Baker R, Allen H, Gibson S, Newth J, Baker E
Research and Development Support Unit, Institute of Health and Community Studies, Bournemouth.
Br J Gen Pract. 1998 Mar;48(428):1049-53.
Research into the effectiveness of counselling in primary care is rare. This study attempts to provide a thorough evaluation of the effects of a new counselling service introduced throughout Dorset.
To evaluate the impact of counselling on client symptomatology, self-esteem, and quality of life. The effect of counselling on drug prescribing, referrals to other mental health professionals, and client and general practitioner (GP) satisfaction were also assessed.
All new clients referred for counselling were asked to complete and return questionnaires before and after counselling. A total of 385 clients took part in the study. The first and second assessments were compared statistically. Clients were ascribed a psychiatric diagnosis using a simplified version of DSM-IIIR (Diagnostic and Statistical Manual of the American Psychiatric Association). GPs' views of the service were determined using a specially designed questionnaire. Drug data were obtained from the Prescription Pricing Authority and referral statistics from Dorset HealthCare National Health Service (NHS) Trust.
The number of psychiatric symptoms and their severity were significantly reduced by counselling. There were no significant differences in the prescription of anxiolytic/hypnotic and anti-depressant medication between matched practices with and without counsellors. The presence of a counsellor did not affect the rate of referral to other mental health professionals. Clients and GPs valued the service highly.
The Psychology Managed Counselling Service is an effective method of running a counselling service and is well received by both clients and GPs. Counselled clients improved significantly on several measures.
关于初级保健中咨询服务有效性的研究很少。本研究试图全面评估在多塞特郡引入的一项新咨询服务的效果。
评估咨询对来访者症状、自尊和生活质量的影响。还评估了咨询对药物处方、转介给其他心理健康专业人员以及来访者和全科医生满意度的影响。
所有被转介接受咨询的新来访者都被要求在咨询前后填写并返还问卷。共有385名来访者参与了该研究。对第一次和第二次评估进行了统计学比较。使用简化版的《美国精神疾病诊断与统计手册》第三版（DSM-IIIR）对来访者进行精神疾病诊断。通过一份专门设计的问卷来确定全科医生对该服务的看法。药物数据从处方定价机构获取，转介统计数据来自多塞特医疗国民健康服务（NHS）信托基金。
咨询显著减少了精神症状的数量及其严重程度。在配备和未配备咨询师的配对诊所之间，抗焦虑/催眠药和抗抑郁药的处方没有显著差异。咨询师的存在并未影响转介给其他心理健康专业人员的比例。来访者和全科医生对该服务评价很高。
心理管理咨询服务是开展咨询服务的一种有效方法，受到来访者和全科医生的好评。接受咨询的来访者在多项指标上有显著改善。
