ABSTRACT
As many practicing psychologists can attest, basic political and economic forces are
reshaping the mental health delivery system in the United States. This evolution has been
stimulated by a growing emphasis on managing how health resources are spent and who
receives them. The first generation of managed health care, with its emphasis on cost
containment strategies, will soon be accompanied by an intense focus on developing cost
and quality oriented delivery systems (cf. Cummings, 1995; Strosahl, 1996a, 1997). A
key theme in the upcoming era will be the integration of health and behavioral health
services. These currently segregated delivery systems will be pressured to merge as a way
to reduce redundant administrative and infrastructure costs as well as address consumer
demands for simpler “one stop shopping” service delivery venues (Strosahl, 1996b).
More fundamentally, integration of services will occur because there is a floor effect in
