Mona Cardell, Ph.D.        Licensed Psychologist

      Providing Affordable Feminist Psychotherapy in the Philadelphia Region

HMO's and Mental Health:
Why Not Use My HMO for Therapy?

As anyone who has tried to go through an HMO to get therapy has discovered by now, it'a hard to get your counseling or mental health needs met through the "managed care" system. Many HMO's require onerous pre-authorizations for psychotherapy, and experiences such as getting told you can have 4 or 8 or 12 sessions to see a psychotherapist are all too common.  In keeping with the short-term nature of the "managed care" approach to mental health, clients and therapists will often be encouraged to focus the treatment on very narrow, concrete goals (e.g., "make three new acquaintances within the next two months"), rather than to look at any long-term underlying issues (e.g., "how can I deal with my history of sexual abuse so I can get closer to people in ways that are healthy for me?")  While there are some good therapists who work for HMO's, it's sometimes hard for a client to find one who's right for her. It's not unusual for a client seeking therapy through an HMO to be assigned to a therapist with minimal training or experience, or to a therapist who doesn't understand her issues or her lifestyle.

Perhaps the most insidious problem plaguing psychotherapy as administered by HMO's is the loss of the confidentiality that is so important in order for therapy to be a safe place to explore areas of difficulty. The loss of confidentiality occurs because HMO "case managers" demand treatment plans and progress reports at regular intervals, in order to make decisions about whether or not they will authorize further treatment. They also use these reports to help them decide whether or not the individual receiving therapy should be sent to a doctor for medication, or "terminated" because therapy is no longer "medically necessary."

Because of the major problems regarding confidentiality and control over the course of therapy which are posed by HMO networks, I cannot recommend their use for obtaining psychotherapy services. 

Web Hosting Companies