Clinical Necessity Guidelines for Psychotherapy, Insurance Medical Necessity and Utilization Review Protocols, and Mental Health Parity

Journal of Psychiatric Practice
Susan G LazarFrank Yeomans

Abstract

The founding members of the Coalition for Psychotherapy Parity present Clinical Necessity Guidelines for Psychotherapy, Insurance Medical Necessity and Utilization Review Protocols, and Mental Health Parity. These guidelines support access to psychotherapy as prescribed by the clinician without arbitrary limitations on duration or frequency. The authors of the guidelines first review the evidence that psychotherapy is effective, cost-effective, and often provides a cost-offset in decreased overall medical expenses, morbidity, mortality, and disability. They highlight the disparity between clinicians' knowledge of generally accepted standards of care for mental health and substance use disorders and the much more limited "crisis stabilization" focus of many insurance companies. The clinical trials that health insurers cite as justification for authorizing only brief treatment for all patients involve highly selected, atypical populations that are not representative of the general population of patients in need of mental health care, who typically have complex conditions and chronic, recurring symptoms requiring ongoing availability of treatment. The standard for other medical conditions reimbursed by insurance is continuation of...Continue Reading

References

Mar 1, 1992·The American Journal of Psychiatry·J Stevenson, R Meares
Dec 1, 1991·Archives of General Psychiatry·M M LinehanH L Heard
Jun 1, 1990·Archives of General Psychiatry·M Zimmerman, W H Coryell
Feb 1, 1986·The American Psychologist·K I HowardD E Orlinsky
Oct 10, 1986·JAMA : the Journal of the American Medical Association·W G ManningJ E Ware
Jan 1, 1986·Journal of Psychiatric Research·P R Casey, P J Tyrer
Nov 16, 1995·The New England Journal of Medicine·M F Shapiro, N S Wenger
Dec 1, 1995·The American Psychologist·M E Seligman
Mar 1, 1996·The American Journal of Psychiatry·T M WickizerK M Travis
May 1, 1997·Health Affairs·A Milstein
Jan 8, 1999·The Milbank Quarterly·M A SchusterR H Brook
Aug 24, 1999·Journal of Occupational and Environmental Medicine·T M WickizerG Franklin
Sep 14, 1999·The Australian and New Zealand Journal of Psychiatry·R MearesA Comerford
Sep 14, 1999·The Australian and New Zealand Journal of Psychiatry·J Stevenson, R Meares
Oct 26, 1999·Archives of General Psychiatry·R F Krueger
Jul 20, 2000·International Journal of Psychiatry in Medicine·M P LuberM E Charlson
Sep 27, 2001·Psychosomatic Medicine·E Y DeykinK Creamer
Mar 23, 2002·Annual Review of Public Health·Thomas M Wickizer, Daniel Lessler
Jun 19, 2003·JAMA : the Journal of the American Medical Association·Ronald C KesslerUNKNOWN National Comorbidity Survey Replication
Nov 15, 2003·Proceedings of the National Academy of Sciences of the United States of America·Charles B NemeroffMartin B Keller
Nov 20, 2003·Journal of Anxiety Disorders·Jonathan D HuppertJonathan R T Davidson
Jun 9, 2005·Archives of General Psychiatry·Ronald C KesslerEllen E Walters
Nov 9, 2005·Journal of Personality Disorders·Andrew E SkodolRobert L Stout
Nov 24, 2005·Journal of Psychiatric Practice·Andrew E SkodolThomas H McGlashan
Feb 22, 2007·Psychological Medicine·Giovanni A FavaCarlotta Belaise
Mar 6, 2007·The Journal of Clinical Psychiatry·John C MarkowitzThomas H McGlashan
Jun 2, 2007·The American Journal of Psychiatry·John F ClarkinOtto F Kernberg
Dec 22, 2007·Harvard Review of Psychiatry·Saskia de MaatFrans De Jonghe
Jun 3, 2008·The British Journal of Psychiatry : the Journal of Mental Science·Antoinette D I van AsseltJohan L Severens
Jul 22, 2008·The Psychiatric Clinics of North America·Mark F Lenzenweger
Oct 2, 2008·JAMA : the Journal of the American Medical Association·Falk Leichsenring, Sven Rabung
Dec 24, 2008·The Journal of Behavioral Health Services & Research·Elizabeth L MerrickMaureen T Stewart
Feb 12, 2009·Harvard Review of Psychiatry·Saskia de MaatJack Dekker

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Citations

Aug 28, 2020·Current Opinion in Psychology·Kiana WallCarla Sharp
Dec 11, 2019·Journal of Psychiatric Practice·Eric M Plakun, Renata M Villela

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