Authors' objectives:

This paper formulates a conceptual framework for counseling in the primary care setting, clarifying the different forms, key principles, and tasks for the counselor that best represent the requirements for successful counseling. It describes four theoretical approaches that have contributed to our understanding of lifestyle change. A series of evidence-based illustrations are used to demonstrate how elements of these different models have been applied. The six risky behaviours addressed in this paper are appropriate targets for counseling. Some situations respond to brief on-the-spot advice, others require a few repeated counseling sessions utilizing concepts from behavioural theory, and certain ones need referral to a structured counseling program that employs a longer time-frame and allows for the opportunity to use a range of methods.

Authors' recommendations: Evidence that counseling by clinicians in a primary care setting can produce long-term behavioural change is only beginning to appear in the literature. The six risky habit patterns addressed in this paper (dietary patterns, unintentional injury, problem drinking, physical inactivity patterns, risky sexual patterns and cigarette smoking) are appropriate targets for behaviour change counseling. Some situations respond to brief on-the-spot advice, others require a few repeated counseling sessions utilizing concepts from behavioural theory, and certain ones need referral to a structured counseling program that employs a longer time-frame and allows for the opportunity to use a range of methods. The description of studies outlined above however, is not meant to infer that any form of brief counseling sessions will necessarily achieve comparable reduction in health outcomes to those reported in this paper. Rather, there is evidence that even brief counseling can be effective in busy primary care settings, that a triage approach for evaluating a patients status regarding predisposing, enabling and reinforcing factors is effective in appropriately targeting education and counseling strategies, and that the use of office support tools and programs improves the delivery and effectiveness of counseling in the primary care setting.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.ctfphc.org/

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Task Force on Preventive Health Care

Contact Address: Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112

Contact Name: ctf@ctfphc.org

Contact Email: ctf@ctfphc.org

Copyright: Canadian Task Force on Preventive Health Care (CTFPHC)