Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-12-02T20:35:59.046Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychotherapy and General Practice

Published online by Cambridge University Press:  02 January 2018

Linda Gask  and
Graeme McGrath
Linda Gask
Affiliation:
Department of Psychiatry, University Hospital of South Manchester, Nell Lane, West Didsbury, Manchester M20 8LR
Graeme McGrath*
Affiliation:
Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

The authors review the development of liaison psychotherapy in general practice, and argue that a 'skill-sharing’ approach, where the general practitioner retains the treatment role, is a more efficient model than a ‘consultation’ approach. Skill-sharing models are reviewed, and the need for psychiatrists and psychotherapists to be more directly involved in teaching basic psychotherapeutic skills to general practitioners is emphasised.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 154 , Issue 4 , April 1989 , pp. 445 - 453
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, A. & Hasler, J. C. (1979) Counselling in general practice. Journal of the Royal College of General Practitioners, 29, 352–356.Google ScholarPubMed
Andrews, G. & Brodaty, H. (1980) General practitioner as psychotherapist. Medical Journal of Australia, 655–659 CrossRefGoogle Scholar
Ashurst, P. (1982) Counselling in general practice. In Psychiatry and General Practice (eds Clare, A. W. & Lader, M.). London: Academic Press.Google Scholar
Balint, E. (1979) The Balint group approach. Journal of the Royal Society of Medicine, 72, 467–469.CrossRefGoogle ScholarPubMed
Balint, M. (1964) The Doctor, His Patient and the Illness (2nd edn). London: Pitman.Google Scholar
Bensing, J. M. & Sluijs, E. M. (1983) Evaluation of an interview training course for general practitioners. Social Science and Medicine, 20, 737–744.CrossRefGoogle Scholar
Blackburn, I. M., Bishop, S., Glen, A. I. M. et al (1981) The efficacy of cognitive therapy and psychotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181–189.CrossRefGoogle ScholarPubMed
Blacker, R. & Clare, A. (1987) Depressive disorder in primary care. British Journal of Psychiatry, 150, 737–751.CrossRefGoogle ScholarPubMed
Blakey, R. (1986) The effectiveness of attached social workers in the management of depressed female patients and their families. Journal of the Royal College of General Practitioners, 36, 209–211.Google Scholar
Boulter, M., Griffiths, J., Hall, D., McIntyre, M., Oliver, B. & Woodward, J. (1984) Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation. Medical Education, 18, 269–274.Google Scholar
Brodaty, H. & Andrews, G. (1983) Brief psychotherapy in family practice: a controlled prospective intervention trial. British Journal of Psychiatry, 143, 11–19.CrossRefGoogle ScholarPubMed
Brook, A. (1978) An aspect of community mental health: consultative work with general practice teams. Health Trends, 10, 37–39.Google Scholar
Brook, A. (1979) An aspect of the use of the psychodynamic model. Journal of the Royal Society of Medicine, 72, 467–469.CrossRefGoogle ScholarPubMed
Brook, A. & Temperley, J. (1976) The contribution of a psychotherapist to general practice. Journal of the Royal College of General Practitioners, 26, 86–94.Google ScholarPubMed
Burns, B. J., Scott, J. E., Burke, J. D., et al (1983) Mental health training of primary care residents: a review of recent literature (1974–1981). General Hospital Psychiatry, 5, 157–169.CrossRefGoogle ScholarPubMed
Byrne, P. & Long, B. E. L. (1976) Doctors Talking to Patients. London: HMSO.Google Scholar
Carney, R. H. (1980) Factors affecting the operation and success of social work attachments to general practice. Journal of the Royal College of General Practitioners, 30, 149–158.Google Scholar
Carney, R. H. (1984) The effectiveness of attached social workers in the management of depressed female patients in general practice. Psychological Medicine, 6 (suppl.), 1–47.Google Scholar
Cartwright, A., Lucas, S. & O'Brien, M. (1976) Some methodological problems in studying consultations in general practice. Journal of the Royal College of General Practitioners, 26, 894–906.Google ScholarPubMed
Catalan, J., Gath, D., Edmonds, G., et al (1984) Effects of non-prescribing of anxiolytics. I. Controlled evaluation of psychiatric and social outcome. British Journal of Psychiatry, 144, 581–602.CrossRefGoogle ScholarPubMed
Cawley, R. (1977) The teaching of psychotherapy. Association of University Teachers in Psychiatry Newsletter, Summer, 19–36.Google Scholar
Cohen-Cole, S. A. (1980) Training outcomes in liaison psychiatry: literature review and methodological proposals. General Hospital Psychiatry, 2, 282–288.CrossRefGoogle ScholarPubMed
Cormack, M. & Forrest, M. (1985) The working relationship between general practitioners and the clinical psychologist. BPS Division of Clinical Psychology Newsletter, 48, 33–36.Google Scholar
Courtney, M. (1981) Sex problems in practice: what can a GP do? British Medical Journal, 282, 873–874.CrossRefGoogle Scholar
Davenport, S., Goldberg, D. & Millar, T. (1987) How psychiatric disorders are missed during medical consultations. Lancet, ii 139–140.Google Scholar
Davis, R. H., Verby, J. E. & Holden, P. (1980) A study of the interviewing skills of trainee assistants in general practice. Patient Care and Health Education, 2, 68–71.Google Scholar
Earl, L. & Kincey, J. (1982) Clinical psychology in general practice: a controlled trial evaluation. Journal of the Royal College of General Practitioners, 32, 32–37.Google Scholar
Egan, G. (1982) The Skilled Helper: Models, Skills and Methods of Effective Helping. Monterey, California: Brooks/Cole.Google Scholar
Freeung, P. (1985) Health outcomes in primary care – an approach to the problems. Family Practice, 2, 177–181.CrossRefGoogle Scholar
Freeung, P. & Harris, C. M. (1984) The Doctor-Patient Relationship (3rd edn). Edinburgh: Churchill Livingstone.Google Scholar
Fry, J., Brooks, D. & McColl, I. (1984) NHS Data Book. Lancaster: MTP Press.CrossRefGoogle Scholar
Gask, L., McGrath, G., Goldberg, D., et al (1987a) Improving the psychiatric skills of established general practitioners. Medical Education, 21, 362–368.CrossRefGoogle ScholarPubMed
Gask, L., Goldberg, D., Lesser, A. L., et al (1987b) Improving the psychiatric skills of the general practice trainee: an evaluation of a group training course. Medical Education, 22, 132–138.CrossRefGoogle Scholar
Ginsberg, G., Marks, I. M. & Waters, H. (1984) Cost benefit analysis of a controlled trial of nurse therapy for neuroses in primary care. Psychological Medicine, 14, 683–690.CrossRefGoogle ScholarPubMed
Goldberg, D. P. (1982) Leading article. British Medical Journal, 284, 143–144.CrossRefGoogle Scholar
Goldberg, D. P. (1986) Teaching methods for use by psychiatrists in primary care settings. Acta Psychiatrica Belgica, 86, 568–574.Google ScholarPubMed
Goldberg, D. P. & Huxley, P. (1980) Mental Illness in the Community. London: Tavistock.Google Scholar
Goldberg, D. P., Steele, J. J. & Smith, C. (1980) Teaching psychiatric interview techniques to family doctors. Acta Psychiatrica Scandinavica, 62, 41–47.CrossRefGoogle Scholar
Hansen, V. (1987) Psychiatric service within primary care. Acta Psychiatrica Scandinavica, 76, 121–128.CrossRefGoogle ScholarPubMed
Hobson, R. H. (1985) Forms of Feeling: The Heart of Psychotherapy. London: Tavistock.Google Scholar
Hurd, J. & Rowland, N. (1985) Counselling in General Practice: A Guide for Counsellors. British Association for Counselling. Oxford: Oxford University Press.Google Scholar
Irving, J. & Heath, V. (1985) Counselling in General Practice: A Guide for General Practitioners. British Association for Counselling. Oxford: Oxford University Press.Google Scholar
Ives, G. (1979) Psychological treatment in general practice. Journal of the Royal College of General Practitioners, 29, 343–351.Google ScholarPubMed
Jannoun, L., McDowell, I. & Catalan, J. (1981) Behavioural treatment of anxiety in general practice. Practitioner, 225, 58–62.Google ScholarPubMed
Journal of the Royal College of General Practitioners (1980) Editorial. Is counselling the key? Journal of the Royal College of General Practitioners, 30, 643–645.Google Scholar
Kamerow, D. B. & Burns, B. J. (1987) The effectiveness of mental health consultation and referral in ambulatory primary care: a research lacuna. General Hospital Psychiatry, 9, 111–117.CrossRefGoogle ScholarPubMed
Kincey, J. A. (1974) General practice and clinical psychology – some arguments for a closer liaison. Journal of the Royal College of General Practitioners, 24, 882–888.Google ScholarPubMed
Koch, H. C. H. (1979) Evaluation of behaviour therapy intervention in general practice. Journal of the Royal College of General Practitioners, 29, 337–340.Google ScholarPubMed
Lesser, A. L. (1985) Problem-based interviewing in general practice: a model. Medical Education, 19, 299–304.CrossRefGoogle ScholarPubMed
Madden, T. A. (1979) The doctors, their patients and their care: Balint reassessed. Psychological Medicine, 9, 5–8.CrossRefGoogle ScholarPubMed
Maguire, P., Roe, P., Goldberg, D., et al (1978) The value of feedback in teaching interviewing skills to medical students. Psychological Medicine, 8, 695–704.CrossRefGoogle ScholarPubMed
Malan, D. H., Sheldon Heath, E., Bacal, H. A., et al (1975) Psychodynamic changes in untreated patients II: apparently genuine improvements. Archives of General Psychiatry, 32, 110–126.CrossRefGoogle ScholarPubMed
Marks, I. (1985) Controlled trial of nurse therapists in primary care. British Medical Journal, 290, 1181–1184.CrossRefGoogle ScholarPubMed
Marks, J. N., Goldberg, D. P. & Hillier, V. F. (1979) Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine, 9, 337–353.CrossRefGoogle ScholarPubMed
Martin, E. & Martin, P. M. L. (1985) Changes in psychological diagnosis and prescription in a practice employing a counsellor. Family Practice, 2, 241–243.CrossRefGoogle Scholar
McGrath, G. & Lowson, K. (1987) Assessing the benefits of psychotherapy: the economic approach. British Journal of Psychiatry, 150, 65–71.CrossRefGoogle ScholarPubMed
Mitchell, A. R. K. (1983) Brief psychotherapy in family practice: a controlled prospective intervention trial. British Journal of Psychiatry, 143, 11–19.Google Scholar
Mitchell, A. R. K. (1985) Psychiatrists in primary health care settings. British Journal of Psychiatry, 147, 371–379.CrossRefGoogle ScholarPubMed
Muroatroyd, S. (1983) Counselling and the doctor (editorial). Journal of the Royal College of General Practitioners, 33, 323–325.Google Scholar
Neighbour, R. (1982) Family therapy in family practice. Journal of the Royal College of General Practitioners, 32, 737–742.Google Scholar
Pendleton, D. (1983) Doctor-patient communication: a review. In Doctor-Patient Communication (eds Pendleton, D. & Hasler, J.). London: Academic Press.Google Scholar
Pendleton, D., Schofield, T., Tote, P., et al (1984) The Consultation: An Approach to Learning and Teaching. Oxford: Oxford University Press.Google Scholar
Pereira Gray, D. J. (1979) The key to personal care. Journal of the Royal College of General Practitioners, 29, 666–678.Google Scholar
Pietroni, P. C. (1986) Would Balint have joined the British Holistic Medical Association? Journal of the Royal College of General Practitioners, 36, 171–173.Google ScholarPubMed
Raynes, N. V. (1980) A preliminary study of search procedures and patient management techniques in general practice. Journal of the Royal College of General Practitioners, 30, 166–172.Google ScholarPubMed
Reilly, S. P. (1987) A psychotherapy service: how general practitioners see it. Bulletin of the Royal College of Psychiatrists, 11, 191–192.CrossRefGoogle Scholar
Robson, M. H., France, R. & Bland, M. (1984) Clinical psychologist in primary care: controlled clinical and economic evaluation. British Medical Journal, 288, 1805–1808.CrossRefGoogle ScholarPubMed
Ross, M. & Scott, M. (1985) An evaluation of the effectiveness of individual and group cognitive psychotherapy in an inner city health centre. Journal of the Royal College of General Practitioners, 35, 181–189.Google Scholar
Rowland, N. & Irving, J. (1984) Towards a rationalisation of counselling in general practice. Journal of the Royal College of General Practitioners, 34, 685–687.Google Scholar
Salmon, P. (1984) The psychologist's contribution to primary care: a reappraisal. Journal of the Royal College of General Practitioners, 34, 190–193.Google ScholarPubMed
Sanson-Fisher, R. & Maguire, P. (1980) Should skills in communication be taught in medical schools? Lancet, ii 523–526.CrossRefGoogle Scholar
Schofield, T. (1983) The application of the study of communication skills to training in general practice. In Doctor-Patient Communication (eds Pendleton, D. & Hasler, J.). London: Academic Press.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C., et al (1981) Psychiatric Illness in General Practice (2nd edn). Oxford: Oxford University Press.Google Scholar
Sowerby, P. (1977) The doctor, his patient and the illness: a reappraisal. Journal of the Royal College of General Practitioners, 27, 583–589.Google ScholarPubMed
Spector, J. (1984) Clinical psychology and primary care: some ongoing dilemmas. Bulletin of the British Psychological Society, 37, 73–76.Google Scholar
Stiles, W. B. (1979) Verbal response mode and psychotherapeutic technique. Psychiatry, 42, 49–62.CrossRefGoogle Scholar
Stimson, G. V. & Webb, B. (1976) Going to See the Doctor: The Consultation Process in General Practice. London: Routledge & Kegan Paul.Google Scholar
Strathdee, G. (1987) Primary care-psychiatry interaction: a British perspective. General Hospital Psychiatry, 9, 102–110.CrossRefGoogle ScholarPubMed
Strathdee, G. & Williams, P. (1983) A survey of psychiatrists in primary care: the silent growth of a new service. Journal of the Royal College of General Practitioners, 34, 615–618.Google Scholar
Teasdale, J. D., Fennell, M. J., Hibbert, G. A., et al (1984) Cognitive therapy for major depressive disorders in primary care. British Journal of Psychiatry, 144, 400–406.CrossRefGoogle ScholarPubMed
Tuckett, D., Boulton, M., Olson, C., et al (1985) Meetings Between Experts: An Approach to Sharing Ideas in Medical Consultations. London: Tavistock.Google Scholar
Verby, J. E., Holden, P. & Davis, R. H. (1979) Peer review of consultations in primary care: the use of audiovisual recordings. British Medical Journal, i 1686–1688.CrossRefGoogle Scholar
Weinman, J. & Medlik, L. (1985) Sharing psychological skills in the general practice setting. British Journal of Medical Psychology, 58, 223–230.CrossRefGoogle ScholarPubMed
Williamson, J. D. (1979) Balint's contribution to general practice. Journal of the Royal College of General Practitioners, 27, 207–209.Google Scholar
Wilson, S. & Wilson, K. (1985) Close encounters in general practice: experiences of a psychotherapy liaison team. British Journal of Psychiatry, 146, 277–281.CrossRefGoogle ScholarPubMed
Zigmond, D. (1978) When Balinting is mind rape. Update, 16, 1123–1126.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.