Ronald Reagan's presidency in the 1980s saw a philosophical shift on the federal level from the public commitment of the Great Society programs toward privatization of public services and individual solutions to problems (Abramovitz, 1986; Arches, 1991; Binner, 1988; Kamerman & Kahn, 1989; Palmer & Sawhill, 1984). In Massachusetts, budget cutbacks and privatization of social services have accelerated under Republican Governor William Weld (Beacon Hill Institute, 1992). In January 1992, Health Pro, a private company, took over assessing all claims for the Emergency Relief for the Elderly, Disabled and Children Program (formerly known as relief). The fiscal year 1992 budget for the program was cut 23 percent, denying services to 10,000 former recipients (Much Pain, 1992). At the same time, a managed care system took over Medicaid services, and the Medicaid budget was reduced by $395 million, disqualifying 9,000 clients (Much Pain, 1992). Many definitions and forms of privatization exist. Privatization generally means the transfer of government services from the public sector to private resources. This process includes divesting state-owned enterprises, raising user fees, allowing the private sector to provide services either in place of or in competition with government, and contracting out service delivery to private firms through a competitive bidding process (Beacon Hill Institute, 1992; Berg, cited in Goodrich, 1988; Bill Restricts, 1993; Schlesinger, Dorwart, & Pulice, 1986). Privatization of social services has meant a greater role for private enterprise in a scaled-down welfare state (Abramovitz, 1986). The Massachusetts experience is relevant for people in other states, because privatization and reductions in funds for social services continue to be trends throughout the United States. The authors conducted a qualitative study to examine social worker and client impressions of changes in agency policy and service delivery in Massachusetts from September 1991 to May 1992. The results presented here contribute to an in-depth understanding of cutbacks and privatization from the perspective of professional social workers, a perspective that has not been well documented in the literature. Such data are important to ensure the validity of the accumulated knowledge base of social services delivery during these politically conservative times. A future large-scale, quantitative study requires the richness and fullness of understanding presented here. Literature Review The 1980s saw an increase in the centralization of departments and in the size of catchment areas for emergency services (Scherl & Schmetzer, 1989). Case management, day treatment, and residential services were substituted for more costly clinical services (Jerrell & Larsen, 1986) such as prevention and outreach (Jerrell & Larsen, 1985; Larsen, 1987; Wineburg, Sparks, & Finn, 1983), consultation and evaluation (Larsen, 1987), and direct services (Terrell, 1981). Hospitalizations of mentally ill people increased (Jerrell & Larsen, 1986; Larsen, 1987; Runck, 1984; Searight, Handal, & McCauliffe, 1989; Scherl & Schmetzer, 1989; Suber, Shumway, Shadoan, & Harbreaves, 1986; Wineburg et al., 1983), and the number of inpatient beds decreased (Searight et al., 1989). An accompanying trend is the reduction of professional social work services in favor of managed care provisions. Utilization review procedures, both for Medicaid (Suber et al., 1986) and private insurers, particularly health maintenance organizations, have resulted in treatment time limits replacing clinical judgment (Borenstein, 1990). Also, by the mid-1980s there was a significant shift away from education and prevention services (Jerrell & Larsen, 1985). Social workers have reported a higher level of burnout and lowered morale in general (Arches, 1991; Baldwin, 1990; Ebben, Bliss, & Perlman, 1991; Jerrell & Larsen, 1985; McNeely, 1988; Wineburg et al. …