To assess how current policy trends may affect the use of counseling for depression, we examined the variation in the use of counseling and usual clinician counseling style for depression across specialty sectors (psychiatry, psychology, and general medicine) and reimbursement type (fee-for-service or prepaid).
Three types of observational data from the RAND Medical Outcomes Study :
(1) patient-reported demographics, depressive symptoms, clinical status, and perceptions about participation style ;
(2) clinician reports of counseling during specific patient encounters ;
and (3) clinician reports of the usual counseling and interpersonal style across patients who were seen in a practice.
While almost all depressed patients who were being treated by mental health specialists received brief counseling for at least 3 minutes, less than half of the depressed patients in the general medical sector received such counseling-even for those patients with a current depressive disorder.
Counseling rates were lower under prepaid than fee-for-service care in general medical practices.
Psychiatrists relied more on psychodynamic approaches, and psychologists relied more on behavioral therapies relative to each other, but both specialty groups provided longer sessions and used more formal psychotherapeutic techniques (eg, interpretation) than did general medical clinicians. (...)
Mots-clés Pascal : Etat dépressif, Trouble humeur, Traitement, Conseil psychologique, Psychothérapie, Personnel sanitaire, Etude comparative, Psychiatre, Psychologue clinicien, Médecin généraliste, Pratique professionnelle, Assurance maladie, Système santé, Etats Unis, Amérique du Nord, Amérique, Homme, Spécialité médicale, Remboursement
Mots-clés Pascal anglais : Depression, Mood disorder, Treatment, Psychological counseling, Psychotherapy, Health staff, Comparative study, Psychiatrist, Clinicien psychologist, General practitioner, Professional practice, Health insurance, Health system, United States, North America, America, Human, Medical specialty
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0473688
Code Inist : 002B18H04. Création : 10/04/1997.