TABLE 4

Management by Specialists in Primary Care

StudyDesignBrief Description of InterventionPopulationSample SizeLength of Follow-UpSummary of Results
Beardslee et al, 200343RCTEither a 2-meeting lecture (parents only) or a 6–11 session clinician-facilitated interventionRelatively healthy children aged 8–15 of parents with mood disorder and their parents93 families (121 children)12 and 24 moBoth interventions promoted resilience-related qualities in these at-risk; Long-standing positive effects in how families problem solve around parental illness.
Benson and Turk, 198844aRCTGroup therapy by psychologist/GP vs routine primary careFrequent attenders1717 moFamily consultations significantly reduced in intervention group 6 mo after intervention completed
Blakey, 198645aCBABehavior therapy vs routine primary carePatients with psychological problems1783 yRates of service use in intervention group were higher pretreatment, reduced posttreatment but increased again over time
Coverley et al, 199546aSBAPsychiatric evaluation by child psychiatristMothers of children with psychiatric disorders2612 mo12-mo clinic attendance reduced from 6.5 to 2.8, and maternal coincidence increased postintervention
Davis and Spurr, 199847aCBAParent counseling by trained HVs vs controlFamilies referred to a parent advisor service (HVs, GPs, nursery) or voluntary, self-referrals9316 wkImprovement within intervention group significant in relation to perceptions of family relationships, child behavior and contacts with primary care professionals; Between-group analyses of change scores significant for family relationships
Finney et al, 199149aCBABehavior therapy by psychologists versus routine careChildren with psychological problems18612 monthsExternalizing and internalizing scores reduced significantly (within intervention group only). HMO medical encounters significantly lower post-intervention in intervention group compared with controls
Finney et al, 198948aCBABehavior therapy by psychologists vs routine careChildren with recurrent abdominal pain3242 wkSchool absence reduced (within intervention group only); Significant reduction in medical visits within intervention group, no change in controls
Graves and Hastrup, 198150aCBAPatients treated by psychologists vs controlsChildren with mental health problems6312 moSignificant reductions in medical visits in intervention group, no significant change in controls
Martin, 1988 (unpublished thesis)aCBABehavior therapy by psychologists vs routine careChildren with mental health problems6512 wkTreatment was associated with a significant drop in intensity of problems, but not the number reported
Nicol et al, 199351aRCTIntensive health visiting vs family therapy (by social workers) vs mother and toddler's groups (social workers and HVs) vs controlPreschool children with emotional and behavioral problems2601 and 3 yAt 1 y, significant difference in developmental quotient, with family therapy lower than other three groups; No difference in total child behavior; At 3 y, none of the major outcome variables showed a treatment effect
  • RCT indicates randomized, controlled trial; GP, general practitioner; CBA, controlled before and after study; SBA, simple before and after study; HV, health visitor; HMO, health maintenance organization.

  • a Studies are taken from Bower et al.24