Will managed care change our way of being?

The authors studied psychotherapeutic practices commonly used in managed care settings and the theories and rhetorical strategies that justify them to speculate about if or how they are beginning to influence societywide understandings about the proper way of being human at the turn of the millennium. The practices--and effects--of managed care regulations on the self are interpreted by studying how the patient, the therapist, and the therapeutic relationship come to light in managed care settings. These categories are then used to speculate about the configuration of the newly emerging, 21st-century self. By extending hermeneutic concerns about instrumentalism and technicism, the authors suggest a new way of thinking about psychotherapy modeled less on positivist science and more on moral discourse. Finally, given this more hermeneutic understanding of psychotherapy, the authors speculate about alternative conceptions and arrangements of care.