This article reviews seven trends that were identified several years ago that have impacted the field of psychotherapy, especially such estimated changes as psycho-economics, managed care, wellness promotion, gender, and elderly care. Six new trends are described that are emerging and are leading the profession into the future: psychotherapy integration, specialization, managing psychotherapy, expansion of the scope of practice, cultural diversity, and psychotherapy without walls. Psychotherapy integration is described as finding the right therapist for the right problem. Through specialization, psychotherapists can offer a unique skill they have developed. How managed care reform continues to change the psychotherapy profession is discussed and the possibility of expanding the scope of practice through prescription drug privileges is examined. It is stated that in order for psychotherapists to survive in practice, they must address how to involve diversity in students coming into the practice and diversity among clients using their services. Psychotherapy without walls acknowledges the reality that future interactions between clients and therapists may be in "virtual" time. The conclusion indicates that the profession will be dealing with a revolutionary explosion of new forms and models for training, practice, and research. (Contains 53 references.) (JDM)