THE PROMISE AND PROBLEMS OF PSYCHOTHERAPY-RESEARCH IN A MANAGED CARE SETTING

Psychotherapy research in managed health-care settings is discussed. I nvestigations of the relationships between amount of therapy and subse quent outcome adjusted by such patient characteristics as diagnosis, i ndicators of illness chronicity and severity, and social support marke rs are well suited to these settings. In addition, research on the eff ectiveness of treatment guidelines, treatment manuals, alternative the rapies, and alternatives to therapy is likely to be conducted in these companies resulting in potentially important applied results. Finally , investigations dealing with the selection and training of therapists and care managers would seem to be particularly relevant in managed c are. Problems associated with the conduct of research in these setting s are presented including lack of experimental control, demand charact eristics, and the effects of business decisions on the collection and dissemination of data. On balance we conclude that managed healthcare organizations will be an important future source of naturalistic studi es on the effects of psychotherapy.