RANDOMIZED CONTROLLED ASSESSMENT OF NONDIRECTIVE PSYCHOTHERAPY VERSUSROUTINE GENERAL-PRACTITIONER CARE

Background We compared the efficacy of and patients' satisfaction with general-practice-based psychotherapists with those of general practit ioners in providing treatment to people with emotional difficulties. M ethods We carried out a prospective, randomised, controlled trial of b rief, non-directive psychotherapy and routine general-practice care. T herapists adhered to a nondirective Rogerian model of psychotherapy. B etween one and 12 sessions of psychotherapy were given over 12 weeks i n 14 general practices in north London, UK. Of 136 patients with emoti onal difficulties, mainly depression, 70 patients were randomly assign ed to the therapist and 66 to the general practitioner. Depression, an xiety, other mental-disorder symptoms, and social adjustment were meas ured by self-report al baseline, 3 months, and 9 months. Patients' sat isfaction was also measured by self-report at 3 and 9 months. Findings All patients improved significantly over time. There were no signific ant differences between the groups receiving brief psychotherapy and r outine general-practitioner care. Patients assigned brief psychotherap y were more satisfied with the help they received than those assigned to the general practitioner at both 3 and 9 months' follow-up (mean sc ores on satisfaction scale 50.9 [SD 7.9] vs 44.4 [9.8] and 45.6 [9.4] vs 37.1 11.2], respectively). Interpretation General-practitioner care is as effective as brief psychotherapy for patients usually referred by doctors to practice-based psychotherapists. Patients with emotional difficulties prefer brief psychotherapy from a counsellor to care fro m their general practitioner.