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Breaking Free of Managed Care

A Step-by-Step Guide to Regaining Control of Your Practice

Dana C. Ackley

August 11, 1999
ISBN 9781572305243
Price: $39.00
317 Pages
Size: 6" x 9"
Copyright Date: 1997

Providing therapists practical solutions to managed care's erosion of their freedom to practice, this book presents a working blueprint for a private-pay psychotherapy practice. Dana C. Ackley casts out the distortions that have crept into many clinicians' thinking as a result of reliance on third-party reimbursement. Based on his own experience, he shows how you can serve clients—and yourself—better by developing real alternatives to the pressures and bureaucracy of managed care. In clear step-by-step detail, including practical exercises and checklists, sample marketing materials, and payment plans, the volume shows you how to: No matter what your clinical style, theoretical orientation, or practice history, you will benefit from the hard-won lessons Dr. Ackley shares in this book.

“Ackley provides creative solutions to difficult situations, and does so as any good therapist shouldin a nonthreatening yet challenging way.”


“Enlightening, energizing, and redeeming.”

The Pennsylvania Psychology Quarterly

“I converted a heavily managed care-dependent practice to one that is 90% managed care-free in one year, using principles from Dr. Ackley's book.”

—Robin Sesan, PhD, Clinical Psychologist, Wilmington, Delaware

“A unique contribution for mental health practitioners inundated by scares of managed care. Dr. Ackley begins with an excellent reminder of why we are in the helping professions and how we have gotten embroiled in the health-care morass. He is careful to not assume his solutions will automatically work for others and provides tools for self-assessment and customizing a plan for any clinician. Finally, in this thoroughly readable and enjoyable work, he provides enough 'nuts and bolts' to actually build a practice.”

—Richard F. Small, PhD, Director, Spring Psychological Associates; Past President of the Pennsylvania Psychological Association; Author, Maximizing Insurance Reimbursement in your Mental Health Practice

“Finally— a worthwhile marketing book for psychotherapists! With deep commitment to his calling, Ackley documents the tremendous value of psychotherapy. Then in a very readable and no-nonsense style, he leads psychotherapists step-by-step through the process of liberation from third parties. The therapy marketing information is excellent. The application of mental health expertise to the American workplace is inspiring. Every psychotherapist who is weary of third-party interference should read this very practical book, and every clinical training program should include it in its curriculum.”

—Janet E. Pipal, PhD, PC

“I especially enjoyed reading Dr. Ackley's book, Building A Managed Care-Free Practice. This is a much needed breath of fresh air to counter the doom and gloom psychotherapists have been feeling. The book is loaded with real life examples showing the need for and benefit of a managed care free practice. Ackley provides numerous charts, exercises, and worksheets to guide the reader through developing such a practice. I teach his model to our doctoral students and I have been using Dr. Ackley's model in my own practice. It works just as he suggests in his book.”

—Marc I. Oster, PsyD, ABPH, Adler School of Professional Psychology

“Dr. Ackley's book comes to our rescue with absolutely crucial 'tools' to enable psychotherapists to flourish in an era dominated by the irrational and nonclinical constraints imposed by managed care. Like the best psychotherapy, he offers new information, an example of success (his own practice), and practical advice and guidance based on his extensive experience in adapting and helping others to adapt to the current environment....If you feel the need to take your independent practice into the future, there is no better guide to that journey than this book.”

—From the Foreword by Edward L. Zuckerman, Ph.D., Series Editor, The Clinician's Toolbox

“Reading Breaking Free of Managed Care is like sitting with 'the Carl Rogers of the year 2000 AD' —wisdom, clarity, and respect abound, along with a compendium of 'killer-resources' for marketing that fits like an 'old, worn shoe.' No jargon, no 'snake oil'—not even the word 'mindfulness' appears in this cutting-edge, mindful book. Get ready to simply 'be where the client is,' the most reliable indicator of a good therapist we have ever known. And get ready to see your practice grow and to feel your professional self-esteem rise, as you see that 'you have all that it takes', with Ackley's book to guide you.”

—Monda Sue Freeman, LICSW, Vice-President, Massachusetts Academy of Clinical Social Work

Table of Contents


I. Looking Beyond Managed Care

1. Descent, Recovery, and Our Future

2. Restoring Professional Self-Esteem, Rediscovering Our Value

3. The Business of Practice

4. Conceptual Changes We Must Make

II. How to Build a Private Pay Therapy Practice

5. The Fundamental Strategy

6. How to Learn from Your Market and Where That May Lead

7. Planning the Business of Your Practice

8. How to Market Traditional Services

III. Diversifying Your Services: Taking Your Skills to the Workplace

9. New Applications for Your Skills: People-Consulting in the Workplace

10. Learning from Those in the Workplace and Where That Can Lead

11. Making a Business Plan for People-Consulting in the Workplace

12. Marketing and Selling to Business


Appendix: Resources

About the Author

Dana C. Ackley, PhD, is a clinical psychologist in independent practice in Roanoke, Virginia. Unwilling to join managed care panels, he has developed a model for practicing outside third party reimbursement. His approach has been featured in the Family Therapy Networker, the National Psychologist, and Practice Strategies. His workshop has been sponsored by APA's Division 42, the Colorado Psychological Association, the Ohio Psychological Association, and NCS Assessments, as well as by therapist groups in Maine and Idaho.


Psychotherapists and trainees, regardless of clinical style, theoretical orientation, or practice history, who seek real alternatives to the pressures and bureaucracy of managed care.