Remarks and Reflections on Managed Care

Abstract The New Jersey Psychological Association surveyed New Jersey psychologists in late 1996 about the impact of managed care on the practice of psychology. Four statements: (SI) My morale and professional identity have changed; (S2) I have changed my approach to therapy; (S3) I have felt pressure to change the quality of care I deliver; and (S4) I have felt pressure to compromise my ethical principles were presented for open-ended responses. Ninety-three to ninety-six percent of psychologists who responded Yes to managed care having affected their practices provided codable comments. Analysis of the codable Yes comments yielded responses emphasizing: loss of control over decision making (SI); excessive emphasis on brief treatment (S2); superficial approach to therapy (S3); and intrusions into confidentiality (S4). The implications for the practice of psychology highlight three key areas where action is needed: professional ethics, funding and coverage, and accountability.