| Popis: |
Aim: To evaluate the clinical effectiveness of a counselling psychology service in primary care. Method: Comparison of SCL-90R and HAD scores of a group of clients in treatment with those of a control group receiving GP-only care, at four points in time; and with scores while waiting for treatment. The design combines elements of an open trial with elements of a randomised controlled trial, although full randomisation was not possible in practice. The results are expressed in terms of numbers of cases and effect size, as well as in terms of test scores, in an attempt to indicate levels of clinical as well as statistical significance. Comparison of number of visits made to general practitioners by participants in each group during the six months before and after treatment. Results: The results indicate that the service was clinically effective: clients improved significantly after treatment on the scales used, the numbers of 'casee decreased significantly, and the number of visits to the general practitioners also dropped. Compared to the control condition, the treated clients did better on all these indicators, but the difference between the two groups was not great enough to show statistical significance at the 0.1% level required by the use of multiple planned tests, or on MANOVA, although on the major indicators (SCL-90R GSI and HAD Depression and Anxiety) significance was reached at the 5% level. The overall effect size was coculated to be 0.32. As it was 15 greater than zero, it indicates that the service's interventions were more effective than GP-care, but the magnitude of the effect was in the small to medium range. Conclusions: The results of the research demonstrate that the counselling psychology service under study was clinically effective. On all indicators used, clients of the service improved over the period of treatment, and did so to a greater extent than patients in the control condition. However the advantage over the control group was not sufficient for statistical significance at the level required, and this is reflected in the relatively moderate effect size. |
