Meaning vs. medical necessity: Can psychoanalytic treatments exist in a managed care world?

Journal/Book: Psychotherapy. 1997; 34: 3900 E Camelback Rd #200, Phoenix, AZ 85018. Amer Psychological Assoc, Div Psychotherapy. 115-123.

Abstract: With more and more insured employees covered by behavioral managed-care organizations (MCOs), psychoanalytically oriented practitioners are confronted with the dilemma of trying to deliver meaning-based treatments in a medical-necessity setting. Like many psychoanalytic dilemmas, resolution requires an appreciation of the situation from the perspective of the other, that is, understanding health care from the perspective of the employer. Based on experiences as a case manager, the author specificially suggests the importance of understanding 1) that the medical necessity standard requires distinguishing health care from growth experiences; 2) population as well as patient needs; 3) four reasons why psychoanalytically oriented clinicians are not popular with payers and vice versa. Supported by vignettes, clinical experiences, and literature, some specific recommendations are presented for analytic clinicians which might allow for less frustrating interactions with the healthcare system.

Note: Article Schwartz J, 27 W 72ND St, Ste 1105, New York,NY 10023 USA

Keyword(s): HEALTH-CARE; PSYCHOTHERAPY; SERVICES

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