ABSTRACT
This chapter provides a conceptual framework in which to view the changes in the National Health Service and their implications for counselling in general practice, in particular the impact of the National Health Service and Community Care Act. It seeks to contextualize these debates within a broader conceptual framework, or meta-theory, borrowed from the field of cultural studies, namely postmodernism. To the two models traditionally applied to counselling in general practice, the bio-medical and psycho-social, will be added a third, the market model. The chapter applies each of these three models to counselling in general practice. Key terms selected from these models are used to explore typical referrals to the counselling service, namely ‘patient’, ‘client’, and ‘customer’. The chapter concludes with the proposal that it is necessary, in a mixed economy of care, to recognize the implications of living and working in a postmodern world.
