Psychoanalytic Therapy as Health Care

In Psychoanalytic Therapy as Health Care, a timely and trenchant consideration of the clash of values between managed care and psychoanalysis, contributors elaborate a thoughtful defense of the therapeutic necessity and social importance of contemporary psychoanalytic and psychodynamic approaches in the provision of mental health care. Part I begins with the question of where psychoanalytic treatments now stand in relation to health care; contributors offer explanations of the current state of affairs and consider possible directions of future developments. Part II looks directly at the conundrums that have resulted from the attempt to integrate psychotherapy and managed care, with contributors examining the ethical and legal dimensions of confidentiality, privacy, and reporting to third parties. Part III opens to wider consideration of the experiences of psychoanalysts under health care systems throughout the world. Finally, Part IV demonstrates the relevance of contemporary psychoanalytic approaches to a variety of contemporary patient populations, with contributors focusing on the applicability of analytically oriented treatment to AIDS patients, seriously disturbed young adults, and inner-city clinic patients. Collectively, the contributors to Psychoanalytic Therapy as Health Care convincingly refute the claim that psychoanalytically informed therapy is an esoteric treatment suited only to the "worried well." Drawing on a wide range of clinical and empirical evidence, they forcefully argue that contemporary psychoanalytic approaches are applicable to seriously distressed persons in a variety of treatment contexts. Failure to include such long-term therapies within health care delivery systems, they conclude, will deprive many patients of help they need - and help from which they can benefit in enduring ways that far transcend the limited treatment goals of managed care.

Harriette Kaley, Ph.D., is Professor Emerita and Adjunct Professor, Brooklyn College, City University of New York Graduate School Psychology Program. She is currently in private practice in New York City. Morris Eagle, Ph.D., is Professor, Derner Institute of Advanced Psychology Studies, Adelphi University, Garden City, New York. He is also Faculty, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. David L. Wolitzky, Ph.D., is Director, New York University Psychology Clinic and Faculty, Department of Psychology, New York University, and former Director, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis.

Kaley, Eagle, Wolitzky, Introduction. Part I: Psychoanalysis and Health Care: Present Problems and Future Prospects.Welch, Psychoanalysis in the Political Arena: The Reality Principle. Bernay, Life After Health Care Reform: A Clinical Solution for Psychoanalysis. Barron, Managed Care and the Denial of Subjectivity. Moldawsky, Is Psychoanalysis Health Care? The Affirmative Position. Hyman, Why Psychoanalysis Is Not a Health Care Profession. Lionells, Psychoanalytic Education in the Age of Managed Care: Staying Alive in Shark-Infested Waters. Cantor, "There Is a Future for Professional Psychology." Part II: Legal Issues: Privacy and Confidentiality.Sundelson, Restoring the Confessional: Reporting Laws and the Destruction of Confidentiality. Cummings, Psychoanalysis Under Managed Care: The Loss of Analytic Freedom. Newman, Privacy and Confidentiality: Issues in Psychoanalysis in the 90s. Part III: International Perspective.Willock, Balzert, Fayek, & Abraham, National Health Insurance Coverage of Psychoanalysis and Psychotherapy: An International Review Highlighting Some Current Problem. Spielman, Psychoanalysis and Health Care in Australia: Health Care Budget Cuts Affect Psychoanalysis. Part IV: Current Issues and Special Populations.Doidge, Who Is in Psychoanalysis Now? Empirical Data and Reflections on Some Common Misperceptions. Blechner, Psychoanalytic Approaches to the AIDS Epidemic. Blatt, Ford, The Effectiveness of Long-Term, Intensive Inpatient Treatment of Seriously Disturbed, Treatment-Resistant Young Adults. Plakun, Managed Care Discovers the Talking Cure. Altman, Psychoanalytic Perspectcives on Clinical Work in the Inner City. Kaley, Eagle, Wolitzky, Epilogue.