Counselling in primary care: a systematic review of the research evidence

Counselling in primary care in the UK is expanding rapidly, and its evidenc e base needs to be established. We present the rationale for conducting con trolled trials of counselling in primary care, and suggest that a systemati c review of controlled trials of counselling in primary care is timely. We describe the process of conducting the review in accordance with Cochrane C ollaboration guidelines. The review aimed to assess the effectiveness and c ost-effectiveness of counselling in primary care, by systematically reviewi ng cost and outcome data from randomised controlled trials and controlled p atient preference trials of counselling interventions, for patients with ps ychological and psychosocial problems considered suitable for counselling. The search strategy, inclusion and exclusion criteria, data collection and data analysis are described. The results of the review are presented. The r eview included only controlled trials of counselling in which counsellors a ccredited by the British Association for Counselling (or equivalent) provid ed non-directive counselling in primary care. Four trials met the inclusion criteria. Results indicated that patients who receive counselling show a m odest but significant improvement in symptom levels compared with those who receive GP care. Levels of satisfaction with counselling are high. There i s very tentative evidence to suggest that counselled patients are more like ly to be considered recovered than usual GP care patients. There is limited information about the cost-effectiveness of counselling. We conclude by re flecting upon the results a the review and their implications for counselli ng research.