know

• methodological foundations of psychotherapeutic impact on a person and a family group;
• conceptual foundations for the difference between family psychotherapy and individual assistance;
• conceptual differences in the content of psychological assistance from different schools of family psychotherapy;

be able to

• determine the circle of family members involved in a family conflict;
• identify therapeutic targets in working with the family;
• determine in which conceptual paradigm one should work with a particular family and a particular type of family conflict;

own

• basic terminology used in family therapy;
• skills to analyze differences in the approaches of different therapeutic schools;
• skills in analyzing problems solved by certain therapeutic techniques.

Types of psychological assistance to a person. Family psychotherapy and its features

Before we start talking about family psychotherapy, let's turn to the generic concept of psychological assistance. The modern professional dictionary basically distinguishes three terms denoting different forms of psychological assistance: psychological correction, psychological counseling and psychotherapy. Despite the fact that each of the practices of psychological assistance has its own goals and methods, the line between them is not so obvious.

We will call psychological correction assistance in which a trained professional helps the client acquire the skills necessary for adequate socialization: educational (speaking, reading, numeracy, writing skills) and behavioral (communication skills and behavior control). The assistance procedures in this case are based on the behavior modification model (in the behavioral paradigm) and have the form of skills training. The position of a specialist is estimated. A specialist in the field of psychological correction is usually focused on the concept of the norm and acts on behalf of an organization, most often an educational or social institution. From what has been said, it follows that the evaluation of the effectiveness of work is carried out not by the client - the recipient of assistance, but by the institution of which he is a member. Evaluation is thus objectified and comes from others - parents, teachers, social workers.

Under psychological counseling refers to "a professional relationship between a trained counselor and a client that is undertaken to help the client clarify his views on his life space and teach him to achieve vital goals through well-considered choices and problem solving of an emotional and interpersonal nature" .

It is especially difficult to draw a line between psychological counseling and psychotherapy. N. Burks and Jr. Stefflre cites the results of a study in which a group of professional psychotherapists and a group of professional counselors are shown a video recording of a psychological assistance session and asked to determine what type of assistance the footage belongs to. It turned out that both groups qualified the presented material in accordance with their professional affiliation: psychotherapists called this type of work psychotherapy, and consultants - counseling. This information suggests that the line between counseling and therapy is very thin, and it is as difficult to determine it as it is to determine in the early morning whether it is still night or already morning.

The following definition of psychotherapy gives an idea of ​​its significant similarity to counseling: “Psychotherapy is a process whose purpose is to bring about change. This process takes place within a professional relationship characterized by contractual obligations between the parties involved, trust and empathy. During this process, the focus is either explicitly or implicitly on the client's personality, psychotherapy technique, or both. As a result, there are lasting changes in numerous areas of the client's life. Criteria for distinguishing psychological counseling from psychotherapy, formed on the basis of the text of N. Burks and Jr. Stefflre, and supplemented by several positions, are tabulated and presented below (Table 7.1).

Although the differences between therapy and counseling can be found and labeled in a descriptive, non-rigorous manner, many experts argue that there are fewer differences between them than similarities, and that there is a large area of ​​overlap in which counseling and psychotherapy are indistinguishable. The distinction is also minimized in everyday language in Europe and in the USA. Further, we will use the terms "psychological counseling" and "psychotherapy" as close in meaning and interchangeable concepts.

Table 7.1

Criteria for the difference between psychological counseling

and psychotherapy

Distinction criterion	Psychological counseling	Psychotherapy
Mental processes that are in the focus of attention of a specialist	Predominantly conscious levels of the psyche	Conscious and unconscious levels of the psyche
Psychological goals	Changing emotional, cognitive, behavioral characteristics in order to better adapt	A profound change in the client's personality, subjectively perceived as well-being
Psychological time on which the process is focused	Present customer	Client's background and personal history
The psychological content of the relationship with a specialist	More based on awareness, boundaries and control	Infused with transference/countertransference phenomenology
Psychological status of the client	Mostly "healthy" people	Mostly "sick" people
Duration process	From one meeting to one year (one and a half years) of work	Several years of systematic meetings
Specialist training	Humanities (psychological education) and special training	Medical education, residency in psychiatry, special training
The degree of elaboration of personal problems of a professional	Brief personal therapy	Personal therapy, supervision, constant participation in the Baliit group 3
Age of formation of professional skills, personal experience	22-25 years old, little personal experience	30 years or more, personal experience of creating family relationships, experience of loss
Efficiency mark	Based primarily on objective indicators of adaptation	Combines objective and subjective evaluation

Questions for reflection

• 1. What types of life experiences do you think are most conducive to becoming a professional psychotherapist?
• 2. What kind of professional, counselor or therapist, do you think should work on hotlines?
• 3. Do you think it is right to combine psychological counseling and psychotherapy into one activity?
• 4. How long do you think it will take to create a professional system of psychotherapeutic assistance to the population in Russia?

Family Psychotherapy as a special method, addressed not to an individual, but to a family group, arose in the USA in the 1950s. from attempts to understand the functioning of families in which one of its members is ill with schizophrenia. In the theory of one of the founders of family psychotherapy, Gregory Bateson, schizophrenia is seen as the result of pathological communications in the family.

“Family therapy is a psychotherapeutic method, the purpose of which is to change the disturbed relationships between family members in such a way that, with the help of changes in the dynamics and structure of relationships - in the family and its subsystems, complaints, problems, symptoms of individual family members will decrease or completely disappear, and the functioning of system as a whole".

Differences of family psychotherapy from other types of individual and group work

• The primary unit of analysis in family therapy is relations that develop between family members.
• The work is carried out in the most significant social group - the group of origin and primary socialization, i.e. where a person received the first communications kati vnye oi i yty.
• Relationship problems are not simply discussed (talking about problems) or imitated through role-playing, they are brought into the living fabric of family life, into the real family situation and lead to changes in it.
• Family psychotherapy is effective not only as a method of helping the family, but also for many types of extra-family problems of a personal and interpersonal nature with neurotic, psychosomatic and even psychotic symptoms.

• 2 Burks I, Stefflre Jr. Theories of counseling. New York, London: McGraw-Hill, 1979.
• Psychotherapy - what is it? Modern ideas. M. : Independent firm "Class", 2000. S. 24.
• The Balint group (named after the British psychoanalyst Michael Balint) is a form of group work, the purpose of which is to analyze the relationship of a psychoanalyst (psychotherapist, consultant, trainer) with his client. In a more general sense - professional assistance to a professional working in the field of human relations.
• 2 Schizophrenia is one of the types of mental illness, the causes of which in different areas of scientific knowledge are localized in different areas: from social (as in Bateson) to genetic (marker genes responsible for the expression of schizophrenia in localized chromosomes have been found). Different mutually contradictory interpretations of the etiology of this disease persist in different areas of psychological, clinical and philosophical knowledge.
• Basic Guide to Psychotherapy / A. Heil-Evers [et al.]. St. Petersburg: East European Institute of Psychoanalysis, 2001. P. 463.

Psychotherapy(from the Greek psyche - soul and therapeia - treatment) literally translates 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 sphere of scientific knowledge about methods of treatment 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 by 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 the formation of consciousness and personality, in which the psychotherapist appears as a companion of the client, his 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 different theoretical approaches leads to the fact that at present there is not even a single definition of psychotherapy. There are about 400 of them in the literature. Some of them clearly attribute psychotherapy to 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 is within the competence of medicine. Foreign definitions of psychotherapy emphasize its psychological aspects to a greater extent.

Psychotherapeutic intervention, or psychotherapeutic intervention, is a type (type, form) of psychotherapeutic influence, which is characterized by certain goals and a choice of means of influence, that is, methods corresponding to these goals. The term psychotherapeutic intervention can mean a specific psychotherapeutic technique, for example, clarification, clarification, stimulation, verbalization, interpretation, confrontation, learning, training, advice, etc., as well as a more general strategy of the psychotherapist's behavior, 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 various types of interventions (interventions). All types of interventions used in medicine are divided into four groups: medical (pharmacotherapy), surgical, physical (physiotherapy) and psychological (psychotherapy).

Psychological interventions, or clinic-psychological interventions, constitute the essence of psychotherapeutic intervention. From the point of view of these authors, clinical and psychological interventions are characterized by: I) the choice of means (methods); 2) functions (development, prevention, treatment, rehabilitation); 3) target orientation of the process to achieve change; 4) theoretical base (theoretical psychology); 5) empirical verification; 6) professional actions.

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

Methods of clinical-psychological interventions are psychological means that the psychotherapist chooses. They can be verbal or non-verbal, focused more on either cognitive or 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 need this help). renders).

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

The functions of clinical 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 the target orientation towards achieving certain changes. Clinical and psychological interventions can be directed both to more general, distant goals, and to specific, closer goals. However, always psychological means of influence must clearly correspond to the goals of influence.

The theoretical validity of clinical and psychological interventions lies in its relationship with certain psychological theories of scientific psychology. Empirical testing of clinical 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 to better understand their problems;

2) eliminates emotional discomfort;

3) encourages free expression of feelings;

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

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

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

1. First, the therapist provides psychological support. First of all, it means listening sympathetically to the patient and giving him balanced advice in a crisis situation. Support also consists in helping the patient to 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, values.

Despite the differences in theories, goals and procedures, psychological treatment comes down to one person trying to help another (even when it comes to group therapy, in which each participant is a kind of psychotherapist in relation to another member of the group) .

An integrated approach to the treatment of various diseases, taking into account the presence of three factors (biological, psychological and social) in the etiopathogenesis, necessitates corrective actions aimed at each factor corresponding to its nature. This means that psychotherapy as the main or additional type of therapy can be used in a complex system of treatment of 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 particular patient is the role of the psychological factor in the onset 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 personality and the disease), the more adequate and necessary the use of psychotherapeutic methods becomes.

Indications for psychotherapy are also due to 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 psycho-traumatic situation, which is the underlying disease.

Secondly, it is the reaction of the individual to the disease, which can either contribute to the healing process or hinder it. An inadequate reaction of a person to a disease (for example, anosognosic or, on the contrary, hypochondriacal) also needs to be corrected by psychotherapeutic methods.

Thirdly, psychological and socio-psychological consequences are possible. A severe illness that changes the patient's habitual lifestyle can lead to a change in social status; the impossibility of realizing and satisfying relationships, attitudes, needs, aspirations that are significant for the individual; to changes in the family and professional spheres; narrowing the circle of contacts and interests; decrease in working capacity, level of activity and motivational components; self-doubt and low self-esteem; the 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 of personal characteristics (increased sensitivity, anxiety, suspiciousness, self-centeredness) in the course of the disease that need corrective influences.

Of course, in each case, the indications for psychotherapy are determined not only by the 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 purposeful use of group dynamics for therapeutic purposes for psychotherapeutic purposes (that is, the entire set of relationships and interactions that arise between group members, including a group psychotherapist).

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

The psychodynamic approach claims that thoughts, feelings and human behavior are determined by unconscious mental processes. Freud compared the personality of a person to an iceberg: the tip of the iceberg is consciousness, while the main mass, located under water and not visible, 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, however, the general, unifying views of the representatives of this approach, are the ideas about unconscious mental processes and psychotherapeutic methods used for their analysis and awareness.

Existential psychotherapy considers the vision of the psyche from the position of nature. The concept of "existence" comes from the Latin word existere, meaning "to stand out, to appear." In translation, the Russian language refers to the process associated with the 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 assert their model of existence, despite the limitations that life imposes.

Existence is a specific form of existence, characteristic only for a person, in contrast to everything that exists. The difference here is that human existence is conscious and meaningful. However, and this is important for psychotherapeutic practice, a variety of life troubles, mental traumas, improper upbringing (which does not give the child a feeling of love and security) can “cloudy” human existence, make it a weak-willed “automaton”, living unconsciously and meaninglessly. The consequence of such a "turbidity of being" is a variety of disorders from the field of "minor psychiatry" and psychosomatics. It is noteworthy that "major" mental disorders (explored 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 properly treated, can lead the patient not to "clouding". ”, 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 can be said with certainty that they prefer conversational methods, because. it is in free conversation that the very “existential communication” can arise. However, especially in the early stages of treatment, humanistic psychotherapists can also use any other methods, up to hypnosis, if this helps to get rid of 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 K. Rogers, Gestalt therapy, transactional analysis.

The behavioral direction in psychotherapy is based on the psychology of behaviorism 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 open forms of behavior, directly observed behavioral reactions (based mainly on classical and operant conditioning) to methods aimed at changing more deep, closed psychological formations (based on social learning theories, modeling and cognitive approaches).

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

Psychological counseling is primarily psychological assistance provided by a specialist (psychologist-consultant) to people who find themselves in a difficult life situation. The process is based on a personal conversation, which includes studying the problem that the person is facing, as well as advice and recommendations that push to solve it. The consultant psychologist listens to the client, taking into account individual characteristics, tries to understand and understand the situation, to explain it.

As in any kind of professional activity, counseling has its own peculiarities of work. It has its own time limit (from 45 minutes to two or more hours). In some cases, a person (family) is invited to come for a consultation again. A prerequisite for conducting consultations is complete confidentiality, that is, not leaving the psychologist's office with information that he learns from the client (the person who applied for the consultation). A necessary condition for the consultation is a specially equipped room, most often a separate office.

All the activities of a consultant psychologist are aimed at contributing to the independent resolution of a difficult situation by the client. The psychologist is convinced that every physically and mentally healthy person is able to cope with all the difficulties that arise in life, including psychological ones. But not always the client manages to initially formulate the problem with which he addressed. This kind of assistance is one of the main tasks of a psychologist-consultant.

In addition to psychological counseling, there is such a type of assistance as psychotherapy.

Psychotherapy is also used to help people through psychological means. This direction is often confused with counseling or put on a par due to the presence of some similarities, expressed as follows: the interaction of the patient and the psychotherapist, the provision of professional assistance in solving emerging problems or mental difficulties, the similarity in the procedure and professional skills.

But it is worth separating these two concepts, since psychological counseling refers more to the pole of situational problems solved at the level of consciousness, and psychotherapy - to a deep analysis of problems, with a focus on the unconscious.

Psychological counseling differs from psychotherapy, firstly, in that it is aimed at a healthy person who has difficulties in everyday life, complaints, may not feel well, but is able to set goals for further development. Second, counseling is based on the healthy aspects of the personality, regardless of impairment. The principle applies here: regardless of adverse factors, influences or difficulties, a person can find the strength in himself to improve his life. Thirdly, psychological counseling is focused on the present and future of a person, and also implies short-term assistance, up to 15 meetings. Fourth, the difference is that the work is aimed at changing behavior and personal development, in the context of the interaction of a person and his environment.

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

2. Preventive psychological assistance.

Question 1. Psychotherapy and psychocorrection as a kind of psychological intervention in cases of problematic behavior are based on the use of the same methods and techniques, so their distinction is conditional. It is associated with a competitive separation of the spheres of influence of psychiatry and psychology, with a different understanding of the mechanisms and leading causes of mental and behavioral disorders in these sciences, as well as with different goals for applying psychological methods of influencing a person. Both psychotherapy and psychocorrection are a targeted psychological impact on individual mental functions or components of a personality structure in the process of interaction of 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 getting rid of what brings him suffering. Historically, the use of this word has been attached to medicine. The main 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 can by no means always bring suffering to its owner: undesirability can be associated with a discrepancy between a person who has some psychological quality or property, and the “ideal model” of a person. And in this sense, the correction is 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 psycho-correctional influence, the psychologist adheres to the following scheme: what is, what should be, and what needs to be done to be due.

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 prevent you from living a life of contentment and happiness. The purpose of psychocorrection is to bring mental indicators to a certain norm, to the optimal level of functioning in society, when deviations have not yet acquired painful forms.

As an independent type of psychological assistance, psychocorrection stands out only in Soviet and post-Soviet science and practice. Two reasons: ideological (education of a “new” person capable of living in a “new” society) and methodological (separation of areas 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, for the level of his professional training, the same procedures and methods of work. However, psychotherapy does not always involve correction and is not limited to it. This is a broader concept, which also includes psycho-corrective 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 not possible to separate conduct disorders caused by pathological processes and disorders due to psychosocial causes alone. In addition, in modern psychiatry, an integrated approach is becoming more and more widespread, taking into account not only biological, but also psychological and social factors in the etiopathogenesis of mental disorders, each of which needs therapeutic or corrective effects that correspond to its nature. If the psychological factor acts as an etiological factor in the occurrence of a disorder, then its correction largely coincides with the content of medical psychotherapy. It is practically impossible to determine the general scheme of the correlation of psychotherapy and psychocorrection outside of a specific case.

In the domestic literature, one can also find such a position, according to which psychocorrection differs from psychotherapy by focusing on the present and the future, while psychotherapy can also use in-depth methods of analyzing the past of clients. 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, mentoring. Unlike therapy and psychocorrection, it consists in providing advice and exchanging information. This is the application of psychological knowledge to achieve some pragmatic results and the training of people as performers who achieve these results. Consulting is based on the collection of 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. Counseling also involves the development of the client's skills to independently solve emerging current (local) problems, helps to develop a reflective position in the problem and provides the client with the necessary skills and knowledge. In fact, counseling initially acted as directive psychological assistance. In the 1940s, counseling began to develop within the framework of a psychotherapeutic paradigm. Counseling here is a psychological help in various aspects of a person's life with the aim of adapting him to constantly changing social conditions. The focus of counseling has shifted to individual problems. The goal is to help the client self-determine in solving problems that arise, while they have not yet turned into painful problems. So, counseling is focused on the goals of educational, professional or personal adaptation of people. Counseling includes methods: interviewing (gathering information), improving relationships (correction), training communication skills, providing information and advice of interest. Types of counseling: 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, which is 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 are determined by the 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 being. It is the experience of one's position in society, the representation of the social sphere of life in the main 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 the individual in certain social conditions, but also with the social organization, the functioning of society. Changing the psychology of the members of society, according to such ideas, can change the society itself. First of all, his reactions, ways of interaction of large social groups, approaches to solving urgent social problems.

In order to successfully influence the psychosocial factors of society in the mid-1950s, a special kind of counseling practice arose. Its emergence is primarily associated with the development of the so-called "social psychiatry" - an attempt to achieve social change with the help of psychotherapeutic influences in the process of mass psychosocial consultations of the population in order to increase its adaptive capabilities and correct deviant behavior. Thus, initially the goal of psychosocial counseling was to increase people's readiness to change behavior through a change in social images, ideas, attitudes of individual individuals in connection with a particular social problem.

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

For example, the goal of psychosocial counseling during HIV testing is to draw patients' attention to the fact of a real threat of infection and personal risk factors in their behavior (even if they do not belong to high-risk groups for HIV infection). The subject, with the help of a consultant, must realize personal responsibility for his behavior, which under certain circumstances can lead to AIDS. The task of a consultant is to help a person think about the need to change their lifestyle, behavioral stereotypes, to help in planning and implementing these changes. Therefore, psychosocial counseling implies the presence of both informational and educational aspects. The subject should be provided with information about the prevalence of this disease, the dynamics of the development of the epidemic process, the features of the course of the stages of HIV infection and diagnosis, about 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 the 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, the existing public opinion can significantly influence the development of such a phenomenon as "AIDS terrorism", which is a defensive psychological reaction of people 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) does not set the task of changing the personality of the person who applied, even if there are direct indications for this. The task of the specialist in this case is to use the personal and individual characteristics of the subject to change the 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 singled out as an independent one - preventive. This help is ahead of an active request from a potential client, expanding his field of consciousness based on a natural interest in himself, in the quality of his interpersonal relationships. This assistance is especially relevant in the context of the psychological illiteracy of the population about the possibility of a professional solution to emerging problems.

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

In the domestic psychological and pedagogical literature, prevention, as a rule, is considered in the context of the problem of deviant behavior or as a kind 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 kind of activity of a practical psychologist, which is aimed at preventing possible troubles in the development of the personality, creating psychological conditions that are most favorable for this development, at 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 particular social environment. On the basis of such work, hypotheses are formulated about the causes of possible psychological problems; methods and specific content of developmental or corrective and preventive work are selected;

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

Enlightenment is aimed at the timely and targeted dissemination of information that helps prevent the emergence of typical difficulties in life, in professional activities, and in interpersonal communication.

Prevention work can be carried out at three levels: a) universal prevention, b) selective prevention and c) indication-based prevention (in the former terms, primary, secondary and tertiary prevention). Psychoprophylaxis differs in the focus of influence: a) direct focus (on neutralizing or blocking factors that provoke problematic 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 problematic behavior at the time of the preventive work. Universal (primary) prevention is carried out with people who do not yet have signs of problem behavior in order to develop and consolidate 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 favorable conditions, and the psychological service is aimed at increasing their stress resistance, developing socio-psychological skills so that they are ready to adequately behave when the social situation in their lives worsens.

Selective (secondary) prevention is aimed at people who are at 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 life conditions associated with poor personal or social functioning, problematic relationships with others.

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

Control questions for the lecture.

1. What is the purpose 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 is the specificity of preventive psychological assistance?

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 chosen?

Bibliography.

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 basis and social formation. - Rostov n / D .: RGU, 2002.

4. Khukhlaeva O. V. Fundamentals of psychological counseling and psychological correction. - M .: Publishing Center "Academy", 2001.

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 varieties 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 dual understanding of the activity of the psychotherapist persists to this day. The activity of a psychotherapist is considered in accordance with his two professional roles:

o a medical specialist who treats a patient with the help of 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 meaningful 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, we take the following assertion as the starting point. 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 the personality.

The purpose of psychotherapy is to assist in the development of a full-fledged personality, capable of taking an active and creative position in relation to himself and his 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 aim of providing psychological assistance to the latter.

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

1) psychotherapy and psychological counseling are activities that are different in content and tasks;

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 the psychotherapist deals with internally personal ones.

OF Bondarenko argues that the main differences between psychological counseling and psychotherapy are regarding 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 psychotechnics of psychotherapy are known. All of them not only find supporters, but also make it possible to effectively provide psychological assistance.

Each type of psychotherapy is designed to help clients operate successfully in the world.

General characteristics of psychological models of psychotherapy

An analysis of the psychotherapeutic literature allows us to state that today in this area of ​​practical psychology there is no single approach to identifying the main areas of psychotherapy. This is due to its consideration either as a method of treatment (more often this approach is found in foreign psychological literature), or as a type of psychological assistance to a client.

So, for example, Yu. G. Demyanov identifies such 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 a variety 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 specifics of the corrected disorder (psychosis, autism syndrome, neurotic disorders, depressive states, fear syndrome, obsessiveness syndrome, etc.).

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

o psychodynamic psychotherapy focused on psychoanalysis;

o humanistic psychotherapy and its main currents - 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 magazine on group psychotherapy and a professional organization of group psychotherapists.

Group psychotherapy is understood as a method of psychotherapy in which several clients are assisted at the same time. The emergence of group psychotherapy is due, according to Moreno, the lack of psychotherapists and significant time savings.

The first method of group psychotherapy was psychodrama.

In the 1940s, T-groups (K. Levin) appeared, providing for the formation of interpersonal relationships and the study of processes in small groups and in their variety - the group of sensitivity.

Today, these groups have evolved into special skill groups and personal development or encounter groups.

Psychotherapeutic groups- These are small temporary associations of people under the guidance of a psychologist or social worker that have a common goal of interpersonal exploration, personal growth and self-discovery.

These are groups in which there is a holistic deep development of the personality and self-actualization of a healthy person, 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 members of the group, determine group norms, that is, the forms and style of behavior of all members of the group.

It is necessary, according to Lemkuhl, to distinguish group training and work with a group from group psychotherapy proper. Remschmidt explains it this way: "Group training is focused on overcoming certain behavioral disorders and requires high structuring (purposeful exercises, a rigid therapeutic plan), in group psychotherapy it is said to gain emotional experience and achieve intrapsychic changes, while the degree of structuring is small" .

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

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