ABSTRACT
This chapter examines the literature on the effectiveness and cost-effectiveness of counselling. It provides a general review of the evidence for the cost-effectiveness of counselling and psychotherapy interventions in healthcare settings. The chapter also provides a more detailed review of a selection of published studies of the cost-effectiveness of counselling interventions. There has been little agreement as to whether counselling and psychotherapy has any effect or is more effective than offering individuals a suitable placebo therapy. Psychotherapy had the greatest impact on utilisation of hospital inpatient care and associated costs. A large relative decline in utilisation was also found for older subsets of patients. In the early 1980s there was a surge of interest in the application of the techniques of cost-effectiveness and cost-benefit analysis to the evaluation of psychotherapy. As with most health promotion initiatives, primary care is seen as a central setting for the provision of mental health services, in particular for counselling and psychotherapy services.
