COUNSELING IN PRIMARY-CARE - A RANDOMIZED CONTROLLED TRIAL

A randomised controlled trial of the effectiveness of counselling (In- House Counselled (MC) group) compared to routine advice from General P ractitioners (Routine Treatment (RT) group) was conducted with three p ractices and a total of 188 patients in East Sussex. Changes in interp ersonal problems using the 32 item Inventory of Interpersonal Problems , symptoms of psychological distress using the Symptom Index and self esteem using Repertory Grids were compared between groups at four mont hs and after a further four month follow-up. A questionnaire monitorin g patient service satisfaction was given to those who had received In- House counselling. The number of counselling sessions, early withdrawa ls and refusers was also monitored. In order to facilitate interprofes sional communication, the three counsellors and a GP representative fr om each practice met monthly for an Action Learning group, led by an e xternal facilitator to provide a forum to discuss working practices. T he group met six times for two and a half hours. An audit of the parti cipants' medical notes was carried out at the end of the study to esta blish any changes in subsequent use of medical services and prescribin g patterns. The results show that patients within both groups improved considerably, in line with similar studies. The MC group was signific antly less likely to be referred out to mental health services. Howeve r, there was no statistical difference between the groups on any of th e measures or in changes in subsequent service use or prescribing patt erns. This may have been a result of Action Learning Group producing m ore psychologically minded GPs. Patients in the MC group were overwhel mingly in favour of counselling and stated that it had helped them wit h a variety of psychological problems. (C) 1997 Elsevier Science Irela nd Ltd.