A few years ago, Bob Jordan had an interesting encounter with managed care. In his capacity then as admissions director for Turning Point of Tampa - he now heads up marketing at South Florida-based Watershed Treatment Programs - Jordan found himself on the phone with a managed care gatekeeper who just didn’t get it.

30 years ago there existed little research, let alone much discussion, of what it was that women needed from their treatment experiences. Few people ever thought or spoke about what is was that could be done to address gender specific issues that arise from addiction, with the possibility of using that knowledge to improve outcomes.

With its roots in the classical conditioned response studies of Pavlov and others, Exposure Response Prevention, ERP, therapy seeks to use conditioning to modify behaviors through repeated exposure to fears, anxieties or situations, combining the exposure with therapy that helps subjects better cope with and, hopefully, overcome their problems. ERP therapy has been used most extensively, and has been found most effective, in treating obsessive compulsive disorders, but the technique has also often been used to treat eating disorders as well.

In a previous incarnation, Howard Brown was a real estate developer in the Los Angeles area, a pursuit that ultimately left him dissatisfied and wanting more. Brown became a family and marriage counselor, eventually turning his attention to behavioral health opportunities on the Internet. He ultimately created 4therapy.com, a network of hundreds of behavioral health and addiction web sites. With over 200,000 pages of content, 4therapy has emerged as probably the most sophisticated Internet marketing operation in the treatment and mental health arenas.

Over the past several years, a relatively rare model of treatment has emerged at Eating Disorder Center of Denver, one in which patients who have diagnoses of serious eating problems like anorexia and bulimia are being treated in an outpatient type setting, bucking the common notion that such patients always require treatment at inpatient or residential settings.

As the private treatment business in recent years has seen much of its growth driven by the founding of new centers whose focus is on a high-end demographic - those treatment facilities who target clients who can pay upfront and out of pocket - a growing group of individuals have begun to question whether growth can continue to be driven as it has to a large extent by these types of facilities, saying that there is a limit to the number people who can afford to pay cash for treatment. But there continue to be entrepreneurs who are proving the high-end naysayers wrong, especially if they are astute enough to found centers in regions where there is little high-end competition.