Brief office counseling and the primary care physician.

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Primary care physicians may often see patients with transient emotional or behavioral problems. Brief office counseling is an action-oriented treatment method that requires the physician to develop both a therapeutic relationship and behavioral contract with the patient. The physician needs to create a secure, permissive, and confidential atmosphere in which the patient can feel comfortable to discuss freely his innermost thoughts and feelings. The physician must be able to convey acceptance, reassurance, concern, understanding, respect, and kindness, and also to guide and instruct without moralizing. The efficacy of brief office counseling relies in large part on the quality of the therapeutic climate that serves as the context in which technical interventions can be introduced by the physician.