Held in the balance.
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Health Services Needs and Demand↗
Biomedical subjects
C Trepka
Publications and source records attributed to C Trepka.
A clinical psychology service for the elderly.
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Aged↗
Evaluation of psychological treatment in primary care.
As clinical psychology services to primary care have grown considerably in recent years, several papers have examined the impact of such services. Benefits to patients following contact with the psychologist have been described, but the few studies which have used control groups have -not shown long-lasting effects. However, assessing the global effects of psychological treatment creates several methodological problems, and many of the studies have serious shortcomings in their use of sampling procedures and dependent measures. Clear results are unlikely to emerge from such studies because psychological treatment is not a single entity but encompasses a number of interventions for different types of problem. A more differentiated approach to evaluation is needed to assess the effectiveness of psychological treatment services in primary care.
Humans↗
Attrition from an out-patient psychology clinic.
Patient attrition is a considerable problem in many health care settings. This study examined attrition among out-patients referred to a clinical psychologist. Forty per cent of all referrals dropped out and different factors were associated with dropping out at different times. Patients who engaged into treatment before dropping out had less initial pathology and made some improvement. Early drop-outs were characterized by lower social class and unemployment. These non-engagers were more likely to have been sent by referring agents who had relatively poorer contact with the psychologist. Further investigation of factors involved in the referral process might lead to practical ways of reducing the large amount of clinical time which is lost because of attrition.
Adolescent↗
Group treatment of general practice anxiety problems.
This study examined the effects on anxiety levels and primary care team workload of group psychological treatment for anxiety compared with individual treatment. Patients making high demands on primary care services were selected for group treatment, following which demands for services were considerably reduced. Two types of group treatment were used: the anxiety support group required less staff time to run than the anxiety management group but neither treatment had a clinically significant impact on anxiety symptoms. Individual psychological treatment was more effective in reducing levels of anxiety but required slightly more staff time per patient. These findings show that there is no close correspondence between reduction of anxiety and reduction of service costs and underline the importance of evaluating treatment effects with reference to the specific objectives of treatment.
Adult↗