Psychodynamics and managed care: the art of the impossible?

Many mental health providers believe that psychodynamic psychotherapy under managed care is virtually impossible. Notwithstanding the many adversities posed by managed care, there are ways to productively apply psychodynamic principles within this health care financing system. This paper critically discusses the possibilities and costs of conducting psychodynamic psychotherapy under managed care using theory, practice applications, and a case vignette. Central to the discussion is elaboration of five central differences between traditional psychodynamic treatment versus that conducted under managed care.