Psychological Counseling and Psychotherapy

The Possibilities of Modern Client-Centered and Experiential Psychotherapy

2024-01-11T12:11:25+00:00

In Ukraine, important processes are underway to identify those areas of psychotherapy that deserve official recognition by law. The official recognition of psychotherapeutic methods and techniques is associated with the fact that they are recognized as clinically and statistically effective. Such psychotherapy is reimbursed by insurance and is actively promoted in training courses, often "at the expense of other methods of psychotherapy." The psychotherapeutic procedure itself is becoming more and more standardized and impersonal, conforming to a protocol. The fate of client-centered and experiential psychotherapy (PCE-therapy) is not so easy in the world: evidence of its effectiveness is not reflected in the NICE (National Center for Collaboration in Mental Health) guidelines for depression and schizophrenia, which to some extent determine health policy. Therefore, there are widespread prejudices about the ineffectiveness of this type of therapy: it is not effective for severe mental illness, crisis states, specific phobias and traumas, behavioral problems, for those clients who need a directive approach, for assessing and diagnosing clients, etc. The article presents specific studies of the effectiveness of client-centered and experiential psychotherapy for specific symptoms (anxiety, depression, schizophrenia, borderline personality disorders, and some somatic disorders), as well as data from a meta-analysis of the effectiveness of client-centered and experiential therapy. PCE-therapy proved to be highly effective according to the criteria: "before-after" treatment; 2) "treatment-no treatment"; 3) "comparison with other types of psychotherapy" - the data obtained are generally statistically and clinically equivalent in terms of effectiveness to other methods of psychotherapy. PCE therapy proved to be the most effective in the following cases: interpersonal problems, self-harming behavior, coping with chronic somatic diseases, psychosis. It turned out that cognitive behavioral therapy (CBT) has mixed benefits compared to PCE therapy. However, Elliott et al. note that, firstly, these "studies were mostly performed by CBT therapists" and, secondly, "low-quality versions of PCE therapy were used as comparison conditions". The most effective methods of PCE therapy were EFT and PCT. A list of approaches included in PCA-therapy is given, and their general characteristics are given.

Hospice from the Point of View of Synergistic Anthropology: Patients, their Relatives, Workers

2023-12-26T10:46:38+00:00

The article, which is based on a report at the 4th national congress on palliative and hospice care with international participation: “War and us. Palliative care in Ukraine: challenges, risks and prospects,” analyzes the conceptual optics of synergistic anthropology, which, synthesizing existential, psychological and religious aspects of a person living in a terminal situation, allows us to provide an appropriate indicative basis for hospice workers in order to optimize their own resources from funds at the stage of palliative care for the dying person and his relatives. The main conceptual categories here - “extreme situation”, “ontic”, “ontological” and “virtual” levels (types) of a person - we owe to such outstanding thinkers as Karl Jaspers, Martin Heidegger, Sergei Khoruzhy. Taking into account anthropological types of consciousness and family constitutes a system of indicative markers that provide hospice workers (from doctors, nurses and social workers to psychologists and priests) with a basic orientation for applying their own efforts in the extremely complex task of helping a dying person.

Dignity Therapy as a Method of Palliative Psychological Assistance

2023-12-26T10:46:40+00:00

Methodological and theoretical grounding of a brief psychological intervention, new for Ukraine, are presented ‒ of so-called dignity therapy created by a Canadian researcher Harvey M. Chochinov the aim of which is fostering the feeling of the personhood of patients, actualization of their feeling of dignity and, as a result, decreasing of sufferings and increasing the quality of their lives. The scope of requests and conditions where dignity therapy could be helpful is defined, palliative care and psychological support of the elderly in particular. The factor contents of the model of dignity around which the intervention is constructed is revealed: feelings around the illness, behavioural repertoire related to the feeling of dignity, and the social model of dignity. The stages of dignity therapy implementation (preparatory, the stage of interview, and the stage of creating Generativity Document), its eight components (setting, comprehension check, probing questions, exploration of one's life path, refocusing, encouraging for meaningful expressions, general processes of the therapy) as well as questions that a therapist asks a patient in order to start a foreseen process are listed and described. Approximate contents of Generativity Document which is a key material product of dignity therapy on the example of summarized results of thematic analysis in the relevant research from different countries is presented (the developed themes include “Family”, “Pleasure”, “Caring”, “A Sense of Accomplishment” and others). The description of the procedure of estimation of efficacy of dignity therapy is provided, in particular through the use of self-reports and with the inclusion of groups of experts. A brief outline of the demands for therapists who implement the intervention is defined (namely, the standardized training with standardized teaching materials, the work at standardized cases, providing supervisions and additional expert support). The importance of the attitude of a specialist towards realization of dignity therapy is stressed ‒ sensitive, self-aware as well as self-reflective.

A Story About Hibuki - A Psychologist's Instruments in Work with Children's Trauma

2023-12-26T10:46:42+00:00

Problem definition. The uncertainty of the consequences of situations related to stressful situations for the child's psyche actualizes the issue of introducing new approaches, methods and tools of psychological influence that would contribute to the preschooler's ability to overcome stress in a constructive way. Problem analysis. Childhood psychological trauma leaves its mark on the subconscious, can shape a person's worldview, beliefs, and identification of the self. And since trauma affects the levels of primary safety, it creates very powerful patterns in the mind. Signs of childhood trauma include mood swings, guilt, anxiety, feelings of abandonment, confusion and impaired concentration, and withdrawal. The conceptualization of traumatic experience is widely presented in scientific literature: theories of traumatic emotional experience (O.S. Kocharyan, R. Lanius, M. Massey, R. Hammer), conceptual foundations of the subverbal model of client-centered psychotherapy (O.S. Kocharyan), theories and typologies of infantile traumas (Johnson St. M., Burbo L., etc.), theoretical positions of procedural-experiential and emotionally-focused psychotherapy (Greenberg L. and Elliott R.), psychoanalytic theory according to Freud Z., ideas about the formation of early maladaptive schemes (Boterhoven de H., Christopher W., Fassbinder E., Hayes C., Katrina L., Yong J.) and others. However, solving many complex problems remains relevant, one of which includes psychological assistance to the most vulnerable population groups in extreme situations, one of which includes children and work with current traumatic experiences. The purpose of the study is to develop and test a multifunctional tool for working with childhood trauma in conditions of long-term traumatic circumstances. Conclusions. The stories about Hibuki, through which the child identified with the hero of the story, contribute to the restoration of internal mechanisms of the psyche, which help the process of restoring the child's psychological health. A psychologist can use these stories both to rehabilitate a child's psyche and to diagnose his or her emotional state.

Hypnosuggestive Therapy and Sexual-Behavioral Training in the Correction of Homosexuality. A Case From Clinical Practice

2023-12-26T10:46:45+00:00

Patient V., 16 years old, studies in the 10th grade of high school. He consulted me in order to correct his homosexual desire on the initiative of his parents who, unlike him, regarded his sexual orientation as pathology. Under their strong psychological pressure he agreed on conversion therapy, since it, in his opinion, would not deteriorate him but would be better for his parents. On the moment of his visit the heterosexual component of sexual desire was entirely absent. His platonic (romantic) libido to girls was awakened at the age of 8-9, and the erotic one at the age of 10. His erotic desire to males was awakened at the age of 12-13, and the sexual desire a year later. At the age of 13 he arrived at the conclusion that he was a gay. When the patient was 14 he liked his classmate of the same age, whom he did not confess in it. They had companionship and “friendship”. He interacted with that boy during
1-1.5 years. At the age of 15 he had his first homosexual contact with a 36-year-old male. The patient had more than 20 sexual contacts with men aged 17-36. Any manifestations of gender incongruence had never been observed. His andrological status have no pathology. The provided correction was as follows: 1. Cognitive influences targeted at formation of the patient’s beliefs about advantages of the heterosexual lifestyle. 2. Hypnosuggestive correction. Programming was targeted at suggestion of futility of the homosexual lifestyle, removal of the homosexual desire and saturation with the heterosexual one, formation of associations between homosexuality and unpleasant sensations and landscapes, negative social consequences of homosexual relations, mental disorders and somatic problems observed in homosexuals. Hypnotic suggestions were also carried out aimed at changing the aesthetic and sexual perception of female and male persons, increasing sexual attraction to girls and women. A normal course of heterosexual masturbation was programmed. Besides, we performed modelling of the normal course of sexual intercourses with persons of the female sex in the hypnotic state.
3. Sexual-behavioural training (sex therapy) using masturbation of the heterosexual character with involvement of porn resources from Internet. Naturally, any use of homosexual plots during masturbation was strictly prohibited. 4. Also the patient was charged with a task to form an ideal of female beauty by focusing his attention on persons of the female sex both in the real life and in Internet. Twenty-one sessions of hypnosuggestive corrections were conducted. In the process of the provided therapy the homosexual component of libido was decreasing, while the heterosexual one was increasing. After the 18^th session of hypnosis the heterosexual desire was expressed by 100% and the homosexual one by 0%. Then 3 more sessions of hypnosis were conducted in order to secure the achieved results. An inquiry of the patient 4 months later after the performed correction demonstrated their stability.