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Impact of an educational intervention on general practitioners’ skills in cognitive behavioural strategies

TO THE EDITOR: The randomised controlled trial recently reported by Blashki and colleagues does not support their hypothesis. The drop-out rates in both arms of the trial were very high — only 62% of general practitioners in the intervention group and 54% in the control group completed the trial. One cannot have any confidence in their conclusion that a short training course can improve GP skills in the provision of cognitive behavioural strategies (CBS). For example, what if the 38% of GPs in the intervention group who dropped out actually deteriorated in their CBS skills and therefore declined to be videotaped? Furthermore, only 56 of 1021 GPs in Victoria were willing to enrol in the trial. The authors concluded that their findings could only be applied to GPs who have a special interest in mental health. Perhaps the low participation rate indicates another more relevant idea — that GPs have had enough of “training models” being imposed on their lives. A recent systematic review has confirmed the low impact that educational training programs have on GPs for the management of mental health problems.