The adaptive practice of psychotherapy in the managed care era.

Managed care is the current state of health care delivery. How to respond to managed care's provider expectations is the key issue for all mental health care professionals. The adaptive response, based on managed care's definition of value and regardless of theoretic orientation, must be clear and definitive in terms of what the provider will do; why the provider will do it; how the provider will specifically achieve patient relief; and how the provider, patient, and managed care representative will know when that change has been achieved. In the managed care era, clinicians must satisfy patients, managed care representatives, and themselves by producing a valid and effective treatment product for all parties involved in the interplay of mental health care delivery.