Factors involved in successful psychotherapy referral in rural primary care.
Many primary care patients are identified as needing psychotherapy. Often family physicians choose to refer these patients for comprehensive treatment, yet psychotherapy referrals are traditionally difficult to transact successfully in comparison with referrals for other biomedical complaints. Previous reports have been published on the beliefs held by family physicians and psychologists regarding factors that affect the success of a referral. This follow-up study reviewed 138 referrals from rural family physicians to psychotherapists. Fifty-nine percent of the referrals were considered successful by the family physicians and 73% by the patients. Successful psychotherapy referral, as evaluated by physicians, was related to psychotherapist-initiated post-referral communication with the referring physician. There was no relationship between success of referral outcome and the number of preparatory (or follow-up) visits with the physician, physician's knowledge about the psychotherapy process, patient economic status, or insurance coverage. However, attending more than one therapy session was associated with the number of physician visits prior to referral, distance to the therapist's office, and referral by a physician who included counseling in his or her practice. Findings indicate that when physicians are kept informed about patients' treatment, they are more likely to evaluate the treatments as beneficial.
Department of Family Medicine, State University of New York, School of Medicine and Biomedical Sciences, Buffalo 14208.
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TC
Rosenthal
J M
JM
Shiffner
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Lucas
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DeMaggio
D000328:Adult; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology; D011320:Primary Health Care / Q000379:methods*; D011613:Psychotherapy / Q000592:standards*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012423:Rural Health / Q000592:standards*; D016896:Treatment Outcome