ABSTRACT
Since the mid-1980s, psychologists, as well as other mental health practitioners, have
experienced a revolutionary shift in the way their profession is practiced, financially
supported, and administratively controlled. Historically, psychologists have been
accustomed to assuming full responsibility for all treatment decisions in terms of the type
of therapy delivered, its length, and any assessment procedures utilized. Costs were
passed on to traditional indemnity payers and practitioners often had little interest or
incentive to control costs, limit services, or involve any third parties in the management
of their patients. As health care costs have continued to spiral out of control, more than
doubling the rate of inflation (Resnick & DeLeon, 1995), managed care organizations
(MCOs) have dramatically expanded, covering increasing numbers of patient lives.
Through a variety of organizational structures, MCOs have sought to address the
financial health care crisis by administering mental health benefits in the most
cost-effective manner possible, attempting to control costs while maintaining the quality
