hospital Psychiatry, 22(2), 97–106.
Rock, B.,& Congress, E. (1999). The new confidentiality for the 21st century in the managed care environment. Social Work, 44(3), 253–262.
Staff. (2000, January). 72 percent work for private organizations. NASW News, p. 8.
Strom-Gottfried, K. (1998). Applying a conflict resolution framework to disputes in managed care. Social Work, 43(5), 393–401.
Wieman, D.A.,& Dorwart, R.A. (1999). A comparison of public and privatized approaches to managed behavioral health care for persons with serious mental illness. Mental Health Services Research, 1(3), 159–170.
Younggren, J.N. (2000). Is managed care really just another, unethical model T? Counseling Psychologist, 28(2), 253–262.
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Gibelman, M., Mason, S.E. Treatment Choices in a Managed Care Environment: A Multi-Disciplinary Exploration. Clinical Social Work Journal 30, 199–214 (2002). https://doi.org/10.1023/A:1015249613286
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DOI: https://doi.org/10.1023/A:1015249613286