Interpersonal counselling Distress

Many patients presenting to primary care practices report psychiatric symptoms, yet do not meet the full criteria for a psychiatric disorder. Their symptoms can be debilitating and may result in high wasted utilization of medical procedures. (79> Interpersonal counselling (IPC), based on IPT, was designed to treat distressed primary care patients who do not meet full syndromal criteria for psychiatric disorders. IPC is administered by health-care professionals, usually nurse practitioners who lack formal psychiatric training, for a maximum of six sessions. The first session can last up to 30 minutes; subsequent sessions are briefer.

IPC therapists assess the patient's current functioning, recent life events, occupational and familial stress, and changes in interpersonal relationships. They assume that such events provide the context in which emotional and bodily symptoms occur. A total of 128 patients presenting to a primary care clinic and scoring six or higher on the Goldberg General Health Questionnaire were randomized to IPC or to usual care without psychological treatment. (80> Over an average of 3 months, often involving only one or two IPC sessions, IPC subjects showed significantly greater symptom relief than controls on this General Health Questionnaire, especially improvement in depressed mood. IPC also led to greater use of mental health services by patients newly attuned to the psychological aspect of their symptoms.

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