Holistic health : the effectiveness of a counselling model in a primary health setting : a thesis presented in partial fulfilment of the requirements for the degree of Master in Social Work at Massey University

Abstract

The interface between mental health services and primary health care is changing, both internationally and within New Zealand. With the shift toward population health principles and funding formulas, as well as health strategies emphasizing primary health care, the incorporation of mental health services within the primary care domain seems a logical step. In New Zealand, there have been and are currently many variations on this theme of integration, most have arisen in response to the need for service integration and all are locally created and sustained. This study examines one of these initiatives, the incorporation of personal counselling in the primary care setting. This study explores the effectiveness of the counselling model being used by the practitioners providing a primary care counselling service in a provincial town in New Zealand. The counselling model is grounded in social work theory and practice, it incorporates a strengths based perspective with solution focused brief therapy and cognitive interventions. Effectiveness was measured according to whether the participants' initial concerns were met, whether there was global improvement, and the level satisfaction with the therapist. Both quantitative and qualitative measures were used including survey questionnaires, interviews, as well as pre and post intervention measurements. Information was gathered about the experience of participating in counselling in the primary care setting. The results from all these methods indicate that this counselling model addressed the main concerns for participants and there was satisfaction with the therapist. There was not always global improvement for participants, some of whom felt uncomfortable participating in counselling at their General Practitioner's surgery. The interviews reflected these results, and the pre and post measures indicated improvement in symptoms. This model does appear to be effective in this setting with the wide range of issues that present in the primary health domain.