Counselling In General Practice Research Articles

Evaluation of counselling in primary care: How can research be made more useful for practitioners?

The paper presents a literature review of research on counselling in general practice critiqued from the perspective of the Practice Counsellor. It is noted that existing studies all focus primarily on outcome of psychological interventions in comparison to routine GP care. The contributions and limitations of these studies are discussed, and the methodological difficulties of conducting controlled trials in this context are explored. It is proposed that future research on counselling in primary care needs to draw on the paradigm shift in psychotherapy and a range of alternative research methodologies which will be more likely to produce research of relevance to Practice Counsellors.

Process and outcome of counselling in general practice

Process and outcome of counselling in general practice

Career counselling in general practice

Career counselling in general practice

Problems with recruitment in a randomized controlled trial of counselling in general practice: causes and implications.

To evaluate the effectiveness of counselling in the management of minor psychiatric morbidity in general practice, and to explore the reasons for difficulties in recruiting patients to such an evaluation. We attempted to conduct a randomized controlled trial of counselling in eight general practices in one NHS family health services authority area in England. Having experienced significant problems recruiting patients, we conducted semi-structured telephone interviews (n = 8) with participating GPs to explore the reasons for these difficulties. Five months after the start of the study only one patient had been recruited. The main reasons identified as contributing to the recruitment problems were: general practitioners' motivation for involvement in the study; their ethical doubts about the randomization process; the perceived lack of a viable non-counselling intervention; and their existing practical commitment to counselling. Although methodological modification might enhance the potential for success in future studies of this sort, more fundamental difficulties concerning general practitioners' attitudes to research and their professional responsibilities lie at the heart of our recruitment problems.

Counselling in general practice: issues and opportunities

Abstract The results are reported of a survey of GP counsellors and primary health care teams concerning the role and contribution of counsellors in primary care. Most of the literature argues the value of this service, which has been growing very quickly. This survey identified the principal tasks of GP counsellors, their relationship with the host team, and some of the organisational and professional dilemmas which need to be addressed. A great deal of variation wasfound in ail of these areas, which suggests the value of a protocol for GP counselling to establish minimum standards and promote best practice.

Counselling in general practice: Issues and opportunities

Abstract The results are reported of a survey of GP counsellors and primary health care teams concerning the role and contribution of counsellors in primary care. Most of the literature argues the value of this service, which has been growing very quickly. This survey identified the principal tasks of GP counsellors, their relationship with the host team, and some of the organisational and professional dilemmas which need to be addressed. A great deal of variation wasfound in ail of these areas, which suggests the value of a protocol for GP counselling to establish minimum standards and promote best practice.

Counselling in general practice

Counselling in general practice

Evaluation of the short-term impact of counseling in general practice

This paper describes the findings of a randomised controlled trial of the short-term impact of counseling in the general practice setting. Compared with patients who received usual advice from their general practitioner for acute problems such as relationship difficulties, anxiety and depression, those who received counseling from qualified counselors working within the primary health care context showed greater improvement in psychological health as measured by the General Health Questionnaire. Significantly fewer of those counselled were prescribed anti-depressant drugs by the general practitioners in the study, or were referred to psychiatrists or clinical psychologists for care. In addition those patients who attended sessions with the practice counselor were more likely to report that they were satisfied with their treatment and more expressed feelings of well-being.

Prevention in practice. How do general practitioners discuss life-style issues with their patients?

Forty-six representative consultations in general practice were video recorded. Afterwards the patients and the GPs separately reviewed the recordings and gave their spontaneous comments. A hypothetical-deductive analysis, with a starting point in current health educations models, was carried out in order to characterize the health counselling discussions. Life-style issues (diet, exercise, smoking and alcohol) were discussed in 15 sequences in eight consultations. Four types of sequences were discerned: short advice by the physician (I), a short question by the patient (II), lengthy advice by the physician (III) and a patient-centred discussion (IV). Most health education constructs studied were identified in the type IV sequence but few in type I–III. In the short and the lengthy advice sequences there was a similar structure; the strategy to affect patients' life-style was condemnations of the patient behaviour and exhortations to change. No physician commented positively on these sequences. Appropriate training might improve life-style counselling in general practice through a patient-centred approach and with guidance from constructs in health education models.

Prevention in practice. How do general practitioners discuss life-style issues with their patients?

Forty-six representative consultations in general practice were video recorded. Afterwards the patients and the GPs separately reviewed the recordings and gave their spontaneous comments. A hypothetical-deductive analysis, with a starting point in current health educations models, was carried out in order to characterize the health counselling discussions. Life-style issues (diet, exercise, smoking and alcohol) were discussed in 15 sequences in eight consultations. Four types of sequences were discerned: short advice by the physician (I), a short question by the patient (II), lengthy advice by the physician (III) and a patient-centred discussion (IV). Most health education constructs studied were identified in the type IV sequence but few in type I-III. In the short and the lengthy advice sequences there was a similar structure; the strategy to affect patients' life-style was condemnations of the patient behaviour and exhortations to change. No physician commented positively on these sequences. Appropriate training might improve life-style counselling in general practice through a patient-centred approach and with guidance from constructs in health education models.

Counselling in General Practice

Counselling in General Practice

Cystic fibrosis carrier testing in early pregnancy by general practitioners.

To assess the feasibility of genetic counselling in general practice by using cystic fibrosis carrier screening at the booking appointment as an integral part of routine antenatal care and as a paradigm for the wider participation of general practitioners in medical genetics. Maternal testing (male partner tested only if woman screens positive) and couple testing for cystic fibrosis carrier status in the antenatal population attending one general practice and, later, in a further six (outreach) practices also. Two partner urban training practice (pilot practice) in south Manchester, and six north west practices (two inner city, three urban, one rural dispensing). Total practice population of 50,000 (pilot practice plus six outreach practices) with an estimated 500-800 pregnancies per year. (a) Proportion of carriers of cystic fibrosis identified, counselled, and appropriately managed within the first trimester of pregnancy; (b) questionnaire and interview measures of patient satisfaction and stress. Eleven carriers of cystic fibrosis were detected including one carrier couple. This carrier couple, after extensive counselling, elected to have prenatal diagnosis by chorionic villus biopsy. The fetus was homozygous normal. General practitioners can successfully integrate genetic counselling and cystic fibrosis carrier screening into the first antenatal booking appointment. When a carrier couple is identified clinical geneticists can help with the discussion of reproductive options, and prenatal diagnosis by chorionic villus biopsy can be completed within the first trimester. The results suggest that general practitioners will have an increasingly important role in medical genetics, subject to continuing evaluation of patient acceptability and stress.

Counselling in general practice.

Counselling in general practice.

Counselling in general practice.

Counselling in general practice.

Counselling in general practice

Counselling in general practice

Counselling in general practice

Counselling in general practice

Lifestyle counselling in general practice

Medical Journal of AustraliaVolume 157, Issue 6 p. 396-398 Counselling Skills Lifestyle counselling in general practice Waste of time or challenge of skill?† Claire L Jackson MB BS, FRACGP, Corresponding Author Claire L Jackson MB BS, FRACGP Lecturer in General Practice n/a@dne.dne Department of Social and Preventive Medicine, The University of Queensland, Medical School, Herston Road, Herston, QLD, 4006 Correspondence and reprints: Dr Claire L Jackson.Search for more papers by this author Claire L Jackson MB BS, FRACGP, Corresponding Author Claire L Jackson MB BS, FRACGP Lecturer in General Practice n/a@dne.dne Department of Social and Preventive Medicine, The University of Queensland, Medical School, Herston Road, Herston, QLD, 4006 Correspondence and reprints: Dr Claire L Jackson.Search for more papers by this author First published: 01 September 1992 https://doi.org/10.5694/j.1326-5377.1992.tb137250.x †* This article is part of a series which has been arranged and coordinated by the Australian Association for Academic General Practice. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume157, Issue6September 1992Pages 396-398 RelatedInformation

The effectiveness of counselling in general practice

This paper will consider the evidence of the value of placing counsellors in general practice including the results of surveys, consumer opinions and clinical trials. We are at an early stage in refining our techniques of evaluation and it must be remembered that the majority of studies carried out in this area are flawed in some way, some more than others. However, the results of more recent studies, which have tended to be more specific in the client group investigated, give tentative support to the value of counselling in general practice.

Counselling in General Practice – Does it Work? Discussion Paper

Counselling in General Practice – Does it Work? Discussion Paper

Counselling in a general practice surgery: results of a study

In ‘Counselling in General Practice: a Review’, Wyld (1981) concluded (p, 136) that some 75 per cent of clients can be expected to show some improvement after being counselled by non-medical workers in a GP setting, and that both GP contact and drug prescriptions are likely to be reduced. Wyld also quotes on the same page from what he calls the most informative paper about counsellors in GP practices, that by Anderson and Hasler (1979), which was a report on the service provided by a part-time counsellor in a GPs practice in Oxford. In this study which was initially of 80 patients, 35 out of 54 who responded to a questionnaire reported ‘general improvement’, and 35 out of 54 said they had reduced their demand for medical treatment. When the cost of prescriptions in the three months before counselling was compared with that for the three months after counselling, there was an estimated saving of £76.92 in the second three months. However, it is clear, as is common with questionnaire studies, that not all those seen responded to the questionnaire. It may also be difficult for patients who have had counselling, and who trouble to respond, to be other than supportive, particularly in view of the time they will have given up. Among the other studies mentioned by Wyld is one by Meacher (1977) in which, as well as patients estimating the help they had received, GPs also gave their estimates. Seventy five per cent of the patients said that counselling had helped and 82 per cent of the patients were said by the GPs to have improved after counselling.