A portfolio of theory, practice and research in a primary care setting
Counselling is a growth area in primary care. Difficulties providing a psychologically based serviced within the medical domain of the surgery have been documented, in particular the difficulties when two professionals from differing backgrounds come together to provide a service to patients. This piece of research aims to explore (both qualitatively and quantitatively) the perceptions and experiences of GPs of primary care counselling. A second aim is to compare GP's perceptions and experiences to those of primary care counsellors themselves. The objective being to help understand these difficulties (from the perspective of both professionals) as well as the factors involved in shaping a GP's perception of primary care counselling. The study focuses on the GP-counsellor relationship, GP satisfaction with the service, GPs' perceptions of counselling and the role of the counsellor in the practice. The research aims are addressed through using three different formats and combining qualitative and quantitative methods of analysis. A small group of GPs were interviewed on their experiences of a counselling service. These findings helped to shape the development of a survey looking at perceptions and experiences of primary care counselling. The survey was sent to a larger group of GPs and also to primary care counsellors. The third stage of the study involved meeting with a group of GPs to hear their views on primary care counselling services. The results obtained from the study suggest that overall GPs value their counselling service but they seem to view counselling as a passive process. There is no consensus among GPs or among counsellors as to what counselling is. The role of the counsellor within the practice does not appear to be clear to the GP and there are differences between the counsellors' perceptions of their role and the GPs' perceptions. Issues of GP power emerge from the study and many GPs believe they offer counselling to their patients. These results are developed into a model showing the factors involved in a GP's perception of primary care counselling and what factors might lead a GP to form a negative or unhelpful perception of practice based counselling. From this model interventions are suggested aimed at changing unhelpful/negative perceptions that GPs may hold and interventions designed to promote good collaborative practice. These interventions are aimed at both GPs and primary care counsellors. The study has implications for the training of both GPs and primary care counsellors as well as implications for service users. The study highlights the importance of collaborative working and the GP-counsellor relationship. Such research can help increase our understanding of inter-professional relationships.