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| Irina Germanovna Malkina-Pykh
| Handbook of Practical Psychologist
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Malkina-Pykh Irina Germanovna – psychologist, Doctor of Physical and Mathematical Sciences, majoring in Biophysics.

Reviewers:
doctor of psychological sciences, professor L.K. Serov;
doctor of medical sciences, professor K.V. Yaremenko.

This book is a reference guide to the effective techniques of psychological counseling and psychotherapy developed to date in various psychotherapeutic directions and schools.
Psychological counseling and psychotherapy is an activity in which we encourage a person to change his relationship with the world. We find out how he imagines and structures the world, and we change this representation to the best for him. It is understood that we strive only for those changes that are beneficial for the person and preserve the integrity of his personality.
When working with each new client, you need to decide whether he needs to overcome problems or a clearer understanding of himself. Clients with a good education, successful in life, most often do not need help in overcoming problems. They need to find out why they behave in a way that causes problems (discovering and clarifying the problem). If such a person is able to understand his problem, then he can solve it. However, the results of the meta-analysis suggest that most clients do not need the discovery of hidden motives for their behavior, but help in overcoming their problems (correction).
Thus, psychological counseling and psychotherapy can be divided into three types of activities:
"Discovery" - we find what is, reveal the individual's ideas about the world. We find out what a person really is and what perceptions and knowledge are available to her.
"Clearing" - we clarify and neutralize alien, unnecessary or inappropriate ideas, we find in the mind of the individual "wrong" answers, patterns that have been established without fully coordinating with the intentions of the individual. Basically, this is material used in isolation from situations. The solution is to return it to the appropriate situations.
"Correction" - we directly build the best ideas about the world for the individual. We amplify what the individual truly desires and translate it into reality, developing the traits and abilities that the individual desires to have.
To achieve these goals, there are a huge number of procedures and techniques from many sources. This handbook provides a group of effective techniques that are useful for solving the problems of people who will come to you for help.
The handbook is intended for practicing psychologists and psychotherapists.

This is not a theory textbook or a study. We wanted to offer a practicing psychologist a guide that could be immediately used in the work. What does a psychologist, consultant, psychotherapist need to know in order to try out one of the techniques with a new client? What difficulties might he experience? What traps might lie in wait for him? Are there any manuals or reminders that a psychologist can give to his client?
This handbook is primarily a collection of techniques, more precisely, exercises that a psychologist (psychotherapist, consultant) can use in their practical work. It was this approach that determined the selection and arrangement of material in the reference book. Of course, psychological counseling and psychotherapy is always a creative process based on insight into the essence of the problem. Nevertheless, based on our own experience in psychotherapeutic counseling, we found it useful to create a bank of methods and techniques, categorized under headings, from which the therapist can extract the necessary exercises. All the techniques discussed in the handbook of areas of psychotherapy were created in a unique situation of interaction between the therapist and the client. Later, they could be used when working with other clients, but they were never blindly transferred from one client to another and, moreover, they were not fetishized.
Whatever school we are talking about, there is always a common denominator that defines what psychological counseling and psychotherapy are. It could be something like this: "The systematic application of techniques that without judgment direct the individual to clarify the less than best mental, emotional, or spiritual aspects of her life, and thus to increase awareness, ability, and freedom."
The book consists of three parts: diagnostics of client's problems, methods and techniques of individual psychological counseling and psychotherapy, methods and techniques of group psychological counseling and psychotherapy. In addition, in the first chapter we give an introduction to the problems of psychotherapeutic counseling, common to all psychological schools and trends.
This book is a guide for psychologists and counselors working in various institutions (public and private clinics, schools, hospitals and community health centers). It was written for practitioners who want to improve the effectiveness of their work with clients in need of psychological help.
We want to especially note that the exercises proposed in this book are not intended for independent use by people who do not have a psychological education. Classes are held under the guidance of a therapist, and only after some techniques are mastered, they can be performed independently, for example, in the form of homework.

The literal meaning of the term "psychotherapy" is associated with its two interpretations, based on the translation of the Greek words psyche - soul and therapeia - care, care, treatment: "healing of the soul" or "healing of the soul". The term "psychotherapy" itself was introduced in 1872 by D. Tuke in the book "Illustrations of the influence of the mind on the body" and became widely popular from the end of the 19th century.
To date, no generally accepted clear definition of psychotherapy has been formulated, capable of covering all its types and forms. We can talk about the existence of medical, psychological, sociological and philosophical models of psychotherapy.
In the narrow sense of the word (medical model), psychotherapy is understood as a complex therapeutic verbal and non-verbal impact on emotions, judgments, self-consciousness of a person. Such psychotherapy is used for many mental, nervous and psychosomatic diseases.
But in science there is also a psychological model of psychotherapy, which means that it (psychotherapy) can be considered as a direction of activity of a practical psychologist. At the same time, psychotherapy should be understood as “the provision of psychological assistance to healthy people (clients) in situations of various kinds of psychological difficulties, as well as in case of a need to improve the quality of one’s own life” (Psychological Dictionary, 1996). Since we adhere to the psychological model of psychotherapy, in the future we will use the terms "client" and "patient" as equal.
A practical psychologist uses the same methods as a clinical psychotherapist. The difference lies primarily in their focus. The most important task of a psychologist is not to remove or alleviate the symptoms of the disease, but to create conditions for the optimal functioning of the personality and its development. The World Health Organization, right in the preamble to its Declaration, states: “Health is not the absence of disease or physical infirmity, but a state of good general physical, mental and social well-being.” In this context, we can say that psychotherapy is aimed at maintaining the "general harmony of well-being" in the broadest sense of the word, and not the "cure", "correction" or "correction" of any disorders.
An expanded understanding of the field of application of psychotherapy is enshrined in the Declaration on Psychotherapy, adopted by the European Association for Psychotherapy in Strasbourg in 1990. This Declaration states the following:
psychotherapy is a special discipline from the field of the humanities, the occupation of which is a free and independent profession;
psychotherapeutic education requires a high level of theoretical and clinical preparedness;
a variety of psychotherapeutic methods is guaranteed;
education in the field of one of the psychotherapeutic methods should be carried out integrally: it includes theory, personal therapeutic experience and practice under the guidance of a supervisor, while gaining a broad understanding of other methods;
access to such education is through various prior training, in particular in the humanities and social sciences.
Even if we consider psychotherapy within the framework of a medical model, one should pay attention to its difference from other methods of treatment. First of all, we are talking about the fact that only psychological methods and means are used in psychotherapy, and not pharmacological, physical, etc. In addition, people with various mental disorders act as patients, and people who have among other things, professional training in the fundamentals of psychology.
In recent years, a clinically oriented psychotherapy is conventionally distinguished, aimed primarily at alleviating or eliminating existing symptoms, and personality-oriented, which seeks to help a person change his attitude to the social environment and to his own personality.
In clinically oriented psychotherapy, methods such as hypnosis, autogenic training, various types of suggestion and self-hypnosis are traditionally used.
In person-centered psychotherapy, a huge variety of methods and techniques are found, based on the conceptual models of many schools and currents.
Nevertheless, we can talk about the presence of a key and leading idea that unites almost all the approaches available in psychotherapy - the desire to help the development of the individual by removing restrictions, prohibitions and complexes. Psychotherapy is based on the idea of ​​the possibility of change, transformation of the human self in a dynamically changing world.
In other words, we are talking about the actual impact on certain components of self-consciousness.
According to modern views (Aleksandrov, 1997; Godefroy, 1992; Karvasarsky, 1999; Rudestam, 1993), the following general tasks can be distinguished in non-medical psychotherapy, combining psychotherapeutic methods that are different in direction and content:
study of the psychological problems of the client and assistance in solving them;
improving subjective well-being and strengthening mental health;
the study of psychological patterns, mechanisms and effective ways of interpersonal interaction to create the basis for effective and harmonious communication with people;
development of self-awareness and self-examination of clients to correct or prevent emotional disturbances based on internal and behavioral changes;
promoting the process of personal development, the realization of creative potential, the achievement of an optimal level of life and a sense of happiness and success.
The main goal of any psychotherapeutic intervention is to help patients make the necessary changes in their lives. How can this be done? Each area of ​​psychotherapy gives the answer to this question in terms of its own concepts. The success or effectiveness of psychotherapy is judged by how persistent and broadly beneficial these changes are for the patient; Those psychotherapeutic measures that provide a stable, long-term positive effect will be optimal. Of course, every school of psychotherapy is convinced that the way it proposes to help patients is optimal, leaving doubters to test it on their own experience. Currently, about 400 varieties of psychotherapy for adult patients and about 200 for children and adolescents are known and used in practice (Kazdin, 1994).
It is not uncommon to read and hear that as a result of psychotherapy there have been significant positive changes in the patient's personality. Thus, as it were, it is implied that psychotherapy changes the personality, makes it different. Strictly speaking, both in the course of therapy and as a result of it, there are no personality changes in the sense of the formation of any of its new qualities or the disappearance of existing ones. Each property or quality of a personality, as is known, is a fairly stable mental formation, and their complex determines the personality as such. These stable mental formations are little affected even by age-related changes. The variability of the personality, its adaptation to changing environmental conditions are achieved due to the fact that each quality has such a wide range of situationally determined manifestations that it can sometimes be perceived as the presence of a quality that is opposite to the real one. Psychotherapeutic influence, without creating new qualities in a person, somehow brings the existing ones into line, for example, with a changed life situation. This “alignment” ensures the success of psychotherapy for minor mental disorders (Burlachuk et al., 1999).
Today there is a trend of convergence of medical and psychological psychotherapy. This is manifested both in the fact that doctors, as well as psychologists, show interest in Western schools and techniques, and in the “blurring” of the boundaries of the medical “territory”, which until recently was strictly guarded, in the penetration of psychologists into this territory.
An opinion is expressed that psychotherapy is a system of specially organized methods of therapeutic influence on neurotics, and psychocorrection is an impact on “not yet sick, but no longer healthy”, i.e. people with maladjusted behavior and emerging neurotic response. Based on this definition, it turns out that the impact on the patient is psychotherapy, and on the healthy - psychocorrection; doctors are engaged in psychotherapy, and psychologists are engaged in psychocorrection; psychotherapy is a method of treatment, and psychocorrection is a method of prevention. It seems that behind such a delimitation of areas of influence on a person lies the desire of the psychologist to outline and protect the “psychological territory”.
We believe that psychotherapy should be discussed in cases where the impact is oriented toward healing or personal growth. The task of the consultant is to help the client understand the situation, the problem: to suggest, give advice, reflect the feelings and behavior of the client, so that he sees himself, enlightens, supports, reassures, etc. At the same time, in some cases it is difficult to accurately qualify the work with the client as psychotherapeutic or consulting. In foreign literature, the terms "therapy" and "psychotherapy" are used as synonyms. Due to the fact that this handbook deals with the main directions of foreign psychotherapy, the authors considered it possible to preserve this tradition. Therefore, in the future in the text, the terms "psychotherapy" and "therapy", "psychotherapist" and "therapist" are used interchangeably. In addition, in some cases we use the term "consultant" in the same sense.
Currently, in psychotherapeutic practice, there are hundreds of schools and directions that can be classified according to different criteria. At the same time, there are basic psychotherapeutic approaches that differ significantly in their conceptual foundations. The differences relate to the description of the personality, the mechanisms of its development, the pathogenesis of neuroses, the mechanisms of therapy and the evaluation of its effectiveness.
The types of psychotherapy considered in this handbook have different “targets” of psychotherapeutic influence. So, the “target” in bioenergetic analysis is the body, and in client-centered therapy it is experiences (not just experienced emotions, but experienced experience), in cognitive therapy it is maladaptive thoughts and other images of the imagination, etc.
Psychotherapeutic approaches can be roughly divided into: 1) problem-oriented and 2) client-oriented. The implied attitude of psychotherapy of the first type is the attitude to the obligatory "immersion" of the patient in the problem. If the patient does not want to do this (“immerse”), this, within the framework of this type of psychotherapy, is interpreted as resistance to therapeutic influence. "Walking in circles" around the patient's problem, without entering, without delving into it, is considered ineffective.
In type 2 psychotherapy, by contrast, the client is free to choose what to talk about with the therapist and how much time to devote to therapy. If the client does not talk about his problem, this is not seen as resistance, but as the client's legal right to speak only about what he himself wants.
The types of therapy under consideration (directive, problem-oriented and non-directive, client-oriented) have significant differences in the process aspect. Thus, in non-directive therapy, there are no or weakly expressed processes of the client transferring his needs to the therapist, such as relationships with significant childhood figures. This happens because, firstly, the client is independent of the therapist in the process of therapy and, secondly, the therapist is not a mystery for the client, a “white screen”. These types of therapy also work with different content: "devilish" (a person is largely a toy in the hands of the devil) and "human" (a person is free and responsible to himself). The differences between these types of therapy could be multiplied, but this is not necessary, since the reader will find a sufficiently detailed analysis of each direction in the text.
Despite the differences in the “targets” of psychotherapeutic influence, in the positions of the psychotherapist and the client in the process of therapy, the orientation and theoretical foundations of various schools of psychotherapy, psychotherapeutic counseling is a process that has a number of strategic and tactical moments common to all schools and approaches. These include:
stages of the psychotherapeutic process;
the principles of the initial consultation and the main techniques of psychotherapeutic intervention;
verbal and non-verbal means of psychotherapeutic work;
creation and use of metaphors in the process of psychotherapeutic counseling;
requirements for the personality of a psychotherapist / consultant;
ethics of the psychotherapist (consultant).
It is to these general questions that this chapter is devoted.

In the literature (Menovshchikov, 2000) a “five-step” model of the consultative interview process is usually given, which all psychotherapists adhere to to one degree or another:
1) establishing contact and orienting the client to work;
2) collecting information about the client, solving the question "What is the problem?";
3) awareness of the desired result, the answer to the question "What do you want to achieve?";
4) development of alternative solutions, which can be described as "What else can we do about this?";
5) generalization by the psychologist in the form of a summary of the results of interaction with the client.
The first stage of the psychotherapist's work with the client is devoted to clarifying the need for help, motivation. The greatest attention is paid to establishing an optimal relationship between the therapist and the client, overcoming the first line of resistance. It communicates the principles of building psychotherapeutic interaction (Burlachuk et al., 1999).
Here it is useful to list the types of motivation of the client who came to the psychotherapist.
1. Referral patients come under pressure from parents, partners, etc., i.e. under pressure from external circumstances. The initial interview is usually difficult; complaints are mostly of a social type. Patients can be compared to "victims". Treatment is most often unsuccessful. A positive result is possible provided that such a patient is considered in a complex of relationships with many surrounding people. In this case, the initial interview requires a special technique, the essence of which is to turn the patient's passive position into an active one (for example, the patient himself sets the time for the next meeting). With such patients, it is also important to avoid making judgments about his environment and, if possible, to recommend that his relatives undergo therapy.
2. Patients greedy for therapy most often have already tried therapy, and therefore the first interview with them can be quite difficult. Such patients bombard the analyst with all sorts of demands and tricky questions. They quickly become frustrated, and in fact find a significant difference between the requirements for therapy and their own desire to work. In a conversation, they can lose control, demonstrate insecurity. The case history they describe is dramatic, multicolored, with many fantasies. Often they are tactless, aggressive and prone to negative assessments. Their important characteristic is their rapid consent to therapy with simultaneous instability, low tolerance for frustration and anger.
3. Unmotivated patients are opposite in relation to the previous ones. Their symptoms are more often found in the field of functional somatic disorders. These are inhibited, passive, stereotyped in behavior, patients without sufficient awareness of their problems. They do not understand the mental nature of the illness; it is difficult for them to find the purpose of therapy.
4. Educated patients (with a psychotherapeutic education) - as a rule, well-informed and intending to work with themselves on their own. Characteristic features: the predominance of the head over the heart, inhibited emotions, rationalization. Such patients are willingly taken into therapy, but working with them requires special firmness.
To study the client's problem, standardized and non-standardized interviews, tests, observation, primarily of non-verbal behavior, the results of self-observation, specific techniques for a symbolic description of the problem, such as directed imagination, projective techniques, role-playing games, are often used. The same methods allow evaluating the intermediate and final results of psychotherapy.
Before starting psychotherapy, various diagnostic procedures are used. Psychotherapeutic schools differ in the way they see the client's problem, the idea of ​​​​the possibilities for resolving it, and the formulation of goals. As an example, here is one of the most complete interview designs used to collect information about a client.
1. Demographic data (sex, age, occupation, marital status).
2. History of the problem: when the client encountered the problem, what else happened at that time. How the problem manifests itself in behavior and at the somatic level, how the client experiences it, how seriously she worries him, what is the attitude towards her. In what context does it manifest itself, are its manifestations influenced by any events, are its manifestations associated with any people whose intervention makes it sharper or weaker. What are its positive consequences, what difficulties does it cause, how the client tried to solve it and with what result.
3. Whether the client received psychiatric or psychological help for this or other problems.

I. G. Malkina-Pykh

Handbook of Practical Psychologist

Malkina-Pykh Irina Germanovna – psychologist, Doctor of Physical and Mathematical Sciences, majoring in Biophysics.

Reviewers:

doctor of psychological sciences, professor L.K. Serov;

Doctor of Medical Sciences, Professor K.V. Yaremenko.

This book is a reference guide to the effective techniques of psychological counseling and psychotherapy developed to date in various psychotherapeutic directions and schools.

Psychological counseling and psychotherapy is an activity in which we encourage a person to change his relationship with the world. We find out how he imagines and structures the world, and we change this representation to the best for him. It is understood that we strive only for those changes that are beneficial for the person and preserve the integrity of his personality.

When working with each new client, you need to decide whether he needs to overcome problems or a clearer understanding of himself. Clients with a good education, successful in life, most often do not need help in overcoming problems. They need to find out why they behave in a way that causes problems (discovering and clarifying the problem). If such a person is able to understand his problem, then he can solve it. However, the results of the meta-analysis suggest that most clients do not need the discovery of hidden motives for their behavior, but help in overcoming their problems (correction).

Thus, psychological counseling and psychotherapy can be divided into three types of activities:

"Discovery" - we find what is, reveal the individual's ideas about the world. We find out what a person really is and what perceptions and knowledge are available to her.

"Clearing" - we clarify and neutralize alien, unnecessary or inappropriate ideas, we find in the mind of the individual "wrong" answers, patterns that have been established without fully coordinating with the intentions of the individual. Basically, this is material used in isolation from situations. The solution is to return it to the appropriate situations.

"Correction" - we directly build the best ideas about the world for the individual. We amplify what the individual truly desires and translate it into reality, developing the traits and abilities that the individual desires to have.

To achieve these goals, there are a huge number of procedures and techniques from many sources. This handbook provides a group of effective techniques that are useful for solving the problems of people who will come to you for help.

The handbook is intended for practicing psychologists and psychotherapists. This is not a theory textbook or a study. We wanted to offer a practicing psychologist a guide that could be immediately used in the work. What does a psychologist, consultant, psychotherapist need to know in order to try out one of the techniques with a new client? What difficulties might he experience? What traps might lie in wait for him? Are there any manuals or reminders that a psychologist can give to his client?

This handbook is primarily a collection of techniques, more precisely, exercises that a psychologist (psychotherapist, consultant) can use in their practical work. It was this approach that determined the selection and arrangement of material in the reference book. Of course, psychological counseling and psychotherapy is always a creative process based on insight into the essence of the problem. Nevertheless, based on our own experience in psychotherapeutic counseling, we found it useful to create a bank of methods and techniques, categorized under headings, from which the therapist can extract the necessary exercises. All the techniques discussed in the handbook of areas of psychotherapy were created in a unique situation of interaction between the therapist and the client. Later, they could be used when working with other clients, but they were never blindly transferred from one client to another and, moreover, they were not fetishized.

Whatever school we are talking about, there is always a common denominator that defines what psychological counseling and psychotherapy are. It could be something like this: "The systematic application of techniques that without judgment direct the individual to clarify the less than best mental, emotional, or spiritual aspects of her life, and thus to increase awareness, ability, and freedom."

The book consists of three parts: diagnostics of client's problems, methods and techniques of individual psychological counseling and psychotherapy, methods and techniques of group psychological counseling and psychotherapy. In addition, in the first chapter we give an introduction to the problems of psychotherapeutic counseling, common to all psychological schools and trends.

This book is a guide for psychologists and counselors working in various institutions (public and private clinics, schools, hospitals and community health centers). It was written for practitioners who want to improve the effectiveness of their work with clients in need of psychological help.

We want to especially note that the exercises proposed in this book are not intended for independent use by people who do not have a psychological education. Classes are held under the guidance of a therapist, and only after some techniques are mastered, they can be performed independently, for example, in the form of homework.

Chapter 1 GENERAL STRATEGIES FOR PSYCHOTHERAPEUTIC COUNSELING

The literal meaning of the term "psychotherapy" is associated with its two interpretations, based on the translation of the Greek words psyche- soul and therapy- care, care, treatment: "healing of the soul" or "treatment of the soul." The term "psychotherapy" itself was introduced in 1872 by D. Tuke in the book "Illustrations of the influence of the mind on the body" and became widely popular from the end of the 19th century.

To date, no generally accepted clear definition of psychotherapy has been formulated, capable of covering all its types and forms. We can talk about the existence of medical, psychological, sociological and philosophical models of psychotherapy.

In the narrow sense of the word (medical model), psychotherapy is understood as a complex therapeutic verbal and non-verbal impact on emotions, judgments, self-consciousness of a person. Such psychotherapy is used for many mental, nervous and psychosomatic diseases.

But in science there is also a psychological model of psychotherapy, which means that it (psychotherapy) can be considered as a direction of activity of a practical psychologist. At the same time, psychotherapy should be understood as “the provision of psychological assistance to healthy people (clients) in situations of various kinds of psychological difficulties, as well as in case of a need to improve the quality of one’s own life” (Psychological Dictionary, 1996). Since we adhere to the psychological model of psychotherapy, in the future we will use the terms "client" and "patient" as equal.

A practical psychologist uses the same methods as a clinical psychotherapist. The difference lies primarily in their focus. The most important task of a psychologist is not to remove or alleviate the symptoms of the disease, but to create conditions for the optimal functioning of the personality and its development. The World Health Organization, right in the preamble to its Declaration, states: “Health is not the absence of disease or physical infirmity, but a state of good general physical, mental and social well-being.” In this context, we can say that psychotherapy is aimed at maintaining the "general harmony of well-being" in the broadest sense of the word, and not the "cure", "correction" or "correction" of any disorders.

An expanded understanding of the field of application of psychotherapy is enshrined in the Declaration on Psychotherapy, adopted by the European Association for Psychotherapy in Strasbourg in 1990. This Declaration states the following:

Psychotherapy is a special discipline of the humanities, the practice of which is a free and independent profession;

Psychotherapeutic education requires a high level of theoretical and clinical training;

A variety of psychotherapeutic methods is guaranteed;

Education in the field of one of the psychotherapeutic methods should be carried out integrally: it includes theory, personal therapeutic experience and practice under the guidance of a supervisor, while gaining a broad understanding of other methods;

Such education is accessed through various prior training, in particular in the humanities and social sciences.

The book is a reference manual on effective techniques of psychological counseling and psychotherapy, developed to date by various psychotherapeutic schools. This includes methods such as classical psychoanalysis, Gestalt therapy, neurolinguistic programming, positive psychotherapy, etc. The book presents general strategies for psychotherapeutic counseling and approaches to diagnosing client problems. But first of all, the techniques of individual psychological counseling and psychotherapy are outlined here. In fact, this is a collection of exercises that a psychologist (psychotherapist, consultant) can use in practical work.

The handbook is intended for psychologists and counselors working in public and private clinics, schools, hospitals and community health centers. We hope that it will be useful not only for professionals, but also for everyone interested in modern psychotherapeutic techniques.

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