From small beginnings in the 1970s, counselling in primary care has now become an established area of practice. It is well recognised that a significant proportion of patients in primary health care have psychological difficulties which are treatable at the 'coal face' before they develop into major problems. Mental health services can now reach a wider population more quickly with cost-effective therapeutic benefits. This text examines the intra - and inter-personal dynamics of primary care essential for counsellors and psythotherapists working in health centres and considers the advantage of multi-disciplinary and multi-agency collaboration.
The progressive approach will be of interest to all who work in primary care. They will recognise in it many of their day-to-day working dilemmas, especially in trying to balance the tension between commitment to individual patients and the demands of the wider organisation. Case illustrations are used to demonstrate the challenges and teamwork opportunities for both counsellors and doctors who work collaboratively. This book is essential reading for counsellors and psychotherapists who work in primary care and for the doctors and health authorities who employ them.

'...this is an excellent new arena for highly effective therapeutic work...Jan Wiener and Mannie Sher have done an excellent job.' - from the foreword by Andrew Elder, Consultant in General Practice and Primary Care, Tavistock Clinic, London

'...an important source of learning, bringing clarity and insight into often isolated areas.' - Journal of Counselling in Medical Settings

'Despite the open and accessible manner in which it is written, I found this to be a quietly provocative book which led me to think about the complexity and challenge represented by the application of psychodynamic thinking in a GP's surgery.' - Psychoanalytic Psychotherapy

Acknowledgements
Preface
Foreword
Hopes and Realities of Work in a Primary Care Setting
The Doctor-Counsellor Relationship
The Nature of Work
Referrals: Who really Needs the Counselling?
Assessment for Counselling and Treatment Options
On-going Work in Primary Care
Psychosomatic Illness: The Path towards a Common Language
Key Professional Issues
Does Counselling Work
Appendix A Key Terms and Concepts
Appendix B Professional Training for Counselling in Primary Care
Appendix C Addresses of Organisations Interested in Counselling in Primary Care
References
Index

JAN WIENER is a Jungian Analyst and Research Psychologist. She works in three different settings: as an Adult Psychotherapist at Thorpe Coombe Hospital, Walthamstow, in her private analytic practice, and as a psychotherapist with a group of GPs in an inner-London practice.

MANNIE SHER is a practising psychoanalytical psychotherapist and organisational development consultant. From both these positions he contributes to the development of counselling and psychotherapy services in primary health care and consults widely to organisations and governments in Britain and abroad on health-care strategies.