Few questions in psychotherapy are of greater importance than the relationship among practitioners, researchers, and managed care. The present and future roles of psychotherapy are covered here. Despite ample evidence that psychotherapy does work, its effectiveness continues to be questioned. When psychotherapy research emerged some 50 years ago, researchers sought to understand patient-therapist dynamics, the nature of treatment outcomes, and the isolation of the effective ingredients in the therapeutic encounter. However, in the 1970s, people demanded greater accountability of practitioners and many persons exhibited hostility toward psychotherapy. People wanted to know if psychotherapy worked; this was a fair question in the beginning, but the question is still currently being raised. People now want empirically validated treatments, thus creating an unholy alliance between managed care companies and hard-nosed researchers in which treatment manuals are given precedence over clinical skills. This focus ignores the fact that psychotherapy is anchored in a human relationship and that it is closer to education than to treatment. Subsequently, assigning a limited number of hours for patient treatment will not work. Greater understanding and tolerance for the conflicting interest of different parties are required. Contains 14 references. (RJM)