Counseling by Family Physicians: Implications for Training

This study explored family physicians' practice of providing psychosocial interventions in the form of counseling, their beliefs about the efficacy of their counseling, their preferences of who should provide counseling, the skills involved in counseling, and their training experiences in learning how to counsel.

A total of 230 faculty and residents completed written surveys at 11 family medicine residency programs in Florida.

Eighty-one percent of study participants regularly offered counseling to their patients, 85% did so for psychosocial problems, and 94% did so for health behavior change. Compared to residents, faculty reported greater use of counseling and a greater willingness to counsel patients for depression or anxiety. Fifty-six percent of the sample stated that their counseling for mental health problems was effective. Sixty percent reported that their training provided them with a basic knowledge of counseling skills; training involved primarily observing a counselor or acting as a co-counselor with an identified counselor. Cognitive Behavioral Therapy, Motivational Interviewing, and the Stages-of-Change Model were the most widely taught counseling approaches.

Family physicians regularly provide counseling for psychosocial problems and health behavior change, and a modest number believe counseling is effective. Residents counsel less regularly and are less confident in the effectiveness of their counseling compared to faculty. Training in counseling skills generally involves direct observation and learning several counseling techniques. Future research should explore whether models of family physician counseling are practical, which techniques should be taught and how.