UNDERSTANDING THE CONTENT OF COUNSELING FOR DEPRESSION

心理咨询是治疗抑郁症的一种有效方法， 了解咨询和人际关怀的内容， 抑郁症患者在基层医疗机构。 我们掌握的信息 来自于对咨询的结构化协议研究， 在精神卫生专业部门内的受控条件。是 重要的是要更好地了解初级保健临床医生通常如何 在一般医疗环境中为他们的抑郁症患者提供咨询， 抑郁症在这一治疗领域很常见;仅在这种情况下， 一半的抑郁症患者接受了充分的治疗， 护理许多抑郁症患者只会接受心理健康护理 一般医疗部门的问题。系统数据描述 平时护理咨询内容也有助于指导医师 报销政策，因为咨询正是这种照顾， 抑郁症患者在购买医疗保健时支付的费用 保险而且，正是这种照顾会影响成本 和抑郁症患者的护理结果。 第一个提案将建立在主要研究者之前的 对临床医生的日常咨询和人际关系的照顾方式的工作 萧条利用两项大型“母体”研究的数据， 抑郁症（AHCPR PORT-II，Kenneth B.威尔斯，PI和NlMH合作 协议，丽莎诉鲁宾斯坦，PI），拟议的项目将审查 抑郁症患者日常心理咨询和人际关怀的内容 患者由初级保健临床医生。本FIRST研究的PI是关键 这些母研究的研究者现在已经进入第一年， 计划的。两项母研究均旨在提高质量， 抑郁症的成本效益的保健预付团体的做法， 六个美国网站在这篇文章中，我们将分析咨询的“黑匣子”。 和人际交往风格的细节比以往任何时候都要详细 大规模的卫生服务研究。我们将进行新的 分析了500名初级保健医生的咨询数据， 2,500名抑郁症患者的研究。新数据将 通过口头咨询的录音内容分析收集 225例抑郁症和非抑郁症患者的行为 和他们的供应商在一个网站上。分析将提供更丰富的 对咨询和人际交往方式的理解比以往任何时候都要多。 以前可用于初级保健中的抑郁症研究。

Counseling is an effective method for treating depression but little is known about the content of counseling and interpersonal care with depressed patients in primary care settings. The information we have comes from structured protocol studies of counseling under highly controlled conditions within the mental health specialty sector. It is important to better understand how primary care clinicians usually counsel their depressed patients in general medical settings because depression is common in this treatment sector; within this setting only half of depressed patients receive adequate treatment, and under managed care many depressed patients will only receive care for mental health problems within the general medical sector. Systematic data describing the content of usual care counseling will also help guide physician reimbursement policy because counseling is exactly the kind of care that depressed patients are paying for when they purchase healthcare insurance. Moreover, it is this kind of care that will affect the costs and outcomes of care among depressed patients. This FIRST proposal will build upon the Principal Investigator's previous work on clinician usual counseling and interpersonal style of care for depression. Utilizing the data from two large "parent" studies of depression (AHCPR PORT-II, Kenneth B. Wells, PI and NlMH Cooperative Agreement, Lisa V. Rubenstein, PI), the proposed project will examine the content of usual counseling and interpersonal care provided to depressed patients by primary care clinicians. The PI for this FIRST study is a key investigator in these parent studies which are now in their first year of planning. Both parent studies are designed to improve the quality and cost-effectiveness of care for depression in prepaid group practices in six US sites. In this FIRST we will analyze the "black box" of counseling and interpersonal style in more detail than has been possible in prior large-scale health services research studies. We will conduct new analyses of the counseling data from 500 primary care clinicians and 2,500 depressed patients in the parent studies. New data will be collected through audiotaped content analysis of verbal counseling behavior from 225 encounters with depressed and non-depressed patients and their providers in one site. Analyses will provide a richer understanding of counseling and interpersonal style than has been previously available for the study of depression in primary care.