The entire field of healthcare has changed dramatically since the initial, unheeded warnings to the profession that behavioral healthcare was about to industrialize (Cummings, 1986; Cummings & Fernandez, 1985). The professions of psychotherapy are still reeling from the magnitude of the change that has occurred in this first wave (1985-1995) and are ill-prepared for the second wave of industrialization that is already underway. The changes that are about to occur will dwarf those of the past decade, and a critical understanding of the course and consequences of industrialization is important if any semblance of independent practice is to survive. This article will address past events and attempt an assessment of the future, even though a bruised and beleaguered profession may not yet be ready for such a reality check.