The British journal of clinical psychology · 2026
Real-world effectiveness of integrating clinical psychologists into primary care: First-year outcomes from a regional programme for common mental disorders in Spain.
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González-Blanch César, Rodríguez-Pérez Noelia, Camino-Sánchez María, Bengochea-Seco Rosario, Montes-Novoa Cintia, Gil-Sanz David, Pérez-Monzón Silvia, Uriz-Zafra Blanca, Muñiz-Videchea Mikel, Díaz-Gómez Paula, Priede Amador
Аннотация
OBJECTIVES: Common mental disorders (CMDs), including depression and anxiety, are highly prevalent in primary care, yet access to psychological therapies, which are the first-line treatment for these conditions, remains limited. This study evaluated the effectiveness of the Clinical Psychology in Primary Care Programme in Cantabria during its first year of implementation, which integrated clinical psychologists into primary care teams to deliver brief, evidence-based interventions.
DESIGN: Naturalistic observational pre-post study in primary care.
METHODS: A total of 1149 patients (66% women; M = 44 years) were assessed with the PHQ-9 and GAD-7 before and after a brief psychological intervention of up to eight sessions per patient delivered individually or in groups. Linear mixed-effects models examined pre-post changes and moderators (intervention format, age, sex). Reliable change, deterioration and recovery were calculated.
RESULTS: Significant and clinically meaningful reductions were observed in depressive (ΔPHQ-9 = -7.8) and anxiety symptoms (ΔGAD-7 = -7.1; p < .001). Individual therapy produced greater improvements than group interventions, and younger participants showed slightly larger gains; sex showed no effect. Moderate variability in outcomes was observed across therapists. Among completers, large effect sizes were found (dRM ≈ 1.3); 73% achieved reliable improvement and 51% met reliable recovery criteria, while deterioration rates were below 1%.
CONCLUSIONS: Findings support the consolidation and expansion of the integration of clinical psychologists into primary care, providing evidence that the psychological interventions delivered in this context are a feasible, equitable and effective approach to treating CMDs in the Spanish public health system.
DESIGN: Naturalistic observational pre-post study in primary care.
METHODS: A total of 1149 patients (66% women; M = 44 years) were assessed with the PHQ-9 and GAD-7 before and after a brief psychological intervention of up to eight sessions per patient delivered individually or in groups. Linear mixed-effects models examined pre-post changes and moderators (intervention format, age, sex). Reliable change, deterioration and recovery were calculated.
RESULTS: Significant and clinically meaningful reductions were observed in depressive (ΔPHQ-9 = -7.8) and anxiety symptoms (ΔGAD-7 = -7.1; p < .001). Individual therapy produced greater improvements than group interventions, and younger participants showed slightly larger gains; sex showed no effect. Moderate variability in outcomes was observed across therapists. Among completers, large effect sizes were found (dRM ≈ 1.3); 73% achieved reliable improvement and 51% met reliable recovery criteria, while deterioration rates were below 1%.
CONCLUSIONS: Findings support the consolidation and expansion of the integration of clinical psychologists into primary care, providing evidence that the psychological interventions delivered in this context are a feasible, equitable and effective approach to treating CMDs in the Spanish public health system.