On Thu, 11 Jul 1996 07:54:57 -0400, John Sproule wrote:
>Reading Discipline and Punish, it
>seemed obvious to me how managed care, especially in the arena of mental
>health, functions as a disciplinary apparatus. Quite simply, managed care
>makes a case of each psychotherapist who contracts with the managed care
>company; data is collected on the all work delivered by that therapist,
>through telephonic and written reports; and this information is stored in
>computer data bases. This information provides a basis to examine each
>therapist to insure that they are functioning within the predetermined norm
>(e.g., prevalence of certain diagnoses, theoretical orientation, number of
>sessions per case, fees, etc.), and further education can be suggested, if a
>therapist is seen as falling outside of what is expected. Behavioral
>managed care can be thought of as the industrialization of psychotherapy
>into a nationwide service delivery system in which a single uniform product
>is to be provided. (MacTherapy anyone?)
What you say is very interesting and important, and as you say, somehow 'predictable',
it reminds me of Lacan's quarrel with the French psychoanalytic association, which peaked
over the question of the 'variable-time session'. Would it appeal to you to think about
the question of managed psychotherapy in terms of of Lacan's psycho-analysis?
Then, could you see place for organised professional opposition to this disciplining? You don't
have to espouse all of Lacan's ideosincretic baggage, but his work could provide some arguments
against this tendency: the insistance on the primacy of speech, on the discourse between the
subjects, etc. principles that would preclude some levels of standartization as
therapeutically counter-productive.
-------------
Gabriel Ash
Notre-Dame
-------------
>Reading Discipline and Punish, it
>seemed obvious to me how managed care, especially in the arena of mental
>health, functions as a disciplinary apparatus. Quite simply, managed care
>makes a case of each psychotherapist who contracts with the managed care
>company; data is collected on the all work delivered by that therapist,
>through telephonic and written reports; and this information is stored in
>computer data bases. This information provides a basis to examine each
>therapist to insure that they are functioning within the predetermined norm
>(e.g., prevalence of certain diagnoses, theoretical orientation, number of
>sessions per case, fees, etc.), and further education can be suggested, if a
>therapist is seen as falling outside of what is expected. Behavioral
>managed care can be thought of as the industrialization of psychotherapy
>into a nationwide service delivery system in which a single uniform product
>is to be provided. (MacTherapy anyone?)
What you say is very interesting and important, and as you say, somehow 'predictable',
it reminds me of Lacan's quarrel with the French psychoanalytic association, which peaked
over the question of the 'variable-time session'. Would it appeal to you to think about
the question of managed psychotherapy in terms of of Lacan's psycho-analysis?
Then, could you see place for organised professional opposition to this disciplining? You don't
have to espouse all of Lacan's ideosincretic baggage, but his work could provide some arguments
against this tendency: the insistance on the primacy of speech, on the discourse between the
subjects, etc. principles that would preclude some levels of standartization as
therapeutically counter-productive.
-------------
Gabriel Ash
Notre-Dame
-------------