ABSTRACT
The advent of managed care has called into question virtually all of the assumptions about client needs and treatment modalities that have formed the basis of traditional approaches to alcohol-related problems. Many treatment providers initially responded to newly implemented utilization review and cost containment processes by expressing the fear that they would no longer be able to provide the intensive, long-term services that some clients needed. As one experienced practitioner put it, “For addicts in publicly supported treatment programs, managed care just means how to manage without care” (D. Deitch, personal communication, 1994). This fear has some basis in fact because managed care protocols do encourage brief, focused interventions at the expense of strategies aimed toward the total life change that some patients require. If adequate care for clients with multiple special needs is assured, however, managed care may also provide the opportunity for a sorely needed revamping of alcohol treatment methods.
