Managed care versus psychoanalytic psychotherapy: Conflicting ideologies

Alperin, Richard M.

doi:10.1007/bf02190470

Cited by 15 publications

(8 citation statements)

References 8 publications

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“…Theorists have speculated that dependency may be associated with increased responsiveness to psychodynamic treatments, and as several writers have noted, such treatments tend to be more interpersonally focused than other therapeutic modalities, with the therapeutic alliance playing a key role. As Alperin noted, psychodynamic therapy, properly implemented, is ‘characterized by safety, security and trust’, which may be particularly helpful to dependent patients. Moreover, contemporary psychodynamic frameworks emphasize the role of internal working models and internalized representations of self and significant others in the aetiology and dynamics of pathological dependency …”

Section: Discussionmentioning

confidence: 99%

Does interpersonal dependency affect therapeutic outcome? A meta‐analytic review

Kane

Bornstein

2019

Personality & Mental Health

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This study examined whether interpersonal dependency affects therapeutic outcome, using meta-analytic techniques to synthesize results from 31 studies (49 effect sizes; overall N = 3807). High levels of dependency were associated with more positive outcome in psychodynamic therapy (r = 0.11, p < 0.05), but not cognitivebehavioural therapy (r = À0.05, ns), and were associated with a less positive outcome in pharmacological treatment (r = À0.15, p < 0.001). Other predictors of outcome included patient diagnosis (high levels of dependency were linked with more positive outcome for patients with anxiety disorders but not those with depression), outcome measure (high levels of dependency were associated with significantly greater improvement in global functioning but not symptom reduction) and dependency measure (cognitive and cognitive-behavioural dependency scales yielded less positive results than other types of measures). These results contribute to a growing body of literature examining effects of personality on treatment process and outcome.

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Section: Discussionmentioning

confidence: 99%

Does interpersonal dependency affect therapeutic outcome? A meta‐analytic review

Kane

Bornstein

2019

Personality & Mental Health

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“…These therapists are expected to focus on helping the client return to his/her previous level of functioning and to refer clients to non fee-for-services such as 12-step and other community-based programs (Alperin, 1994;Jellinek & Nurcombe, 1993). The therapist then sees the client intermittently, while the non-fee-for-service program becomes the primary locus of treatment.…”

Section: Managed Care Organization Strategies To Curtail Service Usementioning

confidence: 99%

Examining the Landscape of Managed Behavioral Health Care Through the Market Paradigm

Hall

Keefe

Csw³

et al. 2000

Journal of Nonprofit & Public Sector Marketing

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“…Alperin notes that the underlying intrapsychic conflicts, which may create symptoms responsible for clients' lessened functioning and consequently lead clients into treatment, are overlooked by managed behavioral health care organization reviewers as reasons to certify treatment. 24 Because managed behavioral health care organizations look to therapists to render short-termoriented therapy, a question emerges as to whether or not the benefits of long-term therapy surpass the benefits of short-term therapy. Herron, Eisenstadt, Javier, et al report that long-term therapy is not necessarily better than short-term therapyY Seltzer stresses that providing more intensive therapy at crucial times in a client's life would lead to successful outcomes, whereas the premature end of treatment could mean a higher potential for continued life adjustment problems, which, in turn, would lead to higher use of medical and mental health benefits.…”

Section: Certification Based On Theoretical Approaches To Treatment mentioning

confidence: 99%

Private practitioners' documentation of outpatient psychiatric treatment: Questioning managed care

Keefe

Hall

1999

The Journal of Behavioral Health Services & Research

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This study investigates how social workers, psychologists, and psychiatrists document the treatment they provide clients to managed behavioral health care organizations. The rosters of the Register of Clinical Social Workers, the American Psychological Association, and the American Psychiatric Association yielded a sample of 168 private practicing social workers, 158 psychologists, and 258 psychiatrists from across the nation. Results indicated that practitioners differed based on age, amount of time spent in private practice, racial self-identification, percentage of time with clients diminished due to communicating with managed behavioral health care organizations, and documentation of clients' prognoses. Some practitioners believe it is necessary to report treatment needs in ways to assure certification rather than in ways that accurately depict clients' clinical profiles. The ramifications for clinicians' evaluation of their own practices, reimbursement for their services, and meeting clients' needs while working under managed behavioral health care guidelines are discussed.

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Managed care versus psychoanalytic psychotherapy: Conflicting ideologies

Cited by 15 publications

References 8 publications

Does interpersonal dependency affect therapeutic outcome? A meta‐analytic review

Does interpersonal dependency affect therapeutic outcome? A meta‐analytic review

Examining the Landscape of Managed Behavioral Health Care Through the Market Paradigm

Private practitioners' documentation of outpatient psychiatric treatment: Questioning managed care

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