Decisions about referrals for psychological therapies: a matched-patient qualitative study
Open accessAbstract
BACKGROUND: Psychological therapies are effective treatments for common mental health problems, but access is limited. GPs face difficult decisions as to whom to refer, but little is known about this decision-making process. AIM: To explore GPs' accounts of decisions to refer, or not refer, patients for psychological therapy. DESIGN OF STUDY: A qualitative study, using a matched-patient procedure. SETTING: General practices in two inner London boroughs. METHOD: In semi-structured interviews, GPs were asked to compare and contrast five matched-patient pairs, consisting of patients who had been referred for psychological therapy paired with patients not referred. The interviews were analysed using a general thematic analysis. RESULTS: Fourteen GPs discussed 130 matched patients (65 patient pairs). Three main factors distinguished GPs' accounts of the patients they referred compared with the matched patients they did not refer. These factors were: patient initiative in requesting or showing interest in referral; estimated capacity of the patient to benefit from psychological therapy; and the GP's own capacity to help the patient in terms of skills, expertise, and time. CONCLUSION: GPs gave accounts of themselves acting as rational decision makers, judging how effective they thought a referral would be based on a patient's clinical presentation and motivation, compared with the GPs' own ability to help.
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There is evidence that GPs are rational decision makers when referring for psychological therapies.
“Relevant to this, there is also evidence to show that GPs are rational decision makers when referring for psychological therapies.53”
From Can a self-referral system help improve access to psychological treatments? (2010) · cites this paper as [53]
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- Authors
- Stavrou, S., Cape, J., & Barker, C.
- Affiliations
- St Pancras Hospital (GB)
- Corresponding author
- Cape, John
- Venue
- British Journal of General Practice
- Published
- 2009-09-01
- Volume
- 59
- Issue
- 566
- Pages
- e289-e298
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC2734375
- OpenAlex
- W1975049157
- Cited by
- 24
- References
- 50
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 1 · 2020: 2 · 2019: 2 · 2017: 3 · 2015: 2 · 2013: 2 · 2012: 2
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- referral decisions, psychotherapy, general practitioners, decision-making, access to mental health care, patient motivation, perceived treatment benefit, common mental disorders
- MeSH terms
- Adult, Attitude of Health Personnel, Attitude to Health, Mental Disorders, Decision Making, Family Practice, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Professional Practice, Psychotherapy, Referral and Consultation, Patient Satisfaction
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