About 85 percent of all dollars for mental health care is managed by a dozen large specialty companies hired by your health insurer. They usually decide the type and length of treatment a therapist can provide. But you can still exert control over your care by doing the following:
* If you and a therapist think more treatment is needed, you can appeal. Appeals can be worth it -- management companies revise their formulas for treating people based on real cases. * When signing up for health care, ask to see the list of providers offered by the company that will manage the mental health part of your coverage. A longer list ensures more choice. Ask around for the reputation of the management company. Ask therapists whether they are approved providers for the company and if not, why.
* Get a second opinion. Consider paying extra for psychological tests if your therapist recommends them but the insurer won't cover them.
* Be aware that your therapist's decisions are guided by a set of clinical protocols originating with the specialty company hired by your medical insurer. Don't assume you can't benefit from continued treatment when your therapy is over.
A recent survey by Consumer Reports found that psychiatrists, psychologists and social workers received equally high marks from their patients. Also, one-third of the respondents went to group therapy and found it helpful.
The survey found that the longer people stayed in therapy, the better they seemed to do. People whose coverage limited the length of therapy or type of therapy reported worse outcomes, according to the survey.