Counsellors in English and Welsh general practices: their nature and distribution.
OBJECTIVE
To establish the prevalence of counselling services in English and Welsh general practices and factors associated with their distribution; to describe qualifications, working arrangements, and case mix of "counsellors."


METHODS
Postal questionnaire and telephone interview survey of a sample of about one in 20 general practitioners in England and Wales.


METHODS
English and Welsh general practices.


METHODS
1880 general practitioners of whom 1542 (82%) completed questionnaires.


METHODS
Prevalence and distribution of practice counselling services; counsellors' qualifications and funding; types of patients referred.


RESULTS
586 counsellors were distributed among 484 of the 1542 practices. Three types of counsellor predominated: community psychiatric nurses (187); "practice counsellors" (145); and clinical psychologists (95). Practice characteristics which independently predicted the presence of a counsellor were for community psychiatric nurses four or more partners (odds = 1.72, 95% confidence interval 1.18 to 2.26); for practice counsellors stress clinic (odds = 2.22; 1.83 to 2.61), training practice (odds = 1.70; 1.24 to 2.16), and health region (chi 2 = 55.94; df = 14; p < 0.001); and for clinical psychologists list size of > or = 10,500 (odds = 1.79; 1.09 to 2.49), training practice (odds = 1.78; 1.31 to 2.25), health region (chi 2 = 48.31; df = 14; p < 0.001). 197 counsellors had training in counselling. The qualifications of 85 were unknown to the general practitioner. The principal source of funding was the district health authority for community psychiatric nurses (150) and clinical psychologists (58) and the family health services authority for practice counsellors (76). All counsellors were referred a wide range of problems.


CONCLUSIONS
Counselling services are wide-spread in general practice, but a high proportion of counsellors lack qualifications, and many may be referred problems outside their knowledge.
Sibbald
B
B
Division of General Practice and Primary Care, St George's Hospital Medical School, London.
Addington-Hall
J
J
Brenneman
D
D
Freeling
P
P
D003376:Counseling / Q000193:education / Q000592:standards / Q000706:statistics & numerical data*; D003695:Delivery of Health Care; D004739:England; D005194:Family Practice / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D011568:Psychiatric Nursing; D011586:Psychology, Clinical; D011795:Surveys and Questionnaires; D014852:Wales; D000078329:Workforce