Psychotherapy in the Age of Accountability

Book excerpt: Mental health care is in a period of upheaval. Having sat on both sides of the table - as a clinician and as a managed care reviewer - Lynn Johnson sees managed care not as a destructive element but as a great force for quality improvement in the psychotherapy. While no one knows which delivery system will prevail when the dust settles, it is clear that to survive therapists must consistently deliver high quality interventions to a variety of clients. This book presents an integrative model of psychotherapy that discourages divisiveness and encourages a common vocabulary among therapists. The first section outlines the components of an integrative, brief/effective model of therapy, defines the role of the therapist and the patient, describes the elements of the therapeutic relationship, and sets forth the idea of focus as an invigorating and empowering therapeutic ingredient. Section II covers the crucial skills of managing time and increasing patient motivation. Therapists who master these skills are likely to cope with managed care much better than those who don't. The final section shows how the model works with the toughest cases seen in managed care: traumatized patients, substance abusers, and adolescents.