Psychological help - what it is, why it is needed, main types, ethical principles

Psychological assistance - assistance to a person or psychological support to a group of people when problems of a psychological nature arise: overcoming difficult situations, personal problems and difficulties in relationships, as well as social adaptation, self-realization and self-development, increasing psychological and social competence. The same term refers to the entire section of practical psychology, which studies professional issues of providing assistance.

The phrase “psychological assistance” refers to a wide range of activities carried out in a variety of situations and having multidirectional tasks. Let's take a closer look.

Types of psychological assistance

Professional psychological assistance can be roughly divided as follows:

• psychotherapeutic course (consists of 5-10 or more meetings with a specialist);
• one-time consultation
• emergency psychological assistance.

Forms of psychological assistance:

• psychotherapy;
• rehabilitation;
• consulting;
• prevention;
• training;
• crisis intervention (refers to emergency assistance).

Founding Supporters

Milton Erickson practiced short-term therapy using clinical hypnosis as his primary tool. To a large extent, he gave birth to this direction of psychological assistance.

His approach was popularized by Jay Haley in the book “Uncommon therapy: The psychiatric techniques of Milton Erickson MD” (in Russia published as “The Unusual Therapy of Milton Erickson”).

Erickson uses the analogy of a man who wants to change the flow of a river. If he resists the river, trying to block it, the river will simply bypass him. But if he takes the power of the river and directs it in a new direction, the power of the river will cut a new channel.

Richard Bandler, one of the founders of neuro-linguistic programming, is another strong proponent of brief therapy. After many years of studying Erickson's therapeutic work, he wrote:

“It's easier to cure a phobia in ten minutes than in five years... I didn't realize that the speed at which you do things is what makes them last... I taught people how to cure phobias. They did part of it one week, part of it the next, and part of it the next. Then they came to me and said: “This doesn’t work!” But if you do it for five minutes and repeat until it happens very quickly, the brain will understand. This is part of how the brain learns... I have found that the human mind is not a slow learner. He learns quickly. I did not know that".

Emergency (crisis) assistance

The first thing the word “emergency” is associated with is, of course, the rescue service. In our country, the Ministry of Emergency Situations has a large staff of highly professional psychologists who work in the most difficult situations - terrorist attacks, floods, major fires, disasters, industrial accidents. The main goal of their outreach activities is to help victims and their relatives cope with shock and stress, and also direct them towards further rehabilitation.

Helplines

Everyday emergency psychological assistance is needed in order to keep a specific person from taking fatal steps. You must understand that the helpline operator will not solve the problem, but will only help a person in a crisis to relieve negative and destructive emotions and release adrenaline. For full-fledged psychotherapy, further contact with a specialist is required.

Here are several free helplines and psychological support in St. Petersburg (area code 812), which may one day save you or your loved ones in a critical moment:

“Short-term” means how many sessions (sessions)?

“Short-term” and “brevity” are slogans that signal effectiveness, in contrast to the deliberately drawn-out course of traditional long-term (usually psychodynamic) therapy.

In fact, most therapy is de facto short by default or by design, meaning just a few sessions, ranging from weeks to months. Not years.

As noted by Budman and Gurman (1988) and others (Bloom, 1992; Garfield, 1986; Koss & Butcher, 1986; Messer & Warren, 1995), numerous studies have shown that the average duration of therapy ranges from three to eight sessions.

The most common treatment duration is actually just one session.

Even with this “shortest of short” duration, many successful results have been reported (Bloom, 1992b; Hoyt, 1994b, 2000a; Hoyt, et al., 1992; Rosenbaum, et al., 1990; Slive, et al., in press ; Talmon, 1990, 1993).

Different authors offer different definitions of what constitutes short-term therapy:

• Some emphasized a number of sessions such as “5-10”, “12” or “up to 20”;
• some emphasized certain types of problems they are trying to solve,
• while others focused more on the idea that the passage of time is a contextual pressure (Hoyt, 1990).

Budman and Gurman (1988), for example, avoid a specific number of sessions in their definition, instead referring to intentional or planned brief therapy as “time-sensitive” or “time-effective” treatment.

However, setting a specific number of sessions can sometimes be useful to provide structure (Wells, 1982) or to deliberately encourage completion (Mann, 1973; Hoyt, 1979).

Attention to timing is important because Parkinson's Law (“Work expands or contracts to fit the time available”) may be at work in psychotherapy (Appelbaum, 1975).

Typically, the focus should be on making the most of each session (Preston, et al., 1995).

Focused intentionality is the key. Count everything, don't be wasteful. Get down to business.

Planned or intentional brief therapy is based on the belief and expectation that change can happen in the moment, especially if theoretical abilities, practical skills and an interest in effectiveness are involved.

This work is not superficial or merely technically oriented; it is accurate and useful, often delivering sustainable long-term benefits as well as more immediate quick results in the here and now.

Indeed, short-term therapists recognize that what really matters is what happens after the session, and so they will need to see its impact (outcome: change and longevity) before judging the “goodness” of the session (Hoyt, 2000a).

Koss and Butcher (Koss & Shiang, 1986; also see Koss & Shiang, 1994) concluded that short-term and long-term methods are equally effective, but short-term methods are more cost-effective.

Many comparative studies may actually underestimate the effectiveness of intended brief therapy because very few therapists in the original studies were specifically oriented or trained in brief therapy (Hoyt & Austad, 1992; Koss, et al., 1986; Messer & Warren, 1995).

Although one may ignore these findings or argue that short-term therapy and long-term therapy have different goals, the equivalence of the results is compelling.

Why not try the short-term approach first? This is consistent with the advice of Lewis Wohlberg (1965, p. 140):

“The best strategy, in my opinion, is to assume that every patient, regardless of diagnosis, will respond to short-term treatment unless they are refractory to it... If this fails, they can always resort to long-term therapy.”

This is similar to the position expressed by psychoanalyst Michael Franz Basch (1995):

“I believe that you cannot arbitrarily decide, based on symptoms or character structure, that a patient will not benefit from short-term therapy. I believe that all patients who are not psychotic or suicidal should be considered candidates for brief psychotherapy until proven otherwise.”

Lazarus and Fay (1990) also make their observations from their multimodal cognitive-behavioral perspective:

“Some long-term therapy is not only ineffective (taking longer than necessary because it is not focused or precise enough) but is even harmful due to the reinforcement of pathological self-concepts. One of the great advantages of a short-term focus is that if therapy doesn't work, it will become obvious much sooner... In this regard, to paraphrase the old saying, effective treatment depends much less on the hours you put in than on what you put into it. this watch."

Even if longer-term treatments sometimes produce results that may be preferable, the question remains, who will pay for such long-term treatments? Most clients want more effective and less expensive care. Given the social and professional imperative to provide psychological services to a wide range of individuals who may need and benefit from psychological assistance, the direction of the accumulated evidence appears clear.

One-time psychological assistance (consultation)

As a rule, a one-time consultation with a psychologist is aimed at helping a person make a decision and understand his own thoughts and feelings. In some cases, one meeting with a psychologist or psychotherapist is enough.

Such a consultation is a kind of guideline, a “beacon” that allows you to clarify where the client wants to move next and make a choice. It is possible to compare your inner feelings with the opinion of an independent specialist.

A one-time meeting with a psychologist also has psychodiagnostic significance. This means that the psychologist can suggest whether there is a need for further meetings or whether the client is able to cope with the difficulties that arise on his own. The specialist will help determine whether there is any danger to the client’s psychological health in the situation that worries him, as well as find the source of anxiety (for example, when outwardly everything seems to be in order, but there is still a feeling of anxiety, dissatisfaction, apathy).

Briefly about the method

Short-term psychotherapy is a type of psychological counseling that is limited in time (number of sessions) and focused on the present.

Brief therapy focuses on the client's current symptoms and current life circumstances and emphasizes, emphasizes, and builds on the client's strengths and resources.

The therapist in short-term therapy is active and directive.

The final number of counseling sessions is the main focus from the first session. This forces the client to mobilize their resources and get results in the shortest possible time.

Transpersonal psychotherapy

Transpersonal psychotherapy studies the phenomena of altered human states, including the so-called “mystical experience”. It is based on the early studies of Carl Jung, William James, and Abraham Maslow. They talked about the connection between the body and consciousness, and considered spirituality. The term “transpersonal” itself means, literally translated, as “existing beyond the personality.” This direction is suitable for those people who view themselves and others from a spiritual perspective. However, it is important to emphasize that in order to work within the framework of this method, the client himself must be ready for this and sufficiently conscious.

A simple free technique on how to become your own psychologist

Negative and irrational emotions, neurosis, apathetic state, depression, getting rid of negative thoughts can be very difficult, this condition drags on and drives into a “corner”.

The most commonly used self-medication tools in such situations:

1. It is possible to work through many life situations on your own. One of the simplest but most effective techniques is keeping a diary. How to help yourself? - keep a personal diary and write down everything that happens to you, devote at least 20 minutes a day to it.

   Describe your feelings, emotions, fears and grievances, do not be shy in your expressions, write everything that comes to mind, let your subconscious work. Regular recordings will help to identify many problems in the future, as well as find a solution and the best way out.

2. If you are lucky and you are the happy owner of a best friend or girlfriend, a caring friend, then just try to talk it out to him or her. The main part of the work of a psychologist, for example, is precisely the ability to listen to the interlocutor, be very sensitive to his troubles and emotions, ask leading questions, ask about where the pain is. So, if you have such a friend, then it’s wonderful, sometimes talking and discussing about his problems, sorrows, a person unexpectedly finds an answer to the question that is tormenting him, it seems to come by itself.

   By speaking various situations out loud, you see their causes and consequences more clearly, which means you will experience relief faster and the problem may be easier to solve. And even if you don’t have someone to vent to, try to carefully write out the problem on paper, and then say it out loud, as if you were reading a book, you will see how different it is from the mental chewing gum we are used to thoughts in my head, without finding any relief or solution.

3. A method of getting rid of unconstructive thoughts using special exercises. You can learn to objectively evaluate your thoughts, obsessions, fears, as well as filter the influence imposed by society, if you consciously begin to concentrate on them and separate actions from emotions, breaking down the situation into components - sensual and active, and working with each of them one by one. separately.
4. Weighing different options for solving a problem is a program that helps you find the best solution to a given situation.
5. The method of cessation, it helps to reduce the negative impact of any image or object. To do this, every time a negative thought comes or you experience a negative emotion, you need to concentrate on this feeling with an effort of will, separate it from the situation and look at everything from the outside. It's like you're watching a stranger.
6. A method of replacing negative images with positive ones. Remember and write down at least 10 negative attitudes.
   “You can’t earn money by honest work”
7. "All men cheat"
8. “All women only need money”
9. “I’m a small person and I don’t decide anything”

And the like, and then find the opposite attitudes to this, if they don’t come to mind, come up with them. Find at least 10 examples and arguments in favor of positive attitudes from personal experience, films, books.

And now, every time you find yourself in a situation that confirms your negative image, remember its opposite and all the arguments “For”. Gradually, the negative image will lose its charge, and the positive one, on the contrary, will be filled with energy and you will begin to notice confirmation of your positive attitudes literally at every step.

Quote A cheerful and cheerful mood is not only a rich source of life's pleasure, but at the same time a strong guardian of character.

Samuel Smiles

Initially short-term methods

Single session therapy

Single session therapy theory

In single-session therapy, the therapist and client meet only once.

The goal of one-session therapy is to stimulate new learning, improve the client's coping with their feelings, and promote growth.

Typically, one session is used to help the client change perspective or acquire skills.

Single-session therapy is most effective for people with specific problems that

• (a) need a change of perspective,
• (b) need an assessment of the current situation or a new direction,
• (c) feel stuck in processing a past event,
• (d) seeking consolation or
• (e) have a specific problem that they can solve on their own (but do not know how).

In contrast, individuals receiving inpatient treatment, individuals requiring ongoing support to process past traumatic events (eg, childhood sexual abuse), individuals with eating disorders or chronic pain, and individuals with conditions caused by biological or chemical mechanisms ( eg schizophrenia) are unlikely to benefit from single therapy or any of the brief methods.

Single session therapy techniques

Single-session therapy uses a variety of techniques. For example, a therapist may contact a client by telephone before a meeting to obtain detailed information about the problem at hand and ask the client to complete specific tasks before the meeting.

A second popular technique is to focus on ambiguity during the session. Focusing on ambiguity allows the client to look at the same problem in a new way.

Therapists often offer to try possible solutions during the session. Rehearsing ideal outcomes or practicing new skills can help the client feel more able to transfer skills from the therapy session into everyday life.

After the session ends, the therapist informs the client that they can schedule another session if necessary.

Cognitive-behavioral therapy (CBT, CBT)

Cognitive Behavioral Therapy Theory

Cognitive behavioral therapy focuses on schemas.

Schemas are patterns that people use to make decisions, manage their reactions, or explain situations.

Schemas develop from life experience and become the standard of normal behavior. Thus, whenever a critical event occurs, the person uses the schema to decide how to respond.

Schemas may not be based on accurate information, so relying on some schemas can lead to cognitive biases. For example, if a child was punished every time he interrupted an adult, he or she may develop beliefs that make him or her hesitant to interrupt someone, even as an adult.

Methods of Cognitive Behavioral Psychotherapy

The focus of cognitive behavioral therapy is on identifying and replacing distorted cognitions (thoughts) based on schemas.

Goal setting is central to cognitive behavioral brief therapy. It serves as a mechanism for measuring performance. Each goal should have specific goals, be stated positively, and be realistic.

Cognitive-behavioral brief therapy focuses on achieving each goal, as opposed to focusing on understanding the client, seeking insights, or the therapy process itself.

Hypnotherapy

Hypnotherapy theory

Hypnotherapy methods

Neuro-linguistic programming (NLP)

NLP theory

NLP methods

Short-term strategic (systemic) therapy (SST)

CST theory

CST methods

EMDR and EMDR

EMDR Theory

EMDR Methods

Cognitive psychotherapy: how your thinking affects your life

Cognitive psychotherapy is based on the idea that all psychological problems arise in a person as a result of incorrect thinking. One of the founders of this direction is George Armitage Miller.

This direction will be useful if you want to explore your beliefs, their origins, manifestations, their influence on your life and relationships with other people. In this case, there is no talk about what is “right” and “wrong” thinking, but the emphasis is on how a given person’s thinking determines his perception and influences his behavior and life.

Body-oriented psychotherapy

Body-oriented psychotherapy, founded by Wilhelm Reich, is based on the connection of bodily muscle tension with the characteristics of a person’s personality and his emotional experience. The psychotherapist works through muscle tension that arises as a result of a person’s experiences and experiences. This type of psychotherapy is used as an element in other directions, however, as an independent direction, it is also quite effective. It will be especially useful for clients who have difficulty expressing themselves and are introverted. The psychologist follows from the body to awareness. We often explain a lot to ourselves, build hypotheses and logical chains, calculate behavior algorithms, predict our reactions and the behavior of other people. However, our body reflects everything that happens to us and provides the key to understanding these processes.

Existential psychotherapy: the path to perfection through understanding basic concepts

Existential psychotherapy is based on the client, first of all, coming to understand his personality, actions, and the situation in which he finds himself. Here a person will need quite a lot of courage and desire not only to understand, but also to accept responsibility for his life without shifting it to someone else or sharing it with other people. If we talk about the assembled existential psychotherapist, Irvin Yalom identified several main areas of research (problems): freedom, inner emptiness, isolation, death. Working through and understanding these issues in your life will give the key to understanding yourself as an individual.

The existential direction considers a series of consistent internal conflicts that a person encounters on his path, realizing which, a person improves as a person.

This direction will be useful when working with anxiety, depression, and crises.

Gestalt therapy: the “here and now” model

Gestalt therapy is based on the scientific research of Fritz Perls and other scientists who studied field theory, the cycle of contact with a need, and the mechanisms for interrupting contact with a need. The psyche strives for integrity, for the completion of processes. The research also dealt with the consideration of the relationship between figure and background, that is, according to what patterns the actualization and bringing to the fore, in the zone of needs, of certain human states is carried out.

One of the leading principles of Gestalt psychotherapy is the “here and now” model. The point is that during the session the psychologist brings the client to an awareness of himself and what is happening to the person in current time. Work with previously occurring events is also built from the position of the present time.

Gestalt psychotherapy can be useful for those clients who are interested in in-depth exploration of themselves, the opportunity to meet themselves. A gestaltist works with a person’s current request, and it happens that he voices one problem area, but in reality it turns out that another is more emotionally charged.

The therapist follows the client. One of the main tasks is to make a person aware of who he is, what is happening to him, what his personal responsibility is for his life and his decisions. The list of issues that a Gestalt psychotherapist works with is similar to that in other areas of counseling, but different tools are used.

Psychodrama will help you understand your own inner world

Psychodrama as a method was founded by Jacob Levy Moreno. The basis of the work of a psychologist is playing roles in a group that allow you to recreate a social situation, gain awareness of aspects of interaction between people, and understand your own inner world. This method will be especially useful for theatrical, creative, and active people.

As an element, psychodramas can be used in the work of other specialists. The range of research can be quite wide, ranging from relationships in the family to social roles. However, if a person is quite closed, shy, and does not like crowds of large numbers of people, then studying this feature can also be useful.

Psychoanalysis: help bring the unconscious into awareness

Psychoanalysis was developed by Sigmund Freud. The leading task is to recognize and study, together with the client, unconscious, unconscious, in particular, traumatic experiences that were the result of a person’s perception of what happened to him earlier. Psychoanalysts have studied human psychosexual development.

Psychoanalysts, working with a client, transfer the unconscious into the realm of awareness. As in the case of Gestalt therapy, psychoanalysis is aimed at in-depth study of the personality, making it possible to study and analyze its motivation, reasons for behavior, characteristics of reactions and other aspects.

Those clients who are prone to analysis, immersion in the construction of theories, and putting forward hypotheses will find in the psychoanalyst’s office the opportunity to immerse themselves in themselves, including through these tools.