At 12:39 AM 7/15/96 +0200, you [breezey@xxxxxxxxxxxxx (Ross James
Swanston)]wrote:
[Quotation from my prior post re: training of psychotherapists deleted]
>
>I find this interesting. I am not a psychologist but I am a sociologist
>having done a study of redundancy and observed surveillance and
>normalisation as it operated on the shop floor. What further education is
>enforced or what procedures are put into place if a therapist should fall
>outside of what is expected?
There are two aspects to disciplinary process of managed care as it is
applied to psychotherapy. The first aspect has to do with the credentialing
of psychotherapists. (The openning of a case on the provider.) Information
is gathered on more than the providers' highest degree and level of
licensure, increasingly the managed care company is interested in the
provider's theoretical orientation, and information about continuing
education credits and experiences is also requested. Given the emphasis on
short-term treatment methods, providers understand that if they state that
they practice psychoanalytic psychotherapy, they risk not being included in
the network of preferred providers. Likewise, they understand that their
continuing education experience best include seminars with the proper
short-term focus. Thus, there really is no need to tell providers to get a
certain training. The examination process inherent in being credentialed
leads providers to accomodate themselves to the new norm.
The same sort of process can be seen at work in the second aspect of managed
care, utilization review. The managed care company uses case managers to
contact the clinician and gather information about each client being
treated. (Another "case" is opened.) In providing the case manager with
the formulation of the client's case and the treatment plan that is being
proposed, clinicians quickly learn that they better be able to talk the same
language that the case manager is using to formulate the case and the
treatment plan. A psychoanalytic formulation is much less likely to result
in an approval for further benefits than a formulation and treatment plan
put in the terms of one of the popular short-term approaches. Again, there
is no need to tell anyone to do anything, the very process of examination
leads to normaliztion. Clinicians will be reading the same books that they
perceive the case manager as relying on to understand psychotherapy.
John Sproule
Knoxville, TN
Swanston)]wrote:
[Quotation from my prior post re: training of psychotherapists deleted]
>
>I find this interesting. I am not a psychologist but I am a sociologist
>having done a study of redundancy and observed surveillance and
>normalisation as it operated on the shop floor. What further education is
>enforced or what procedures are put into place if a therapist should fall
>outside of what is expected?
There are two aspects to disciplinary process of managed care as it is
applied to psychotherapy. The first aspect has to do with the credentialing
of psychotherapists. (The openning of a case on the provider.) Information
is gathered on more than the providers' highest degree and level of
licensure, increasingly the managed care company is interested in the
provider's theoretical orientation, and information about continuing
education credits and experiences is also requested. Given the emphasis on
short-term treatment methods, providers understand that if they state that
they practice psychoanalytic psychotherapy, they risk not being included in
the network of preferred providers. Likewise, they understand that their
continuing education experience best include seminars with the proper
short-term focus. Thus, there really is no need to tell providers to get a
certain training. The examination process inherent in being credentialed
leads providers to accomodate themselves to the new norm.
The same sort of process can be seen at work in the second aspect of managed
care, utilization review. The managed care company uses case managers to
contact the clinician and gather information about each client being
treated. (Another "case" is opened.) In providing the case manager with
the formulation of the client's case and the treatment plan that is being
proposed, clinicians quickly learn that they better be able to talk the same
language that the case manager is using to formulate the case and the
treatment plan. A psychoanalytic formulation is much less likely to result
in an approval for further benefits than a formulation and treatment plan
put in the terms of one of the popular short-term approaches. Again, there
is no need to tell anyone to do anything, the very process of examination
leads to normaliztion. Clinicians will be reading the same books that they
perceive the case manager as relying on to understand psychotherapy.
John Sproule
Knoxville, TN