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This provocatively titled book was written by a clinical psychologist, but is predominantly a work in sociology. Philipson performs an important service by providing her observations of crucial trends taking place in mental health care. Primarily, she describes the emergence of an occupational bifurcation along gender lines, with economic and psychological implications for the mental health profession as well as for society as a whole. Her analyses of the causes of these trends and her prescriptions for change are less powerful than her observations.
The book is divided into seven chapters that read quickly and interestingly. Philipson begins with a description of several current forces affecting the field of psychotherapy. She documents the in-creasing numbers of women entering the field and the decreasing numbers of men. She reviews the decreasing federal and insurance dollars allocated for psychotherapy and the current emphasis on biological explanations for behavior. Further, she describes the abbreviated forms of treatment offered by the managed care firms and the limited flexibility that the mostly women therapists are given by these firms. She emphasizes that it is the men who are becoming the managers, and she stresses the heavy workload they impose on the female treaters. Philipson hopes that the rest of the book will begin a discussion about what the feminization of this “field portends—not only for psychotherapy but for our society, its priorities and commonly shared ethics and beliefs” (p. 21).
Putting this in the sociological context, the author explains that occupational sex segregation has always been the case. A historical concomitant to occupational gender shifts, she informs us, has been the “declassing” and “deskilling” of the occupations that open to women. Her description of “deskilling” is convincing, in that many professional schools with lowered acceptance and graduation standards have flooded the field with women, who are more easily coerced b