A study of the relationship between General Medical Practitioners and Counsellors & Psychotherapists in the treatment of Depression and Anxiety.
A study of a sample of General Medical Practitioners and Counsellors & Psychotherapists in Wicklow, Wexford, Galway and Clare, in regard to multidisciplinary co-operation and referrals, in relation to the treatment of Depression and Anxiety.
Patrick Kelly BA (Hons) Counselling and Psychotherapy 2008
This research project is not just a result of my work over the last few months. It is a result of a four year journey. I have had lots of help and support along the way.
First and foremost I wish to thank Caroline for putting up with me for so long during and before this course. I also wish to thank my parents who provided that support before Caroline and particularly my father who still does. I want to thank Eve and Ferdia, their light kept me going when the road seemed too dark to travel on.
I want to mention those who left along the way. I only knew Shane for a short while, I remember Sinéad fondly. I really miss Jennifer and I also miss the chats with “Gran”.During this journey
I have met lots of people who have inspired me and supported me in so many ways. In this regard, I really want to thank all my former lecturers, Supervisors and Therapists. I can’t express my gratitude enough, in the language available to me, for the warmth, friendship and new ways of looking at life that my former classmates have provided.
I wish to thank Dr. Michael Carroll, Dr. Elaine Neville and Ms. Caroline Whiriskey for taking part in the pilot study. I would also like to extend my gratitude to all the GPs and Therapists who took the time to complete the questionnaires that contributed to this study.
I would also like to thank Dr. Nick Buggle and Dr. Siobhán McCabe for providing me with a place to practice from when I was starting out.
Patrick Kelly April 2008
The object of this research project was to discover general attitudes that GPs had towards the Counselling & Psychotherapeutic profession. It also set out to discover how the GPs saw Psychological Therapy as beneficial in practical terms by the frequency they refer to or would prefer to refer to these services. It also aimed to discover general attitudes Therapists held towards GPs. To this end two questionnaires were devised and sent out to 100 GPs and 40 Counsellors & Psychotherapists in Wexford, Wicklow, Galway and Clare. The study found that 4.7% of GPs list referral to a counsellor as a preferred treatment for the various diagnoses of Depression. 11.6% of GPs consider Psychotherapy as a valid treatment option for the various diagnoses of Depression. 29.3% favour prescribing medication as a treatment option for the various levels of Depression. 27% considered the option of treating with a combination of Psychotherapy and medication. It also found that there did not seem to be enough knowledge among GPs about the qualifications and accreditations of various psychological service providers to make an informed and confident decision to refer to these services. The study concluded that more education was needed to be provided to the GPs in regard to the service provision, qualifications and accreditation processes of the various psychological therapy providers.
CHAPTER TWO – LITERATURE REVIEW
2.2 What are Mood Disorders?
2.3 What are Anxiety Disorders?
2.4 Recommendations for Treatment in the UK.
2.5 Recommendations for treatment in Ireland.
CHAPTER FOUR – RESEARCH FINDINGS
4.2 Findings from the GP questionnaire.
4.2.1 Age and Gender.
. 4.2.2 Qualifications in a Mental Health Discipline.
4.2.3 Referrals to Specialist Mental Health Services.
4.2.4 The Services which GPs are most likely to refer to.
4.2.5 How frequently would a GP refer for Psychotherapy and
between Counselling and Psychotherapy.
4.2.10 The barriers to referring to Counselling and Psychotherapy
diagnosis of Severe Depression with Psychotic symptoms.
4.2.15 The preferred method of treatment for a patient with mixed
4.3 Findings from the Counsellor and Psychotherapist questionnaire.
4.3.1 Percentage of referrals from GPs.
4.3.2 Relationship with Local GPs.
4.3.3 How familiar are GPs with the services provided?
4.4 Conclusion from the Research Findings.
CHAPTER FIVE – DISCUSSION
5.1 Strengths and weaknesses of this study.
5.2 An overview of question 12 from the GP questionnaire.
5.3 An overview of the general comments from the GP questionnaire.
5.4 An overview of question 4 from the Therapist questionnaire.
5.5 General Conclusions.
LIST OF FIGURES
Figure 1 -Frequency of referrals of a patient with a mental health issue to primary or secondary care that specialises in mental health.
Figure 2 - Which service GPs are most likely to refer a patient with mental health difficulties to.
Figure 3 - Frequency of referral for Counselling or Psychotherapy.
Figure 4 - Preferred theoretical orientation when referring for Counselling and/or Psychotherapy.
Figure 5 - The relationship between GPs and local Counsellors and Psychotherapists.
Figure 6 - Familiarity with the process of Counselling and Psychotherapy.
Figure 7 - Statistical representations of the scored responses to question 10.
Figure 8 - The barriers to referring for Counselling and Psychotherapy.
Figure 9 - The preferred method of treatment for a diagnosis of Mild Depression.
Figure 10 - The preferred method of treatment for a diagnosis of Moderate Depression.
Figure 11 - The preferred method of treatment for a diagnosis of Severe Depression.
Figure 12 - The preferred method of treatment for a diagnosis of Severe Depression with Psychotic symptoms.
Figure 13 - The preferred method of treatment for a patient with mixed episodes.
Figure 14 - The preferred method of treatment for a diagnosis of Depression comorbid with one or more other mental health disorders.
Figure 15 - The preferred method of treatment for a diagnosis of an Anxiety Disorder.
Figure 16 – Relationship with local GPs.
Figure 17 – GP familiarity with the services provided from a Therapist’s perspective.
LIST OF TABLES
Table 1 - Age and Gender analysis of GP respondents.
Table 2 - Breakdown of GPs who refer a patient with a mental health issue to primary or secondary care that specialises in mental health.
Table 3 - Breakdown of the services a GP is most likely to refer to, for a patient with mental health difficulties, in relation to the age and gender of the GPs.
Table 4 - Frequency of referral for Counselling or Psychotherapy by age and gender.
Table 5 - Analysis of the relationship between GPs and Counsellors and/ or Psychotherapists in the community in terms of age and gender.
Table 6 - Familiarity with the process of Counselling and Psychotherapy in relation to age and gender.
Table 7 - Scored responses to question 10 in relation to age and gender.
APPENDIX ONE – LETTER SENT TO GENERAL PRACTITIONERS.
APPENDIX TWO – QUESTIONNAIRE SENT TO GENERAL PRACTITIONERS.
APPENDIX THREE – LETTER SENT TO THERAPISTS.
APPENDIX FOUR – QUESTIONNAIRE SENT TO THERAPISTS.
APPENDIX FIVE – GENERAL PRACTITIONERS VERBATIM RESPONSES
APPENDIX SIX – GENERAL COMMENTS / FEEDBACK FROM GENERAL