The specifics of psychological counseling as a type of psychological assistance and its differences from psychotherapy. Psychological assistance: types, stages, features

Psychology and esoterics

Conventionally, a distinction is made between clinically oriented psychotherapy, aimed primarily at mitigating or eliminating existing symptoms, and personality-oriented psychotherapy, which seeks to help a person change his attitude towards the social environment and his own personality. History of the development of psychotherapy abroad and in Russia. The Department of Psychotherapy appears under the leadership of V. Karvasarsky and organizes the Department of Psychotherapy at the Bekhterev Institute, which focuses on group and individual psychotherapy. Alekseychik opens...

5. Psychotherapy as a type of psychological assistance.

Psychotherapy a system of therapeutic effects on the psyche, and through the psyche on the entire body and behavior of the patient. This is a complex therapeutic effect on the emotions, judgments, and self-awareness of a person in many mental, nervous and psychosomatic disorders and diseases. Conventionally, a distinction is made between clinically oriented psychotherapy, aimed primarily at mitigating or eliminating existing symptoms, and personality-oriented psychotherapy, which seeks to help a person change his attitude towards the social environment and his own personality.

History of the development of psychotherapy abroad and in Russia.

Abroad. 1895 S. Freud discovered the method of free association, attaching great importance to ritual and description of practical cases. (which later began to resemble literary novels.)

In the 30s, the direction of autogenic therapy by Schultz, play therapy by M. Klein, psychodrama by Moreno, behavioral and cognitive psychotherapy developed.

At the turn of the 1960s-70s. XX century In American psychology, a new direction emerges, called humanistic psychology. This direction arose as a counterweight to the behaviorism-psychoanalysis dilemma and opened up a new look at the nature of the human psyche.

1970s the birth of NLP (neuro-linguistic programming). D. Grinder, R. Bandler et al.

In Russia. 1965 the Department of Psychotherapy appears under the leadership of V.E. Rozhnova, the cat focuses on hypnosis and autogenic training.

1968 B.D. Karvasarsky organizes the department of psychotherapy at the Bekhterev Institute, which focuses on group and individual psychotherapy. In Vilnius, prof. Alekseichik opens the Department of Psychotherapy, where they focus on group psychotherapy. The rules adopted by the group at the beginning of the lesson were important to him. Violating them gives a person the opportunity to demand payment for him - recognition of responsibility, the ability to keep his word.

1985 emergence of the profession of psychotherapist. The USSR joins the International Psychotherapeutic Association. (A medical field that should be handled by doctors). The Russian Psychotherapeutic Association and the International Psychotherapeutic League are being organized (a humanistic specialty that people of the human profession have the right to engage in) and the Russian Psychotherapeutic League is being organized (2 models of understanding psychotherapy: a doctor and a humanitarian specialist)

1985 Many foreign specialists begin to come to the USSR, reprints and translations appear, and there is a surge of interest in alternative therapy.

In the last decade, interest in psychotherapy in our country has increased sharply, opportunities have opened up to study the entire spectrum of its theories and methods, the quality of training of specialists has improved, and organizational models of psychotherapeutic services are being improved.

The main characteristics of psychotherapy in comparison with other types of therapeutic practice.Doctors are working. Mostly clinically abnormal. Long-term (more than 30 meetings). Working mainly with the past. The work is not anonymous (exception: in a commercial case for the norm).

Indications for psychotherapy.

1. The patient has a problem that can be treated
psychotherapeutic treatment: neuroses, neurotic reactions
psychotraumatic syndrome, personal and professional stress, problems of self-esteem, self-expression, anxiety, fears, panic disorders, obsessions, problems of family relationships, aggressiveness,
psychosomatic disorders, sleep disorders, appetite disorders, etc.;

2. The patient himself has a desire for treatment.

3. The patient does not have a mental illness (during an exacerbation, they are treated in a psychiatric hospital).

Contraindications to psychotherapy.

1. The patient does not perceive psychotherapy as treatment.

2. The patient has an acute mental illness.

3. Lack of real desire to be treated by the patient himself.

The problem of emotional burnout in psychotherapy.Burnout syndrome is a complex psychophysiological phenomenon, which is defined as emotional, mental and physical exhaustion due to prolonged emotional stress. The syndrome is expressed in a depressive state, a feeling of fatigue and emptiness, a lack of energy and enthusiasm, loss of the ability to see the positive results of one’s work, and a negative attitude towards work and life in general. It is believed that people with certain personality traits (anxious, sensitive, empathetic, introverted, humanistic, identified with others) are more susceptible to this syndrome.

To prevent burnout, a psychotherapist must use special techniques to regulate the emotional state, relieve internal tension, and must also follow the rules of interaction with patients.

Ethical principles of psychotherapy.

1. Not causing harm to the patient the organization of the psychotherapist’s work must be such that neither the process nor the results cause harm to health, condition and social status.

2. The principle of competence of a psychotherapist a psychotherapist has the right to take on the solution only of those issues in which he is professionally knowledgeable and endowed with the appropriate rights and powers to perform psychological or any other influences.

3. The principle of impartiality a biased attitude towards the patient is unacceptable, no matter what subjective impression he makes with his appearance, legal and social status.

4. Principle of confidentiality material or information obtained by a psychotherapist in the process of working with a patient on the basis of a trusting relationship is not subject to deliberate or accidental disclosure.

5. Rules of informed consent it is necessary to notify the patient about the ethical principles and rules of psychological activity.

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1. The concept of psychotherapy. its specifics, goals and objectives.

2. General characteristics of psychological models of psychotherapy.

3. Group psychotherapy. The concept of a psychotherapeutic group.

The concept of psychotherapy. its specifics, goals and objectives

Psychotherapy occupies a special place among the types of professional assistance to the individual. The question of the professional affiliation of psychotherapy is not an easy one. In the Soviet Union, psychotherapy was a medical specialty. In the West, psychotherapy has traditionally been a branch of practical psychology. This double understanding of the activity of a psychotherapist still persists. The activities of a psychotherapist are considered in accordance with his two professional roles:

o a medical specialist who treats the patient using both psychological influence and specific medical means (medicines, hypnosis, etc.);

o a specialist psychologist, designed to help the individual survive in various life and social situations and focused on working with the client’s deep-seated life problems. In this case, he uses only psychological means of activity.

Of course, a specialist in practical psychology can carry out psychotherapy only in the second sense of this concept and has no right to use medical means. Therefore, let us take the following statement as the initial one. Psychotherapy is aimed at deep penetration into the personality and the implementation of progressive shifts in its interaction with the world through a change in self- and worldview and provides for the creation of conditions for the full development of personality.

The goal of psychotherapy is to assist in the development of a full-fledged personality, capable of taking an active and creative position in relation to oneself and one’s life, coping with traumatic situations and experiences, making decisions and acting productively, unconventionally and with dignity in appropriate socio-cultural conditions.

It is customary to distinguish between group and individual psychotherapy.

Individual psychotherapy is a dialogue between a psychotherapist and a client with the goal of psychological assistance to the latter.

In modern psychological literature, several approaches have emerged that characterize the relationship between psychological counseling and psychotherapy:

1) psychotherapy and psychological counseling are different types of activities in content and objectives;

2) psychotherapy and psychological counseling are identical, have identical theoretical and practical foundations, but differ in details;

3) psychological counseling deals with interpersonal problems, and a psychotherapist deals with internal personal problems.

O.F. Bondarenko argues that the main differences between psychological counseling and psychotherapy are related to the interpretation of a person as an object of influence.

In the process of psychotherapy, people change along with their models of the world.

Today, about 100 different psychotherapy techniques are known. All of them not only find supporters, but also allow them to effectively provide psychological assistance.

Each type of psychotherapy aims to help clients function successfully in the world.

General characteristics of psychological models of psychotherapy

An analysis of psychotherapeutic literature suggests that today in this area of ​​practical psychology there has not been a unified approach to identifying the main directions of psychotherapy. This is due to its consideration either as a method of treatment (this approach is more often found in foreign psychological literature) or as a type of psychological assistance to the client.

For example, Yu. G. Demyanov identifies the following methods of psychotherapy used in practice:

o rational psychotherapy;

o psychoanalytic psychotherapy;

o cognitive-analytical psychotherapy;

o psychotherapy based on transactional analysis;

o person-oriented psychotherapy;

o Gestalt therapy;

o autogenic training;

o emotional stress therapy;

o group psychotherapy;

o positive psychotherapy.

The classification of psychotherapy models as types of therapeutic actions is described by H. Remschmidt. He proposes a classification of psychotherapy models according to the following principles:

The theoretical concept that underlies psychotherapy (psychoanalysis, behavioral psychotherapy, cognitive therapy, etc.);

Organizational forms of treatment (individual, group and family therapy);

The specificity of the corrected disorder (psychosis, autism syndrome, neurotic disorders, depressive states, fear syndrome, obsession syndrome, etc.).

In the psychological literature there is also no consensus in identifying the main models of psychotherapy. So, in particular, G. Onishchenko, V. Panok identify three main models of psychotherapy:

o psychodynamic psychotherapy, focused on psychoanalysis;

o humanistic psychotherapy and its main trends - Rogerian, existential, Gestalt therapy;

o behavioral (behavioral) psychotherapy.

A somewhat different approach is presented by A.F. Bondarenko. He identifies four main theoretical approaches to psychotherapy:

1) psychodynamic;

2) humanistic;

3) cognitive;

4) behavioral or behavioristic.

Group psychotherapy. The concept of a psychotherapeutic group

Group psychotherapy was introduced into the practice of psychological assistance in 1932 by J. Moreno, and 10 years later there was already a journal on group psychotherapy and a professional organization of group psychotherapists.

Group psychotherapy is a method of psychotherapy in which several clients are helped at the same time. The emergence of group psychotherapy is due, according to Moreno, to an insufficient number of psychotherapists and significant time savings.

The first method of group psychotherapy was psychodrama.

In the 40s, T-groups appeared (K. Levin), providing for the formation of interpersonal relationships and the study of processes in small groups and in their variety - the sensitivity group.

Today these groups have evolved into skill groups and personal development groups or meeting groups.

Psychotherapy groups are small temporary associations of people led by a psychologist or social worker who have a common goal of interpersonal exploration, personal growth and self-discovery.

These are groups in which holistic, in-depth development of personality and self-actualization of a healthy person occurs, and the process of his mental maturation is accelerated.

Depending on the overall goal, the group has a relatively clear hierarchical structure. One of the members of the psychotherapeutic group acts as a leader, the rest are in the role of subordinates. This structure may change depending on the goals of psychotherapy. Common goals, combined with the needs of individual group members, determine group norms, that is, the forms and style of behavior of all group members.

It is worth, according to Lehmkuhl, to distinguish group training and work with a group from group psychotherapy itself. Remschmidt explains it this way: “Group training is focused on overcoming certain behavioral disorders and requires high structure (targeted exercises, a strict therapeutic plan), while group psychotherapy is about gaining emotional experience and achieving intrapsychic changes, while the degree of structure is low.”

All forms of group therapy use primarily verbal methods, as well as action-oriented or behavioral methods. Recently, activity-oriented approaches have become increasingly important. They contain the therapeutic elements and basic principles of both of the above methods, but differ from them in their emphasis on vigorous activity and group exercise.

The success of group psychocorrection and psychotherapy largely depends on the personality of the leader (group coach). The team leader typically has four roles: expert, catalyst, conductor, and role model. That is, he comments on group processes, helps participants objectively assess their behavior and its impact on the situation; contributes to the development of events; equalizes the contributions of each participant in group interaction; open and authentic.

Psychotherapy (from the Greek psyche - soul and therapeia - treatment) is literally translated as “treatment of the soul.” Currently, the term does not have an unambiguous interpretation. With all the variety of interpretations, two approaches can be traced: clinical and psychological.

In the first approach, psychotherapy is considered as a field of scientific knowledge about treatment methods that affect the state and functioning of the body in the areas of mental and somatic activity. In the second approach, psychotherapy is defined as a special type of interpersonal interaction in which clients are provided with professional assistance through psychological means in solving their problems or difficulties of a psychological nature. Thus, the main goal of the second approach is not a cure for mental disorders, but assistance in the process of formation of consciousness and personality, in which the psychotherapist appears as the client’s companion, friend and mentor.

Psychotherapy as a scientific discipline must have its own theory and methodology, its own categorical apparatus and terminology, etc., in a word, everything that characterizes an independent scientific discipline. However, the diversity of directions and currents, schools and specific methods of psychotherapy, based on various theoretical approaches, leads to the fact that currently there is not even a single definition of psychotherapy. There are about 400 of them in the literature. Some of them clearly classify psychotherapy as medicine, others focus on psychological aspects. The domestic tradition is that psychotherapy is defined, first of all, as a method of treatment, that is, it falls within the competence of medicine. Foreign definitions of psychotherapy largely emphasize its psychological aspects.

Psychotherapeutic intervention, or psychotherapeutic intervention, is a type (type, form) of psychotherapeutic influence, which is characterized by certain goals and the choice of means of influence, that is, methods, corresponding to these goals. The term psychotherapeutic intervention can denote 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 (primarily , with an understanding of the nature of a particular disorder and the goals and objectives of psychotherapy).

Psychology and medicine use different types of interventions. All types of interventions used in medicine are divided into four groups: medications (pharmacotherapy), surgical, physical (physiotherapy) and psychological (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: I) choice of means (methods); 2) functions (development, prevention, treatment, rehabilitation); 3) target orientation of the process to achieve change; 4) theoretical basis (theoretical psychology); 5) empirical testing; 6) professional actions.

Let us consider the main characteristics of clinical and psychological interventions.

Methods of clinical and psychological interventions are psychological means that the psychotherapist chooses. They can be verbal or non-verbal, focused more on either cognitive, emotional or behavioral aspects and are implemented in the context of relationships and interactions between the patient or patients (those who need help) and the psychotherapist (those who provide this help). renders).

Typical psychological means are conversation, training (exercises) or interpersonal relationships as a factor of influence and influence.

The functions of clinical and psychological interventions are prevention, treatment, rehabilitation and development. Clinical and psychological interventions that perform the function of treatment (therapy) and partially rehabilitation are essentially psychotherapeutic interventions.

The goals of clinical and psychological interventions reflect a goal orientation to achieve 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.

The theoretical validity of clinical psychological interventions lies in its relationship with certain psychological theories of scientific psychology. Empirical testing of clinical and psychological interventions is primarily related to the study of their effectiveness; they should always be carried out by professionals.

The goal of psychotherapy common to most psychotherapeutic approaches can be formulated as follows: The overall goal of psychotherapy is to help patients change their thinking and behavior in such a way as to become happier and more productive. When working with patients, this goal is differentiated into a number of tasks, namely:

1) the therapist helps the patient better understand his problems;

2) eliminates emotional discomfort;

3) encourages free expression of feelings;

4) provides the patient with new ideas or information about how to solve problems;

5) assists the patient in testing new ways of thinking and behaving outside the therapeutic situation.

When solving these problems, the therapist resorts to three main methods.

1. First, the therapist provides psychological support. First of all, this means listening sympathetically to the patient and giving him sound advice in a crisis situation. Support also involves helping the patient recognize and use their strengths and skills.

2. The second method of therapy is to eliminate maladaptive behavior and form new, adaptive stereotypes.

3. Finally, the therapist promotes insight (awareness) and self-disclosure (self-exploration), as a result of which patients begin to better understand their motives, feelings, conflicts, and values.

Despite differences in theories, goals and procedures, psychological treatment boils down to one person trying to help another (even in the case of group psychotherapy, in which each participant is a kind of therapist to another member of the group). .

An integrated approach to the treatment of various diseases, taking into account the presence of three factors in the etiopathogenesis (biological, psychological and social), necessitates the need for corrective actions aimed at each factor corresponding to its nature. This means that psychotherapy, as a primary or additional type of therapy, can be used in a comprehensive treatment system for patients with a wide variety of diseases. Indications for psychotherapy are determined by the role of the psychological factor in the etiopathogenesis of the disease, as well as the possible consequences of a previous or current disease.

The most significant indication for psychotherapeutic work with a specific patient is the role of the psychological factor in the occurrence and course of the disease.

The more pronounced the psychogenic nature of the disease (that is, the more pronounced the psychologically understandable connection between the situation, the person and the disease), the more adequate and necessary the use of psychotherapeutic methods becomes.

Indications for psychotherapy are also determined by the possible consequences of the disease. The concept of “consequences of the disease” can be specified. They may be associated with clinical, psychological and socio-psychological problems.

Firstly, this is a possible secondary neurotization - a manifestation of neurotic symptoms caused not by primary psychological causes, but by a psychotraumatic situation, which is the underlying disease.

Secondly, it is the individual’s reaction to the disease, which can either contribute to the treatment process or hinder it. An inadequate personality reaction to an illness (for example, anosognosic or, conversely, hypochondriacal) also needs to be corrected by psychotherapeutic methods.

Thirdly, psychological and socio-psychological consequences are possible. A serious illness that changes the patient’s usual lifestyle can lead to a change in social status; the impossibility of realizing and satisfying relationships, attitudes, needs, and aspirations that are significant to the individual; to changes in family and professional spheres; narrowing the circle of contacts and interests; decreased performance, activity level and motivational components; lack of self-confidence and decreased self-esteem; formation of inadequate stereotypes of emotional and behavioral response.

Fourthly, in the process of a chronic disease, a dynamic transformation of personal characteristics is possible, that is, the formation during the course of the disease of personal characteristics (increased sensitivity, anxiety, suspiciousness, self-centeredness) that require corrective influences.

Of course, in each specific case, indications for psychotherapy are determined not only by nosological affiliation, but also by the individual psychological characteristics of the patient, including his motivation to participate in psychotherapeutic work.

Group and individual psychotherapy are the two main forms of psychotherapy. The specificity of group psychotherapy as a therapeutic method lies in the targeted use of group dynamics for therapeutic purposes (that is, the entire set of relationships and interactions that arise between group members, including the group psychotherapist).

There are three main directions, or approaches, in psychotherapy: psychodynamic, phenomenological (existential-humanistic), behavioral (cognitive-behavioral).

The psychodynamic approach states that human thoughts, feelings and behavior are determined by unconscious mental processes. Freud compared a person's personality to an iceberg: the tip of the iceberg is consciousness, but the main mass, located under water and invisible, is the unconscious.

The dynamic direction in psychotherapy is based on depth psychology - psychoanalysis. Currently, within the framework of the dynamic direction, there are many different schools, but the common thing that unites the views of representatives of this approach is the idea of ​​unconscious mental processes and psychotherapeutic methods used for their analysis and awareness.

Existential psychotherapy examines the vision of the psyche from the perspective of nature. The concept of “existence” comes from the Latin word existere, meaning “to stand out, to appear.” In Russian translation it means a process associated with emergence or formation. Therefore, existential methods in psychotherapy are associated with psychological work at the ontological level (from the Greek ontos - “being”), aimed at helping patients defend and approve their model of existence, despite the limitations that life imposes.

Existence is a specific form of existence, characteristic only of man, in contrast to all things. The difference here is that human existence is conscious and meaningful. However - and this is important for psychotherapeutic practice - various life troubles, mental trauma, improper upbringing (which does not give the child a feeling of love and security) can “cloudy” human existence, making him a weak-willed “automatic machine”, living unconsciously and meaninglessly. The consequence of this “turbidity of being” is a variety of disorders from the field of “minor psychiatry” and psychosomatics. It is noteworthy that “major” mental disorders (studied in detail by one of the founders of existential psychology, Karl Jaspers), as well as severe, incurable somatic diseases, are often considered as an “existential challenge” that, if treated correctly, can lead the patient not to “cloudiness.” ”, but, on the contrary, to the “clarification” (Jaspers’ term) of existence.

The arsenal of psychotherapeutic techniques used by humanistic psychotherapists is extremely wide. However, it is safe to say that they give preference to conversational methods, because It is in free conversation that that very “existential communication” can arise. However, especially in the early stages of treatment, humanistic psychotherapists can use any other methods, including hypnosis, if this helps to free oneself from specific factors that “cloud” the patient’s existence.

The most important areas of the humanistic “family”: Dasein analysis (existential psychoanalysis according to Binswanger), logotherapy (existential analysis according to Frankl), client-centered counseling according to C. Rogers, Gestalt therapy, transactional analysis.

Behavioral psychotherapy is based on behavioral psychology and uses the principles of learning to change cognitive, emotional and behavioral structures. Behavioral psychotherapy includes a wide range of methods. The development of methodological approaches within this direction reflects the evolution of the goals of behavioral psychotherapy from external to internal learning: from methods aimed at changing overt forms of behavior, directly observable behavioral reactions (based mainly on classical and operant conditioning) to methods aimed at changing deeper , closed psychological formations (based on theories of social learning, modeling and cognitive approaches).

In general, behavioral psychotherapy (behavior modification) is aimed at managing human behavior, retraining, reducing or eliminating symptoms and bringing behavior closer to certain adaptive forms of behavior - replacing fear, anxiety, restlessness with relaxation until the reduction or complete elimination of symptoms, which is achieved in the process of learning through the use of certain techniques.

1. Types of psychological assistance: psychotherapy, psychological correction, counseling.

2. Preventive psychological assistance.

Question 1. Psychotherapy and psychocorrection as types of psychological intervention in cases of problem behavior are based on the use of the same methods and techniques, so their distinction is conditional. It is associated with the competitive division of the spheres of influence of psychiatry and psychology, with different understandings of the mechanisms and leading causes of mental and behavioral disorders in these sciences, as well as with different purposes for the use of psychological methods of influencing the individual. Both psychotherapy and psychocorrection represent a targeted psychological impact on individual mental functions or components of the personal structure in the process of interaction between at least two people: a doctor and a patient, a psychologist and a client. Etymologically, the term “therapy” is associated with alleviating the condition of a suffering person or ridding him of something that brings him suffering. Historically, the use of this word was assigned to medicine. The basic meaning of the term "correction" is the correction, elimination or neutralization of what appears to be undesirable or harmful to a person. An undesirable component may not always bring suffering to its owner: undesirability may be associated with a discrepancy between a personality possessing some psychological quality or property and the “ideal model” of a person. And in this sense, correction turns out to be closely related to the concept of “education.” Psychocorrection is part of the educational process, since the psychologist influences indicators of mental (memory, attention, thinking, emotions, will) and personal (motives, attitudes, value orientations) development that go beyond the established norm, leading it to the “optimal level” of functioning in society . In psychocorrectional influence, the psychologist adheres to the following scheme: what is, what should be and what needs to be done so that it should be.

Thus, psychotherapy and psychocorrection differ only in the goals and object of psychological influence. The goal of psychotherapy is to help change or eliminate painful symptoms or behavior patterns that interfere with living with a sense of satisfaction and happiness. The goal of psychocorrection is to bring mental indicators to a certain norm, to an optimal level of functioning in society, when deviations have not yet acquired painful forms.

Psychocorrection is identified as an independent type of psychological assistance only in Soviet and post-Soviet science and practice. Two reasons: ideological (raising a “new” person capable of living in a “new” society) and methodological (separation of spheres of application - in medicine or in non-medical practice).

In general, there are two points of view on the relationship between the concepts of “psychocorrection” and “psychotherapy”.

A) Recognition of the complete coincidence of the two concepts. Reasons: identical requirements for the personality of a specialist, the level of his professional training, identical procedures and working methods. However, psychotherapy does not always involve correction and is not limited to it. This is a broader concept that includes psychocorrectional measures as separate methods of providing psychological assistance. Psychocorrection as a special case of psychotherapy.

B) Psychocorrection – work with healthy people. Psychotherapy is working with sick people. However, in many cases it is impossible to separate behavioral disorders caused by pathological processes from disorders due only to psychosocial causes. In addition, in modern psychiatry, an integrated approach is becoming increasingly widespread, taking into account in the etiopathogenesis of mental disorders not only biological, but also psychological and social factors, each of which requires therapeutic or corrective influences corresponding to its nature. If the psychological factor is the etiological factor in the occurrence of the disorder, then its correction largely coincides with the content of medical psychotherapy. It is almost impossible to determine the general scheme of the relationship between psychotherapy and psychocorrection without a specific case.

In the domestic literature one can also find a position according to which psychocorrection differs from psychotherapy by focusing on the present and future, while psychotherapy can also use in-depth methods of analyzing clients’ past. However, it should be noted here that in the English-language literature there is a completely opposite position, according to which psychotherapy refers to methods of providing assistance that do not use the techniques of psychoanalysis.

Counseling is a type of psychological assistance for the purpose of training and mentoring. Unlike therapy and psychocorrection, it consists of providing advice and exchanging information. This is the application of psychological knowledge to achieve any pragmatic results and train people as performers who achieve these results. Consulting is based on collecting accurate information about the problem and the people involved in it, which is necessary to assess the situation and provide ready-made solutions (alternatives) to correct the situation based on any theoretical models. Consulting also involves developing the client’s skills for independently solving emerging current (local) problems, helping to develop a reflective position on the problem and providing the client with the necessary skills and knowledge. In essence, counseling initially acted as directive psychological assistance. In the 40s, counseling began to develop within the framework of the psychotherapeutic paradigm. Counseling here is psychological assistance in various aspects of a person’s life with the aim of adapting to constantly changing social conditions. The focus of counseling has shifted to individual problems. The goal is to help the client self-determinate in solving emerging problems before they become painful problems. So, counseling is focused on the goals of educational, professional or personal adaptation of people. Consulting includes methods: interviewing (gathering information), improving relationships (correction), training communication skills, providing information and advice of interest. Types of consultation: on education, career, leisure, development, health, dismissal, hiring, etc. Assistance in choosing suitable leisure activities, work, education by increasing the competence of clients, motivation for certain types of activities.

In some cases, there is a special type of counseling called psychosocial. This term is most often found in medical practice, primarily when describing preventive and palliative psychological care for HIV infection.

The term “psychosocial” is widely used in modern Western science to refer to such states of the human psyche that are caused by social influences and determined by factors of social life. This term arose in a certain paradigm in which the social and mental have long been considered as separate, independent spheres of an individual’s existence. It is the experience of one’s position in society, the representation of the social sphere of life in basic mental processes (emotions, thinking, will) that belong to the area of ​​psychosocial.

Another meaning of this term is determined by the fact that psychological factors are associated not only with the behavior of an individual in certain social conditions, but also with social organization and the functioning of society. Changing the psychology of members of society, according to such ideas, can change society itself. First of all, his reactions, ways of interaction of large social groups, approaches to solving pressing social problems.

In order to successfully influence the psychosocial factors of society, the practice of a special kind of counseling arose in the mid-50s of the twentieth century. Its emergence is primarily associated with the development of so-called “social psychiatry” - an attempt to achieve social changes through psychotherapeutic influences in the process of mass psychosocial consultations of the population in order to increase its adaptive capabilities and correct deviant behavior. Thus, the initial goal of psychosocial counseling was to increase people’s readiness to change behavior through changing social images, perceptions, and attitudes of individuals in connection with a particular social problem.

Behavioral changes are still the only means of primary prevention of HIV infection. Therefore, the practice of psychosocial counseling has been applied in Western countries to the problem of the AIDS epidemic, the mass spread of which primarily depends on both the behavior of the affected population and the adequacy of the response of representatives of various social institutions to the problem.

For example, the goal of psychosocial counseling during HIV testing is to focus patients' attention on the fact of a real threat of infection and personal risk factors in their behavior (even if they do not belong to groups at high risk of HIV infection). The person being examined, with the help of a consultant, must realize personal responsibility for his behavior, which can, under certain circumstances, lead to AIDS. The consultant’s task is to help a person think about the need to change his lifestyle, behavioral patterns, and help in planning and implementing these changes. Therefore, psychosocial counseling involves both informational and educational aspects. The examinee should be provided with information about the prevalence of this disease, the dynamics of the development of the epidemic process, the characteristics of the stages of HIV infection and diagnosis, ways to prevent infection and the possibility of observing the rules of safe sex and safe drug use in specific life situations, etc.

An important part of advisory work is also the formation of a non-hostile attitude towards HIV-infected people and representatives of groups at increased risk of infection. After all, existing public opinion can significantly influence the development of such a phenomenon as “AIDS terrorism,” which is a defensive psychological reaction of individuals rejected by society.

Psychosocial counseling has its own characteristics in comparison with other counseling practices in psychology and medicine. If in ordinary psychological counseling the emphasis is on changing some of the client’s personal characteristics, then in psychosocial counseling on HIV infection, the consultant (psychologist, doctor) is not tasked with changing the personality of the client, even if there is direct evidence for this. The specialist’s task in this case is to use the personal and individual characteristics of the subject to change components in his behavior that are risky from the point of view of the epidemiology of HIV infection.

Question 2. Sometimes a special, intermediate type of psychological assistance is identified as an independent one - preventive. This assistance anticipates an active request on the part of a potential client, expanding his field of consciousness based on a natural interest in himself and the quality of his interpersonal relationships. This assistance is especially relevant in conditions of psychological illiteracy of the population about the possibility of professional solutions to emerging problems.

Preventive psychological care often includes a special type of psychological services - psychoprophylaxis.

In the domestic psychological and pedagogical literature, prevention is usually considered in the context of the problem of deviant behavior or as a type of training and education process. The primary importance of preventive tasks aimed at preventing the development of defects, in comparison with the tasks of correcting already formed defects, was noted by L.S. Vygotsky. Psychoprophylaxis is a type of activity of a practical psychologist that is aimed at preventing possible problems in personal development, creating psychological conditions that are most favorable for this development, and preserving, strengthening and developing psychological health. Psychoprophylaxis does not exclude other types of work. In the context of psychoprophylactic work, they act as structural elements and means of psychoprophylaxis, which changes their focus:

Diagnostic and correctional work is aimed at providing information about the characteristics of personality development in a certain social environment. Based on such work, hypotheses are formulated about the causes of possible psychological problems; methods and specific content of developmental or correctional and preventive work are selected;

Consulting is aimed at discussing and clarifying the possible causes of problematic behavior, personal difficulties of a certain person or group of people in order to timely prevent or overcome unfavorable tendencies, ensure psychological well-being in the development of their personality;

Education is aimed at the timely and targeted dissemination of information that makes it possible to prevent the emergence of typical difficulties in life, in professional activity, and in interpersonal communication.

Preventive work can be carried out at three levels: a) universal prevention, b) selective prevention and c) prevention according to indications (in previous terms - primary, secondary and tertiary prevention). Psychoprophylaxis differs in the focus of influence: a) direct focus (on neutralizing or blocking factors that provoke problem behavior), c) indirect focus (formation of successful, positive life skills and increasing the effect of protective factors that prevent the development of problem behavior).

The level of preventive impact depends on the level of severity of problem behavior at the time of preventive work. Universal (primary) prevention is carried out with people who do not yet have signs of problem behavior in order to develop and strengthen their personal resource to cope with difficult life circumstances in adaptive ways. At the same time, the target audience of universal prevention is in relatively prosperous conditions, and the psychological service is aimed at increasing their resistance to stress, developing socio-psychological skills so that they are ready to behave adequately when the social situation in their life worsens.

Selective (secondary) prevention is aimed at people who have a high risk of developing problem behavior in difficult life circumstances. As a rule, this level of prevention is aimed at people who already have psychological difficulties (but can still cope with them on their own), are in stressful living conditions associated with poor personal or social functioning, and problematic relationships with others.

Prevention according to indications (tertiary) is aimed at those people who have already had isolated cases of problematic, maladaptive behavior, disorders of social or personal functioning, but they have not yet acquired a stable and total manifestation that requires psychocorrection or psychotherapy.

Test questions for the lecture.

1. What is the goal of psychotherapy?

2. What is the purpose of psychocorrection?

3. What is the purpose of psychological counseling?

4. What are the reasons for the separation of psychotherapy and psychocorrection in domestic psychological practice?

5. What points of view on the relationship between psychotherapy and psychocorrection do you know?

6. What is psychosocial counseling?

7. What are the specifics of preventive psychological care?

8. List the levels of preventive work of a psychologist. What is the purpose of prevention at each of these levels?

9. By what criterion should the level of preventive work be selected?

References.

1. Abramova G.S. Practical psychology. – M.: Academic project, 2001.

2. Kociunas R. Fundamentals of psychological counseling. – M.: Academic project, 1999.

3. Romek E.A. Psychotherapy: theoretical foundation and social formation. – Rostov n/d.: RSU, 2002.

4. Khukhlaeva O. V. Fundamentals of psychological counseling and psychological correction. – M.: Publishing Center “Academy”, 2001.