Psychotherapy in Residential Treatment: The Human Toll of Scientism and Managed Care

Abstract

SUMMARY This paper briefly reviews the intentions of some of the early founders of residential treatment centers for children, and then presents a discussion of contemporary efforts to comply with the insistence upon proof of treatment efficacy for group care and individual psychotherapy. The demands for empirical evaluation are considered in terms of the body of scientistic attacks upon the conceptual foundations of psychoanalysis and verbal psychotherapy, and in light of the historical emergence of managed care as a delimiting power in mental health care. The discussion concludes with a reconsideration of those attacks in light of contemporary refinements of psychoanalytic theory and technique, and then examines the implications of the objectivist perspective with regard to our broader conceptions of the treatment process, the human mind, and ideas about modern culture.