Johnston M
J R Coll Gen Pract. 1978 Nov;28(196):661-7.
The data presented suggest that general practitioners would be likely to refer a large number of patients with diverse problems to clinical psychologists working in health centres. Compared with a centrally organized clinical psychology service, the work of the primary care psychologist is likely to offer the following advantages:1. Access to psychological help for patients with a need for such help, but who could not attend a central clinic owing to problems associated with travel, work, physical disability, or even a presenting problem such as agoraphobia.2. Greater continuity of care of patients.3. Increased communication between the psychologist and members of the primary care teams.4. Possibility of the psychologist seeing the patient earlier, before the problems have become entrenched.5. Less need for referral to other agencies.6. Reduced stigma for the patient.7. Development of new therapeutic approaches relevant to problems presenting in primary care.8. More flexible and more relevant therapy due to seeing the patients in their home setting.9. Greater therapeutic involvement of the patient's family.10. Reduced costs and inconvenience for the patient's family.11. Reduced administrative and ambulance service costs.While these points do not overcome the need for a formal evaluation of the work of psychologists in primary care, they do suggest that there are advantages in this type of service over the services which are currently available and that a full evaluation would be worth undertaking.
所呈现的数据表明,全科医生可能会将大量存在各种问题的患者转介给在健康中心工作的临床心理学家。与集中组织的临床心理学服务相比,初级保健心理学家的工作可能具有以下优势:1. 为有心理帮助需求但因出行、工作、身体残疾甚至如广场恐惧症等就诊问题而无法前往中心诊所的患者提供心理帮助。2. 为患者提供更持续的护理。3. 心理学家与初级保健团队成员之间的沟通增加。4. 心理学家有可能在问题变得根深蒂固之前更早地见到患者。5. 减少转介到其他机构的需求。6. 减轻患者的污名感。7. 开发与初级保健中出现的问题相关的新治疗方法。8. 由于在患者家中进行诊疗,治疗更灵活且更具针对性。9. 患者家庭在治疗中的参与度更高。10. 降低患者家庭的成本和不便。11. 降低行政和救护车服务成本。虽然这些观点并未消除对初级保健中心理学家工作进行正式评估的必要性,但它们确实表明这种服务类型相对于目前可用的服务具有优势,并且值得进行全面评估。