What will be left for patients and providers? In any future edition of the book, Budman and Steenbarger might include a section that discusses and illustrates strategies to avoid carve-outs of behavioral health. Can local, collaborating mental health professionals operate under a budget within physician hospital organizations, provider sponsored organizations, multispecialty independent practice associations, and health maintenance organizations? Will such local, integrated arrangements forestall the continuing downward spiral in money for behavioral health? Even more to the point, how does one facilitate clinical collaboration within multispecialty "supergroups" to ensure optimal, cost-effective care of the psyche and the soma?