Psychology and Psychiatry

Psychological counseling

Psychological counseling - this is a relatively new professional sphere of psychological practice, which is a type of psychological assistance. This trend originates from psychotherapy and is aimed at a clinically healthy individual who cannot independently overcome everyday difficulties. In other words, the key task of this methodology lies in helping individuals find a way out of the current problematic circumstances that they cannot win without outside help, realizing and changing ineffective behavioral patterns for making meaningful decisions, resolving current life difficulties, achieving their goals. . In the target area, the tasks of psychological counseling are divided into a correctional effect, and tasks aimed at achieving personal growth, self-development and success in life by a client.

Basics of psychological counseling

Counseling is a set of activities aimed at assisting the subject in solving everyday problems and making fateful decisions, for example, regarding family and marriage, professional growth, self-improvement, the effectiveness of interpersonal interaction.

The purpose of this method of psychological support is to help individuals comprehend what is happening on their life path and achieve their intended goal, based on a conscious choice in resolving emotional problems and interpersonal difficulties.

All definitions of psychological counseling are similar and include several important positions.

Psychological counseling contributes to:

- conscious choice of the person to act according to his own discretion;

- learning new behavior;

- personal development.

The core of this method is considered to be the "consultative interaction" that occurs between the specialist and the subject. The emphasis is on the responsibility of the individual, in other words, counseling recognizes that an independent and responsible person is able to make and decide in certain conditions, and the task of the consultant is to create conditions that encourage the volitional behavior of the individual.

The goals of psychological counseling are borrowed from various psychotherapeutic concepts. For example, followers of the psychoanalytic trend, the task of counseling, see in transforming into conscious images repressed into unconscious information, helping the client in recreating early experience and analyzing repressed conflicts, restoring basic personality.

It is not easy to predetermine the goals of psychological counseling, since the goal depends on the client's needs and the theoretical orientation of the consultant. The following are some of the universal counseling tasks that are mentioned by practitioners of various schools:

- to promote the transformation of behavioral reactions for a more productive life of the client, increase the level of life satisfaction, even in the presence of some essential social constraints;

- develop the ability to overcome difficulties in the course of confrontations with new everyday circumstances and conditions;

- to ensure the effective adoption of important decisions;

- develop the ability to make contacts and maintain interpersonal relationships;

- facilitate the growth of personal potential and self-realization.

Psychological counseling approaches are characterized by a general system model that combines six stages arising from each other.

At the first stage, the study of problems. The psychologist establishes contact (report) with the individual and achieves reciprocal trust: the psychologist listens attentively to a client who narrates his life difficulties, expresses maximum empathy, utmost sincerity, care, does not resort to evaluation and manipulative techniques. The consultant should choose a promotional tactic that contributes to the in-depth consideration by the client of their problems, and note his feelings, the content of the replicas, non-verbal behavioral reactions.

At the next stage, a two-dimensional definition of the problem situation occurs. The consultant is focused on the exact description of the client’s problem, emphasizing both emotional and cognitive aspects. At this stage, the clarification of problematic issues takes place until the client and the psychologist see and understand them the same way. Problems are formulated with specific concepts that make it possible to comprehend their causes, and, moreover, often indicate possible ways to resolve them. If there are ambiguities and difficulties in identifying problems, then you should return to the previous stage.

The third stage is the identification of alternatives. It identifies and discusses potential solutions to problems. The consultant with the help of open questions encourages the subject to list all possible alternatives that he finds suitable and real, helps to find additional options, while not imposing his own solutions. During the conversation, it is recommended to write in writing a list of alternatives to facilitate their comparison and comparison. It is necessary to find such solutions to the problem that the subject could apply directly.

The fourth stage is planning. It carries out a critical assessment of selected alternatives. The consultant helps the subject to understand which options presented fit and show themselves realistic in accordance with previous experience and today's willingness to change. Drafting a strategy for solving difficult situations is also aimed at not gaining an understanding by the client that not all difficulties are solvable: some of them require time resources, others can be partially resolved by reducing their destructive and disorganizing effects. At this stage, it is recommended, in terms of solving problems, to envisage by what methods and methods a subject will be able to verify the realism of the solution he preferred.

The fifth stage is an activity itself, that is, a consistent implementation of the planned problem-solving strategy takes place. The psychologist helps the client to build up activities, taking into account the circumstances, emotional and time costs, as well as the possibility of failure in the implementation of goals. The individual must realize that a partial failure does not yet become a complete collapse, so one should continue to implement the strategy of resolving difficulties, directing all actions towards the final goal.

The last step is to evaluate and maintain feedback. The subject together with the psychologist at this stage evaluates the degree of achievement of the goal (that is, the level of problem resolution) and sums up the results achieved. If necessary, it is possible to refine and refine the solution strategy. In the case of the emergence of new or the discovery of deeply hidden problems, one should return to the preceding stages.

The described model reflects the content of the consultative process and helps to better understand how specific counseling results. In practice, the process of counseling is much more extensive and often not always guided by this algorithm. In addition, the allocation of stages or stages is arbitrary, since in practice some stages are connected with others, and their interdependence is much more complicated than that presented in the described model.

Types of psychological counseling

Due to the fact that people belonging to different age categories, free and in relationships, characterized by the presence of a variety of problems, need psychological help, psychological counseling is divided into types according to client’s problem situations and their individual characteristics, family, psychological, educational, professional (business) and multicultural counseling.

First of all, individual psychological counseling (intimate-personal) is distinguished. This type of counseling is addressed to individuals on issues that deeply affect them as a person, provoking their strongest experiences, often carefully hidden from the surrounding society. Such problems, for example, include psychological disorders or behavioral deficiencies that the subject wants to eliminate, difficulties in personal relationships with relatives or other significant persons, all kinds of fears, failures, psychogenic diseases that require medical help, deep dissatisfaction with themselves, problems in intimate sphere.

Individual psychological counseling at the same time requires a closed consultant-client relationship and a trusting, open relationship for interaction between them. This type of counseling should be carried out in a special setting, since it often resembles confession. Also, he can not be episodic or short-term, due to the content of the problems for which he is focused. In the first turn, individual counseling implies a great psychological pre-setting of the psychologist and the client on the process, then a long and often difficult conversation between the consultant and the subject, after which there is a long period of searching for a way out of the difficulties described by the client and directly solving the problem. The last stage is the longest, since most of the problematic issues of intimate and personal orientation are not immediately solved.

A variety of this type of counseling is age psychological counseling, which includes issues of mental development, upbringing features, principles of teaching children of different age subgroups. The subject of such counseling is the dynamics of the development of the child and adolescent psyche at a certain age stage of formation, as well as the content of mental development, which is a significant difference from other types of counseling. Age psychological counseling solves the problem of systematically monitoring the course of the formation of children's mental functions for optimization and timely correction.

Group counseling is aimed at self-development and growth of participants in the process, the release of everything that stands in the way of self-improvement. The advantages of the described type of psychological assistance before individual counseling include:

- team members can learn their own style of relationships with the environment and acquire more effective social skills, in addition, have the opportunity to conduct experiments with alternative forms of behavioral response;

- clients can discuss their own perception of others and receive information about their perception by the group and individual participants;

- the team reflects, in some way, the familiar environment for its participants;

- As a rule, groups offer participants understanding, assistance and assistance, which increases the participants' determination to study and resolve problem situations.

Family counseling involves the provision of assistance in matters relating to the client’s family and the relationships therein relating to interaction with another close environment. For example, if an individual is worried about the upcoming choice of a life partner, optimal building of relationships in a future or current family, regulation of interactions in a family connection, prevention and correct exit from intra-family conflicts, relationship between spouses and relatives, behavior during divorce, solving various current intrafamily problems , he needs family psychological counseling.

The described type of psychological assistance requires consultants to know the essence of intrafamily problems, ways out of difficult situations and methods for resolving them.

Psychological and pedagogical counseling is in demand when it is necessary to cope with difficulties that are associated with the education or upbringing of children, when it is necessary to improve the pedagogical skills of adults or to teach management of various groups. In addition, issues of psychological substantiation of pedagogical and educational innovations, optimization of tools, methods and training programs are related to the described type of counseling.

Business (professional) counseling, in turn, is characterized by as many varieties as there are professions and activities. This type of assistance addresses issues that originate in the course of the occupation of the subjects of professional activity. These include issues of vocational orientation, improvement and the formation of the individual skills, work organization, increase efficiency, etc.

Multicultural counseling is aimed at interacting with individuals who perceive the social environment in different ways, but at the same time try to cooperate.

The effectiveness of advice to clients differing in culturally-mediated features (gender orientation, gender, age, professional experience, etc.), and in addition, the ability to understand these clients, their requirements is interconnected with the cultural characteristics of the psychologist and the manner adopted in a certain social culture organization of the practice of psychological counseling.

Consultative work requires a number of personality traits and specific characteristics from a consulting psychologist. For example, an individual practicing this technique must necessarily have a higher psychological education, love people, be sociable, insightful, patient, good and responsible.

Psychological counseling for children

The tasks of psychological support for children and adults are similar, but the approaches of psychological counseling and the specialist’s methods of work need to be modified, as a result of children's lack of independence and immaturity.

Psychological counseling for children and adolescents is characterized by a certain specificity and is an incomparably more complex process than counseling adults.

There are three key features of psychological counseling for children:

- children almost never, on their own initiative, seek professional help from psychologists, often parents or teachers who notice some developmental disabilities;

- psychocorrectional effect should come very quickly, because in children one problem provokes the emergence of new ones, which will significantly affect the development of the child's psyche as a whole;

- a psychologist cannot entrust responsibility for finding answers and solutions to existing problems, since in childhood the mental activity and self-consciousness are not yet sufficiently formed, moreover, in the child's life all significant changes depend almost completely on their close environment.

Most of the obvious differences between a child and an adult subject are in the level of communication used by them. The child’s dependence on parents forces the consulting psychologist to consider their life difficulties in one bundle with each other.

Problems of psychological counseling for children consist in insufficient mutual understanding. The kid is limited in his own communicative resources, because, in the first turn, he has an underdeveloped ability to share and integrate the external environment with emotional experiences, and secondly, his verbal abilities are also imperfect, due to the lack of communication experience. Hence, in order to achieve effective communication, the consultant has to rely on behavioral methods, rather than verbal ones. Due to the characteristics of children's mental activity, the game process in therapy has become widespread at the same time as one of the key methods for establishing contact and effective therapeutic techniques.

Due to the lack of independence of the child, an adult is always included in psychological counseling for children. The importance of the role of an adult is dependent on the age category of the child, a sense of responsibility for it. Usually, a child receives psychological counseling with his mother. Its task is to provide the consultant psychologist with preliminary data on the baby and to assist in the planning of remedial work.Communication with the mother provides the specialist with an opportunity to assess her place in children's problems, her own emotional disorders and get an idea of ​​family relationships. The lack of help from the inner circle of the child, in particular, parents, seriously complicates the process of achieving positive transformations in the child.

Parental relationships and their behavior have decisive importance in children's development. Therefore, quite often, family psychological counseling or psychotherapy of parents can play a leading role in modifying the environment in which their children grow, form and grow.

Due to the lack of stability of children to the effects of external conditions, the environment stress and the inability to control the situations in which they are located, a specialist, assisting them, places a great responsibility on his own shoulders.

In correctional work with an emotionally unstable child, in the first turn, you need to change your home environment: the more comfortable it is, the more effective the process will be.

When a child begins to become successful in areas in which he had previously failed, his attitude toward the external environment will gradually change. As he will become aware that the world around us is absolutely not hostile. The task of the consultant is to act in the interests of the small individual. Often, the solution of some problems may be placing a child in a camp for a vacation or a change of school. In this case, the psychologist should promote the transfer of the crumbs to a new school.

The immaturity of children often does not allow for the formation of a clear correction strategy. Since the kids do not know how to separate the imaginary from the real. Therefore, it is very difficult for them to separate real events from situations that exist solely in their imagination. Hence, all the correction work must be built on the basis of a mixture of what is represented and what really exists, which is not conducive to the achievement of fast, sustainable results.

Psychological counseling for children and adolescents has a number of rules and is characterized by specific techniques of conduct.

Firstly, confidentiality is an important condition for establishing contact with children (teenagers) and further maintaining it. The counselor should keep in mind that all information obtained during the counseling process should be applicable solely for the benefit of the children.

The following equally important condition for the effective counseling of adolescents and children is reciprocal trust. According to the existential concept of Rogers (humanistic approach), there are several conditions for the relationship of a specialist consultant and client that contribute to the personal growth of the individual: the ability to empathize with the consultant (empathic understanding), the authenticity, the irresponsible acceptance of the other person’s identity. Very important for a practical psychologist is the ability to listen to a partner. After all, quite often, the most effective therapy is the provision of an individual the opportunity to speak out without fear of a negative assessment from a partner or a condemnation. Empathic understanding means the ability to sensitively perceive spiritual experiences, the inner world of a partner in communication, to correctly understand the meaning of what was heard, to grasp the inner state, to capture the true feelings of the client.

Authenticity presupposes the ability to be yourself, an honest attitude to one’s own person, the ability to openly express emotions, sincerely express feelings, intentions and thoughts.

Independent acceptance of the personality implies acceptance of the subject as he is, that is, without undue praise or condemnation, willingness to listen, to accept the interlocutor's right to his own judgment, even if it does not coincide with the generally accepted or the opinion of the consultant.

Peculiarities of psychological counseling for children are also in the absence of any motivation in children to interact with a counselor. Often they do not understand why they are being examined, as they do not worry about their own disorders. Therefore, psychologists often need all their ingenuity to establish contact with a small individual. This primarily applies to shy, insecure babies, children with low self-esteem and behavioral patterns with negative experiences of interaction with adults. Children and adolescents, with the described features and problems, finding themselves at a consultation with a specialist, experience emotional overstrain, which is expressed in high affectivity and increased aggressiveness in relation to the specialist. The problems of psychological counseling for adolescents and toddlers also lie in the difficulty of making contact with them. A significant obstacle in this is usually the distrust on the part of the children, secrecy and shyness.

The process of counseling small individuals can be divided into several stages:

- establishment of mutual understanding;

- collecting the necessary information;

- a clear definition of the problem aspect;

- corrective measures and recommendations;

- summation of the results of the consultation process.

Psychological counseling methods

The basic methods of counseling include: observation, conversation, interview, empathic and active listening. In addition to basic methods, psychologists also use special methods that have arisen as a result of the influence of individual psychological schools based on a certain methodology and a specific theory of personality.

Observation is the purposeful, deliberate, systematic perception of mental phenomena, aimed at studying their changes due to the influence of certain conditions and finding the meaning of such phenomena, if it is not known. The consultant psychologist must be able to observe the verbal behavior and non-verbal manifestations of the client. The basis for understanding non-verbal behavioral responses is knowing the different variants of nonverbal speech.

Professional conversation consists of a variety of techniques and techniques used to achieve the corresponding result. A huge role is played by the techniques of dialogue, stimulation of statements, approval of client's opinions, conciseness and clarity of the consultant's speech, etc.

The functions and tasks of the conversation in counseling are to collect information about the state of the psyche of the subject, to establish contact with him. In addition, the conversation often has a psychotherapeutic effect and helps to reduce anxiety of the client. Consultative conversation is a means of resolving problems that concern a client, serves as a background and accompanies all psychotechnics. The conversation can carry a clear structured nature, occur according to a predetermined strategy or program. In this case, the conversation will be considered the interview method, which happens:

- standardized, that is, characterized by a clear tactic and sustainable strategy;

- partially standardized, based on plastic tactics and sustainable strategy;

- Freely managed diagnostic, based on a robust strategy and absolutely free tactics, depending on the specifics of the client.

Empathic listening refers to the type of hearing, the essence of which lies in the exact reproduction of the interlocutor's feelings. This type of hearing involves avoiding evaluation, condemnation, avoiding the interpretation of ulterior motives of the interlocutor. At the same time, it is necessary to demonstrate an exact reflection of the experience, emotions of the client, to understand and accept them.

Active listening contributes to a more accurate and correct understanding of each other by the interlocutors, which allows you to build an atmosphere of trust and emotional support. In addition, active listening helps to broaden the subject’s awareness of the problem. In psychological counseling, this method is mandatory.

Psychological counseling of children and parents has differences in the methods used. As for children, all the above methods should be adapted according to the degree of maturity of the children and modified. Since in children, often, behavioral manifestations are the main means of expressing feelings, the success of a consultant depends on his ability to observe, understand, and the ability to interpret the actions of the child.

Psychological counseling techniques

The specific techniques that the consultant applies at each stage of the consultation procedure and within these stages are called consulting technicians. They are universal, successfully applied at any stage of counseling, and specific, which are most suitable for a particular stage of the process.

Techniques should be considered in accordance with the stages of the psychological counseling model.

The first stage - the beginning of the work and the first procedure, is marked by the meeting of the subject with a consultant. The techniques applicable to this task include: greeting the individual, holding him to the place, choosing the individual place in the room, choosing a place for yourself as a consultant, methods of establishing psychological contact.

Welcoming techniques are carried out through standard phrases, for example: "Nice to meet you", "Glad to see you."

The technique of "holding a potential client in place" is appropriate when the subject first visits the consultation. It looks like this: the consultant goes ahead of the individual, shows him the way and skips ahead of himself when entering the office.

Establishing a positive customer attitude is the second procedure in this phase. The main technique here is the establishment of rapport. You can install it with everything that can make a favorable impression: a neat appearance, respect for the area of ​​communication, a benevolent facial expression.

The third procedure is the release of psychological barriers. The client feels the excitement, which will help to remove special equipment. For example, you can give him a little time alone, include calm, unobtrusive music, which will also help create a favorable climate.

The second stage is the collection of information. The first procedure covers the diagnosis of the client’s personality, in which the following methods are applied: observation, conversation, interview.

Clarification of the problem and the definition of client resources is the second procedure. Applied techniques: dialogue and listening.

Activating client memory is the third procedure. The techniques used are: assistance in formulating statements and determining genuine feelings, psychological support of the subject, provoking a client, saturation of pauses. In order to assist the subject in identifying true feelings and in verbal form, they apply active listening methods.

Technique "saturation pause" involves the use of a pause by a consultant. He can fill them with a question or a metaphor or "pause."

The provocation technique is based on putting the client's words into question. Its purpose is to help the subject look at a difficult situation from another side.

Stage three is the drafting of a strategy. The first procedure involves determining the likely exits from problem events. The following techniques are applicable for this purpose: advice, informing the individual, persuasion and explanation.

Technique "advice" involves the nomination of an opinion by a consultant and further joint discussion.

Technique "informing" speaks for itself. It is important that the information provided by the consultant meets such requirements as objectivity, accessibility, concreteness.

Technique "persuasion" consists of a logical argument, proving the correctness of the expressed judgment.

The “clarification” technique implies a detailed and concrete explanation of the consultant’s judgment regarding the client’s problem.

The second procedure is the coordination of the action plan. Applicable techniques: finding multiple solutions, specifying the expected result, stimulating questions, establishing a solution algorithm.

Before working out a specific strategy, you need to maximize possible solutions. The Dilts technique is excellent for this. Suggest a subject to come up with incredible ways to solve a problem issue. Assumptions must be at least twenty.

Psychological counseling of children and parents also has differences in the practiced techniques associated with child incompetence and lack of independence.

Stages of psychological counseling

Nemov developed a model of counseling, which includes the following basic stages of the psychological process: preparatory, adjustment, diagnostic, recommendatory, control stages.

Acquaintance of a consultant with a potential client according to information about him received from others, for example, from a psychological counseling specialist who accepted the application for consultation from a future client, as well as according to the recording in the registration log, takes place at the preparatory stage. In addition, at this stage involves the preparation of a consultant for consultation. It lasts an average of 30 minutes.

The second stage of psychological counseling marks the meeting of the subject with a consultant. The psychologist meets a potential client and is configured to work together with the client. The duration of this stage is no more than 7 minutes.

At the diagnostic stage, the consultant listens to the client confession, clarifies and clarifies the problem, based on its analysis. The key content of this stage is the client's story about his own person and the problem. Such a story is called confession. In addition, the described stage may include psychodiagnosis of the subject, if necessary, its conduct in order to clarify the problem of the individual and find the optimal solution. It is impossible to establish the exact time required to complete this stage, since its establishment depends on the characteristics of the problem and the individual characteristics of the client.

The recommendation stage involves the formulation by the client and the consultant of practical recommendations for resolving the problem. At this stage, the recommendations developed are refined, concretized, detailed. The average duration is up to 60 minutes.

The control stage includes the establishment of standards for control and the procedure for evaluating the practical implementation of practical advice received by the client. Average duration - up to 30 minutes.