Collaborative care in the United Kingdom

It is estimated that in 1999, psychological counselors will work in over half of all general practices (primary care physician partnerships) in the United Kingdom. The history of the growth of counseling in general practice is, in many ways, typical of the British way of doing things. Ad hoc arrangements at a personal level, in which individual general practices let a counselor, of ten a social worker, colleague, or personal friend, see those patients who had a variety of problems the primary care physician felt unskilled to handle, characterized many of the early reports of General Practice Counseling.(2,3,26) From provisional data available from the first ever National Survey of general practice counselors,(29) it seems that most counselors are women (87%), with an average age of 48 years; all but a tiny handful have recognizable counselling or psychotherapy qualifications. Fifty percent usually possess a British Association for Counseling Recognized Certificate and Diploma, 25% possess additional counselling and psychotherapy qualifications, and 13% possess qualifications at a Masters level. The counselors surveyed come from many backgrounds, including social work, teaching, and nursing, and they work between 5 to 30 hours a week in general practice. As more research studies are published in the United Kingdom, their work, along with other members of the primary care teams (doctors, nurse practitioners, health visitors, psychotherapists, social workers, and others), is becoming increasingly valued by their fellow primary care team members, and by the patients they see who are referred to them by their primary care colleagues.(4,21,24)