Continuous psychotherapy within an HMO.

The authors describe the long-term psychotherapy program developed by the Harvard Community Health Plan, focusing on its planning, implementation, and monitoring. The inclusion of coverage for chronic conditions in an HMO practice led to the development of a range of extended treatment services, exploratory as well as supportive, and to the enhancement of short-term methods. The control of utilization and cost is effected through the willingness of the provider group to adapt treatment methods to patient needs, rather than through the benefit structure. With the broad range of treatment methods available in this plan, only 1%-2% of patients require long-term continuous psychotherapy.