Referring patients to counsellors in primary care: Qualitative investigation of general practitioners’ perceptions

Abstract

Despite growing evidence of the effectiveness of counselling in primary care, questions arise concerning the role of general practitioners in the referral process. This involves both liaison with counsellors and the management of people who do not wish to see counsellors. Respondents (n=23) in this qualitative study of general practitioners’ perceptions were clear about which patients should be referred to counsellors, based on guidelines. Additionally, these doctors perceived their role and skills as negotiating with their patients about referral to a counsellor, and managing patients who are either waiting to see a counsellor or who prefer not to see a counsellor. These doctors feel inadequately trained in managing this latter group, whose outcome they perceive as unclear. Despite this, respondents accept a role in ongoing support for their patients with consequent training issues for doctors and opportunities for liaison and mentoring by counsellors.

Keywords:

• Counselling
• primary care
• doctor's role
• referral
• GP patient relationship
• patients who refuse referral to counsellors

We thank participating general practitioners for their time and candour, and Denise Mukadam and Caroline Connolly for secretarial assistance. We are grateful to Peter Bower, Chris Dowrick, Nicki Mead, Martin Roland, Keith Sharp and Carl Whitehouse for their comments on the study from which this paper is drawn.