Psychological therapy in primary care: work in progress

This paper considers the benefits to the mental health of patients of the provision of psychological services in primary care. I describe by means of context, the development of such a service over the last 7 years. In the following section I discuss the question of who is 'the patient' who gets referred and who can benefit from psychological treatment in a primary care setting. More specifically I consider the spectrum of psychopathology of patients who are referred in primary care for psychological help and in relation to this question I discuss what would constitute a meaningful clinical intervention. In the last section, I look at the question of what needs to be in place for a successful psychological service in a primary care setting. I argue that, while benefits for mild to moderate psychological problems have been documented by research findings, clinical scrutiny of the interventions in primary care suggest that this is not necessarily the case when it comes to patients with more severe psychological problems. I further argue that there are still important issues to be considered and researched and structures to be put into place before we can safeguard the clinical effectiveness of psychological interventions in primary care.