Skip to main content
PMC home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1994 May;44(382):229–232.

Controlled trials in the evaluation of counselling in general practice.

M King 1, G Broster 1, M Lloyd 1, J Horder 1
PMCID: PMC1238872  PMID: 8204338

Abstract

In this paper the difficulties of conducting a controlled evaluation of counselling (brief psychotherapy) in general practice are discussed. Results of a pilot study indicate that patients referred by family doctors to counsellors are often seriously emotionally distressed and recovery is slow. Counsellors come from different backgrounds and use a variety of therapies. Although the results show that controlled research is feasible, in a definitive trial patients should be randomized in a stratified manner, according to severity, by the researcher after initial assessments have been made. Counsellors should have a recognized accreditation and preferably be employed for the trial to ensure uniformity of approach and avoid long waiting lists. Blind assessments of outcome are desirable but are not always feasible and reliance on patient self-report is important. Within the limitations of current knowledge, only controlled evaluations will provide a greater understanding of the efficacy of counselling in general practice.

Full text

PDF
229

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BECK A. T., WARD C. H., MENDELSON M., MOCK J., ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004. [DOI] [PubMed] [Google Scholar]
  2. Brewin C. R., Bradley C. Patient preferences and randomised clinical trials. BMJ. 1989 Jul 29;299(6694):313–315. doi: 10.1136/bmj.299.6694.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brodaty H., Andrews G. Brief psychotherapy in family practice. A controlled prospective intervention trial. Br J Psychiatry. 1983 Jul;143:11–19. doi: 10.1192/bjp.143.1.11. [DOI] [PubMed] [Google Scholar]
  4. Catalan J., Gath D., Edmonds G., Ennis J. The effects of non-prescribing of anxiolytics in general practice. I. Controlled evaluation of psychiatric and social outcome. Br J Psychiatry. 1984 Jun;144:593–602. doi: 10.1192/bjp.144.6.593. [DOI] [PubMed] [Google Scholar]
  5. Corney R. H. Development and use of a short self-rating instrument to screen for psychosocial disorder. J R Coll Gen Pract. 1988 Jun;38(311):263–266. [PMC free article] [PubMed] [Google Scholar]
  6. Corney R. H. Marriage guidance counselling in general practice. J R Coll Gen Pract. 1986 Sep;36(290):424–426. [PMC free article] [PubMed] [Google Scholar]
  7. Counselling in general practice. J R Soc Med. 1985 Sep;78(9):785–786. [PMC free article] [PubMed] [Google Scholar]
  8. Fallowfield L. J. Evaluation of counselling in the National Health Service. J R Soc Med. 1993 Jul;86(7):429–430. doi: 10.1177/014107689308600722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Goldberg D. P., Cooper B., Eastwood M. R., Kedward H. B., Shepherd M. A standardized psychiatric interview for use in community surveys. Br J Prev Soc Med. 1970 Feb;24(1):18–23. doi: 10.1136/jech.24.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gossop M., Johns A., Green L. Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment. Br Med J (Clin Res Ed) 1986 Jul 12;293(6539):103–104. doi: 10.1136/bmj.293.6539.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gray D. P. Counsellors in general practice. J R Coll Gen Pract. 1988 Feb;38(307):50–51. [PMC free article] [PubMed] [Google Scholar]
  12. Greenberg G. Clinical trials in general practice. BMJ. 1991 Oct 19;303(6808):940–940. doi: 10.1136/bmj.303.6808.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hart J. T. Recruitment to randomised controlled trials. Lancet. 1993 Jun 12;341(8859):1539–1539. doi: 10.1016/0140-6736(93)90680-f. [DOI] [PubMed] [Google Scholar]
  14. Holden J. M., Sagovsky R., Cox J. L. Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression. BMJ. 1989 Jan 28;298(6668):223–226. doi: 10.1136/bmj.298.6668.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Knipschild P. Trials and errors. BMJ. 1993 Jun 26;306(6894):1706–1707. doi: 10.1136/bmj.306.6894.1706. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Marks I. Controlled trial of psychiatric nurse therapists in primary care. Br Med J (Clin Res Ed) 1985 Apr 20;290(6476):1181–1184. doi: 10.1136/bmj.290.6476.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Martin E., Martin P. M. Changes in psychological diagnosis and prescription in a practice employing a counsellor. Fam Pract. 1985 Dec;2(4):241–243. doi: 10.1093/fampra/2.4.241. [DOI] [PubMed] [Google Scholar]
  18. Oxtoby A., Jones A., Robinson M. Is your 'double-blind' design truly double-blind? Br J Psychiatry. 1989 Nov;155:700–701. doi: 10.1192/s0007125000018225. [DOI] [PubMed] [Google Scholar]
  19. Rowland N., Irving J., Maynard A. Can general practitioners counsel? J R Coll Gen Pract. 1989 Mar;39(320):118–120. [PMC free article] [PubMed] [Google Scholar]
  20. Rowland N., Irving J. Towards a rationalization of counselling in general practice. J R Coll Gen Pract. 1984 Dec;34(269):685–687. [PMC free article] [PubMed] [Google Scholar]
  21. Sibbald B., Addington-Hall J., Brenneman D., Freeling P. Counsellors in English and Welsh general practices: their nature and distribution. BMJ. 1993 Jan 2;306(6869):29–33. doi: 10.1136/bmj.306.6869.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Taylor K. M. Integrating conflicting professional roles: physician participation in randomized clinical trials. Soc Sci Med. 1992 Jul;35(2):217–224. doi: 10.1016/0277-9536(92)90169-q. [DOI] [PubMed] [Google Scholar]
  23. Tognoni G., Alli C., Avanzini F., Bettelli G., Colombo F., Corso R., Marchioli R., Zussino A. Randomised clinical trials in general practice: lessons from a failure. BMJ. 1991 Oct 19;303(6808):969–971. doi: 10.1136/bmj.303.6808.969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Trepka C., Griffiths T. Evaluation of psychological treatment in primary care. J R Coll Gen Pract. 1987 May;37(298):215–217. [PMC free article] [PubMed] [Google Scholar]
  25. Waydenfeld D., Waydenfeld S. W. Counselling in general practice. J R Coll Gen Pract. 1980 Nov;30(220):671–677. [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES