The intervention group received psychotherapy that was based on a model developed by Hobson.[1] The therapy is described in a standardised manual,[2] and involves identifying and helping to resolve interpersonal difficulties that cause or exacerbate psychological distress. Therapy was delivered by nurse therapists in the patients’ homes. Four weekly 50 minute sessions were offered. Treatment fidelity and adherence was ensured by weekly supervision, audiotaping of interviews, and use of a standardised rating scale.[2]

The control group received usual care, which consists of an assessment by a casualty doctor or junior psychiatrist in the emergency department. Approximately one third of patients are routinely referred for follow up as a psychiatry outpatient, a few are referred to addiction services, and the rest are advised to consult their own general practitioner. No patients are routinely referred to psychotherapy or psychology services.

1 Hobson RF. Forms of feeling: the heart of psychotherapy. London: Tavistock Publications, 1985.

2 Shapiro DA, Startup MJ. Raters’ manual for the Sheffield psychotherapy rating scale. Sheffield: MRC/ESRC Social and Applied Psychology Unit, University of Sheffield, 1990.

The manual cited in reference 2 is available from:

The Psychological Therapies Research Centre
School of Psychology
University of Leeds
17 Blenheim Terrace
Leeds LS2 9JT, UK

E-mail ptrc{at}psychology.leeds.ac.ukFax +44 (0)113 233 1956