ENTERING THE NEW FRONTIER OF MANAGED MENTAL-HEALTH-CARE - GOLD-MINES AND LAND MINES

This article examines issues that behavior therapists must address as they adapt to the new and complex trends of managed mental health care. The origins of the managed health care movement are reviewed. Major shifts in clinical practice will occur in four primary areas: viewing both the client and payer as ''customers,'' accepting accountability for clinical outcomes, providing efficient, empirically based care, and accepting the technical and ethical challenges of being both cost conscious and quality focused. Behaviorally trained clinicians and researchers will have many potential advantages working in the era of managed care. To capitalize on their background strengths, behavior therapists must learn to work with and not against managed care systems, learn the language necessary to have constructive, change-oriented dialogues with managed care executives, and learn to conduct ''field based'' research to answer important questions about the clinical efficacy and cost efficiency of behavioral interventions. Finally, the behaviorally trained clinician should try to find the right ''fit'' between practice style preferences and choice of managed care setting.