ABSTRACT
A public health paradigm wants to offer cost-effective, mass-oriented ways of helping families who want and need professional help. A private practice paradigm offers fee-for-service only to families who can afford it. Psychotherapy, as presently practiced with individuals, couples, and families, cannot deal with the number of people that need some kind of help. Cost-effective will mean also relying either on intermediary paraprofessional personnel or mechanical devices to minimize the high cost of professional time. Subjective opinions must be verified; otherwise, the field of family therapy will continue to rely on personal, idiosyncratic beliefs and opinions unsubstantiated by objective evidence. Managed-care companies have been reviled for their stress on this criterion from many mental health professionals. Creation of workbooks finds its historical roots in teaching machines and programmed instruction. The Internet is fast becoming an alternative source of service delivery in the mental health field.
