This chapter presents longitudinal data from mental health care providers in one large public sector agency to describe how their caregiving work has changed with managed care. Psychological burnout is a concept that has received a great deal of empirical attention and has most often been measured with the Maslach Burnout Inventory. Emotional labor has most commonly been associated with service work, or work that involves interactions with clients and entails the management of feeling and the expression of appropriate emotions. The primary ways in which managed care controls costs are by limiting access to services and by limiting the utilization of more costly services while encouraging the use of less costly services. In terms of specific findings, critical attitudes toward managed care, a lack of autonomy, and disagreement with organizational priorities are significant predictors of emotional exhaustion.