Psychotherapy in primary care

With 90% of all mental health consultations occurring in primary care, and only 10% ever being referred on successfully for specialised help, there is a clear role for psychotherapists in primary care. The majority of general practices in UK now have therapists (psychotherapists or counsellors) attached to their teams. The work is unexpectedly complex and demanding, requiring advanced skill in assessment and in tailoring in-house short-term and short-in-long term psychotherapy to the varying needs of patients, and their referrers. It is argued that the characteristics of primary care - the emotionally significant relationships that patients often form with their GPs, and the role of the practice as a secure base to which patients become attached in a variety of characteristic ways - are not sufficiently taken into account when considering appropriate techniques for psychotherapy in primary care. There is a need for training (and supervision) to become more setting-specific and to include appropriate experience in psychological therapies for use in primary care.