Only general assumptions about the length and overall goals of therapy may be made. Managed health care decrees that most therapy group be brief and problem oriented-and, indeed, as reviewed in chapter 10, there is evidence that brief group approaches may effectively offer symptomatic relief. There is also evidence, however, that therapy is most effective when the ending of treatment is collaboratively determined and not arbitrarily imposed by a third party. Managed care is most interested in what will be most useful for the majority of a large pool of clients. Psychotherapists are less interested in statistics and aggregates of client than in the individual distressed client in their office