Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Stephen M. Auerbach, Ph.D.


Primary care clinics are increasingly integrating psychological services into their service programs, however few studies have used a comparison group to demonstrate the effectiveness of these services. This study evaluated the psychological services provided at the Ambulatory Care Clinic (ACC) at the Virginia Commonwealth University Health System (VCUHS) by comparing changes in 147 patients’ PHQ-9 depression scores and GAD-7 anxiety scores over time to the scores of 139 patients at the Hayes E. Willis Health Center, a comparison clinic with demographically similar patients but no integrated psychological services. Assessment data were collected from participants in the ACC at VCUHS during their first or second primary care psychology appointment and during their 3rd-5th appointment. To maximize similarity in baseline levels, participants in the Hayes clinic were matched to participants from the ACC at VCUHS according to their initial levels of depression and anxiety. Participants from the Hayes clinic were then evaluated with follow-up measures of depression and anxiety at approximately the same time interval as their matched counterparts from the ACC at VCUHS. Results indicated that participants from the ACC at VCUHS experienced significantly greater decreases in their depression and anxiety scores compared to participants in the Hayes Clinic. These results remained significant after accounting for participants’ medication for depression and anxiety and participants’ medical diagnoses. The influence of additional mental health services, treatment resistance factors, marital status, employment status, and general demographic variables were also evaluated. This study provided modest preliminary evidence that indicate integration of psychological services is effective. Strengths, limitations, and implications and future directions are discussed.


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Date of Submission