School of Psychology, Trinity College, Dublin 2, Ireland.
Health Service Executive, Counselling in Primary Care National Evaluation, 19 Upper Ormond Quay, Dublin 2, Ireland.
BMC Psychiatry. 2021 May 3;21(1):227. doi: 10.1186/s12888-021-03226-x.
The Counselling in Primary Care service (CIPC) is the first and only nationally available public counselling service in the Republic of Ireland. This study provides initial data for the effectiveness of short-term psychotherapy delivered in a primary care setting in Ireland for the first time.
A practice-based observational research approach was employed to examine outcome data from 2806 clients receiving therapy from 130 therapists spread over 150 primary care locations throughout Ireland. Pre-post outcomes were assessed using the CORE-OM and reliable and clinically significant change proportions. Binary logistic regression examined the effect of pre therapy symptom severity on the log odds of recovering. Six and 12 month follow up data from a subsample of 276 clients were also analysed using growth curve analysis.
Of 14,156 referred clients, 5356 presented for assessment and 52.3% (N = 2806) consented to participate. Between assessment and post-therapy a large reduction in severity of symptoms was observed- Cohen's d = 0.98. Furthermore, 47% of clients achieved recovery,a further 15.5% reliably improved, 2.7% reliably deteriorated and34.7% showed no reliable improvement. Higher initial severity was associated with less chance of recovering at post-therapy. Significant gains were maintained between assessment and12 months after therapy- Cohen's d = 0.50.
Outcomes for clients in the CIPC service compared favourably with large scale counselling and psychotherapy services in jurisdictions in the U.K., the U.S.A., Norway and Sweden. This study expands the international primary care psychotherapy research base to include the entire Republic of Ireland jurisdiction.
初级保健咨询服务（CIPC）是爱尔兰共和国首个也是唯一一个全国范围内提供的公共咨询服务。这项研究首次提供了在爱尔兰初级保健环境中提供短期心理治疗的有效性的初步数据。
采用基于实践的观察性研究方法，检查了来自 130 名治疗师的 2806 名患者的治疗结果数据，这些治疗师分布在爱尔兰 150 个初级保健场所。使用 CORE-OM 和可靠且具有临床意义的变化比例评估治疗前后的结果。二元逻辑回归分析了治疗前症状严重程度对恢复对数几率的影响。还使用增长曲线分析对 276 名患者的子样本的 6 和 12 个月随访数据进行了分析。
在 14156 名转介患者中，有 5356 名接受了评估，其中 52.3%（N=2806）同意参与。在评估和治疗后，症状严重程度大幅下降- Cohen's d=0.98。此外，47%的患者达到了康复，还有 15.5%的患者可靠地改善，2.7%的患者可靠地恶化，34.7%的患者没有可靠的改善。初始严重程度较高与治疗后康复的机会较低相关。在治疗后和治疗后 12 个月之间，仍保持显著改善- Cohen's d=0.50。
CIPC 服务的患者的结果与英国、美国、挪威和瑞典的大规模咨询和心理治疗服务相比表现良好。这项研究将国际初级保健心理治疗研究基础扩展到包括整个爱尔兰共和国管辖范围。
