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Transference and Countertransference in a Third-Party Payment System (HMO)
SIDNEY S. GOLDENSOHN; ESTHER HAAR
Am J Psychiatry 1974;131:256-260.
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Director of Mental Health Services of the Health Insurance Plan of Greater New York, 625 Madison Ave., New York, N. Y. 10022

Fellow and Faculty Member, William Alanson White Institute of Psychiatry, Psychoanalysis, and Psychology, New York, N. Y.

1974, The American Psychiatric Association

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Abstract

The authors discuss the transference and countertransference reactions characteristic of a mental health service in a health maintenance organization. Among the transference issues considered of greatest interest are responses to payment premium rather than fee-for-service; attitudes toward the limited duration of treatment and the circumscribed return-to-function goals; reactions to the therapist and to the HMO as authorities; and the effects of being a clinic patient on one's self-image. The countertransference issues considered most significant include reactions by the therapist to being salaried rather than receiving fees for service; responses to self-exposure, peer review, and quality control; and alterations of the therapist's self-image related to such factors as his value system, cultural milieu, and therapeutic orientation.

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