Medical psychology Mendelevich. Clinical and medical psychology - V.D. Mendelevich How Psychologists Work
Clinical (medical) psychology
INTRODUCTIONChapter 1 METHODS OF RESEARCH IN CLINICAL PSYCHOLOGY
Clinical interviewing
Experimental psychological (patho- and neuropsychological) research methods
Pathopsychological research methods.
Pathopsychological assessment of attention disorders
Pathopsychological assessment of memory impairment
Pathopsychological assessment of perception disorders
Pathopsychological assessment of thinking disorders
Pathopsychological assessment of intellectual disabilities
^ Pathopsychological assessment of emotion disorders
Pathopsychological assessment of individual psychological characteristics
Experimental neuropsychological research
Evaluation of the effectiveness of psychocorrectional and psychotherapeutic influence
^
Chapter 2 CLINICAL MANIFESTATIONS OF MENTAL STANDARD AND PATHOLOGY
The principles of distinguishing between psychological phenomena and psychopathological symptoms
^ Diagnostic principles-alternatives
Disease-Personality
Nosos pathos
Reaction-state-development
Psychotic-non-psychotic
Exogenous-endogenous-psychogenic
Defect-recovery-chronization
Adaptation-disadaptation, compensation-decompensation
Negative-positive
Phenomenology of clinical manifestations
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 3 PSYCHOLOGICAL AND PATHOPSYCHOLOGICAL CHARACTERISTICS OF Cognitive Psychic Processes
Semiotics
Feel
Perception
Attention
Memory
Thinking
Intelligence
Emotions
Will
Consciousness
Psychological phenomena and pathopsychological syndromes in mental illness
^ Neurotic disorders
Personality disorders.
Schizophrenia
Epileptic mental disorders
Organic mental disorders
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 4 PSYCHOLOGY OF INDIVIDUAL DIFFERENCES
Temperament
Classification of A. Thomas and S. Chess:
Character
Personality
Personality structure (according to K.K. Platonov)
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 5 Psychology of the Patient
Mental response to illness and psychology of the physically ill
^ Gender
Age
Profession
Features of temperament
Character traits
Personality features
Psychological characteristics of patients with various somatic diseases
^ Oncological pathology
Obstetric and gynecological pathology
Therapeutic pathology
Surgical pathology
Body and sensory defects
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 6 PSYCHOLOGY OF THERAPEUTIC INTERACTION
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 7 NEUROTIC, PSYCHOSOMATIC AND SOMATOFORM DISORDERS
Neuroses
Psychosomatic disorders and diseases
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 8 PSYCHOLOGY OF DEVIANT BEHAVIOR
Aggressive behavior
Auto-aggressive behavior
Substance abuse causing altered mental activity
Eating disorders
^ Sexual deviations and perversions
Overvalued psychological hobbies
Overvalued psychopathological hobbies
Characterological and pathocharacterological reactions
Communicative deviation
Immoral and immoral behavior
Unaesthetic behavior
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 9 SPECIAL SECTIONS OF CLINICAL PSYCHOLOGY
Developmental Clinical Psychology *
Social and biological components of normal and abnormal human development
^ Mental characteristics and psychosomatic disorders during the neonatal period, infancy and early childhood
Mental characteristics and psychosomatic disorders in children of preschool and primary school age
^ Psychology and psychopathology of early adolescence
Psychological characteristics and mental disorders of persons of mature, elderly and old age
Family Clinical Psychology
^ PROGRAMMED KNOWLEDGE CONTROL:
Chapter 10 PSYCHOLOGICAL COUNSELING, PSYCHOCORRECTION AND BASICS OF PSYCHOTHERAPY
^ Psychological counseling
Psychological correction
Psychotherapy
Parapsychology and psychic healing
^ PROGRAMMED KNOWLEDGE CONTROL:
ANNEXES
ANNEX to the topic: "PSYCHOLOGY OF INDIVIDUAL DIFFERENCES"
Shooting Questionnaire
Eysenck test
Characterological questionnaire of K. Leonhard
ANNEX to the topic: "PATIENT'S PSYCHOLOGY"
LOBI (Leningrad questionnaire of the Bekhterev Institute)
^ APPENDIX to the topic: "NEUROTIC DISORDERS"
Clinical questionnaire for the identification and assessment of neurotic conditions (K.K.Yakhin, D.M. Mendelevich)
^ ANNEX to the topic: "PSYCHOLOGY OF DEVIANT BEHAVIOR"
Pathocharacterological diagnostic questionnaire (PDO)
ANNEX to the topic: AGE CLINICAL PSYCHOLOGY
Test assessment of knowledge of youth psychology
^ ANSWERS to programmed control
TABLE OF CONTENTS
INTRODUCTION
The history of the development of clinical psychology is a winding path. Situated on the border between medicine and psychology, the new science now and then nailed to one or the other bank of the river under the name of "human knowledge". For the sake of fairness, it should be noted that until now the location of clinical psychology has not been completely determined, which can be explained by the interdisciplinary nature of this science.The starting point for the emergence of clinical psychology can be considered the appeal of physicians "to treat not the disease, but the patient." It was from that time that the interpenetration of psychology and medicine began. Initially, clinical psychology, which was actively developed by psychiatrists, was aimed at studying deviations in intellectual and personal development, correction of maladaptive and delinquent forms of behavior. However, subsequently, the area of interest of clinical psychology was expanded through the study of the mental state of persons with somatic diseases.
The term "clinical psychology" comes from the Greek kline, which means a bed, a hospital bed. In modern psychology, as a rule, the terms "clinical" and "medical" psychology are used interchangeably. Taking into account this fact, in the further presentation we will use only one of them. However, let us take into account the existing tradition of physicians to designate this area of knowledge "medical psychology", and psychologists - "clinical psychology".
^ Clinical (medical) psychology - a science that studies the psychological characteristics of people suffering from various diseases, methods and methods for diagnosing mental deviations, differentiating psychological phenomena and psychopathological symptoms and syndromes, psychology of relationships between a patient and a health worker, psycho-preventive, psycho-corrective and psychotherapeutic methods of helping patients, as well as theoretical aspects psychosomatic and somatopsychic interactions.
Today there is a fairly large number of related psychological disciplines related to clinical psychology: pathopsychology, psychopathology, neuropsychology, psychology of deviant behavior, psychiatry, neurosology, psychosomatic medicine, etc. Each of these disciplines combines medical and psychological knowledge. However, they are all related to the clinic and, as a result, can be recognized as constituent parts of clinical psychology. In accordance with tradition, the following sections are included in clinical psychology:
Patient psychology
The psychology of therapeutic interactions
Norm and pathology of mental activity
Pathopsychology
The psychology of individual differences
Developmental clinical psychology
Family Clinical Psychology
Psychology of deviant behavior
Psychological counseling, psychocorrection and psychotherapy
Neurosology
Psychosomatic medicine
Clinical psychology is closely related to related disciplines, primarily psychiatry and pathopsychology. The sphere of general scientific and practical interest of clinical psychology and psychiatry is diagnostic process. Recognition of psychopathological symptoms and syndromes is impossible without knowledge of their psychological antonyms - the phenomena of everyday life, reflecting the individual psychological characteristics of a person and located within the normal variation of mental response. In addition, the process of diagnosing mental illness cannot do without “pathopsychological verification”.
Clinical psychology borrows methods of research of mental characteristics of somatically patients from psychodiagnostics and general psychology; assessment of the adequacy or deviance of human behavior in psychiatry, developmental psychology and developmental psychology. The study of clinical psychology is impossible without medical knowledge, in particular, in the field of neurology, neurosurgery and related disciplines. The psychosomatic section of clinical psychology is based on scientific concepts from such areas as: psychotherapy, vegetology, valeology.
The most complete list of theoretical knowledge and practical skills of a clinical (medical) psychologist can be gleaned from the qualification characteristics of a specialist in this area. In accordance with the order of the Ministry of Health of the Russian Federation No. 391 of 11/26/96, a medical psychologist must have the following
^ Theoretical knowledge:
Psychology and its importance for medicine: subject, tasks and interdisciplinary connections of medical psychology, the history of the formation of medical psychology as a field of psychological science; medical psychology as a profession; the main sections of medical psychology.
^ The main theoretical and methodological problems of medical psychology: brain and psyche, psychosomatic and somatopsychic relationships. The relationship between biological and social, the problem of norm and pathology, genetic and acquired, hereditary and personal-environmental, development and disintegration of the psyche, organic and functional, conscious and unconscious, adaptation and maladjustment, deficit and adaptive.
^ Systems approach as a theoretical basis for understanding the psychological structure of the disease, rehabilitation treatment and rehabilitation of patients.
Basic (fundamental) medical concepts: etiology, pathogenesis and sanogenesis, symptom, syndrome, clinical diagnosis, functional (multidimensional or multi-axis) diagnosis.
^ Related knowledge: the basics of general and private psychiatry, the basics of neurology, the doctrine of borderline mental disorders, self-destructive behavior, the basics of psychophysiology and psychopharmacology.
^ Psychological (psychogenic) factors in the etiology, pathogenesis and pathoplasty of mental and psychosomatic disorders, the concept of pre-illness, impaired mental adaptation, social stress disorders, crisis conditions.
^ Classification of methods of medical psychology, psychological diagnostics as a tool for purposeful study of personality, methods of psychological diagnostics in the clinic, computer psychodiagnostics, psychological correction.
^ Psychological diagnosis concept, functional diagnosis as a result of the integration of the clinical, psychological and social aspects of the disease, the concept of psychological contact.
^ The main categories of medical psychology: mental activity, perception, attention, memory, thinking, intellect, emotions, will, temperament, character, personality, motivation,
Nost, stress, frustration, consciousness and self-awareness, self-esteem, conflict, crisis, psychogenesis, psychological protection, coping, alexithymia.
^ Experiment theory, concepts of standardized and non-standardized methods, theory and classification of tests, basic psychometric concepts (validity, reliability, standardization, norm, etc.).
^ Fundamentals of Clinical Neuropsychology: systemic mechanisms of the brain in the organization of higher mental functions, processes and states, functional specialization of the hemispheres - the basic concepts and practice, the ratio of cerebral and local in neuropsychology, the nosological specificity of disorders of higher mental functions, the specificity of neuropsychological research in childhood; the main neuropsychological syndromes and methods of their diagnosis.
The concept of pathopsychology: the ratio of qualitative and quantitative approaches in the analysis of psychodiagnostic data, Pathopsychological phenomenology, patterns and structural features of disorders of cognitive processes, properties and conditions caused by the disease, nosological and syndromological specificity of pathopsychological phenomenology, differential diagnostic and expert significance of a pathopsychological experiment, pathopsychological studies in assessing the dynamics of treatment ...
^ Age-related aspects of psychological disorders: age characteristics of psychological disorders in various diseases, mental development of an abnormal child, childhood autism, the problem of dysontogenesis and mental retardation, psychological anomalies of adolescence, features of childhood and adolescent forms of pathological response, psychological aspects of mental infantilism, psychological problems of geriatrics and gerontology.
^ Teaching about character: the concept of accentuation and psychopathy, classification of character accentuations, diagnostic methods.
The doctrine of personality: basic concepts of personality in domestic and foreign psychology, diagnostic methods, the concept of the protective mechanisms of personality, personality and disease.
^ Basic concepts of psychosomatic relationships. Psychosomatic and somatopsychic. The internal picture of the disease and attitude to the disease, methodology and research methods, the nosological specificity of psychological phenomena and the internal picture of the disease. Theoretical and methodological aspects, methods of psychological diagnostics in various types of expertise.
^ Theoretical, methodological and methodological approaches in solving the problems of psychoprophylaxis and psychohygiene, the concept of mass
Investigations, psychological screening, risk factors, mental maladjustment and illness.
^ Rehabilitation approach in medicine: concept, concepts, basic principles, forms and methods.
Psychology of extreme and crisis states, the concept of traumatic stress, social frustration and social stress disorder.
^ Basic principles of psychological support of the treatment process: organization of a psychotherapeutic environment in treatment units. The relationship of doctor-patient, psychologist-doctor-treatment room, etc.
^ Psychological aspects of drug and non-drug therapy, placebo effect, psychological problems of preparing patients for surgery, prosthetics, psychological problems of chronically ill, disabled and dying.
^ Medical and psychological aspects of social behavior: communication, role behavior, interaction in groups, social normativity, etc.
Features of the work of medical psychologists in stationary, out - patient and preventive institutions of various types, psychological counseling, professional selection, vocational guidance.
^ Psychological foundations of psychotherapy, restorative education and rehabilitation.
Basic psychotherapeutic theories: psychodynamic, behavioral, existential-humanistic; personality-oriented psychotherapy; medical and psychological models of psychotherapy; the main forms of psychotherapy: individual group, family, environment therapy, psychotherapeutic community, sociotherapy; mechanisms of the therapeutic action of psychotherapy; nosological specificity and age-related aspects of psychotherapy and psychological counseling; psychological problems of non-verbal methods of psychotherapy: music therapy, choreotherapy, art therapy, etc.
^ Psychotherapy and psychological counseling in crisis conditions.
Legal Aspects activities of medical psychologists.
Deontological aspects behavior of a medical psychologist.
Practical skills:
Practical skills and abilities of a medical psychologist should provide a qualified professional solution to problems in the field of psychodiagnostics (including expert), psychocorrection and psychological counseling.
^ In the field of psychodiagnostics:
Ability to conduct a psychological examination, taking into account nosological and age specifics, as well as in connection with the tasks of medical and psychological examination; creation of the necessary psychological contact and adequate current control of psychological distance; planning and organization of research; selection of an adequate methodological apparatus; the ability to carry out a quantitative and qualitative analysis of research results in connection with various purposes: differential diagnosis, analysis of the severity of the condition, assessment of the effectiveness of therapy, etc., mastery of the main interpretation schemes and approaches, adequate presentation of available data in a psychodiagnostic report, mastery of the main clinical and psychological methods (psychological conversation, collection of a psychological history, psychological analysis of biography, natural experiment);
Possession of basic experimental psychological techniques aimed at studying mental functions, processes and states: perception, attention, memory, thinking, intelligence, emotional-volitional sphere, temperament, character, personality, motivational characteristics and needs, self-awareness and interpersonal relationships.
Possession of the basic techniques of neuropsychological research (methods for assessing the state of gnosis, praxis, speech functions, etc.);
Knowledge of the basics of computer diagnostics.
^ In the field of psychological counseling and the use of psychocorrectional methods:
The use of the main methods of psychological correction (individual, family, group) in working with patients and psychological counseling, taking into account nosological and age specificities;
Possession of methods of individual, group and family counseling of healthy people, taking into account age specificity in connection with the tasks of psychoprophylaxis;
Possession of the basic techniques of restorative education;
Possession of approaches to the organization of the psychotherapeutic environment and the psychotherapeutic community;
Possession of the skills of conducting personally and professionally oriented trainings.
Picture 1.
| DOCTOR | ||
| ^ NURSE | A PATIENT | SOCIAL WORKER |
| CLINICAL PSYCHOLOGIST |
A clinical (medical) psychologist, along with a doctor, a nurse and a social worker, make up the closest circle that provides medical and psychological assistance to the patient (Figure 1). At the same time, the role of a clinical psychologist is essential both in the diagnostic and psychocorrectional and psychotherapeutic terms.
The practical guide is intended both for physicians (psychiatrists, psychotherapists, neuropathologists and representatives of other disciplines), medical and practicing psychologists, nurses and social workers, and for students studying clinical (medical) psychology.
PSYCHOLOGY
Clinical interviewing
Experimental psychological (patho- and neuropsychological) research methods
Pathopsychological research methods.
Pathopsychological assessment of attention disorders
Pathopsychological assessment of memory impairment
Pathopsychological assessment of perception disorders
Pathopsychological assessment of thinking disorders
Pathopsychological assessment of intellectual disabilities
Pathopsychological assessment of emotion disorders
Pathopsychological assessment of individual psychological characteristics
Experimental neuropsychological research
Evaluation of the effectiveness of psychocorrectional and psychotherapeutic influence
Chapter 2 CLINICAL MANIFESTATIONS OF MENTAL STANDARD AND PATHOLOGY
The principles of distinguishing between psychological phenomena and psychopathological symptoms
Diagnostic principles-alternatives
Disease-Personality
Nosos pathos
Reaction-state-development
Psychotic-non-psychotic
Exogenous-endogenous-psychogenic
Defect-recovery-chronization
Adaptation-disadaptation, compensation-decompensation
Negative-positive
Phenomenology of clinical manifestations
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 3 PSYCHOLOGICAL AND PATHOPSYCHOLOGICAL CHARACTERISTICS OF Cognitive Psychic Processes
Semiotics
Feel
Perception
Attention
Memory
Thinking
Intelligence
Emotions
Will
Consciousness
Psychological phenomena and pathopsychological syndromes in mental illness
Neurotic disorders
Personality disorders.
Schizophrenia
Epileptic mental disorders
Organic mental disorders
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 4 PSYCHOLOGY OF INDIVIDUAL DIFFERENCES
Temperament
Classification of A. Thomas and S. Chess:
Character
Personality
Personality structure (according to K.K. Platonov)
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 5 Psychology of the Patient
Mental response to illness and psychology of the physically ill
Age
Profession
Features of temperament
Character traits
Personality features
Psychological characteristics of patients with various somatic diseases
Oncological pathology
Obstetric and gynecological pathology
Therapeutic pathology
Surgical pathology
Body and sensory defects
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 6 PSYCHOLOGY OF THERAPEUTIC INTERACTION
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 7 NEUROTIC, PSYCHOSOMATIC AND SOMATOFORM DISORDERS
Neuroses
Psychosomatic disorders and diseases
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 8 PSYCHOLOGY OF DEVIANT BEHAVIOR
Aggressive behavior
Auto-aggressive behavior
Substance abuse causing altered mental activity
Eating disorders
Sexual deviations and perversions
Overvalued psychological hobbies
Overvalued psychopathological hobbies
Characterological and pathocharacterological reactions
Communicative deviation
Immoral and immoral behavior
Unaesthetic behavior
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 9 SPECIAL SECTIONS OF CLINICAL PSYCHOLOGY
Developmental Clinical Psychology *
Social and biological components of normal and abnormal human development
Mental characteristics and psychosomatic disorders during the neonatal period, infancy and early childhood
Mental characteristics and psychosomatic disorders in children of preschool and primary school age
Psychology and psychopathology of early adolescence
Psychological characteristics and mental disorders of persons of mature, elderly and old age
Family Clinical Psychology
PROGRAMMED KNOWLEDGE CONTROL:
Chapter 10 PSYCHOLOGICAL COUNSELING, PSYCHOCORRECTION AND BASICS OF PSYCHOTHERAPY
Psychological counseling
Psychological correction
Psychotherapy
Parapsychology and psychic healing
PROGRAMMED KNOWLEDGE CONTROL:
ANNEXES
ANNEX to the topic: "PSYCHOLOGY OF INDIVIDUAL DIFFERENCES"
Shooting Questionnaire
Eysenck test
Characterological questionnaire of K. Leonhard
ANNEX to the topic: "PATIENT'S PSYCHOLOGY"
LOBI (Leningrad questionnaire of the Bekhterev Institute)
APPENDIX to the topic: "NEUROTIC DISORDERS"
Clinical questionnaire for the identification and assessment of neurotic conditions (K.K.Yakhin, D.M. Mendelevich)
ANNEX to the topic: "PSYCHOLOGY OF DEVIANT BEHAVIOR"
Pathocharacterological diagnostic questionnaire (PDO)
ANNEX to the topic: AGE CLINICAL PSYCHOLOGY
Test assessment of knowledge of youth psychology
ANSWERS to programmed control
INTRODUCTION
The history of the development of clinical psychology is a winding path. Situated on the border between medicine and psychology, the new science now and then nailed to one or the other bank of the river under the name of "human knowledge". For the sake of fairness, it should be noted that until now the location of clinical psychology has not been completely determined, which can be explained by the interdisciplinary nature of this science.
The starting point for the emergence of clinical psychology can be considered the appeal of physicians "to treat not the disease, but the patient." It was from that time that the interpenetration of psychology and medicine began. Initially, clinical psychology, which was actively developed by psychiatrists, was aimed at studying deviations in intellectual and personal development, correction of maladaptive and delinquent forms of behavior. However, subsequently, the area of interest of clinical psychology was expanded through the study of the mental state of persons with somatic diseases.
The term "clinical psychology" comes from the Greek kline, which means a bed, a hospital bed. In modern psychology, as a rule, the terms "clinical" and "medical" psychology are used interchangeably. Taking into account this fact, in the further presentation we will use only one of them. However, let us take into account the existing tradition of physicians to designate this area of knowledge "medical psychology", and psychologists - "clinical psychology".
Clinical (medical) psychology- a science that studies the psychological characteristics of people suffering from various diseases, methods and methods for diagnosing mental deviations, differentiating psychological phenomena and psychopathological symptoms and syndromes, psychology of relationships between a patient and a health worker, psycho-preventive, psycho-corrective and psychotherapeutic methods of helping patients, as well as theoretical aspects psychosomatic and somatopsychic interactions.
Today there is a fairly large number of related psychological disciplines related to clinical psychology: pathopsychology, psychopathology, neuropsychology, psychology of deviant behavior, psychiatry, neurosology, psychosomatic medicine, etc. Each of these disciplines combines medical and psychological knowledge. However, they are all related to the clinic and, as a result, can be recognized as constituent parts of clinical psychology. In accordance with tradition, the following sections are included in clinical psychology:
Patient psychology
The psychology of therapeutic interactions
Norm and pathology of mental activity
Pathopsychology
The psychology of individual differences
Developmental clinical psychology
Family Clinical Psychology
Psychology of deviant behavior
Psychological counseling, psychocorrection and psychotherapy
Neurosology
Psychosomatic medicine
Clinical psychology is closely related to related disciplines, primarily psychiatry and pathopsychology. The sphere of general scientific and practical interest of clinical psychology and psychiatry is diagnostic process. Recognition of psychopathological symptoms and syndromes is impossible without knowledge of their psychological antonyms - the phenomena of everyday life, reflecting the individual psychological characteristics of a person and located within the normal variation of mental response. In addition, the process of diagnosing mental illness cannot do without “pathopsychological verification”.
Clinical psychology borrows methods of research of mental characteristics of somatically patients from psychodiagnostics and general psychology; assessment of the adequacy or deviance of human behavior in psychiatry, developmental psychology and developmental psychology. The study of clinical psychology is impossible without medical knowledge, in particular, in the field of neurology, neurosurgery and related disciplines. The psychosomatic section of clinical psychology is based on scientific concepts from such areas as: psychotherapy, vegetology, valeology.
The most complete list of theoretical knowledge and practical skills of a clinical (medical) psychologist can be gleaned from the qualification characteristics of a specialist in this area. In accordance with the order of the Ministry of Health of the Russian Federation No. 391 of 11/26/96, a medical psychologist must have the following
Theoretical knowledge:
Psychology and its importance for medicine: subject, tasks and interdisciplinary connections of medical psychology, the history of the formation of medical psychology as a field of psychological science; medical psychology as a profession; the main sections of medical psychology.
The main theoretical and methodological problems of medical psychology: brain and psyche, psychosomatic and somatopsychic relationships. The relationship between biological and social, the problem of norm and pathology, genetic and acquired, hereditary and personal-environmental, development and disintegration of the psyche, organic and functional, conscious and unconscious, adaptation and maladjustment, deficit and adaptive.
Systems approach as a theoretical basis for understanding the psychological structure of the disease, rehabilitation treatment and rehabilitation of patients.
Basic (fundamental) medical concepts: etiology, pathogenesis and sanogenesis, symptom, syndrome, clinical diagnosis, functional (multidimensional or multi-axis) diagnosis.
Related knowledge: the basics of general and private psychiatry, the basics of neurology, the doctrine of borderline mental disorders, self-destructive behavior, the basics of psychophysiology and psychopharmacology.
Psychological (psychogenic) factors in the etiology, pathogenesis and pathoplasty of mental and psychosomatic disorders, the concept of pre-illness, impaired mental adaptation, social stress disorders, crisis conditions.
Classification of methods of medical psychology, psychological diagnostics as a tool for purposeful study of personality, methods of psychological diagnostics in the clinic, computer psychodiagnostics, psychological correction.
Psychological diagnosis concept, functional diagnosis as a result of the integration of the clinical, psychological and social aspects of the disease, the concept of psychological contact.
The main categories of medical psychology: mental activity, perception, attention, memory, thinking, intellect, emotions, will, temperament, character, personality, motivation,
stress, frustration, consciousness and self-awareness, self-esteem, conflict, crisis, psychogenesis, psychological protection, coping, alexithymia.
Experiment theory, concepts of standardized and non-standardized methods, theory and classification of tests, basic psychometric concepts (validity, reliability, standardization, norm, etc.).
Fundamentals of Clinical Neuropsychology: systemic mechanisms of the brain in the organization of higher mental functions, processes and states, functional specialization of the hemispheres - the basic concepts and practice, the ratio of cerebral and local in neuropsychology, the nosological specificity of disorders of higher mental functions, the specificity of neuropsychological research in childhood; the main neuropsychological syndromes and methods of their diagnosis.
The concept of pathopsychology: the ratio of qualitative and quantitative approaches in the analysis of psychodiagnostic data, Pathopsychological phenomenology, patterns and structural features of disorders of cognitive processes, properties and conditions caused by the disease, nosological and syndromological specificity of pathopsychological phenomenology, differential diagnostic and expert significance of a pathopsychological experiment, pathopsychological studies in assessing the dynamics of treatment ...
Age-related aspects of psychological disorders: age characteristics of psychological disorders in various diseases, mental development of an abnormal child, childhood autism, the problem of dysontogenesis and mental retardation, psychological anomalies of adolescence, features of childhood and adolescent forms of pathological response, psychological aspects of mental infantilism, psychological problems of geriatrics and gerontology.
Teaching about character: the concept of accentuation and psychopathy, classification of character accentuations, diagnostic methods.
The doctrine of personality: basic concepts of personality in domestic and foreign psychology, diagnostic methods, the concept of the protective mechanisms of personality, personality and disease.
Basic concepts of psychosomatic relationships. Psychosomatic and somatopsychic. The internal picture of the disease and attitude to the disease, methodology and research methods, the nosological specificity of psychological phenomena and the internal picture of the disease. Theoretical and methodological aspects, methods of psychological diagnostics in various types of expertise.
Theoretical, methodological and methodological approaches in solving the problems of psychoprophylaxis and psychohygiene, the concept of mass
investigations, psychological screening, risk factors, mental maladjustment and illness.
Rehabilitation approach in medicine: concept, concepts, basic principles, forms and methods.
Psychology of extreme and crisis states, the concept of traumatic stress, social frustration and social stress disorder.
Basic principles of psychological support of the treatment process: organization of a psychotherapeutic environment in treatment units. The relationship of doctor-patient, psychologist-doctor-treatment room, etc.
Psychological aspects of drug and non-drug therapy, placebo effect, psychological problems of preparing patients for surgery, prosthetics, psychological problems of chronically ill, disabled and dying.
Medical and psychological aspects of social behavior: communication, role behavior, interaction in groups, social normativity, etc.
Features of the work of medical psychologists in stationary, out - patient and preventive institutions of various types, psychological counseling, professional selection, vocational guidance.
Psychological foundations of psychotherapy, restorative education and rehabilitation.
Basic psychotherapeutic theories: psychodynamic, behavioral, existential-humanistic; personality-oriented psychotherapy; medical and psychological models of psychotherapy; the main forms of psychotherapy: individual group, family, environment therapy, psychotherapeutic community, sociotherapy; mechanisms of the therapeutic action of psychotherapy; nosological specificity and age-related aspects of psychotherapy and psychological counseling; psychological problems of non-verbal methods of psychotherapy: music therapy, choreotherapy, art therapy, etc.
Psychotherapy and psychological counseling in crisis conditions.
Legal Aspects activities of medical psychologists.
Deontological aspects behavior of a medical psychologist.
Practical skills:
Practical skills and abilities of a medical psychologist should provide a qualified professional solution to problems in the field of psychodiagnostics (including expert), psychocorrection and psychological counseling.
In the field of psychodiagnostics:
Ability to conduct a psychological examination, taking into account nosological and age specifics, as well as in connection with the tasks of medical and psychological examination; creation of the necessary psychological contact and adequate current control of psychological distance; planning and organization of research; selection of an adequate methodological apparatus; the ability to carry out a quantitative and qualitative analysis of research results in connection with various purposes: differential diagnosis, analysis of the severity of the condition, assessment of the effectiveness of therapy, etc., mastery of the main interpretation schemes and approaches, adequate presentation of available data in a psychodiagnostic report, mastery of the main clinical and psychological methods (psychological conversation, collection of a psychological history, psychological analysis of biography, natural experiment);
Possession of basic experimental psychological techniques aimed at studying mental functions, processes and states: perception, attention, memory, thinking, intelligence, emotional-volitional sphere, temperament, character, personality, motivational characteristics and needs, self-awareness and interpersonal relationships.
Possession of the basic techniques of neuropsychological research (methods for assessing the state of gnosis, praxis, speech functions, etc.);
Knowledge of the basics of computer diagnostics.
In the field of psychological counseling and the use of psychocorrectional methods:
The use of the main methods of psychological correction (individual, family, group) in working with patients and psychological counseling, taking into account nosological and age specificities;
Possession of methods of individual, group and family counseling of healthy people, taking into account age specificity in connection with the tasks of psychoprophylaxis;
Possession of the basic techniques of restorative education;
Possession of approaches to the organization of the psychotherapeutic environment and the psychotherapeutic community;
Possession of the skills of conducting personally and professionally oriented trainings.
Picture 1.
|
DOCTOR | ||
|
NURSE |
A PATIENT |
SOCIAL WORKER |
|
CLINICAL PSYCHOLOGIST |
A clinical (medical) psychologist, along with a doctor, a nurse and a social worker, make up the closest circle that provides medical and psychological assistance to the patient (Figure 1). At the same time, the role of a clinical psychologist is essential both in the diagnostic and psychocorrectional and psychotherapeutic terms.
The practical guide is intended both for physicians (psychiatrists, psychotherapists, neuropathologists and representatives of other disciplines), medical and practicing psychologists, nurses and social workers, and for students studying clinical (medical) psychology.
Http://marsexx.narod.ru/psychology/mendelevich-klinich-psy.html#089 Mendelevich V.D. Clinical and Medical Psychology: A Practical Guide. - M .: MEDpress, 2001 .-- 592 p. The practical guide reflects the main sections of clinical (medical) psychology: research methods (clinical interviewing, pathological and neuropsychological experiments), the principles of differentiation of the norm and pathology of mental activity, the psychology of individual differences, the psychology of the patient and the psychology of treatment interaction, the psychology of deviant behavior, neurotic and psychosomatic disorders , developmental and family clinical psychology, psychological counseling, psychocorrection and the basics of psychotherapy, etc. Each section contains tests for programmed control of knowledge. The manual is intended for medical and practical psychologists, psychotherapists, psychiatrists, doctors of various profiles, nurses, social workers, and is also intended for students studying clinical (medical) psychology. Psychological counseling Counseling in the process of providing psychological assistance implies a joint discussion of a doctor, a clinical psychologist, on the one hand, and a patient or client, on the other hand, the problems a person has, possible options for overcoming and preventing them, as well as informing the individual about his individual psychological qualities , specific types of response, methods of self-regulation. Counseling is aimed at developing an active position of a person in relation to psychological problems, frustrations and stresses in order to teach how to restore or maintain emotional comfort in critical life situations. The diagnostic process in the structure of psychological counseling includes clinical interviewing (see Chapter 1) and the use of a battery of experimental psychological techniques to determine the characteristics of the functioning of mental processes and personality parameters. In practical terms, essential in consulting is the process of informing a person about the objective parameters of his mental activity and personality traits, as well as teaching methods of mental self-regulation. Informing a client is a rather delicate and complex process, since it involves not only impartial presentation of facts, but also taking into account possible reactions of a person to information about himself. There are several communication strategies, fundamentally differing in the degree of use of evaluation categories, focus and the terminology used. Considering the fact that a clinical psychologist or doctor obtains a sufficiently large amount of objective data in the process of examining a client (patient), different focusing is possible when informing. You can focus on: a) obvious deviations in the functioning of the body and psyche; b) all available deviations; c) deviations that the individual is able to comprehend and change; d) the entire spectrum of manifestations - both normal and abnormal; e) normative signs and manifestations. There are three known approaches to focusing attention and informing a person: optimistic, pessimistic and neutral. The same information can be perceived as positive, negative or indifferent. A classic example is informing about the amount of liquid in a glass of water: 1) the glass is half full, 2) it is half empty, or 3) the liquid in the glass takes up half the volume. The choice of various objects of focusing a person's attention in the process of providing psychological assistance is possible. These can be individual functions or activities of the entire body of cash ("You have a qualitatively disturbed process of motivational mediation of activities and a change in the hierarchy of values" or "You have significant deviations in behavior due to character accentuations and violations of volitional regulation of activity"). In the process of informing, a different approach is noted not only to focusing, but also to the description and assessment of clinical phenomena identified in the process of interviewing and diagnostics. Estimated or descriptive approaches are possible. In the first case, information includes evaluation categories (adequate-inadequate, normal pathological, healthy-sick, defective, etc.). In the second, a psychologist or a doctor, when informing, tries to avoid evaluative categories and focuses only on the description of clinical phenomena, providing, if necessary, a multivariate interpretation of the facts obtained. - 476 The terminology used by the clinician (psychologist or doctor) is also essential in the process of informing. He can use specific scientific terminology and even jargon (“diversity of thinking”, “use of causal attribution”, etc.), incomprehensible to the surveyed, or, taking into account the linguistic and other parameters of the client, make a conclusion in ordinary language. Training in self-regulation skills in the process of psychological counseling is carried out in various ways with a focus on the priority of providing the client or patient with the maximum possible information about the methods and methods of psychological protection and compensation, sleds and pathogenetic patterns of thinking and forecasting, patterns of development, stages and outcomes of interpersonal and intrapersonal conflicts. In the process of counseling, an individual learns the skills of a reflexive style of thinking, sanity and adaptive forms of response exclusively through information, since the training method is part of the structure of another type of psychological assistance - psychocorrection. First of all, the client or patient acquires knowledge of the methods of psychological defense. Their essence is to maintain a balance between external forces acting on a person and internal resources. The following variants of psychological defense mechanisms are distinguished: rationalization, projection, repression, identification, compensation, overcompensation, fantasizing, dominant ideas (M. Yarosh). Rationalization is the desire for self-justification, the search for reasons and motives for their actions in the external environment. Blaming, for example, the people around you for the occurrence of an illness or psychological problem. At the same time, the patient tries to find the most convincing and plausible evidence of the external conditioning of his painful statements and inappropriate actions, trying to consciously or subconsciously avoid recognizing the painful fact of the development of his disease. Projection is the attribution of unfavorable character traits to others. This mechanism of personal defense is most often observed in patients with borderline mental pathology (with personality disorders and neuroses). The patient consciously or unconsciously tries to give the doctor the impression that his painful breakdown is the result of negative character traits of people close to him. Repression - manifests itself in forgetting, ignoring the obvious facts of improper behavior or symptoms of the disease, up to its complete non-recognition. Repression is most clearly manifested in hysterical disorders - the patient often does not remember the most unpleasant and difficult events for him. Identification is the achievement of internal mental calmness by comparing, identifying oneself with someone else (for example, with his children - the desire for them to achieve in life what he did not achieve himself). Compensation is based on the desire to achieve success in one area and, thus, to compensate for failures in another area, caused, for example, by insufficient physical abilities, lack of gifts, speech impairment (for example, increased music lessons in order to be different from someone and draw attention to yourself). Hypercompensation is the desire to achieve success and a sense of significance in the area that has been the most difficult so far (physically weak, with the help of intense training, tries to be the strongest in any sport, a timid and cowardly person hides behind feigned swagger and rudeness, deceitful a person seeks to convince others and partly even himself is convinced of his exceptional honesty). Fantasy manifests itself in the form of imagining the fulfillment of unrealizable desires or the successful resolution of some painful situation, in identifying oneself with some literary or epic hero. It helps to reduce the painful intrapsychic tension caused by life failure or illness. Dominant, or overvalued, ideas are beliefs with a strong emotional charge, which are taken as the most important in life and serve as a motivational stimulus to achieve a certain goal, despite the difficulties that arise. At the same time, one's own inconveniences and offenses inflicted on others are not taken into account. According to P. Leister, the main defense mechanisms of the personality have both advantages and disadvantages, which is important to inform the client in the process of psychological counseling in order to form his conscious or unconscious attitude to psychological problems associated with life difficulties or intrapersonal conflicts (table 22) ... The individual's assimilation of knowledge about the mechanisms of psychological defense can form a new view of his own psyche, patterns and features of mental response in stressful situations; change these views if they turn out to be unacceptable after appropriate analysis. Thus, in the process of counseling and obtaining information about the methods of psychological defense, the person himself will be able to choose from the proposed options that are suitable for him. Counseling does not impose on the client or patient the only correct way to solve interpersonal or intrapersonal problems, but gives a multivariate overview of possible behavior. Unlike psychocorrection and psychotherapy, the choice of a way to resolve problems or personal transformation remains with the individual. Psychological counseling is used for any psychological problems of a person as an initial stage of therapy and "personality reconstruction". Often, its use is combined with the use of psychocorrection and psychotherapy. A specific target of counseling is psychological phenomena caused by identity crises and other worldview problems, as well as communication disorders. In the field of analysis and assessment of ideological crises, existential problems, the use of psychocorrection or psychotherapy is considered unreasonable and ineffective. The only way to provide effective psychological assistance to a person in a period of existential crisis, not accompanied by severe psychopathological manifestations, is to use psychological counseling - joint (client and psycho-479 Table 22 Advantages of psychological protection Advantages and disadvantages of methods Disadvantages Rationalization Justifications for their actions that hide true motives are sought. It serves to preserve. Self-esteem and self-affirmation against external criticism Business and constructive discussion of the problem is eliminated, a person creates an obstacle for himself to look better from the point of view of other people. Projection You can “not see the beam in your own eye” and criticize it “in the eye of another” You can fight your own mistakes without doing anything with yourself Self-knowledge and maturation of the personality becomes difficult. An objective perception of the external world is impossible. The projection is hardly distinguishable by a person, this deprives it of its realism. Repression The unacceptable unacceptable are repressed from desire and Repression requires energy to represent its maintenance. The problem of not consciousness is solved for the sake of it, it remains, and this is peace, which becomes a threat to the psychic momentary liberation to health.Identification Thanks to introjection, the formation of the super-ego takes place, norms are adopted that bring liberation from conflicts.The controller (superego) becomes an internal tyrant. Man becomes a slave to introjected norms and therefore not free. Through identification with the aggressor and authority, the principle spreads further: what they do to me, I do to others. Sublimation The energy of tension will fully respond in socially useful activities: creativity, sports, etc. The causes of tension are overlooked. Sublimated tension does not disappear, therefore a more or less conscious state of frustration arises Formation of reactions Masking of already existing feelings, Formation of reactions leads to a decrease in tension due to lies, which tightens and the newest types of interaction between a person and those around him Advantages Disadvantages Flight A person avoids criticism due to this frustration and the position of the observer reduces the productivity and activity of a person, in the future there are problems with self-regulation Stunning Due to alcohol or Addiction to alcohol and narcotic drugs. Change eliminates conflicts, organic structures, illness of frustration, fears, guilt, achieves a sense of strength. This is a salvation from a frightening reality Shielding Shielding from mental Symptoms disappear without eliminating stress, depressive causes. This leads to the accumulation of moods, fears, negative experiences, anxiety occurs in a short time. There is a transient feeling of peace, stability, relaxation, balance and, as a result, a satisfactory temporary release. Interpretation of powerlessness “I can’t do anything - these are the circumstances” - in this way a person avoids solving problems. Psychological problems are not eliminated, but spread further. There is a danger of manipulation Role-playing Role-mask brings Failure to find oneself for safety. The need for a put on, programmed safety is stronger than the blocked freedom of individual expression by a mask. Petrification, dulling of feelings. Business mask, a picture of complete emotionlessness and mental equanimity. The shell on the feelings does not allow them to manifest outside and get inside. A person is guided by the behavior of an automaton. Interpersonal contacts are impoverished, suppressed feelings are burdened with organs and muscles. He who does not allow himself to be emotional, then becomes sick physically and mentally. It should be borne in mind that the choice of the method of action in such conditions remains with the individual. A classic example of the collision of various types of psychological influence is the suicidal intentions of the individual, due to interpersonal or intrapersonal conflicts. After excluding psychopathological (unconscious or painful) motives of a person's desire to commit suicide, a clinical psychologist, as a rule, can choose three known paths of psychological influence on a person: "the path of counseling", "the path of psychocorrection" and "the psychotherapeutic path." His choice will be based, first of all, on theoretical preferences and understanding of the mechanisms of suicidal behavior, while the individual psychological characteristics of a potential suicide may not be considered at all. Due to theoretical (ideological and professional) views, a psychologist can choose either counseling using a joint discussion of existential issues and transferring responsibility for making a decision to the client himself; or psychocorrection, in the conditions of which he will engage in training aimed at maintaining the focus on saving life with the help of a system for eradicating the “wrong worldview attitude” towards death; or psychotherapy, in which suicidal thoughts and intentions will be considered as a pathology that requires relief, for example, by suggestion. The target for psychological counseling is also interpersonal conflicts: divorce, treason, dismissal, punishment and others, which are considered by the individual through the prism of worldview and moral problems. External psycho-traumatic events are interpreted by a person as immoral and bring to life the fundamental questions of being - justice, loyalty, trust, etc. Consequently, in these cases, the most appropriate should be recognized the use of psychological counseling and give it preference over other methods of psychological influence. A similar process occurs when a person develops a somatic disease. It also requires not correction or therapy, but, first of all, counseling. The most famous methods that relate to psychological counseling are rational psychotherapy (P. Dubois), logotherapy (V. Frankl), self-realization psychology (A. Maslow), positive psychotherapy (N. Peseschldan), cognitive therapy (A. Vesk ), rational-emotional psychotherapy (A. Ellis) and psychotherapy with “common sense”. Despite the fact that the name of the techniques contains the term psychotherapy, in fact, these techniques should be recognized as advisory. This is due, firstly, to the fact that psychological assistance is provided by influencing the worldview; secondly, because the main method is the method of informing the client; and thirdly, because of the "therapeutic target", which in this case is the worldview and worldview of a person and, secondarily, psychological problems and neurotic symptoms. Domestic methods, which should also be classified as advisory, primarily include the so-called. pathogenetic psychotherapy based on the theory of personality relations V.N. Myasishchev. The main task of pathogenetic psychotherapy is to inform the patient or client with the aim of: awareness of the motives of their behavior, the characteristics of their relationships, emotional and behavioral reactions, awareness of the non-constructive nature of the emotional and behavioral stereotypes of a number of their relationships, awareness of the connection between various psychogenic factors and neurotic (psychosomatic) disorders of awareness of the measure their participation and responsibility in the emergence of conflict and psychotraumatic situations of awareness of the deeper causes of their experiences and methods of response, rooted in childhood, as well as the conditions for the formation of their system of relationships, learning to understand and verbalize their feelings. learning self-regulation Pathogenetic psychotherapy is carried out in four stages. The first is to overcome the patient's misconceptions about his illness; on the second - awareness of the psychological causes and mechanisms of the disease; on the third - the solution of the conflict and on the fourth - the reconstruction of the system of personality relations. Logotherapy refers to the humanistic direction of psychotherapy in the broad sense of the term and sets as its goal the therapy of noogenic neuroses through the acquisition of the meaning of life lost by a person for some reason. The mechanism of development of psychological problems and neurotic symptoms is seen in the moral quest of a person, the conflict of conscience and, in general, in the "existential crisis". The task of logotherapy is to restore or gain a person's lost spirituality, freedom and responsibility, based on the well-known position of A. Einstein, expressed in the following words: "A person who considers his life meaningless is not only unhappy, he is hardly fit for life at all." V. Frankl believed that it is possible to return the lost meaning with the help of the method of persuasion. A conviction uses a system of logical justifications for the uniqueness of the values (meaning) of life with the absolute value of transcendence - the essence of existence. The basis of logotherapy is the healing of the soul through the formation of a meaningful striving for meaning and even for the ultimate meaning (super-meaning) as opposed to the desire for pleasure or power. Within the framework of the psychology of self-realization, the emphasis is on developing a psychological strategy to maximize the use of one's own personal potential in life, which includes: 1. The inner nature of a person, his individual self in the form of basic needs, abilities, individual psychological characteristics. 2. Potential opportunities, not real final states, the realization of which is determined by extrapsychic factors (civilization, family, environment, education, etc.). 3. Authenticity - the ability to know your true needs and capabilities. 4. Ability to accept oneself. 5. The need for love. A.Maslow recognized that an individual has values of being (Values) and values that are formed according to the principle of eliminating a deficit (Values). The values of being include such as: 1) integrity - unity, integration, striving for homogeneity, interconnectedness; 2) perfection - necessity, naturalness, appropriateness; 3) completeness - finiteness; 4) justice - legality, duty; 5) vitality - spontaneity, self-regulation; 6) completeness - differentiation, complexity; 7) simplicity - sincerity, essence; 8) beauty is correctness; 9) righteousness - righteousness, desirability; 10) uniqueness - originality, individuality, incomparability; P) ease - lightness, lack of tension, grace; 12) play - fun, joy, pleasure; 13) truth - honesty, reality; 14) self-sufficiency - autonomy, independence, the ability to be oneself without the participation of other people. Positive psychotherapy is based on the principle of a person's ability to self-development and harmony. The main goals of positive psychotherapy are: changing a person's ideas about himself, his current and basic abilities of cognition, traditional for him, his family and culture, mechanisms for processing conflicts; expanding his life goals, identifying reserves and new opportunities for overcoming conflict situations and diseases. an approach to assessing certain psychological phenomena and painful symptoms. Its essence is to provide the client or patient with information about the attitude towards similar psychological manifestations, symptoms, problems or diseases in other cultures. For example, with a pathological emotional reaction of an individual to alopecia (baldness) revealed in him, he is given an example of the attitude towards baldness in some African tribes, where the standard of beauty is not a thick head of hair, but a bald voice. Transcultural comparisons are aimed at developing the client's understanding of the relativity of life values. Another way in positive psychotherapy is a positive interpretation of any problems and symptoms (for example, impotence is interpreted as the ability to avoid conflicts in the sexual sphere, frigidity as the body's ability to say “no”, anorexia as the ability to get by with a minimum of food, etc.). Particular attention in positive psychotherapy is paid to the formation of personal and characterological harmony by providing information about traditional transcultural ways of processing conflicts and forming values (see Chapter 4). Cognitive therapy examines the mechanisms of the emergence of various emotional phenomena in connection with the patient's deviations in assessing reality in the form of "systematic biases". It is believed that emotional -485 disorders arise from "cognitive vulnerability" - a predisposition to stress due to the use of severely specified irrational delusions ("cognitive distortions") in the analysis of external events. Among them, the following stand out: overgeneralization (unjustified generalization based on a single case) catastrophization (exaggeration of the consequences of any events) arbitrariness of inferences (unsubstantiated and inconsistent in drawing conclusions) personalization (a tendency to interpret events in the context of personal meanings) dichotomous thinking (a tendency to use in thinking extremes) selectivity of abstraction (conceptualization of the situation based on the details extracted from the context). The goal of cognitive therapy is to correct erroneous processing of information and modify beliefs in the direction of rationalizing it and developing a common sense life strategy. Regional-emotional therapy aimed at eradicating cognitive distortions, etc., is considered to be close in meaning to cognitive therapy. "Irrational attitudes and thoughts." A. Ellis described twelve basic irrational ideas that should be corrected in the process of counseling: 1. It is absolutely essential for an adult that his every step is attractive to others. 2. There are deeds that are vicious, bad. And those guilty of them should be severely punished. 3. It's a disaster when things don't go the way they would like. 4. All troubles are imposed on us from the outside - by people or circumstances. 5. If something scares or causes concern - be constantly on the alert. 6. It is easier to avoid responsibility and difficulties than to overcome them. 7. Everyone needs something stronger and more significant than what he feels in himself. 8. You need to be competent, adequate, reasonable and successful in all respects. 9. The thing that influenced your life once, will always affect it. -48610. Our well-being is influenced by the actions of other people, so everything must be done so that these people change in the direction we want. 11. Go with the flow and do nothing - this is the way to happiness. 12. We have no control over our emotions and cannot help but experience them. In accordance with the principles of rational-emotive therapy on the part of the client or patient, there should be a "rejection of requirements" to reality and oneself, based on irrational ideas (attitudes), which are divided into four groups: “The spouse must be faithful”); catastrophic attitudes ("everything is terrible and irreparable"); setting the compulsory realization of their needs ("I must be happy"); evaluation setting. The main method of therapy is Socratic dialogue - a cognitive debate using the laws of logic. The method of regional psychotherapy is also based on the logical persuasion of the client or patient, aimed at teaching a person correct thinking, avoiding logical errors and delusions in order to prevent the appearance of neurotic symptoms. Psychotherapy "common sense" includes, along with elements of rational psychotherapy, i.e. persuading a person on the basis of logical argumentation and the formation of correct thinking based on certainty, consistency and evidence, the formation of a multivariate way of understanding reality. Oi is opposed to a single-variant (rigid), which is part of the Pathological thinking pattern in the so-called. causal attribution. The basis of a personal position in psychotherapy "common sense" is considered "anticipatory consistency" (V. D. Mendelevich) - a person's ability to anticipate the course of events, build a forecasting process on a multivariate flexible basis, using past life experience. It is believed that harmonious character traits and personality traits, as well as neurosis resistance, are capable of forming only if such principles are used: a) refusal of claims (“no one owes me anything”); b) rejection of unambiguity (when interpreting the events taking place - "it can mean anything"); c) rejection of fatality (with the interpretation of future events - "everything is possible"); d) developing a strategy of “anticipatory coping” and “anticipatory sadness” instead of “anticipatory joy”. Psychological correction The goals of using psychological correction (psychocorrection) are to optimize, correct and normalize any mental functions of a person, deviations from the optimal level of his individual psychological characteristics and abilities. There are five types of psychocorrection strategies (Yu.S. Shevchenko): 1. Psychocorrection of individual mental functions and components of the psyche (attention, memory, constructive and verbal thinking, phonemic perception, manual skill, cognitive activity, etc.), or personality correction ... 2. Directive impact. or non-directive strategy of psychocorrectional 3. Correction aimed at the individual or focused on the family. 4. Psychocorrection in the form of individual or group lessons. 5. Psychocorrection as a component of clinical psychotherapy in the complex treatment of neuropsychic diseases, or as the main and leading method of psychological influence on a person with behavioral and social deviations. In contrast to psychological counseling, during psychocorrection, the role of the client or patient is not so active and even more often passive. Correction implies the development of new psychologically adequate and beneficial skills in the process of specially designed training programs. The activity of the client or patient consists only in the desire to change, but by no means in the existential work on oneself. A person is ready to "entrust himself" to a clinical psychologist or psychotherapist in order for him to make up for existing shortcomings, correct deviations, and instill new skills and abilities. Even when it comes to psychocorrection of personal or characterological properties, it means that the main method of change and psychological assistance should be the process of learning to effectively accept oneself and reality, and not a philosophical understanding of one's place in the world, one's capabilities and abilities. Psychocorrection, in contrast to psychological counseling, uses manipulation, formation and management of a person as the main methods, having clear ideas about the desired state, the level of development of mental functions or individual personality qualities. Standards and ideals are set. A person acts as a material from which the image that is optimal for him or ideal for society is "molded". Responsibility for psychological changes rests solely with the psychologist. The spectrum of manipulative techniques is classic: from Carnegie's advice to neurolinguistic programming and various trainings (female charm, personal growth, sexual training, etc.). In clinical psychology, psychocorrection is used for psychological problems identified in a client that arise in connection with characterological deviations and personality anomalies, as well as for neurotic psychosomatic disorders. The development of optimal skills occurs in the course of trainings, among which the most famous are: auto-training, behavioral (behavioral) therapy, neurolinguistic programming, psychodrama, transacg analysis (E. Bern). Autogenic training (auto-training) is a technique aimed at mastering the skills of mental self-regulation using relaxation methods. Relaxation (relaxation) is understood as a state of wakefulness, characterized by low psychophysiological activity, felt either in the whole organism or in any of its systems. In clinical psychology, especially in psychosomatic disorders and diseases, such varieties are used as the actual autogenous training with the so-called. neuromuscular relaxation and biofeedback technique. With progressive muscle relaxation, a person is taught to control the state of the muscles and induce relaxation (relaxation) in certain muscle groups in order to relieve secondary emotional stress. Autogenic training is carried out in several stages, aimed at mastering exercises to weaken the neuromuscular tension to a specific muscle or muscle group, followed by the formation of a "rest habit". -489 The biofeedback technique is built on the principle of conditioned reflex fixation of the skill to change one's somatic state when controlling it with the help of various devices (Figure 26). In the course of training, the patient independently controls the biological functioning of his body (from the rate of elementary biochemical reactions to complex activities) with the help of the device and learns to change it using various methods of self-regulation. The following types of biofeedback are distinguished (A.A. Aleksandrov): electromyographic biofeedback; temperature biofeedback; electrocutaneous biofeedback; electroencephalographic biofeedback; The technique of temperature biofeedback allows you to acquire the skills of expanding and narrowing the peripheral vessels, which leads to a change in the temperature of the limbs and body. Electrocutaneous biofeedback makes it possible to learn how to control galvanic skin reactions, influencing sympathetic nervous activity. With electroencephalographic biofeedback, the formation of skills for changing the bioelectrical activity of the brain occurs by changing the ratio of waves of different frequencies and, first of all, increasing alpha activity to reduce the level of excitability and sedation. Behavioral psychotherapy abounds in techniques based on the development of conditioned reflex activity in order to relieve psychopathological symptoms or the skills of adequate habits instead of inadequate, neurotic ones. The best known techniques are the “systematic desensitization” and “paradoxical intention” techniques used to treat obsessive fears. With "systematic desensitization", a person is immersed in a situation that causes fear (imaginary or real) with the formation of a new adequate response to the situation and the attenuation of the old painful one. The technique, called "paradoxical intention", is aimed at changing the patient's attitude to phobias by "turning over" this attitude and bringing the situation to the point of absurdity (with erectophobia, fear of blushing, learning to set oneself up like this: "Well, show everyone how you are you know how to blush. Let everyone see how you succeed "). The task of the paradoxical intention is to deprive the emotionally negative reinforcement of fears, replacing them with irony and humor. Neuro-linguistic programming is a system of psychological manipulations based on the study of the linguistic metamodel of a person, the essence of which lies in the recognition of the template for each group of people or one person of the linguistic system of knowing the world and oneself, expressing feelings and solving problems. For this, in neurolinguistic programming (NLP) there is the concept of modality - the most typical and characteristic way of perceiving and reflecting the surrounding reality for an individual. There are three types of modality: visual, auditory and kinesthetic. After identifying the dominant modality of a person, correction of his behavior is assumed, which may or may not be realized by the person himself. In the first case, we can talk about controlling the individual, in the second, about manipulating him with the help of verbal and non-verbal methods. The goal of programming is to develop a specific behavior strategy that is desirable for a person or environment. Within the framework of neurolinguistic programming, several techniques are used: "anchoring", "swing", "explosion", "metaphor". -491 The main thing is considered to be "reframing" - the reformation of the personality, giving it a new predetermined form. Reframing is based on the following basic provisions of neurolinguistic programming: 1. Any symptom, any reaction, or human behavior is initially defensive in nature and therefore useful; they are considered harmful only when used in an inappropriate context; 2. Each person has his own subjective model of the world, which can be changed; 3. Each person possesses hidden resources that allow to change both subjective perception, and subjective experience, and the subjective model of the world. Reframing is usually done in six stages. On the first, the symptom is determined; in the second, the patient is invited to make a kind of splitting himself into parts (healthy and pathological, represented by a symptom) and come into contact with the part responsible for the formation and manifestation of a symptom, and comprehend the mechanism of its occurrence; on the third, the symptom is separated from the original motive (intention); on the fourth - the discovery of a new part, capable of satisfying this intention in other ways with "anchoring" (an associative connection between events or thoughts); on the fifth and sixth - the formation of the consent of the whole I to a new connection. In the process of psychodrama, a person plays roles in order to study the inner world and develop the skills of optimal social behavior. As a rule, psychodrama is used when an individual has characterological deviations and an “inferiority complex”. In the process of playing activity, a person learns stereotypes of behavior in various life situations, tests them, chooses the most suitable for him and thereby overcomes communication problems. Transactional analysis considers a person's personality as a set of three states of "I", conventionally called Parent, Adult and Child. Their essence is a genetically programmed pattern of behavior and manifestation of emotional reactions. The child manifests himself as infantile traits of character and attitude to reality, the Adult - signs of mature mental activity, and the Parent is characterized by the presence of normative and evaluating stereotypes of behavior. Psychological interaction, from the point of view of E. Bern, occurs in the form of a dyadic contact (transaction) using certain roles. The main goal of transactional analysis is to make the individual understand the peculiarities of his interaction with others using the appropriate terminology and to teach him normative and optimal behavior. Psychotherapy Psychotherapy is one of the types of psychological assistance and psychological influence on the patient in order to relieve psychopathological (primarily neurotic and psychosomatic) symptoms. As shown above, psychotherapy belongs to the field of medical activity, because: a) combines psychological and general medical knowledge regarding indications and contraindications; b) imposes on the psychotherapist responsibility (including criminal) for improper or inappropriate (unskilled) use of methods and methods of psychotherapy. Traditionally, there are three approaches to psychotherapy: psychodynamic, behavioral (behavioral) and phenomenological: Their differences are presented in table 23 (N. Karasu). The goal of psychotherapy in the narrow sense of the term is to heal the patient from psychopathological symptoms within the framework of neurotic, characterological (personality) or psychosomatic disorders. The choice of a specific psychotherapeutic technique depends on a number of objective and subjective factors. Among the objective ones stand out: the nature of the psychopathological symptom (syndrome), the etiopathogenesis of mental disorders, the individual psychological characteristics of the patient. Among the subjective parameters, great importance is attached to: a) the individual psychological characteristics of the psychotherapist; b) the breadth of his psychotherapeutic knowledge and skills; c) situational moments (availability of time and appropriate place for a psychotherapeutic session). The focus on the identified clinical parameters is substantiated by the effectiveness of certain techniques practiced by certain psychotherapists in certain mental states and processes of the patient. -493 Table 23 Differences in psychotherapeutic approaches Basic Dynamic Behavioral Phenomenological Thematic Approach Approach Parameters Human Nature Moves Product of sexual and social aggressive learning and conditioning instincts; behaves on the basis of past experience Has free will and the ability to self-determination and self-actualization The main problem Sexual suppression Mental alienation The concept of pathology Conflicts in the Acquired sphere of stereotypes of instincts: behaviors Unconscious early libidinal drives Existential alienation: loss of opportunities, splitting "I", mismatch between thoughts, feelings and behavior (loss of authenticity) The concept of health The resolution of intrapsychic conflicts: the victory of the "Ego" over the "Id", i.e. ego strength Symptom elimination: absence of specific symptom or reduction of anxiety Personal potential actualization: self-growth, authenticity and spontaneity Type of change Deep insight: understanding the early past Direct learning: behavior in the current present, i.e. action or action in imagination Immediate experience: sensation or feeling at the moment Temporal approach "focus" Non-historical: Lack of historicism: objective phenomenological present moment ("here-and-now") Historical: and subjective past Anxiety -494 approach approach approach parameters Therapist's tasks Understand the unconscious mental content and its historical, hidden meaning Program, reinforce, suppress or form specific behavioral responses to eliminate anxiety Interact in an atmosphere of mutual acceptance that promotes self-expression (from physical to mental) Basic techniques Interpretation. Material: free association, dreaming, everyday behavior, transference and resistance Conditioning systematic desensitization, positive and negative reinforcement, modeling "Encounter" ("meeting"): equal participation in dialogue, experiments or games, dramatization or acting out the role of the therapist Neutral ... Helps the patient explore the meaning of free associations and other material from the unconscious Teacher (trainer). Facilitator Helps (accelerator) the patient to replace personality maladaptive behavior with adaptive one. Active, action-oriented The nature of the relationship between therapist and patient Transferential and primary for treatment: unreal relationship Real, but secondary to treatment: no relationship Real and primary for treatment, real relationship Treatment model Medical: doctor-patient. Authoritarian. Therapeutic Union Educational teacher-student. Authoritarian. Learning Union Existential: communication of two equal people. Egalitarian (equal). Human union -495- growth The most famous and widespread psychotherapeutic methods are: opposite (hypnosis and other forms of suggestion), psychoanalytic (psychodynamic), behavioral, phenomenological and humanistic (for example, gestalt therapy), used in individual, collective and group forms. Suggestive methods are understood as a variety of psychological influences using direct or indirect suggestion, i.e. verbal or non-verbal influence on a person in order to create in him a certain state or inducement to certain actions. Often, the suggestion is accompanied by a change in the patient's consciousness, the creation of a specific mood for the perception of information on the part of the psychotherapist. Providing a suggestive influence implies that a person has special qualities of mental activity: suggestibility and hypnotizability. Suggestibility is the ability to uncritically (without the participation of will) perceive the information received and easily succumb to persuasion, combined with signs of increased gullibility, naivety and other features of infantilism. Hypnotizability is a psychophysiological ability (susceptibility) to easily and easily enter a hypnotic state, succumb to hypnosis, i.e. change the level of consciousness with the formation of transitional states between sleep and wakefulness. There are three stages of hypnosis: lethargic, cataleptic and somnambulistic. In the first, a person develops drowsiness, in the second - signs of catalepsy - waxy flexibility, stupor (immobility), mugism, in the third - complete detachment from reality, sleepwalking and suggested images. The use of hypnotherapy is justified for hysterical neurotic, dissociative (conversion) disorders and hysterical personality disorders. Suggestion, used in the form of heterosugestion (suggestion made by another person) and autosuggestion (self-hypnosis), is aimed at relieving emotional neurotic symptoms, normalizing a person's mental state in times of crisis, after exposure to mental trauma, and as a method of psychoprophylaxis. The use of suggestive methods of psychotherapy is effective for removing psychological maladaptive types of an individual's response to a somatic illness. Use indirect and direct methods of suggestion. With an indirect one, they resort to the help of an additional stimulus. Psychoanalytic psychotherapy proceeds from the unconscious mechanism of the formation of psychopathological symptoms (non-neurotic, psychosomatic) and, as a result, is aimed at translating unconscious drives into human consciousness, their processing and response. In classical psychoanalysis, such psychotherapeutic techniques are distinguished as: the method of free associations, transference reactions and resistance. When using the method of free associations, a person produces a stream of thoughts, childhood memories, not yielding to their analysis and criticism, and the psychotherapist-psychoanalyst evaluates them, sorting them according to their significance, trying to identify pathogenic childhood experiences that have been forced out of consciousness. Then the patient is required to respond (catharsis) significant experiences in order to get rid of their negative impact on mental activity. In a similar way, the process of therapy occurs when analyzing dreams, erroneous actions (clericals and reservations) of a person, behind which, as it is believed in psychoanalysis, there is a symbolic designation of symptoms and problems in connection with their displacement from consciousness. The main indication for the use of psychoanalytic psychotherapy is the patient's analysability (a phenomenon similar to hypnotizability and suggestibility in suggestive psychotherapy), which depends on the patient's personality characteristics, first of all, on the intensity of motivation for a long-term therapy process, as well as on the ability to take control of one's thoughts and feelings and the ability to identify with other people. Contraindications include hysterical personality disorders. Behavioral psychotherapy is described in the section on psychocorrectional measures, since it is not fully therapeutic. Its essence is not stopping, i.e. treatment of psychopathological symptoms, introduction into the process of etiopathogenesis of the disease, but learning and training. Cognitive psychotherapy is more fairly classified as a method of counseling than as a therapy. This is due to the formation of a personal position to a greater extent through the methods of dialogue and partnership between the patient (client) and the therapist. Of the phenomenological and humanistic direction of psychotherapy, which is also close to psychological counseling, the most technically developed is gestalt therapy. The main methods of Geshalt therapy include: exercises aimed at expanding awareness using the principle of "here and now"; the formation of complete gestalts through the integration of opposites; work with dreams, etc. -497-
Year of issue: 2005
Genre: Psychology
Format: Doc
Quality: OCR
Description: The history of the development of clinical psychology is a winding path. Situated on the border between medicine and psychology, the new science now and then nailed to one or the other bank of the river under the name of "human knowledge". For the sake of fairness, it should be noted that until now the location of clinical psychology has not been completely determined, which can be explained by the interdisciplinary nature of this science.
The starting point for the emergence of clinical psychology can be considered the appeal of physicians "to treat not the disease, but the patient." It was from that time that the interpenetration of psychology and medicine began. Initially, clinical psychology, which was actively developed by psychiatrists, was aimed at studying deviations in intellectual and personal development, correction of maladaptive and delinquent forms of behavior. However, subsequently, the area of interest of clinical psychology was expanded through the study of the mental state of persons with somatic diseases.
The term "clinical psychology" comes from the Greek kline, which means a bed, a hospital bed. In modern psychology, as a rule, the terms "clinical" and "medical" psychology are used interchangeably. Taking into account this fact, in the further presentation we will use only one of them. However, let us take into account the existing tradition of physicians to designate this area of knowledge "medical psychology", and psychologists - "clinical psychology".
The textbook "Clinical and Medical Psychology" reflects the main sections of clinical (medical) psychology: research methods (clinical interviewing, patho- and neuropsychological experiments), principles of differentiation of the norm and pathology of mental activity, psychology of individual differences, patient psychology and psychology of therapeutic interaction, psychology of deviant behavior, neurotic and psychosomatic disorders, age-related and family clinical psychology, psychological counseling, psychocorrection and the basics of psychotherapy, etc. In each section of the book "Clinical and Medical Psychology" tests for programmed control of knowledge are given.
The textbook "Clinical and Medical Psychology" is designed for medical and practical psychologists, psychotherapists, psychiatrists, doctors of various profiles, nurses, social workers, and is also intended for students studying clinical (medical) psychology.
"Clinical and Medical Psychology"
RESEARCH METHODS IN CLINICAL PSYCHOLOGY
- Clinical interviewing
- Experimental psychological (patho- and neuropsychological) research methods
- Pathopsychological research methods
- Pathopsychological assessment of attention disorders
- Pathopsychological assessment of memory impairment
- Pathopsychological assessment of perception disorders
- Pathopsychological assessment of thinking disorders
- Pathopsychological assessment of intellectual disabilities
- Pathopsychological assessment of emotion disorders
- Pathopsychological assessment of individual psychological characteristics
- Experimental neuropsychological research
- Evaluation of the effectiveness of psychocorrectional and psychotherapeutic influence
- The principles of distinguishing between psychological phenomena and psychopathological symptoms
- Diagnostic principles-alternatives
- Disease-Personality
- Nosos pathos
- Reaction-state-development
- Psychotic-non-psychotic
- Exogenous-endogenous-psychogenic
- Defect-recovery-chronization
- Adaptation-disadaptation, compensation-decompensation
- Negative-positive
- Phenomenology of clinical manifestations
- Semiotics
- Feel
- Perception
- Attention
- Memory
- Thinking
- Intelligence
- Emotions
- Consciousness
- Psychological phenomena and pathopsychological syndromes in mental illness
- Neurotic disorders
- Personality disorders
- Schizophrenia
- Epileptic mental disorders
- Organic mental disorders
- Temperament
- Classification by A. Thomas and S. Chess
- Character
- Personality
- Personality structure (according to K.K. Platonov)
- Mental response to illness and psychology of the physically ill
- Age
- Profession
- Features of temperament
- Character traits
- Personality features
- Psychological characteristics of patients with various somatic diseases
- Oncological pathology
- Obstetric and gynecological pathology
- Therapeutic pathology
- Surgical pathology
- Body and sensory defects
NEUROTIC, PSYCHOSOMATIC AND SOMATOFORM DISORDERS
- Neuroses
- Psychosomatic disorders and diseases
- Aggressive behavior
- Auto-aggressive behavior
- Substance abuse causing altered mental activity
- Eating disorders
- Sexual deviations and perversions
- Overvalued psychological hobbies
- Overvalued psychopathological hobbies
- Characterological and pathocharacterological reactions
- Communicative deviation
- Immoral and immoral behavior
- Unaesthetic behavior
- Developmental clinical psychology
- Social and biological components of normal and abnormal human development
- Mental characteristics and psychosomatic disorders during the neonatal period, infancy and early childhood
- Mental characteristics and psychosomatic disorders in children of preschool and primary school age
- Psychology and psychopathology of early adolescence
- Psychological characteristics and mental disorders of persons of mature, elderly and old age
- Family Clinical Psychology
- Psychological counseling
- Psychological correction
- Psychotherapy
- Parapsychology and psychic healing
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RECOMMENDED REFERENCES
