Counseling and psychotherapy. Psychological counseling, psychological correction and psychotherapy
The widespread introduction of psychology into practice naturally leads to the development of those areas that are traditionally designated as methods of psychological influence. Among them, one of the most important places undoubtedly belongs to psychological counseling. What are the specifics of different types of advisory practice?
The definition of psychoconsulting as a type of psychological assistance has already been discussed above. It is indeed difficult to specifically and clearly define this type of activity or clearly indicate the scope of its application, since the word “consulting” has long been a generic concept for various types of advisory practice. So, in virtually any area in which psychological knowledge is used, counseling is used to one degree or another as one of the forms of work. It includes career counseling, pedagogical, industrial consulting, management consulting, and much, much more.
But perhaps the widest area of application of psychological counseling today is helping those who come to us about their family and personal problems. This industry includes many separate areas, among which we can highlight such as work with married couples, joint counseling of children and parents, premarital counseling, psychological assistance to those who are going to divorce, etc.
So what is the essence of the relationship between psychoconsulting, psychocorrection and psychotherapy?
Psychological counseling is closely related, and in many ways directly intertwined with psychological correction and psychotherapy. Moreover, these areas are often confused by practicing psychologists.
Psychological correction and psychotherapy (along with psychological counseling) are types of psychological assistance.
Unlike psychological counseling, they provide for a more active, targeted impact on the personal, behavioral and intellectual levels of human functioning and, as a rule, require more time to implement.
Psychological correction is a tactful intervention in the processes of mental and personal development of a person in order to correct deviations in these processes and often affects not only the individual, but also his environment and the organization of life.
Psychotherapy is aimed at deep penetration into the personality and the implementation of progressive shifts in its interaction with the world through changes in self- and worldview. In this regard, they talk about changes in the radical or existential, which determines personality, about integration (3. Freud), individuation (Col. G. Jung), compensation (A. Adler), personalization, personal growth (Col. Rogers), self-actualization (A. Maslow), strengthening of the “I” (behavioral orientation), etc.
When considering the terms “psychotherapy” and “psychological correction”, it is worth remembering that in psychological and psychological-pedagogical theory and practice they are often used as synonyms. This is due to the fact that the concept of psychotherapy in Russian psychology appeared relatively recently. For a long time, psychotherapy developed as a branch of purely medical care. According to correction, having emerged from the depths of defectology, subsequently moving into developmental and educational psychology and being actively used in working with children (acquiring designations as “psychological correction”), this term went beyond the boundaries of child psychology and began to be used in relation to adults when providing them with psychological help.
The penetration of the achievements of foreign psychology and ITS concepts into the context of our science has introduced some misunderstanding into the existing terminology. Thus, in relation to psychological assistance in the non-medical aspect, the term “correction” was more often used in domestic psychology, while in foreign psychology it was “psychotherapy”. So, since there are two terms, let's try to explore the specifics of each of them and what is common between them.
Where a psychologist works not with abnormal individuals, but with those whose ontogenetic development is within the normal range and who need help not with intellectual, but with personal development, the separation of psychotherapy and correction becomes much more complicated. Let's consider two fundamental points: the goals and methods of these types of psychological assistance.
The goal of psychotherapy is to create conditions for the full development of personality, the goal of psychological correction is to eliminate deficiencies in personality development.
So, the task of psychological correction has a certain semantic difference, although it may be subordinated to the psychotherapeutic goal as a more general one. As for the methods, psychological correction, unlike psychotherapy, does not have its own special methods, but uses methods of psychotherapy, pedagogy, and medicine, depending on the needs.
Thus, psychological correction approaches psychotherapy and even coincides with it, when the implementation of corrective influence helps to realize the psychotherapeutic goal, and also when it uses exclusively (or predominantly) psychotherapeutic methods of helping a person
Important signs of psychological correction are discreteness and orientation to age norms. Discreteness means the psychologist’s influence on relatively independent specific components of a person’s inner world. The influence is carried out on the basis of theoretical ideas about the normal course of cognitive and emotional processes, about the norms of an entire education in a particular age period. Orientation to age norms determines the contingent of correctional influence (mainly children, adolescents, youth) and the use of psychodiagnostic techniques.
The tasks of psychological correction are formulated depending on their addressee - a child with abnormal development or an individual who has certain deviations and difficulties within the psychological norm. They are also determined by the content of correctional work:
o correction of mental development;
o correction of emotional development;
o correction and prevention of neurotic conditions, neuroses. There are various character flaws that are subject to psychocorrection. They attract the attention of others and are often the subject of their concern.
Let's consider the typologies of shortcomings in the personal development of people who are within the psychological norm:
o increased excitability, anger;
o timidity and painful fears; pessimism or exaggerated cheerfulness;
o instability, increased impulsiveness;
o conflict;
o stubbornness;
o indifference;
o sloppiness;
o deceit;
o constant thirst for pleasure;
o excessive activity or passivity;
o isolation; painful shyness;
o tendency to steal; negativism;
o tendency to wander; inattention;
o despotism; excessive helplessness;
o cruelty to animals;
o looked evil or cute, mockery of others, etc.
These shortcomings can be relatively discrete and relate only to certain aspects of the emotional-volitional sphere or have a more total nature and be associated with the formation of accentuation, leading experiences, a system of relationships and value orientations. This point is important for diagnosing and choosing types of psychological assistance to the individual - correction or psychotherapy, or correction within the framework of psychotherapy.
The main stages of psychocorrectional work are diagnosis, prognosis, creation of a psychological and pedagogical correctional program, its implementation and analysis of its effectiveness. The diagnosis (based on psychological diagnostics using tests) records indicators of mental development, their compliance with standards, and formulates a hypothesis regarding the causes of deviations.
Psychological diagnosis also includes the formation of a prognosis. Forecast is a prediction of further personality development, subject to timely correction and in the absence of such.
The peculiarities of the correction program are the presence of purely psychological and pedagogical parts. The psychologist develops and implements the psychological part. The psychologist can develop the pedagogical part either independently or together with parents, social workers, teachers, and relatives (depending on who will work with the child).
The pedagogical part is carried out under the constant supervision of a psychologist. Since the corrective action is aimed at certain specific characteristics, the indicator of effectiveness is the measurement of this characteristic before and after correction.
Let us give an example of a short recording of the stages of possible psychocorrectional work with an important teenager who is lagging behind in his studies.
Diagnosis: school maladjustment with a pronounced deviation in the development of motivational and volitional processes, in learning and behavior in general. The level of self-control and impulsiveness of behavior correspond to the norms of older preschool age. Possible reasons are an exacerbation of individual character traits and regression in self-control due to the crisis of adolescence and psychotrauma due to young circumstances in the family.
Prognosis: without special intervention and help, the guy will leave the influence of his family and educational institutions in one or two years. Provided psychocorrectional work is carried out, a teenager can significantly increase the level of self-organization of behavior to normalize learning throughout the year. The correction program is drawn up taking into account the individual and age characteristics of the client, his socio-psychological situation at home and at school.
The main goal is to correct such a character deficiency as laziness, increase motivation for learning, and help in social adaptation in general. The program develops tasks at three levels: the maximum task is the boy’s return to school, the minimum is continuing education at home, and an intermediate option is attending private educational institutions. The stages, their corresponding deadlines, tasks and areas of work, and those who are responsible for these types of work (psychologist, parents, teachers, social worker, tutor, etc.) are indicated. The effectiveness of the psychocorrection program is determined step by step.
Psychological counseling as direct work with people aimed at solving various kinds of psychological problems associated with difficulties in interpersonal relationships, in which the main means of influence is a conversation constructed in a certain way.
The corresponding form of conversation is actively used both in psychocorrectional work and in psychotherapy. But if counseling is focused primarily on helping the client reorganize his interpersonal relationships, then psychocorrectional influence is focused mainly on solving a person’s deep-seated personal problems, which form the basis of most of life’s difficulties and conflicts.
The direction of the locus of complaint and the person’s readiness determine the form of work during psychological counseling. The main task of a psychologist-consultant is to help the client look at his problems and life difficulties from the outside, to demonstrate and discuss those aspects of relationships that are sources of difficulties, usually not realized and not controlled.
The organizational basis of this form of influence is, first of all, a change in the client’s attitudes towards other people, and towards various forms of interaction with them. During the advisory conversation, the client gets the opportunity to take a broader look at the situation, evaluate his role in it differently and, according to this new vision, change his attitude to what is happening and his behavior.
Psychotherapeutic influence is constructed differently. Complaints as such play a minor role, since already at the initial stages of work they are deepened and reformulated. In a conversation with a psychotherapist, not only current situations of the client’s relationship are discussed, but also the past (events of childhood, youth), and specific forms of mental production such as dreams and associations are actively used.
An important feature of psychotherapy is special attention to the relationship between the person seeking help and the professional, the analysis of which is one of the most important means of deepening and expanding the possibilities of influence, while in counseling such issues are almost never discussed.
Analysis of the deep foundations of the psyche leads to an understanding of the causes of pathogenic experiences and behavior and thus contributes to the solution of personal problems (Ursano R., Sonnenberg S., Lazar S., 1992).
The duration of these types of psychological effects also varies. Thus, if psychological counseling is often short-term and only sometimes exceeds 5-6 meetings with a client, then the process of psychotherapy lasts incomparably longer and is focused on dozens or even hundreds of meetings over several years.
The above distinctions are also related to the types of clients. At an appointment with a psychologist-consultant, you can equally likely meet almost any person, regardless of his mental status, employment, material security, intellectual potential, etc., while the circle of people whose problems can be solved within the framework of in-depth psychocorrectional work is somewhat limited . The ideal client is a normal neurotic, with a high level of reflection, able to pay for an often expensive and lengthy course of treatment, and has sufficient time and motivation for this.
It is natural to assume that if there are a certain number of significant differences in these two forms of influence, the training of the relevant specialists should also differ. As noted above: the main requirements for a psychological consultant, in our opinion, are a psychological diploma, as well as special training in the theory and practice of psychological counseling (work under the guidance of a supervisor), which may not be particularly long. The requirements for psychotherapy specialists are much greater, and they include, along with theoretical psychological training and certain medical knowledge, also long-term experience in their own psychotherapy and work under the guidance of an experienced supervisor. It is no coincidence that psychotherapy is historically closely connected with psychiatry, and among psychologists, along with professional psychologists, psychiatrists are no less often found, who, of course, also received special training. Note that a person who turns to a psychologist is traditionally called not a client, but a patient. It is possible to imagine full-fledged training of a specialist in this situation without the experience of his own psychotherapy, thanks to which he can better navigate the problems of patients, work more fully, without fear of such interference as burnout syndrome or communication overload, and also freely use such means of influence as transference and countertransference.
The differences between psychotherapy and counseling are a broad and multifaceted topic. Of course, here we can only outline general lines of comparison. Those who are especially interested in this issue can be advised to read specialized literature (Karvasarsky B.D., 1985; Vasilyuk F.E., 1988).
A “man on the street” who turns to a psychologist for help, especially in our country, in which not everyone even understands what psychology is in principle, does not always understand what kind of help he needs and in what form it can be be provided. Often, clients’ expectations are inadequate, do not correspond to the reality of life and the logic of relationships (for example, as sometimes happens, the client begins to demand that someone fall in love or fall out of love with someone as a result of the influence of a psychologist, etc.). In this regard, often the first thing that has to be done with the client is to explain what exactly he can expect psychological help and what kind. From this point of view, psychological counseling, as something that is focused primarily on achieving a specific goal and is not too obligatory on the type of impact, often serves as a kind of stepping stone, the first step towards longer and deeper psychological work.
It happens that, having come to a consultant, a person for the first time thinks about his own role in his life’s failures and begins to understand that in order to really get help, one or even several meetings with a psychologist are not enough. It does not follow from this that she will immediately seek more serious help - this may not happen immediately or even never happen, but the simple knowledge that help, in principle, can be provided to him can be very important.
This relationship between counseling and psychotherapy is the basis for the broad and multifaceted possibilities of practical psychology, a guarantee that everyone who applies can find for themselves what is most suitable for them at the moment.
Depending on the specifics of the specific situation of psychological assistance, two main forms of work are used: individual and group. Individual work is used in cases where, for personal, social or public reasons (specificity of the problem, for example, betrayal, grief; client status: excessive shyness, etc.), a group form of psychological assistance is not possible. It can be said that the individual form of work has an advantage in all those cases where the nature of the problem requires not only a developmental and educational focus, but also consolation and recovery, bringing psychological assistance closer to psychological influence. In the domestic tradition, such a practice is increasingly called “non-medical psychotherapy.”
When the emphasis is on developmental, educational or group, social support, as, for example, in the “Alcoholics Anonymous” movement or in the “Human Potential Movement” in the 70s in the USA, there is an undoubted advantage is on the side of group work. The very fact of sharing emotionally intense events in a group is the most important source and factor of psychological support and personal development.
Questions and tasks for self-control
1. Which, in general terms, is the task of providing psychological assistance?
2. Describe the relationship and differences between psychotherapy and counseling.
3. What is psychological correction?
4. What is the relationship between the terms psychological correction and psychotherapy?
5. What are the tasks of psychological correction?
6. Name the main stages of psychological correction.
7. Describe how a psychocorrection program develops and find examples of such programs in the literature.
References
1. Abramova G. S. Introduction to practical psychology". Moscow, 1995.
2. Aleshina Yu. E. Individual and family psychological counseling. - Moscow, 1993.
3. Atwater N. I’m listening to you... - Moscow, 1988.
4. Burmenskaya G.V., Karabanova O.A., Dieders A.G. Age-related psychological counseling. -Moscow, 1990.
5. Vaskoeskaya S.V., Gornostay P.P. Psychological counseling: Situational tasks. -Kiev, 1996.
6. Ermine P. P., Vaskoeskaya S. V. Theory and practice of psychological counseling: A problem-based approach. - Kyiv, 1995.
7. Journal of a practicing psychologist. 1995. No. 1.
8. May R. The Art of Psychological Consulting. - Moscow, 1994.
9. Ovcharova R.V. Reference book of a school psychologist. - Moscow, 1993.
10. Fundamentals of developmental psychological counseling / Ed. A.G. Leaders. -Moscow, 1991.
11. Fundamentals of consulting psychology: Analysis of modern concepts. - Kyiv, 1992.
12. Workbook of a school psychologist / Ed. Y. V. Dubrovina. Moscow, -1991.
13. Family in psychological consultation: Experience and problems of psychological counseling / Ed. A. A. Bodaleva, V. V. Stolina. -Moscow, 1989.
14. Scott J. G. Conflicts, ways to overcome them. -Kiev, 1991.
15. Kochunas R. Fundamentals of psychological counseling. Per. from Lithuanian. M.: Academic project. -1999. -240 s.
16. Tsapkin V.N. Unity and diversity of psychotherapeutic experience//Moscow. psychotherapist - 1992. No. 2.
17. Eidemiller Z. G., Justitsky V. V. Family psychotherapy. - Leningrad, 1990.
Despite the similarity of the tasks solved by psychological counseling and psychotherapy, these two areas of activity differ very significantly, so significantly that even talking about the possibility of mixing these areas is not recommended, although one can often find the use of such concepts as “psychological counseling with elements psychotherapy". Psychological counseling is based on the scientific picture of the world and rationalism, psychotherapy is based on proven intervention technologies and the personal art of the psychotherapist.
Substantive differences between psychological counseling and psychotherapy
1. Wider scope of application with almost unlimited scope of problems. Psychological counseling is used both in individual practice and in education, management, industry, law enforcement agencies, etc.
2. Mental illness is not within the competence of a consulting psychologist.
3. Widespread use of empirical research, analysis of results using mathematical statistics methods.
4. Focus primarily on local situational problems, rationalism.
5. Mainly subject-subject relationships with the client, even when working with children - dialogical communication.
6. Reliance on the constructive in the client’s personality, rejection of the concept of illness, recognition of the client’s rights to greater variability in behavioral reactions and mental states.
7. The desire for a mutual understanding of the roots of the client’s psychological problem under discussion. Orientation towards greater activity and independence of the client in the process of working with him and - so to speak - some delegation of authority to him. Excessive submission on the part of the client, “agreement” with the authority of the psychologist, is generally recognized as more harmful than useful.
8. Lack of one universal model of conducting psychological consultation.
9. An experienced psychological consultant differs from his less experienced colleague primarily in that he knows a lot, and not in that he can do a lot.
Procedural differences
1. Nature of the customer complaint. Psychological counseling: the client complains of difficulties in interpersonal relationships or in carrying out any activity. Psychotherapy: the client complains of being unable to control himself.
2. Diagnostic process. Psychological counseling: aimed at events of the present and recent past, at the current mental state, personality traits; Considerable attention is paid to specific behavior and interpersonal relationships. Psychotherapy: diagnosis is mainly aimed at events in distant childhood and adolescence (the probable time of receipt of psychological trauma); attention is also paid to the analysis of the unconscious and other psychotherapeutic concepts.
3. Impact process. Psychological counseling: changing the client’s individual attitudes towards other people and various forms of relationships with them, towards his own behavior; The relationship with the client is more coldly rationalistic. Psychotherapy: focuses on the relationship between client and therapist (transference and countertransference); a change not in individual aspects of the personality, but, as it were, in the entire personality.
4. Working hours. Psychological counseling: mostly short-term, rarely exceeding 5–6 meetings. Psychotherapy: often focuses on dozens or even hundreds of meetings over a number of years.
5. Types of clients. Psychological counseling: the client can be almost anyone. Psychotherapy: mainly aimed at neurotics with a confused inner world, with a high level of development of inclination towards introspection and introspection, able to pay for an often expensive and lengthy course of treatment, and with sufficient time and motivation for this.
6. Requirements for the level of specialist training. Psychological counseling: a psychological diploma is required (certifies his knowledge of the achievements of scientific psychology), some additional special training in the field of theory and practice of psychological counseling. Psychotherapy: education is mainly speculative-pragmatic, with a minimum of psychological theory, but with a maximum of practical training; work experience is very important.
Literature
Aleshina Yu. E. Specifics of psychological counseling // Bulletin of psychosocial and correctional rehabilitation work. Magazine. – 1994. - No. 1. – P.22-33.
Other news on the topic:
The client is the best expert of his own problems, so during counseling you should help him take responsibility for solving his problems. The client’s vision of his own problems is no less, and perhaps more important, than the consultant’s view of them.
In the counseling process, the client's sense of security is more important than the consultant's demands. Thus, in counseling it is inappropriate to pursue a goal at any cost without paying attention to the client's emotional state.
In an effort to help the client, the consultant is obliged to “connect” all his professional and personal capabilities, but in each specific case he must not forget that he is only a person and therefore is not able to be fully responsible for another person, for his life and difficulties.
One should not expect an immediate effect from each individual counseling meeting - problem solving, as well as the success of counseling, is not like a straight upward line; This is a process in which noticeable improvements are replaced by deterioration, because self-change requires a lot of effort and risk, which do not always and do not immediately result in success.
A competent consultant knows his level of professional qualifications and his own shortcomings, he is responsible for observing ethical rules and working for the benefit of clients.
Different theoretical approaches can be used to identify and conceptualize each problem, but there is not and cannot be the best theoretical approach.
Some problems are fundamentally human dilemmas and are fundamentally insoluble (for example, the problem of existential guilt). In such cases, the counselor must help the client understand the inevitability of the situation and come to terms with it.
Effective counseling is a process that is carried out together with the client, but not instead of client.
5. Factors influencing the choice of counseling strategy
Summarizing the consideration of psychological counseling as a direction, we note that the conduct of psychological counseling has significant differences among different specialists. Let's consider the factors influencing the consultant's choice of strategy.
1. Features of the consultant himself a) personal characteristics - gender, age, social status, set of life values, personal experience of living in problematic situations, level of self-esteem, etc.)
b) methodological and methodological preferences (which scientific school he belongs to, what professional ideas he professes, what principles he is guided by);
c) professional experience (successful/unsuccessful models of professional behavior, types of preferred clients and thematic preferences, for example, family issues, business consulting, conflict management.
2.Customer Features:
Client's readiness to receive psychological help:
a) his awareness of the possibility and specifics of the consultative process;
b) active desire for change (in oneself, not in other people)
c) the presence or absence of previous experience of psychological assistance, and if so, its effectiveness.
Area of expected changes:
a) its magnitude (the difference between the real Self and the ideal Self);
b) the “price” of such changes (possible and inevitable losses);
C) resources, means of achievement (including time and financial)
Qualitative signs of a problem:
a) place of focus of tension - internal (emotional experiences, attitudes) or external (behavior);
b) voltage duration
c) the severity of the problem (acute crisis state or dull, chronic state);
d) the context of the problem (against what it arose);
e) possible coincidence of the client’s problem with the consultant’s current problem
Personal characteristics of the client.
Mastering psychological counseling requires serious work by the future specialist related to the development of relevant competencies (knowledge, skills).
6. Definition and scope of non-medical psychotherapy
According to the Psychotherapeutic Encyclopedia, edited by B.D. Karvasarsky psychotherapy “is currently not a clearly understood area of scientific knowledge and practical approaches...”. Psychotherapy in general terms is “a special type of interpersonal interaction in which patients are provided with professional assistance through psychological means in solving their problems or mental difficulties.”
There are medical and psychological definitions of psychotherapy in the scientific literature. We are certainly interested in the latter. Psychotherapy is defined as a process in which a person, wishing to change his symptoms or life problems, or seeking personal growth, explicitly or implicitly enters into an agreement to interact in one way or another in prescribed ways with the person presented as helping"; psychotherapy is “an experience of growth, and everyone should have it” (quoted by I.N. Karitsky).
When considering the objects of psychotherapy, the issue of norm and pathology is debatable. Extreme options for answering it: this is the thesis that almost the entire population of the earth has serious mental problems (radical psychiatry), and the opposite thesis that there are no mentally ill people, all mental manifestations are manifestations of an individual norm (antipsychiatry).
Of course, there are a number of transitional stages from normality to pathology - borderline states. A number of steps between them gravitate toward pathology (psychopathy), but the other row, without a doubt, is a unique feature of the norm (accentuation).
Normal Borderline conditions Pathology
Non-medical psychotherapy (this is what we are talking about within the framework of the specialty) is used in relation to certain personal suffering, personal problems and psychological needs of a mentally healthy person (the norm) or a person whose condition can be classified as borderline. Medical psychology deals with pathological conditions.
Thus, the consideration of psychotherapy is a type of psychological practice. It meets the criteria for psychological practice (see Lecture 4).
Psychotherapy can be carried out in both individual and group forms. Most often, group psychotherapy is considered the most effective.
Psychological assistance in psychotherapy is provided through the complex influence of a number of so-called “therapeutic factors”. I. Yalom, the author of the monograph “Theory and Practice of Group Psychotherapy,” which is a kind of encyclopedia on psychotherapy, describes and analyzes them in detail in his monograph Let’s consider these factors.
7. Psychotherapeutic factors, according to I. Yalom
1.Instilling hope. I. Yalom claims that infusion is the cornerstone of any psychotherapy. Belief in treatment in itself can give a therapeutic effect, so psychotherapists should place emphasis on this, in every possible way strengthening the patient’s faith in the success of the group method of psychotherapy. Research shows that the expectation of help from the upcoming treatment significantly correlates with the positive outcome of therapy.. This work begins yet before the actual start of the group, during introductory meetings, when the psychotherapist strengthens the positive attitude and eliminates preconceived negative ideas. What contributes to the success of group therapy is not only a general positive attitude, but also hope. Additionally, seeing others improve is also an important aspect.
2. Universality of experiences. Many patients enter therapy with anxiety, believing that they are unique in their unhappiness, that they are the only ones who have frightening or unacceptable problems, thoughts, impulses, or fantasies. Due to their social isolation, people have a heightened sense of their own uniqueness.
In the therapeutic group, especially in the early stages of functioning, the weakening of this inherent sense of the patient's own uniqueness is more conducive to alleviating his condition. After listening to other group members share concerns similar to their own, patients report feeling more connected to the world: “We're all in the same boat.”
3. Supply of information. Therapists, in group work, present information on issues of mental health, mental illness and general psychodynamics, give advice, suggestions or direct guidance that offers the patient recommendations for specific cases. In addition, in a group, its members receive information, advice, and recommendations from each other.
The provision of information from the psychotherapist can be in the form of educational instructions and direct advice. Let's look at them.
Educational instruction. Most therapists do not provide explicit training, but in many approaches to therapy, formal instruction or psychological training has become an important part of work programs.
For example, bereaved group facilitators teach participants about the natural cycle of grief, thereby helping them to recognize that they are going through a sequence of stages of suffering and that their pain will naturally, almost inevitably, ease. Facilitators help patients anticipate, for example, the acute attacks that they will experience on each significant date (holidays, anniversaries, birthdays) in the first year after loss.
Another example: the leaders of groups for women with their first pregnancy can provide them with significant assistance by explaining the physiological basis of the physical and psychological changes that occur in them, as well as describing the process and features of pregnancy and childbirth. Participants are encouraged to voice their fears, which enables facilitators to systematically and rationally address irrational beliefs using appropriate information.
Direct advice. In contrast to overt instructional instruction from the therapist, direct advice from group members is present in all therapy groups without exception. The least effective form of advice is a directly stated proposal, the most effective is systematic, detailed instructions or a set of alternative recommendations to achieve the desired goal.
4. Altruism. Many who come to groups at the very beginning are convinced that they have nothing to give to others; they are accustomed to looking at themselves as unnecessary and uninteresting to anyone. Gradually, here they become a source of support and consolation for each other, give advice, promote insights, they share problems with each other. When they part with the group at the end of its work, they thank each other for the participation that each took in relation to each other.
5. Corrective recapitulation of the primary family group. (in other words, correction of unconstructive experiences of living in a family group with constructive ones gained in a therapeutic group). Most patients typically have a history of extremely unsatisfactory experiences with their primary group, the family. The therapeutic group is like a family in many ways: it also includes authoritative parental figures, peer siblings, deep personal relationships, strong emotions, and deep intimacy as well as hostility and competition. In practice, psychotherapy groups are often led by two therapists - a man and a woman - in a deliberate attempt to simulate the parental family. All this allows you to gain constructive experience of the “family group” experiences.
The distribution of these two areas of psychological assistance is a difficult task, since in many cases it is difficult for a professional to say whether he is engaged in psychological counseling or psychotherapy. Both counseling and psychotherapy use the same professional skills; the requirements for the personality of the client and the psychotherapist are the same; The procedures used in counseling and psychotherapy are also similar. Finally, in the first and second cases, assistance to the client is based on the interaction between the consultant (psychotherapist) and the client. Due to the difficulty of separating these two areas, some practitioners use the concepts of “psychological counseling” and “psychotherapy” as synonyms, arguing for the similarity of the activities of a psychotherapist and a psychological consultant.
There is no doubt that the boundaries between psychotherapy and counseling are very arbitrary, which has been noted more than once by various authors (Polyakov Yu. F., Spivakovskaya A. S.). But since this work is designed for people who do not have special training in the field of psychotherapy or, as we usually say, psychocorrection, we will designate these differences quite strictly, thus limiting the area where specialist consultants can work from those cases where they active influence is undesirable, since just having a psychological education and understanding the general principles of work is not enough to achieve a positive effect.
How can you differentiate between counseling and psychotherapy? What is the meaning of dividing client problems into interpersonal and deep personal, which was already mentioned above?
What problems the client comes with, interpersonal or deep-seated personal, often manifests itself in the forms of seeking help, in the specifics of complaints and expectations from a meeting with a psychologist. Clients of counseling psychologists usually emphasize the negative role of others in the emergence of their own life difficulties; For clients focused on in-depth psychocorrectional work, the locus of complaints is usually different: they are more often concerned about their own inability to control and regulate their internal states, needs and desires. Thus, a client of a psychological consultant will be characterized by complaints like: “My husband and I constantly fight” or “My wife is jealous of me for no reason.” Those who turn to a psychotherapist more often talk about their problems differently: “I can’t control myself, I’m very hot-tempered, I constantly yell at my husband” or “I’m always not sure how my wife treats me, it seems to me that she deceives, jealous of her and, apparently, for no reason.” Such a difference in the locus of complaints means quite a lot and, in particular, the fact that the client himself has already done some work to analyze his own problems and failures. The fact that a person perceives himself as responsible for what is happening to him—a step that requires a certain courage—is a guarantee that he is ready for deeper and more frank self-knowledge.
The direction of the locus of complaint and the person’s readiness determine the form of work with him. The main task of a psychological consultant is to help the client look at his problems and life difficulties from the outside, to demonstrate and discuss those aspects of relationships that, being sources of difficulties, are usually not realized and not controlled. The basis of this form of influence is, first of all, a change in the client’s attitudes both towards other people and towards various forms of interaction with them. During the advisory conversation, the client gets the opportunity to take a broader look at the situation, evaluate his role in it differently and, in accordance with this new vision, change his attitude to what is happening and his behavior.
Psychotherapeutic influence is structured differently. Complaints as such play a minor role, since already at the initial stages of work they are deepened and reformulated. In a conversation with a specialist, not only current situations of the client’s relationship are touched upon, but also the past (events of distant childhood, youth), and such specific forms of mental production as dreams and associations are actively used. An important feature of psychotherapy is special attention to the relationship between the person seeking help and the professional, the analysis of which in terms of transference and countertransference is one of the most important means of deepening and expanding the possibilities of influence, while in counseling such issues are almost never discussed. Analysis of the deep layers of the psyche leads to an understanding of the causes of pathogenic experiences and behavior and thus contributes to the solution of personal problems.
The duration of these types of psychological effects also varies. Thus, if psychological counseling is often short-term and rarely exceeds 5-6 meetings with a client, then the process of psychotherapy lasts incomparably longer and is focused on tens, or even hundreds of meetings over a number of years.
Certain differences are also associated with the types of clients. At an appointment with a psychologist-consultant, you can equally likely meet almost any person, regardless of his mental status, employment, material security, intellectual potential, etc., while the circle of people whose problems can be solved within the framework of in-depth psychocorrectional work is more limited . The ideal client is a normal neurotic, with a high level of reflection, able to pay for an often expensive and lengthy course of treatment, and with sufficient time and motivation for this. To the credit of psychotherapy, it should be said that narrowing the circle of clients and increasing the time of exposure leads to a significant expansion of the range of problems being solved, which in a certain sense becomes limitless.
It is natural to assume that with such significant differences between these two forms of influence, the training of the relevant specialists should also differ. The main requirements for a psychological consultant, from our point of view, are a psychological diploma, as well as special training in the theory and practice of psychological counseling (including work under the guidance of a supervisor), which may not be particularly long. The requirements for the education of psychotherapy specialists are much greater, and they include, along with theoretical psychological training and certain medical knowledge, also long-term experience in their own psychotherapy and work under the guidance of an experienced supervisor. It is no coincidence that psychotherapy is historically closely connected with psychiatry, and among psychotherapists, along with professional psychologists, psychiatrists are no less often found, but, of course, also those who have received special training. Note that a person who turns to a psychotherapist is traditionally called not a client, but a patient. It is impossible to imagine the full training of a specialist in this field without the experience of his own psychotherapy, thanks to which he can better navigate the problems of patients, work more fully, without fear of interference such as burnout syndrome or communication overload, and also freely use such means of influence as transference and countertransference.
The differences between psychotherapy and counseling are a broad and multifaceted topic. Of course, here we can only outline general lines of comparison. Those who are especially interested in this issue can be advised to read specialized literature (Karvasarsky B.D.; Vasilyuk F.E.).
A “man on the street” who turns to a psychologist for help, especially in our country, where not everyone understands what psychology is in principle, does not always understand what kind of help he needs and in what form it can be provided. Often, clients’ expectations are inadequate, do not correspond to the reality of life and the logic of relationships (for example, as often happens, the client begins to demand that someone fall in love or fall out of love with someone as a result of the influence of a psychologist, etc.). In this regard, often the first thing that has to be done with the client is to explain what he can expect psychological help and what kind. From this point of view, psychological counseling, being more goal-oriented and a less binding type of influence, often serves as a kind of stepping stone, the first step towards longer and deeper psychotherapeutic work. It happens that, having come to a consultant, a person for the first time thinks about his own role in his life’s failures and begins to understand that in order to really get help, one or even several meetings with a psychologist are not enough. It does not follow from this that he will immediately seek more serious help - this may not happen soon or may never happen, but even the simple knowledge that help, in principle, can be provided to him can be very important. This relationship between counseling and psychotherapy is the basis of the broad and multifaceted possibilities of practical psychology, a guarantee that everyone who applies can find for themselves what is most suitable for them at the moment.
There are specific features of psychological counseling that distinguish it from psychotherapy:
· counseling is focused on a clinically healthy person; these are people who have psychological difficulties and problems in everyday life, complaints of a neurotic nature, as well as people who feel good, but who set themselves the goal of further personal development;
· counseling is focused on the healthy aspects of the personality, regardless of the degree of impairment; this orientation is based on the belief that a person can change, choose a life that satisfies him, find ways to use his inclinations, even if they are small due to inadequate attitudes and feelings, delayed maturation, cultural deprivation, lack of finances, illness, disability, old age;
· consulting is more often focused on the present and future of clients;
· counseling usually focuses on short-term assistance (up to 15 meetings);
· counseling focuses on problems arising in the interaction of the individual and the environment;
· in counseling, the value-based participation of the consultant is emphasized, although the imposition of values on clients is rejected;
· counseling is aimed at changing the behavior and developing the client’s personality.
The difference between psychotherapy and psychological counseling and psychocorrection.
(definition by S. Kratochvil): “Psychotherapy is the purposeful regulation of the disturbed activity of the body by psychological means.”
In contrast to psychological correction, aimed at harmonizing the personality and increasing the efficiency of its functioning, in contrast to psychological counseling, focused on solving the client’s current psychological problems, psychotherapy in the narrow sense of the term, its main task is the relief of psychopathological and pathopsychological symptoms. Relief of painful symptoms entails an increase in the individual’s capabilities in solving his psychological problems, and creates conditions for personal development and growth, which, in turn, determines an increase in the efficiency of the individual’s functioning both intrapsychologically and interpersonally.
The differences between psychological counseling and psychotherapy are not always noticeable to the lay eye, but they exist. The main difference is that if counseling is aimed mainly at problems of interaction between an individual and his environment in society, then psychotherapy is focused on a person’s intrapersonal problems. At the first, sometimes second, session, the specialist diagnoses the client’s problem and determines the possibility of helping him within the framework of psychological counseling, which involves a small number of consultations. In some cases, one or two are enough. However, it happens that a client’s request to resolve a problem in relationships with other people is practically impossible to fulfill without psychological study of his intrapersonal characteristics. In this case, the client is asked to undergo a certain course of corrective psychotherapy. Of course, its duration is noticeably longer than that of counseling. The techniques and methods of psychocorrection used in this case are determined at the first, sometimes second, diagnostic session. What the psychotherapist is obliged to inform the client about, as well as explain to him all the features and subtleties of their joint work.
The difference between psychotherapy and psychocorrection is that psychotherapy deals with various types of disorders in people suffering from various types of somatic or mental illnesses (disorders). Many anomalies in the psyche and behavior of people that manifest themselves in diseases are similar to those that a psychologist involved in psychocorrection deals with. However, people who seek help from a psychotherapist are usually called patients or patients, and those who need only correctional help are called clients.
A client is a normal, physically and mentally healthy person who has experienced psychological or behavioral problems in his life. He is not able to resolve them on his own and therefore needs outside help.
Perret and Baumann, considering the relationship between psychological counseling and psychotherapy, indicate the following as differences: a) in psychological counseling, among the means of influence, information (transfer of information to the person seeking help) comes first; 6) psychological counseling in medicine primarily performs the function of hygiene and prevention; c) within the framework of counseling, options for solutions to a specific problem are analyzed, but they are carried out by the person himself and not within the framework of counseling, but independently; d) in the practice of counseling, changes occur at the end of the counseling itself without the support of a specialist; in psychotherapy, the essence is the process of change itself, accompanied by a specialist.
It seems appropriate to consider the similarities and differences between psychotherapy and psychological counseling, as types of psychological intervention, in terms of their basic and additional characteristics.
Main characteristics:
1. Means of influence (methods): psychotherapy and psychological counseling use psychological means of influence, but in psychological counseling, information is the leading technique.
2. Goals: psychotherapy and psychological counseling are aimed at achieving more pronounced positive changes in the cognitive, emotional and behavioral spheres in the direction of increasing their effectiveness, psychotherapy is aimed at achieving significant personal changes, and counseling is aimed at helping a person make better use of his own resources and improving quality of life.
3. Functions: psychotherapy performs the function of treatment and partially rehabilitation, and psychological counseling - prevention and development (naturally, we are talking about the primary focus of psychotherapy and psychological counseling, since in some cases these functions may overlap).
4. Theoretical validity: psychotherapy and psychological counseling have psychological theories as their scientific basis.
5. Empirical testing: psychotherapy and psychological counseling need to study the effectiveness of interventions.
6. Professional activities: psychotherapy and psychological counseling are carried out by specialists within a professional framework. Additional characteristics:
7. Duration of influence: psychotherapy involves a duration of at least 15-20 sessions, psychological counseling can be limited to 1-5 sessions.
8. Place of change: in psychotherapy, changes occur directly during therapy and are the essence of the psychotherapeutic process; in psychological counseling, solutions to a specific problem are analyzed, but decisions and changes are made by a person not within the framework of counseling, but after it ends.
9. The degree of independence of the client: in psychotherapy, the process of change is accompanied by a psychotherapist; in psychological counseling, changes are carried out by a person independently without the accompaniment of a consultant.
2. Stages of the psychotherapeutic process.
The literature (Menovshchikov, 2000) usually provides a “five-step” model of the consultative interview process, which all psychotherapists adhere to to one degree or another:
1) establishing contact and orienting the client to work;
2) collecting information about the client, solving the question “What is the problem?”;
3) awareness of the desired result, the answer to the question “What do you want to achieve?”;
4) development of alternative solutions, which can be described as “What else can we do about this?”;
5) generalization by the psychologist in the form of a summary of the results of interaction with the client.
First stage The work of a psychotherapist with a client is devoted to clarifying the need for help and motivation. The greatest attention is paid to establishing an optimal relationship between the therapist and the client, overcoming the first line of resistance. It communicates the principles of constructing psychotherapeutic interaction.
To study a client’s problem, standardized and non-standardized interviews, tests, observation, primarily of nonverbal behavior, the results of introspection, and specific techniques for symbolically describing the problem, such as directed imagination, projective techniques, and role-playing games, are often used. These same methods make it possible to evaluate the intermediate and final results of psychotherapy.
Before starting psychotherapy, various diagnostic procedures are used. Psychotherapeutic schools differ in the way they view the client’s problem, their idea of the possibilities for resolving it, and the formulation of goals.
The interview allows you to assess the client’s psychological status, general life situation, understand the characteristics of the problem, the main difficulties he faces, the motivation for his appeal and the possibilities for solving the problem. The psychotherapist discusses with the client what he would like to achieve as a result of psychotherapy. Such a conversation can prevent inadequate goals and unrealistic expectations. It promotes the conscious construction of a system of goals, in which participants in the psychotherapeutic process focus on a specific and achievable result in the near future.
The customer's initial presentation of a problem can be defined as a "complaint." For further work, it is necessary to select a request that allows you to determine the prospects for further work. However, this request may not be defined clearly enough. In this case, separate work should be carried out to identify the client’s request and its understanding by the client himself.
Second phase dedicated to representing relationships. Participants in the psychotherapeutic process agree on cooperation, the psychotherapist outlines a model of psychotherapy. Often the client tries to offer the psychotherapist the role of a doctor who only needs detailed information to make the correct diagnosis and formulate good advice. Therefore, the most important point of this stage is the establishment of relationships of mutual responsibility. The success of psychotherapy largely depends on how actively the client gets involved in the work and accepts his responsibility for the result obtained.
In the process of psychotherapy, certain personal transformations occur, and the psychotherapist’s duty is to discuss this perspective with the client. After all, he may be consciously or unconsciously frightened by the possibility of parting with any habits, unproductive but long-established relationships, and even painful experiences. The features of psychotherapeutic relationships and the degree of self-disclosure of the psychotherapist vary significantly depending on the direction, however, in all schools of psychotherapy, common features are preserved: expression of support, acceptance and interest in the client. Since cooperation is a necessary condition for work, the psychotherapist takes into account the client’s attitudes, expectations, and communication style. It is important for the client to feel that he can openly express his experiences, express his concerns and they will be accepted.
Maintaining a relationship of cooperation and trust is important for subsequent stages of psychotherapy. Different schools develop different models of relationships between its participants.
It is recognized that the client needs to constantly check whether the psychotherapist can be trusted.
The establishment of a good therapeutic relationship can be judged by the extent to which the client and psychotherapist are ready for self-disclosure and can discuss difficulties in the therapeutic process in general and in their communication in particular. If the client is really involved in the process, strives to work, is open, says that the psychotherapist correctly understands his feelings, and the psychotherapist does not feel tension when self-disclosing, using confrontation and other techniques, you can move on to the next stage of work.
On third stage Goals are defined and alternatives are developed. The psychotherapist substantiates the psychotherapeutic strategy, outlines its main milestones and components. The choice of strategy is determined by the psychotherapist’s training, the client’s personality traits, and the characteristics of the problem. The client masters the psychotherapeutic metaphor of this direction, becomes familiar with the main characteristics of the chosen approach, including those associated with difficulties and negative experiences, accepts his role as a client, and participates in choosing a goal. He is included in the work as an active participant, starting with the choice of a specific psychotherapeutic direction or psychotherapist. It is important that the client’s increasing activity and responsibility continues throughout the entire work process, whether he expresses his preferences verbally or non-verbally. The psychotherapist takes into account his attitudes, coordinates them with his methodological arsenal, while adequately responding to manipulative behavior. The client's active, conscious participation in psychotherapy is a catalyst for its success.
Work on a problem begins with its research. The study involves the client's expression, acceptance and awareness of unconscious emotions. Expressing feelings has a cathartic effect, reducing tension. The client acknowledges previously rejected feelings. This effect is achieved primarily due to the fact that these feelings were accepted by the psychotherapist. The client realizes the ability to manage his feelings, not by expelling them, but by experiencing them. Thus, at a deep level, he gains the experience of evoking and stopping emotions without suppression.
The next important step is to move from expressing feelings to understanding them. The focus of the work shifts from experience to awareness and integration of experience.
The concept of insight has a long history and a variety of interpretations. It was understood as identifying the causes of a symptom as a result of interpretation, and recognizing the connection between past experiences, fantasies and current conflicts, and an emotional response to understanding this connection, and instant insight when understanding the deep level of experience. There is a distinction between intellectual and emotional insight. Emotional insight leads to deeper changes, but requires greater effort on the part of the participants in the psychotherapeutic process.
Fourth stage represents work towards set goals. The adopted theoretical model structures for the psychotherapist his vision of psychological reality and determines the choice of methods. Flexibly and productively organizing his picture of the world, the psychotherapist generates a unique strategy for interaction with a specific client, focusing on the characteristics of the problem, the client’s personal characteristics and resources (financial, time, personal), and the role of his immediate environment. For example, individual psychotherapy on addiction issues can be very difficult with a client whose wife has taken on the role of a maternal figure.
The nature of the problem determines the choice of methods used. When choosing a strategy for therapeutic work, much depends on the individual’s ability to solve the problem. The client's problem does not have one projection, it manifests itself at all levels, so its assignment to any level depends on the theoretical framework that the psychotherapist uses, and, accordingly, different methods can be equally effective.
On fifth stage, After a phase in which the client gains new understanding of himself, the goal is to translate internal changes into actual behavior. In some types of psychotherapy, this stage is, as it were, moved beyond its boundaries (for example, in psychoanalysis), in others the main emphasis is placed on it (for example, in behavioral psychotherapy). During this stage, the client masters new behavioral patterns and acquires the ability to act spontaneously, based on adaptive cognitive strategies, in accordance with his internal needs.
Sixth stage– termination of psychotherapy is determined by achieving a balance among various factors: the need for change, therapeutic motivation, psychotherapeutic frustration, cost of psychotherapy, etc. Before making a decision to terminate treatment, it is necessary to evaluate the result obtained in qualitative and quantitative characteristics. The psychotherapist talks with the client about whether the symptoms that bothered him at the beginning of psychotherapy have disappeared, whether he has begun to feel better, whether his self-perception and relationships with others have changed, his attitude towards important life goals, whether the client can provide self-support without psychotherapy.
In the final phase, it becomes clear what has changed during psychotherapy and in what aspects. If changes are not achieved in some way, the reasons become clear. The way in which what is achieved in psychotherapy is transferred to actions and relationships outside of it is discussed.
Psychotherapy stops if the client has achieved independence, accepts responsibility for his problems, sees them and can solve them without the professional help of a psychotherapist.
As seventh, the last one, stage assessment of the effectiveness of psychotherapy should be highlighted. Due to the difficulty of recording the achieved result, there is a wide variety of views on the criteria for the effectiveness of psychotherapy. The disappearance of a symptom, positive changes in the client’s life outside of psychotherapy, client satisfaction, the opinion of the psychotherapist, and testing indicators are considered as such.
The study of changes achieved as a result of psychotherapy involves answering three questions:
1. Has the client changed during psychotherapy?
2. Were these changes the result of psychotherapy?
3. Are the changes sufficient to improve his condition?
3. Psychotherapeutic intervention. Its goals, objectives and functions.
Psychotherapeutic intervention, or psychotherapeutic intervention, is a type of psychotherapeutic influence that is characterized by certain goals and a choice of means of influence corresponding to these goals, i.e. methods (Karvasarsky B. D., 2000). The term “psychotherapeutic intervention” can mean a specific psychotherapeutic technique, for example, clarification, clarification, stimulation, verbalization, interpretation, confrontation, teaching, training, advice, etc., as well as a more general strategy of behavior of the psychotherapist, which is closely related to the theoretical orientation ( first of all, with an understanding of the nature of a particular disorder and the goals and objectives of psychotherapy).
Psychological interventions, or clinical-psychological interventions, constitute the essence of psychotherapeutic intervention. From the point of view of these authors, clinical and psychological interventions are characterized by:
Choice of means (methods);
Functions (development, prevention, treatment, rehabilitation);
Target orientation of the process to achieve change;
Theoretical basis (theoretical psychology):
Empirical testing;
By professional actions.
Functions
Clinical and psychological interventions consist of:
prevention,
treatment,
rehabilitation
development.
Psychological interventions that are not strictly psychotherapeutic also play an important role in prevention and rehabilitation. It consists of identifying risk groups and developing appropriate preventive measures, working with individuals who have a variety of difficulties and problems of a psychological nature, personal crisis and traumatic stress situations, with individuals characterized by prognostically unfavorable personal characteristics (low self-esteem, high levels of anxiety, rigidity, increased sensitivity to stress, low frustration tolerance), increasing the risk of neuropsychic and psychosomatic disorders.
Along with psychoprophylaxis itself, clinical and psychological interventions play an important role in the prevention of other somatic diseases. Preventive measures, as a rule, require a person to monitor their physical and mental state more clearly than usual, adhere to a certain work and rest schedule, give up bad habits, partially change habitual behavior patterns, and maintain what is called a healthy lifestyle. Regular use of pharmacological agents and certain therapeutic and preventive procedures are often required. All this can be realized by a person with a certain level of organization, understanding of the need to carry out the entire complex of preventive measures, and, most importantly, active involvement in this process and the presence of high and adequate motivation for this kind of behavior.
For neuropsychiatric diseases characterized by fairly pronounced personality disorders in the patient’s system of relationships, in the sphere of interpersonal functioning, clinical and psychological interventions play an extremely important role, essentially performing the function of psychotherapy (treatment). In severe chronic diseases, many problems of a psychological and socio-psychological nature arise that require the use of clinical and psychological intervention: the individual’s reaction to the disease, inadequate attitude towards the disease (underestimation or overestimation of one’s illness, excessive emotional reaction, passivity, the formation of unreasonably broad restrictive behavior), which can have a significant impact on the treatment and rehabilitation process as a whole.
The psychological and socio-psychological consequences of a chronic disease change a person’s usual way of life. This can lead to a change in his social status, decreased performance, problems in the family and professional spheres, partial inability to satisfy significant needs, lack of faith in one’s own strengths, self-doubt, denial of existing opportunities and one’s own resources, narrowing of interests and circle of friends, and lack of life prospects. . Just as in prevention and treatment, the success of rehabilitation measures largely depends on the activity of the patient himself and the presence of adequate motivation. In addition to the “personal” block, clinical and psychological interventions play an important role in the rehabilitation of patients with mental disorders (memory, attention, motor skills, speech).
Development is not considered by all authors as one of the independent functions of clinical and psychological interventions and is understood by them differently. This is due to the fact that psychotherapy, psychoprophylaxis, rehabilitation, along with their own direct functions (therapeutic, preventive, rehabilitation), also contribute to personal development and harmonization by improving self-understanding and self-awareness, processing and overcoming intrapersonal and interpersonal conflicts, developing new, more adequate ways of emotional and behavioral response, more accurate understanding of other people and interpersonal interaction in general. In a number of psychotherapeutic systems (for example, in Rogers' client-centered psychotherapy), personal growth and personality development are one of the most important tasks of psychotherapy.
Thus, on the one hand, the development function for clinical-psychological interventions (psychological interventions in the clinic) is secondary, additional. On the other hand, psychological counseling in a clinic (for example, counseling patients with somatic and neuroorganic diseases who are not undergoing actual psychotherapeutic treatment, but who have sought help due to personal problems not directly related to their illness) contributes to a person’s new vision of himself and their problems and conflicts, emotional problems and behavioral characteristics. In the future, this can lead to certain changes in the cognitive, emotional and behavioral spheres and contribute to personality development.
Goals of clinical and psychological interventions focused on achieving certain changes. Clinical and psychological interventions can be aimed both at more general, distant goals, and at specific, closer goals. However, psychological means of influence must always clearly correspond to the goals of influence.
5. Personal characteristics of an effective psychotherapist.
An effective therapist shows empathy, unconditional positive regard, and a relationship based on sincerity. 1) Authenticity, sincerity of relationships. “The more the therapist is himself in his relationship with the client, the less he is separated from the client by his professional or personal facade, the more likely it is that the client will change and move forward in a constructive way.” 2) Unconditional positive regard for the client. "When the therapist feels a positive, non-judgmental and accepting attitude towards the client, regardless of who the client is at the moment, therapeutic progress or change is more likely. Acceptance of the therapist involves allowing the client to be in whatever his immediate experience is - embarrassment, hurt, resentment , fear, anger, courage, love or pride. This is selfless caring. When the therapist acknowledges the client holistically rather than conditionally, progress is more likely." 3) Empathic understanding. "This means that the therapist accurately perceives the feelings, personal meanings experienced by the client, and conveys this perceived understanding to the client. Ideally, the therapist penetrates so deeply into the inner world of another that he can clarify not only those meanings that he is aware of, but even those , which lie just below the level of awareness.Qualities of an effective psychotherapist:
1.Natural ability to incline to trust.
2. Faith in one’s own ability to help a person, because if there is no faith, the client feels it and this affects the success of therapy (for this, in fact, the therapist must undergo personal psychotherapy, largely in order to feel the process from the inside, or in other words, to own skin, and also make sure that it works).
3. The ability to enjoy work.
4. Personal maturity and experience, the ability to understand the cultural context of another.
5. Calm perception of the fact of loss, grief, death (even your own). And this is logical, because a fainting psychotherapist, overexcited by what he heard, is unlikely to be able to provide effective help.
Theoretical foundations of psychotherapy. Characteristics of the main directions and approaches of psychotherapy.
There are 3 main directions in psychotherapy (psychodynamic, behavioral and humanistic “experiential”), each of them is characterized by its own approach to understanding personality and personality disorders and its own logically related system of psychotherapeutic influences.
If, within the framework of the psychodynamic approach, unconscious mental processes are considered as the main determinant of personal development and behavior, and neurosis (and personality disorders) is understood as a consequence of the conflict between the unconscious and consciousness, then psychotherapy will be aimed at achieving awareness of this conflict and the unconscious. The psychoanalytic method itself is subordinated to this task. Awareness is achieved through the analysis (including certain procedures) of free associations, symbolic manifestations of the unconscious, as well as resistance and transference. The psychoanalytic procedure itself is designed to facilitate the manifestation of the unconscious. This is what determines the strategy and tactics of the psychotherapist, his role and position, level of activity, intensity and frequency of sessions, etc.
Representatives of the behavioral group focus their attention on behavior as the only psychological. reality accessible to direct observation. The norm is adaptive behavior, and a neurotic symptom or personality disorders are considered as maladaptive behavior formed as a result of incorrect learning. Thus, the goal of psychological intervention is learning, that is, replacing non-adaptive forms of behavior with adaptive ones (standard, normative, correct).
Humanistic or “experiential”, for example, comes from the recognition of the uniqueness of the human personality and considers the need for self-realization and self-actualization as a basic need. neurosis is a consequence of the impossibility of self-actualization, a consequence of blocking this need, which is associated with insufficient self-understanding and self-acceptance, insufficient integrity of the Self. In this case, the goal of psychological intervention will be to create conditions in which a person can experience a new emotional experience that promotes awareness and self-acceptance and integration. The need to create conditions within which a person receives the best opportunities to acquire new emotional experience determines the specific. features of the psychotherapist’s behavior, his role, position, orientation and style.
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