ABSTRACT
Let us turn back the clock to the late 1950s and early 1960s and magically recall what the delivery of mental health services was like. Psychiatry was well established, psychology was flexing its muscles and growing rapidly, and social work was well respected, but very few social workers were in the private practice of psychotherapy as were psychiatrists and psychologists. Counselors and marriage/family therapists did not yet exist as independent professions, and there was a shortage of psychotherapists as Americans clamored for services. No one could even conceive of what later came to be known as managed care, for psychotherapy was a stated exclusion in health insurance policies. Paying out of pocket did not deter prospective patients, as fees were nominal: $15 per 50-minute hour for established psychiatrists and $10 for emerging psychologists.
