Providers’ and payers’ endorsements of empirically supported therapy: A power–knowledge relationship?

Abstract

Abstract The promotion of empirically supported therapies (ESTs) has been prompted in part by the need to meet perceived demands of 3rd-party payers. Yet little communication has occurred between psychologists and payers as to how decisions regarding treatment are made. In this study, providers of psychological treatment and representatives of the insurance industry were interviewed about their views on this topic. Transcriptions of the interviews were analyzed using an approach derived from the grounded-theory method. In addition to the expected influence by payers on providers for lowered costs and “objective” outcomes, it was evident that both payers and providers were influenced by providers’ promotion of cognitive–behavior therapy as an EST. The respective practices of providers and payers were interpreted to constitute a complex matrix of joint influence. In light of the literature suggesting little compelling evidence for the exclusionary claims made for ESTs, the relevance of Foucault's notions re...