PSYCHOLOGICAL INTERVENTIONS IN THE ERA OF MANAGED COMPETITION

The importance of psychological treatments in forthcoming national health care plans has been deemphasized in federally sponsored clinical practice guidelines published to date, and questioned by certain policymakers and consumer groups. Many critics impugn the clinical efficacy and effectiveness of psychological treatment compared to drug treatments. This article reviews evidence suggesting that psychological interventions from a variety of theoretical perspectives have demonstrated effectiveness for a wide range of disorders-either alone or, in some cases, in combination with medications. In most cases these treatments are more effective and often longer lasting than credible alternative psychological interventions serving as ''psychological placebos.'' Political and public relations issues, as well as problems with dissemination, must be overcome if the public is to benefit fully from powerful and effective psychological interventions in any national health care plan.