ABSTRACT:This article analyzes the structural contradictions in the professional lives of social workers and counselors ("psychotherapists") that give rise to a set of rationalizing discourses that align billing practices with notions of therapeutic appropriateness. I propose that, bound by a normative professional trajectory that prescribes upward mobility on one hand and the performance of a commitment to helping the underprivileged on the other, psychotherapists attempt to manage the ambivalence that these divergent imperatives invoke by working discursively to disavow the role of political economy in shaping their clinical activities. As therapists move along a career path that begins in an agency setting and culminates in private practice, they deploy situated strategies for effacing economic considerations by shifting to a moral register. In so doing, I argue, psychotherapists inadvertently articulate and legitimate a class-differentiated "moral economy of mental healthcare" that reasserts precisely the market-based logics that it seeks to transcend.

中文翻译：

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收费服务与“治疗费”：论政治经济学的否定及其在临床实践中的重新出现

摘要：本文分析了社会工作者和咨询师（“心理治疗师”）职业生活中的结构性矛盾，这些矛盾导致了一系列合理化话语，使计费实践与治疗适当性的概念保持一致。我建议，一方面受到规范的职业轨迹的约束，一方面规定向上流动，另一方面承诺帮助弱势群体，心理治疗师试图通过话语工作来否认这些不同的命令所引起的矛盾心理。政治经济学塑造他们的临床活动。随着治疗师沿着从代理机构开始到私人执业的职业道路前进，他们通过转向道德登记来部署情境策略，以消除经济考虑。我认为，在这样做的过程中，心理治疗师无意中阐明了阶级差异化的“精神保健的道德经济”并使其合法化，该经济恰恰重申了它试图超越的基于市场的逻辑。