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'Provides a useful insight into the revolution that has taken place in psychotherapy practice in the United States' - Michael Maltby, The Journal of Critical Psychology, Counselling and Psychotherapy In an age when psychotherapists are subjected to cost-saving measures which run counter to their wish to optimize care for their clients, this book is particularly timely. After chapters on the mechanics of cost containment and the clash between cost containment and client care, the author shows practitioners how to live with the enemy and to provide psychotherapeutic care in these adverse circumstances.