Rosenthal T C, Shiffner J M, Lucas C, DeMaggio M
Department of Family Medicine, State University of New York, School of Medicine and Biomedical Sciences, Buffalo 14208.
Fam Med. 1991 Sep-Oct;23(7):527-30.
Many primary care patients are identified as needing psychotherapy. Often family physicians choose to refer these patients for comprehensive treatment, yet psychotherapy referrals are traditionally difficult to transact successfully in comparison with referrals for other biomedical complaints. Previous reports have been published on the beliefs held by family physicians and psychologists regarding factors that affect the success of a referral. This follow-up study reviewed 138 referrals from rural family physicians to psychotherapists. Fifty-nine percent of the referrals were considered successful by the family physicians and 73% by the patients. Successful psychotherapy referral, as evaluated by physicians, was related to psychotherapist-initiated post-referral communication with the referring physician. There was no relationship between success of referral outcome and the number of preparatory (or follow-up) visits with the physician, physician's knowledge about the psychotherapy process, patient economic status, or insurance coverage. However, attending more than one therapy session was associated with the number of physician visits prior to referral, distance to the therapist's office, and referral by a physician who included counseling in his or her practice. Findings indicate that when physicians are kept informed about patients' treatment, they are more likely to evaluate the treatments as beneficial.
许多初级保健患者被确定需要心理治疗。家庭医生通常会选择将这些患者转介接受综合治疗，然而，与因其他生物医学问题进行的转介相比，传统上心理治疗转介很难成功完成。此前已有报告发表，内容涉及家庭医生和心理学家对于影响转介成功因素的看法。这项后续研究回顾了138例从农村家庭医生转介给心理治疗师的案例。家庭医生认为59%的转介是成功的，患者认为成功率为73%。根据医生的评估，成功的心理治疗转介与心理治疗师在转介后主动与转诊医生沟通有关。转诊结果的成功与否与患者与医生的预备（或后续）就诊次数、医生对心理治疗过程的了解、患者经济状况或保险覆盖范围无关。然而，接受不止一次治疗与转诊前的医生就诊次数、到治疗师办公室的距离以及由在其执业中提供咨询服务的医生进行转诊有关。研究结果表明，当医生了解患者的治疗情况时，他们更有可能认为治疗是有益的。
