Selecting patients for brief office counseling

Family physicians in training are expected to develop expertise in a variety of clinical areas, including the capability to respond to the psychological needs of their patients. Despite this, many physicians in training are not taught to discriminate between patients likely to benefit from brief office counseling and patients who are not. Certain criteria may predict success in brief counseling. These include characteristics of the patient, the patient's presenting problem, the physician's initial response to the patient and his problem, and the ability of the patient and the physician to come to an agreement on the nature and resolution of the problem. Clinical examples depicting requests for counseling illustrate the problems associated with the failure to consider these prognostic criteria. Precautions associated with using these predictors of counseling success are listed and discussed.