THE THERAPEUTIC CONTRACTING PROGRAM: A COMPREHENSIVE CONTINUUM OF CARE MODEL Philip G. Levendusky, Ph.D., B. Steven Willis, Ph.D., and Frank A. Ghinassi, Ph.D. THE CHANGING FACE OF PSYCHIATRIC CARE Increased patient acuity, shrinking lengths of stay, perceived com- promises in quality of treatment, and managed care are all factors that must be addressed in the 1990's by those who provide treat- ment for the seriously mentally ill (Canton & Gralnick, 1987, Messick & Coffman, 1985). The days of elective admissions, 60 day hospitalizations, and leisurely courses of treatment are long past (Craig, 1988). Although many traditionalists lament the passing of the "good old days" and assert that patient care today suffers from the harsh Philip G. Levendusky, Ph.D., is Director/Psychologist in Charge Cognitive Behavior Therapy Unit and Director of Ambulatory Care Services, McLean Hospital, and Instructor in Psychology, Harvard Medical School. B. Steven Willis, Ph.D., is Coordinator of Obsessive-Compulsive Disorder Program and Child and Adolescent Behavior Therapy, McLean Hospital, and Instructor in Psychology, Harvard Medical School. Frank A. Ghinassi, Ph.D., is Coordinator of Partial Hospital Services and Coordinator of Group, Individual and Psychotherapy Ser- vices, McLean Hospital, and Instructor in Psychology, Harvard Medical School. Address correspondence to Philip G. Levendusky, Ph.D., McLean Hospital, 115 Mill Street, Belmont, MA 02178. PSYCHIATRIC QUARTERLY, Vol. 65, No. 3, Fall 1994 0033-2720/94/0900-0189507.00/0 9 1994 Human Sciences Press, Inc. 189