Psychotherapy for FPs?

[scubadoc78]

Did you guys know there is a manual for PCPs to do psychotherapy? It makes sense if PCPs are frontline but how many of you guys do this or would even consider it?

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[sarcopenia]

My program offers random courses from time to time, including "GP psychotherapy." There are not enough psychiatrists to do psychotherapy. If patients want to go to a psychologist instead, it costs them out of pocket. Hence, the (somewhat) readily available family doctor can do a reasonable job, and the patient is still covered under provincial healthcare.

No manual that I know of...I think all you need is to sharpen up your assessment skills, and then take maybe 20 or 30 hours worth of a preferred technique (likely CBT) to get started.

There are certainly full-time GP/FP psychotherapists around where I am who do nothing else. I don't know if I could go that far (I'd fear losing my general medical diagnostic ability), but it's good (easy) money for those inclined.

 

[deleted87716]

I don't think you have any business doing psychotherapy unless you're trained and qualified to do so, regardless of the lack of qualified personnel for referral. Do the best you can within the scope of your training.

 

[lowbudget]

Start with reading Stuart and Liberman's The 15 Minute Hour. It's practical therapy for the primary care setting and helps you structure the visit. Read and practice using BATHE technique and crisis counseling towards the end of the book.

If you're interested in doing this, you should spend the time/effort to learn more about it via training. Like any other medical condition, you need to know when to get help, when to go with a team approach, know what you're dealing with.

 

[scubadoc78]

You don't think it's appropriate to ask someone about their childhood while checking their prostate? I think it's a good way to save money.

 

[deleted87716]

You don't think it's appropriate to ask someone about their childhood while checking their prostate?

Actually, I think that's a great time for a joke.

 

[scubadoc78]

Actually, I think that's a great time for a joke.

Come on now, what could possibly be funny about a prostate exam???

 

[deleted87716]

Come on now, what could possibly be funny about a prostate exam???

Exactly.

 

[EdibleEgg]

Come on now, what could possibly be funny about a prostate exam???

Not too long ago I visited a friend from residency who does entrance physicals for a branch of the military, which includes a prostate exam. I noticed a rubber glove full of sand on his desk.... During the prostate exam he puts his hand on the patients left shoulder, the rubber glove on the right, then gives the one finger wave. I thought that was pretty funny.

 

[scubadoc78]

Not too long ago I visited a friend from residency who does entrance physicals for a branch of the military, which includes a prostate exam. I noticed a rubber glove full of sand on his desk.... During the prostate exam he puts his hand on the patients left shoulder, the rubber glove on the right, then gives the one finger wave. I thought that was pretty funny.

Aww, teasing military recruits is shooting fish in a barrel. When I was in basic training we all were told anyone doing submarine duty had to receive a "testicular shot" for protection from radiation. You can imagine the ensuing line of recruits trying to get out of sub duty...and one odd fellow who was not

 

[chartero]

Here's a potential resource, especially for Canadians: The General Practice Psychotherapy Association.