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When is enough enough? Structuring the organization of treatment to maximize patient choice and control

Published online by Cambridge University Press:  24 March 2009

Timothy A. Carey  and
Margaret B. Spratt
Timothy A. Carey*
Affiliation:
Centre for Applied Psychology, University of Canberra, ACT, Australia
Margaret B. Spratt
Affiliation:
Department of Clinical Psychology, Stratheden Hospital, Fife, UK
*
*Author for correspondence: Dr T. A. Carey, Centre for Applied Psychology, University of Canberra, Canberra ACT 2601, Australia. (email: [email protected])
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Abstract

The psychological treatment offered to clients is important. However, an equally important consideration may be the way the treatment is delivered. Reducing waiting lists and improving access to services are priorities for many health services. So is increasing patient control over their own health-care outcomes. While waiting times and access to services have typically been addressed by increasing the numbers of clinicians available, our work suggests that a strategy of providing patients with the ability to determine the frequency and duration of their treatment may be an option that is simpler, more effective, and financially more attractive. After describing policy and ethical guidelines as well as empirical and theoretical information, we provide data from our work in one GP practice about the improvements in waiting times and access to services that occurred when we adopted an approach that allowed patients rather than clinicians to decide how the organization of treatment would occur. There seem to be many benefits to this approach; however, it may also raise dilemmas for clinicians when patients' preferences differ from their own. Ultimately, these conundrums can only be reconciled by the individual clinicians based on their attitudes to mental health problems and service provision.

Keywords

Anxietycontroldepressionprimary care
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 2 , Issue 3 , September 2009 , pp. 211 - 226
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Recommended follow-up reading

Carey, TA (2005). Can patients specify treatment parameters? Clinical Psychology and Psychotherapy: An International Journal of Theory and Practice 12, 326–335.CrossRefGoogle Scholar
Carey, TA (2006). Estimating treatment duration in primary care. Journal of Public Mental Health 5, 23–28.CrossRefGoogle Scholar
Carey, TA, Mullan, RJ (2007). Patients taking the lead: A naturalistic investigation of a patient led approach to treatment in primary care. Counselling Psychology Quarterly 20, 27–40.CrossRefGoogle Scholar

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