Clinical psychology - basic methods, existing ethics, useful literature, who can you work with?

Increasingly, people are faced with various mental disorders and illnesses that can be corrected with proper and timely therapy. The main direction for this is clinical psychology, which includes many areas and solves a number of important problems.

What is clinical psychology?

This term refers to the branch of psychology that studies mental phenomena in connection with diseases. It includes diagnosis, research, response assessment, and behavior modification. There is another name - medical psychology, which includes consultation, personal and family psychotherapy, and so on. The term “clinical psychology” appeared in 1907 thanks to the psychologist L. Whitman.

What does clinical psychology study?

In a broad sense, this branch of psychology involves the use of the existing body of knowledge to solve various issues and problems that arise in medical practice. The subject of clinical psychology includes:

Disturbances in the functioning of the psyche and human behavior.
Features of behavior or personality of people who have different diseases.
The influence of numerous psychological factors on education, development and recovery from various diseases.
Features of interaction between people with diseases and the social environment in which they live.

Job responsibilities of a specialist

The job responsibilities of these professionals are to study and eliminate social and behavioral problems that cause people suffering in their lives. More specifically, these problems cover a wide range of issues, from emotional problems such as depression , to behavioral disorders such as ADHD or autism, to serious mental health problems such as schizophrenia or dissociative identity disorder.

Some clinical psychologists work in laboratory settings conducting research on the aforementioned mental health issues. In this capacity, the focus is on developing a better understanding of human behavior through research aimed at improving the diagnosis and treatment of these disorders. In a laboratory setting, a clinical psychologist will be responsible for a variety of responsibilities, from designing experiments and recruiting participants to collecting and analyzing data.

Tasks of clinical psychology

As an independent direction, this industry is capable of solving a number of problems:

To study the influence of various psychological and psychosocial factors on the occurrence of deviations in the behavior and personality of a child, and also to carry out their correction and prevention.
The next goal of clinical psychology is to study changes in various mental functions in somatic and mental problems.
Determine the specifics and nature of disruptions in mental development.
Develop basic principles and methods of clinical psychological research.
Explore different personality types that determine a person's possible reactions to illness.
Another task of clinical psychology is to study the psychology of therapeutic interaction.
To study the psychological characteristics of a person with various diseases.
Explore behavior that is a deviation from the norm and determines a person’s reaction to the environment.
Clinical psychology is a method of studying family relationships, which can also become a factor provoking the development of the disease.
Provide psychocorrection, psychotherapy and counseling to people with various problems.

Differences between a psychologist and a psychiatrist

A clinical psychologist specializes in the medical field of the origin of mental illnesses, examines them using diagnostics, applies correction, but does not always have the right to prescribe medications for these remedies. The psychologist’s “tool” is communication, therapy, but not pills. Such a specialist uses a complex of psychodiagnostic and psychocorrectional techniques in his work, focusing on a theoretical basis that combines the knowledge of a psychologist and a doctor. Thus, he significantly expands his professional capabilities for helping patients and his own development.

However, psychiatrists and psychologists have one task - to help and cure a person from mental pathologies and disorders. Set the patient up for positive results, change his worldview, worldview, guide him along the right path, reduce destructive behavior. However, a psychiatrist is a doctor first and foremost. For 5 years he undergoes exclusively medical training, like any other specialist from the medical field, goes on to practice as an internship, as a result of which he chooses his future profession and is determined with a narrow specialization. For example, he may prefer to work with children or only with disabled people. Psychiatrists use the medical model when communicating and treating patients. That is, they use, of course, psychological knowledge and techniques, but they focus more on the medical position. And, like doctors, they prescribe drugs - psychotropic, heavy sedatives. Drug therapy is the prerogative of psychiatrists. But not without psychotherapy. Psychiatrists deal with much more complex cases of mental illness than clinical psychologists.

Clinical psychologists do not resort to drug treatment, although such methods are practiced in some states in America. But, nevertheless, for this they undergo special training in order to understand medications and have the right to prescribe them. The range of drugs used in this area includes sedative and psychotropic drugs.

A clinical psychologist often works in conjunction with a psychiatrist to expand on the information gained through therapy.

Sections of clinical psychology

This science is extensive, so there are different branches of clinical psychology:

Psychosomatics
. Helps to understand the presence and origin of human psycho- and somatic problems. This section examines the relationship between serious illness and mental health factors.
Psychotherapy
. This is the main method used in psychocorrection. It includes a large number of methods and techniques that allow you to determine the presence of a problem, improve your mood, adjust behavior, and so on. Describing what clinical psychology is, we note that this section can be used both individually and in a group.
Neuropsychology
. The branch that studies the brain and central nervous system. To understand how human consciousness functions, psychiatry, neurology, and so on are used.
Psychocorrection
. This section is aimed at helping people. It includes not only therapy, but also a program of further rehabilitation. Thanks to psychocorrection, a person can recover and again become a full-fledged member of society.
Pathopsychology
. Based on the study of issues related to mental disorders and disorders, incorrect perception of the world, and so on.

Now more about clinical practice

Clinical practice requires the psychotherapist, first of all, to comprehend and comprehend in a diagnostic-clinical spirit (disorders are understood in the natural sciences as protective-adaptive processes) of clinical classical psychiatry (in contrast, for example, to psychoanalytic psychiatry) and also to comprehend classical, natural-scientific, Kretschmerian, medical psychology (as opposed to theoretical psychological concepts).

Thus, in the case of obsessive-compulsive (obsessive-compulsory) syndrome with compulsion to perform some annoying, debilitating obsessive actions (with full understanding of their humiliating meaninglessness, “stupidity,” uselessness), nature “suggests” its own methods of protection and adaptation, other , rather than with depressive anxieties, with painful, painful doubts. The clinical, personal, often strictly pedantic, soil is different here than in psychasthenic, psychasthenic-like cases—anankastic, anankastic-like. Compulsive (compelling) obsessions grow from it. This soil transforms suffering, essentially, not into the suffering of the soul in itself, but into anxious suffering, as if due to the “breakdown of the mechanism,” the emerging helplessness of the soul, the inability to control oneself (albeit within the limits of one’s will). And you need to “escape”, distract yourself from this suffering with the acute change of life, “turn off” it, somehow switch, train. Escape on an exotic trip, move to live in another, unusual country, and gain unprecedented, soul-stirring sensations. And, of course, a variety of psychotherapeutic cognitive-behavioral exercise techniques help here. All my life, unfortunately, I had no desire to practice these methods. Referred patients to cognitive behavioral psychotherapists (including psychologists). Despite the fact that cognitive-behavioral methods, although based on their own concepts, are sometimes close to clinical practice.

Where, basically, the soul itself suffers in its complex depths, we help, first of all, with our hearts, with a clear, serious explanation, with creative therapy imbued with clinicalism. For anankasts (anankast-like), the latter is usually not so important. Anankastic and psychasthenic disorders are different conditions, with the exception of some complex, mixed (for example, pedantic (anankastic)-autistic) cases.

Anankasm (obsession), in the classical sense of Karl Westphal, and pathological (morbid) doubt (Arnold Pick, Pyotr Borisovich Gannushkin) are two different ways of mental-natural adaptation to amorphous anxiety. Anxiety, in turn, is an adaptation to other difficulties. The psychasthenic method is an analyzing-concretizing, anxious-doubting natural method. So an anxious psychasthenic developed a “suspicious”, from his point of view, formation on the skin. An acute anxiety state of “imminent danger” arose. "Cancer?" Consultations with dermatologists and an oncologist (“it’s a harmless wart”) do not give the patient peace. In response to ongoing anxiety (“doctors may be wrong”), nature encourages the psychasthenic in this anxiety to analyze, doubt, reflect on whether the dermatologists and oncologist are right. “Isn’t it cancer after all?” And we help the psychasthenic understand himself with explanations, an explanation that psychasthenic characterological anxiety so “bitterly,” but in its own therapeutic way, concretizes the incomprehensibility and danger. "Cancer?" As a result of specification, “probability of cancer” is better than terrible uncertainty. This is already some kind of certainty. Let it be lack of conviction, but only doubt, painful doubt. “Probable, bitter doubting certainty” - and also incorrect. But it still softens the alarming panic uncertainty, the pointlessness from which it is not known where to run. “Probable certainty,” even bad, is better than panic. Now, we tell the psychasthenic, the “bad, doubtful certainty” has been uprooted by specialists (dermatologists, oncologists). So, there is no danger for this reason and for this reason. This story to the patient about the origin of his painful, anxious doubt often turns out to be very important and effective psychotherapeutically.

Of course, it’s time to calm down, but you will become alarmed again for some other frightening reason. All that remains is to enter, with or without the help of a psychotherapist, into some lifelong creative passion. More often, in such relatively severe cases, this passion for life is not present, but psychasthenics are usually latently, even shyly, predisposed to it. And here we, together with the patient, rely, in more or less detail, on those natural spiritual characteristics that guide self-healing through creative self-expression. There is an abyss of psychotherapeutic techniques here. Living in creative inspiration seriously softens chronic psychasthenic (psychasthenic-like) anxiety with its bright meaning.

The work in anankastic cases with a similar hypochondriacal plot looks completely different. The anankastic natural adaptation here is also a concretization of amorphous panic anxiety, but a pedantic concretization. Anxious specific hypochondria is pedantically “sealed” to the also unfortunate sufferer. He, unlike a psychasthenic, in typical cases does not doubt that this is in fact a “harmless wart”, but cannot get rid of truly obsessive anxiety about it. Anankasm torments him with this obsessive anxiety with endless visits to specialists. It torments, obscuring life. And psychotherapeutic assistance, basically, here is usually aimed, if not at a possible bright change in life (including also creative, but often scientifically pedantic passion), then at a psychotherapeutically technical battle with anankasm.

Gannushkin subtly noted that obsession is formed like a habit: it is, as it were, “a kind of pedantry” that has crossed a healthy line. Therefore, I think, let the energy of pedantry be spent on healthy pedantic work, rather than on cultivating obsessions on pedantic soil.

This is how I see things from my practical experience.

In cases of painful persistent hypochondriacal anxiety, medicinal reinforcement is necessary.

This is how, if possible, everything is directed in clinical classical psychotherapy in different ways, according to the clinic, the peculiarities of the self-healing power of nature itself. This is psychotherapeutic listening to the protective and adaptive work of nature itself. But wise nature, of course, is also the element. The job of the doctor, created by Nature and Society, is to constantly improve natural self-healing. Improve in accordance with previous scientific discoveries, spiritual culture, but worshiping Nature. In one case, a surgical operation is used to remove a bag of pus from a sick person (a graveyard of harmful microbes destroyed by the organism itself). In the other, starting from the internal natural latent impulse of a chronic depressive patient to self-saving self-expression in depressive darkness, skillfully and psychotherapeutically develop in him creative inspiration, the meaning of life, saving him from suicide.

Basic problems of clinical psychology

This industry deals with the problem of determining what is normal and what is pathological. Experts talk about two human states – health and illness. Studying the problem of clinical psychology is a complex task that concerns numerous areas of activity. The criteria for mental norms include age-appropriate maturity of feelings, adequate understanding of reality, and the presence of a harmonious perception of the surrounding world. Any deviations are considered pathological.

Research methods in clinical psychology

This industry uses a large number of different techniques, the choice of which depends on the specific problem of a person. Among the most common are the following methods of clinical psychology:

Art therapy
. This includes drawing, sculpting and other creative activities. With the help of a ready-made object, a person expresses existing experiences and fears, which allows a specialist to identify a psychological problem.
Hypnosis
. The specialist puts the person into a semi-conscious state and helps to find the causes of the existing problem.
Body-oriented methods
. Specialists, working with the human body, correct his thinking and get rid of existing problems.
Metaphorical methods
. Here, abstract images are used to work, allowing you to look into deep thoughts and feelings.
Group methods
. The most common option is trainings in which people perform different tasks together, helping each other identify and get rid of existing problems.

Wage

As for wages, it depends on work experience, place of work, region, etc. However, the generalized average salary of such specialists in Russia is 26 thousand rubles. As for the capital, this figure is almost twice as high (45 thousand rubles).

A graduate of the Department of Clinical Psychology begins his career with a salary of 15.4 thousand rubles. By moving up the career ladder or opening his own business, his income can increase to 235 thousand rubles.

Clinical psychology - who to work with?

A specialist in this area can conduct a private practice, helping people in critical situations that do not require delay. It is worth noting here that a clinical psychologist can help not only patients, but also people who, in a difficult situation, cannot find a way out and make a decision on their own. Specialists in this industry work in clinics in neuropsychiatric and psychiatric departments. There is also the position of “clinical psychologist” in special institutions, where specialists help people fight neuroses and borderline conditions.

In clarifying the features of clinical psychology and the peculiarities of the work of specialists in this field, we note that the help of a medical psychologist is required in orphanages and nursing homes, as well as in various institutions for people with various developmental problems. You can meet such a specialist in sanatoriums, rest homes, rehabilitation centers and the like. To summarize, we can say that a clinical psychologist is a specialist who has a wide range of work with different people.

general information

In the 90s, medical and clinical psychology meant the same thing. Today these are still two different disciplines. They should not be confused with psychiatry. They have similar tasks, but different treatment methods. Psychiatry is aimed at eliminating pathologies and defects that require hospitalization or inpatient treatment. These diseases are schizophrenia, manic-depressive psychosis, epilepsy. Clinical psychology studies the problems of maladaptation and borderline mental states, when a person is not yet pathologically ill, but is no longer normal.

The distinction between pathology and norm is a rather complex process. At the moment, the corresponding norms for age-related development are divided; each period has its own criteria for feeling the world and relating to it. The psychologist assesses how harmoniously developed a person is - how he gets along with himself and others, whether he knows how to be flexible, the ability to think objectively, resistance to stress, the ability to plan and adjust his daily routine, and observe a work and rest schedule. The norm is how a person copes with life’s difficulties, enters society, works productively, and how critically he thinks.

When diagnosing, a clinical psychologist and psychiatrist use their personal experience, adhere to the recommendations of general psychology, as well as information from the ICD and the Handbook of Mental Disorders.

The subject of clinical psychology can be:

Preparation and implementation of psychotherapy methods.
Disturbances in mental development.
The emergence of destructive changes in the psyche.
The use of psychological techniques to influence the patient’s consciousness for the purpose of treatment and as prevention.
Organizing research using specific tools and defining principles for this, methodology.
Finding out how various disorders affect the patient’s psyche.
The role of the psyche in the emergence, progression and prevention of disorders.

So, clinical psychology is a discipline that involves assessing mental health, planning and conducting research in the scientific field to diagnose and identify mental problems.

Psychologists develop and conduct psychocorrection and psychotherapy. They also explore issues of general psychology, compare normality and pathology, study the boundaries of the normal, determine how the social and biological relate in a person, and try to resolve the problem of mental decay.

Ethics in Clinical Psychology

This area is studied in deontology, which is largely associated with understanding the different forms of psychological influence of health workers on a person with problems. The fundamentals of clinical psychology distinguish four models of medical ethics:

Hippocratic model
. Includes the moral principles of healing of the time, on the basis of which the oath was drawn up. It concerned obligations to do no harm, to provide assistance and show respect, to refrain from sexual relations with patients, and so on.
Paracelsus' model
. Based on an understanding of the relationship between doctor and patient. It was formed in the Middle Ages. The main principle of this model is to do good.
Deontological model
. Evaluates the action not only taking into account the result, but also the thoughts. It functioned before the revolution.
Model of bioethics
. Formed in the 60s and 70s, it views medicine with human rights in mind.

Books on clinical psychology

There is a large amount of useful literature that will help you understand this area of psychology.

“Introduction to psychiatry and psychoanalysis for the uninitiated” by
E. Berne. A thorough book that will introduce basic concepts, describe the subject of clinical psychology, and other concepts.
"Modern clinical psychiatry"
. Yu.V. Popov, V.D.Vid. If you are looking for books on clinical psychology for beginners, then pay attention to this work. It covers all the basic concepts and is a useful tool for the clinician.

Education

You can get a diploma in the field of training clinical psychologists at any university in the country where there is a psychology department. Particular emphasis during training for this direction is placed on the study of such disciplines as:

Neuropsychology;
Pathopsychology;
Psychosomatics.

Training in the specialization of a clinical psychologist does not involve an internship; graduates of such departments upon completion of training receive a specialist diploma (Specialty, duration of study is 5.5 years).

To enter a university for the educational program 05/37/01 “Clinical Psychology”, a school graduate must provide Unified State Examination certificates in: