Entering psychological treatment: Decision-making factors for GPs and service users

This article examines patient and referrer decision-making factors surrounding entry to psychological treatment in a primary care setting. Drawing on qualitative data generated by a case study of patients and general practitioners (GPs), the help seeking concerns of patients and frameworks of understanding of their referrers are compared and contrasted. The accounts of patients reveal a complex process of access which operates in a unique biographical context. The latter includes expectations and experience of counselling, the timing of help seeking, triggers to help seeking, lay problem formulation, the perceived adequacy of GPs and self-care strategies. The analysis presented suggests that negotiations for help seeking to ameliorate psychological distress in a primary care setting reflect both objective processes and subjective attributions about these processes from the two parties studied.