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Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling

Chiesa, M; Fonagy, P; Bateman, AW; (2007) Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling. PSYCHOL PSYCHOTHER-T , 80 591 - 603.

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Abstract

Objectives. Although several studies have described patient populations in primary care counselling settings and NHS (National Health Service) specialist psychotherapy settings, there is a paucity of studies specifically comparing differences in clinical characteristics between the two groups of patients. The aim of this study is to ascertain if specialist psychotherapy referrals represent a more challenging client group than primary care counselling patients. Design. We compare the socio-demographic features and severity of presentation in the symptomatic, interpersonal problems and global adjustment dimensions of a sample of patients (N = 384) assessed by a primary care counselling service located in North London and a sample of patients (N = 853) assessed in eight NHS psychotherapy centres located within urban settings in England. Methods. Both the groups completed the Brief Symptom Inventory, the Inventory of Interpersonal Problems and Clinical Outcomes in Routine Evaluation Outcome Measure. Results. Patients referred for specialist psychotherapy services were more dysfunctional than those referred for primary care counselling. The linear function constructed to discriminate the groups showed that a combination of more psychotic symptoms, social inhibitions and higher risk of self-harm effectively identified those referred to psychotherapy services, while patients exhibiting greater levels of somatic and anxiety symptoms and non-assertiveness were more likely to be seen in primary care settings. However, similarities between the two samples were also marked, as shown by the overlap in the distribution of clinical outcomes in routine evaluation clinical scores in the two samples. Conclusions. The findings are discussed in terms of their implications for policy and service delivery of these two types of psychological therapy services.

Type: Article
Title: Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling
Keywords: RANDOMIZED CONTROLLED-TRIAL, GENERAL-PRACTITIONER CARE, CORE-OM, POPULATION, DEPRESSION, SERVICES, OUTCOMES, THERAPY, UTILITY
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/133817
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