Managed health care, ethics, and psychotherapy

Clinical psychologists express major concerns about the interplay of managed care, psychotherapy, and professional ethics that center around issues of quality, quantity, and continuity of care; patient-provider autonomy; patient abandonment; third-party intrusiveness; guidelines, outcome research, utilization review; malpractice; confidentiality; truth in advertising; and allocation of resources. To guide psychologists working in today's ever-changing health care system the current code of ethics needs revision to encourage use of accurate, empirical standards to study health care delivery; determination of psychotherapy as an entitlement ora business; distinguishing between necessary and discretionary psychotherapy; and articulating a clear-cut social ethic that would assure fair and equal access to needed therapy for all.