May 2011


Depression in general practice

Consultation duration and problem solving therapy

Volume 40, No.5, May 2011 Pages 334-336

David Pierce

Jane Gunn


General practitioners have expressed concern that consultations offering psychological therapy approaches will take up too much time. However, problem solving therapy (PST) for depression may be able to be used within the time constraints of general practice. This study investigates whether GPs’ concerns that PST would result in unacceptably long consultations are justified.


General practitioners were observed providing PST in simulated consultations before and after PST training – PST skill and duration of consultations were measured.


Twenty-four GPs participated. Problem solving therapy skill increased markedly, but mean consultation duration changed minimally: 17.3 minutes and 17.9 minutes


This research suggests that GPs can provide an evidence supported psychological treatment for depression within the time constraints of routine practice. The structured nature of PST may allow GPs to provide additional mental healthcare for depression, without significantly increasing consultation duration. It suggests GPs’ concerns about the time PST may take up in practice may be unjustified and that further research into the use of PST in routine general practice should be undertaken.

Each year 700 000 Australians experience depression.1 Most patients who seek professional help for depression visit a general practitioner, with more Australians receiving clinical care from a GP than all other health professionals combined.2 It is estimated that GPs in Australia deliver more than 3 500 000 services for depression each year.3 General practice consultations for psychological problems have been reported to take longer than consultations that address nonpsychological issues.4,5 Many GPs report concern that time is a limiting factor in their capacity to address psychological issues, including depression.4,6 A range of solutions to address this difficulty, including opting to adjust consultation duration to respond to psychological needs by ‘running over time’ have been reported.7

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