Publication Date


Document Type

Masters Thesis


School for Social Work


Managed mental health care-Evaluation, Social workers-Attitudes, Therapeutic alliance, Psychotherapist and patient, Social workers, Perceptions, Managed care, Effects on therapeutic relationship


The purpose of this study is to explore social workers' perceptions of the impact of managed care on their work with clients. The thesis question is "What are clinical social workers perceptions of the impact of managed care on practice?" Included in this question are social workers' perceptions of the impact of managed care on their therapeutic relationships with clients, their effectiveness and autonomy, helpful support systems when interacting with managed care organizations, ethical issues including confidentiality and issues of social justice, assessment, implementation of the treatment plan - including the time frame of treatment and choice of treatment modality, and assignment of the mental health care provider. There were 12 participants in this qualitative study. Five of the participants worked in agency settings, and seven of the participants worked in private practice settings. All of the participants expressed the feeling that managed care negatively impacts their work with clients, specifically the therapeutic relationship. Participants discussed several factors that influenced the therapeutic relationship, but control over the treatment process emerged as the overarching factor. Participants related grappling with the issue of how one maintains control when a third party is involved in the treatment. The answer for many participants was to be proactive in finding constructive ways to positively impact treatment decisions through interactions with clients, other workers, and managed care representatives.




iii, 66 p. Thesis (M.S.W.)-Smith College School for Social Work, Northampton, Mass., 2011. Includes bibliographical references (p. 57-59)