Category: Frequently asked questions to a psychologist / January 30, 20200
A psychologist is a certified specialist with practical experience in the field of psychological research. The specialty of a psychologist should not be confused with the specialty of a psychiatrist. A psychologist may have a doctorate, but he is not a doctor without a medical education.
A psychologist studies higher mental functions: memory, attention, thinking, speech, as well as the psycho-emotional state of a person. And also, psychologists help people cope with difficult events in their lives, help people suffering from depression, various phobias, drug or alcohol addiction, and having problems in relationships with loved ones or colleagues.
What tasks does a psychologist set for himself when working with clients?
A psychologist is a person who must not only correctly determine the essence of the problem of the person who turns to him, but also find the right ways to solve it.
A specialist in the field of psychology sensitively delves into problems, which allows him to correctly assess a traumatic event. Finds out whether a person can use his intellectual, emotional, mental abilities in his current state, how complex he is.
Next, the underlying factors causing the problem are identified. A psychologist deeply understands what feelings and emotions a person experiences when a traumatic event persists.
After this, the psychologist directs the person’s thought processes in a positive direction. This is done with the aim of helping the client independently solve the problems that arise. Such influence usually turns out to be effective.
In other words, the competence of a psychologist includes the ability to determine a person’s psychological state, to understand whether there are deviations from the norm and, if there are any, to provide psychological assistance and return the person to the usual and understandable channel of life.
After all, we all know that difficult times periodically come in the life of any of our compatriots. A person ceases to control his emotions and actions for the following reasons:
- onset of depression;
- manifestations of various types of phobias;
- dependence on alcohol, toxic drugs, psychotropic drugs, drugs;
- inability to communicate normally with colleagues;
- chronic manifestation of family discord;
- instability of the external world (affected by crises, wars, terrorist attacks, murders, natural disasters, etc.).
At the same time, only the positive personal qualities of a practicing psychologist are a guarantee of his successful work. After all, only with a friendly psychologist will you come into full contact, fully open up and trust. This is one of the main points in the effectiveness of psychological counseling and further therapy.
Clients are not always satisfied with the work of a psychologist or psychotherapist and may share their negative experiences on social networks. How and where is it better for a person to contact if he considers the therapist’s actions unethical? What recommendations are there for specialists in dealing with negative comments in the public space? Psychological Newspaper asked experts to answer these questions.
Sergey Babin , Doctor of Medical Sciences, Professor of the Department of Psychotherapy, Medical Psychology and Sexology, Faculty of Therapeutics, North-Western State Medical University. I.I. Mechnikova, President of the Russian Psychotherapeutic Association:
“It would be good for a client who seeks psychotherapy to have a very general idea of what psychotherapy is, how it takes place, in what forms, in what forms. He should know whether he is a psychologist or psychotherapist, what education he has, whether he is a member of any public organizations, and how adequate his therapy is. The therapist may be a member of the Intergalactic Association - he has such a diploma hanging on the wall, then I can Google this association and see what it is about. You can see how a specialist positions himself on social networks. If he writes on the networks that he is engaged in psychotherapy and at the same time astrology, this should not be a surprise to the client.
In our country, ethical standards are not regulated by the state. They are regulated by public organizations, of which the therapist may be a member, which is also not required by law in our country. Accordingly, if I, as a client, turned to a therapist and believe that certain ethical standards were violated in relation to me, I can tell the therapist about this and listen to his answer. Now all major psychotherapeutic associations in Russia have an ethics committee and ethical codes that are freely available. The client has the right to write a complaint to the ethics committee of the association in which the therapist is a member. The ethics committee receives the complaint, reviews and responds to the client.
Public organizations do not have the right to impose fines. Each association develops its own system of consequences for ethical violations.
It is important to emphasize that the ethics committee is not a punitive organization. The ethics committee is a structure that assists both the client and the therapist.
We do not pass a verdict as a court, we are trying to figure it out: we can offer the client psychological help if he asks for it or we think that he needs it, we can offer some help to the therapist himself, for example, supervision. There are associations that require a certain number of hours of personal therapy.
We cannot prohibit a colleague from working because we are not a state. We may consider that some action (these are exceptional things) is incompatible with membership in the association. In the West, exclusion from an association almost always automatically leads to a ban on work; for example, in the USA, an employer will not hire a person who is not a member of the association. For us, it is rather an institution of reputation.
If I, as a therapist, encounter negative feedback from a client about himself, then I need to look at whether the client has already completed therapy or not yet. If he is still in therapy, then perhaps I can discuss this with him in therapy. It makes sense on what platform the review was left: if I run a page, blog, website, and a negative review appears there, depending on the site’s policy, I may or may not respond. On my personal page, I can delete reviews, ban people, and block access to comments on my posts. If this is a psychotherapist’s page where activities are advertised, then this is a slightly different situation, and here you need to look at how to handle a specific post and comment.
Social networks have entered our lives relatively recently, and ethical standards in psychotherapy have not kept pace with them.
Many associations prohibit adding clients as “friends” on social networks, and many codes of ethics prohibit asking clients to leave reviews of work.
The therapist is required to maintain client confidentiality. Even if a client writes that I am a bad therapist, and I answer: “Yes, I advised you for six months,” this is a violation of the client’s confidentiality, even if it is secondary. The therapist can bring this situation to his closed professional group, get help, support, and ask a question. This is acceptable, but causing a scandal in the comments, in my opinion, is unacceptable.
You need to understand what kind of person leaves a comment. As a therapist, I need to understand him better. I may not agree with his opinion, but one might think about what prompted such a review. I would warn my colleagues against sorting out relationships with former clients in a public space. This will not lead to anything good."
Alena Prikhidko , candidate of psychological sciences, associate professor at Florida International University (USA):
“There is no law on psychological counseling in Russia yet, so associations are the only way to regulate work from an ethical point of view. Unfortunately, many psychologists are not members of associations, and in this sense, clients are not at all protected. I would recommend that clients ask before starting work whether the psychologist is a member of an association and whether there is an ethics committee.
Clients have the right to leave reviews about the work of a psychologist on relevant sites all over the world, I often see ratings of 3 and 4 in Google reviews for the work of psychologists and psychiatrists. I know that a psychologist can write to Google with a request to remove a negative comment, but the decision is up to Google. The psychologist cannot comment on a negative comment as it violates confidentiality. For the same reason, in the United States, psychologists, in accordance with ethical codes, cannot take feedback on their work from clients.
Contacting sites with a request to remove a review and the inability to comment on it yourself is our reality.
A psychologist has the right to disclose confidentiality in exceptional circumstances, for example, if there is violence against children or the elderly in the client’s family, a risk of suicide for minors, or a high risk of threat to life. In some states, a psychologist may also violate confidentiality if a client sues him or her. But publishing negative reviews does not apply to all of the above.”
Nadezhda Klyueva , Doctor of Psychology, Head of the Department of Consulting Psychology, Faculty of Psychology, Yaroslavl State University. P.G. Demidova, Elena Runovskaya , Candidate of Psychological Sciences, Associate Professor of the Department of Consulting Psychology, Yaroslavl State University. P.G. Demidova, Anastasia Armashova , candidate of psychological sciences, consulting psychologist:
“The consultant’s ability to determine the boundaries of interaction and distinguish unethical feedback that discredits reputation, distorts the essence of what is happening in consulting, from negative one is decisive. Surely you shouldn’t challenge the client’s unethical point of view in a public space or get involved in discussions. At the same time, it is important to keep public space open. The existence of both positive and negative reviews is also necessary for clients to understand the essence of the advisory contact.
If the content of the review concerns feedback on the methods used, features of the style of interaction, psychological comfort, you should clarify this with the client, in no case ignore it and answer publicly, without, of course, touching on confidential information, without affecting the specifics of the contact.
Reading such feedback will help potential clients better understand your work style, see you in open interaction, and once again clarify for themselves the points of responsibility for the result of the advisory interaction.
In order for the client-consultant relationship to be clarified openly and with the participation of the expert community in the informed consent, it is important to include the clause: “If you believe that your (client’s) rights were violated during the counseling (therapy) process, you can send a complaint to the Ethics Committee (hereinafter a public organization is indicated - a professional association of which a psychologist (consultant, psychotherapist) is a member.”
In this case, the Ethics Commission (committee) considers the client’s complaint in accordance with the established procedure. In the textbook “Ethics in Psychological Counseling,” we describe in detail the rules for considering a client’s complaint.
There is a legal option to solve the problem. Currently, the Internet is classified as mass media. There is Article 152 of the Civil Code of the Russian Federation “Protection of honor, dignity and business reputation”, and in this article there is a clause: “If information discrediting the honor, dignity or business reputation of a citizen turns out to be available on the Internet, the citizen has the right to demand the removal of the relevant information , as well as refutation of the specified information in a way that ensures that the refutation is communicated to Internet users.”
In such a turn of events, a specialist against whom negative statements were made that discredited his business reputation collects facts, documents them (screenshots, photographs, etc.) and can file a claim for protection of honor and dignity, compensation for moral damage. It is necessary to determine what specific information caused harm to the psychologist and whether this information is defamatory.”
Elena Kuleva , Candidate of Psychological Sciences, senior lecturer at the Department of Social Management of the St. Petersburg State University of Service and Economics, member of the Ethics Committee:
“The degree of satisfaction among clients with the psychotherapy process does not always depend on the effectiveness of the specialist’s work. Our job is thankless. The peculiarity of a neurotic problem is that it ceases to exist after its resolution - unlike a mathematical problem.
Taking into account the fact that human memory stores “good” information better, clients often not only devalue the work of a specialist, but displace the very fact of the existence of a problem.
A specialist can “get” the client to take over. In this case, the patient feels that without the help of a psychotherapist he himself will not be able to take a single step in life. As a result, rave reviews of such psychocorrection may appear online. Unfortunately, there is no direct correlation here.
Therefore, we must distinguish between issues of ethical violations and dissatisfaction with the work of a specialist. Everyone - clients and specialists alike - understands the difference intuitively. We often encounter a situation where half of the clients idolize the same psychologist, and the other accuses him of violating ethical standards. The brighter the figure, the more contradictory it is.
But, if questions of this kind still arise, it is worth contacting the Ethics Committee. It is assumed that it consists of qualified psychologists and psychotherapists. Their competence should be sufficient to distinguish between the above issues. Unfortunately, in most cases, when filing a complaint, it is no longer possible to talk about continuing psychotherapeutic work with this specialist. The ethics committee can reduce the severity of the client’s dissatisfaction and suggest the most correct way out of the current situation.
A specialist faced with negative reviews on social networks finds himself more helpless. It is simply impossible to refute anything in such a situation. The only small consolation can be that negative PR is also PR. Due to his training, he should be ready for this.”
Yulia Zakharova , co-founder of the College of Ethics in Psychology and Psychotherapy, member of the Association of Cognitive Behavioral Therapy and the Society of Cognitive Consultants and Psychotherapists, Natalya Kiselnikova , PhD in Psychology, Deputy Director for Scientific and Organizational Development, Head of the Laboratory of Counseling Psychology and Psychotherapy of the Psychological Institute of the Russian Academy of Education:
“Client dissatisfaction with the work of a psychologist is a fairly common and natural phenomenon that accompanies the processes of psychological counseling and psychotherapy. Low work efficiency, problems with the setting (payment, postponements and cancellations of sessions, lateness, interaction outside of sessions), insufficiently careful behavior of the psychologist are the main reasons for client dissatisfaction.
It is good when clients are aware in advance that dissatisfaction may well arise during the work process.
For example, the informed consent that the client signs at the beginning of work may indicate rules and ways to resolve conflict situations related to the setting. It is also necessary to invite the client not to hesitate to clarify confusion and express dissatisfaction. The informed consent must contain a clause about where the client should turn if a joint clarification of the conflict situation does not produce results - contacts of the ethical committee of the association to which the psychologist is a member.
It is necessary not only to encourage the client when he gives positive feedback to the psychologist, but also to be ready to face the client’s dissatisfaction, try to discuss it, understand it, and take note. If the client is not afraid to share his doubts with the psychologist and understands that he will be heard, there will most likely be no need to contact the ethics committee.
If you are a client:
1. When choosing a psychologist, pay attention to whether he is a member of professional associations. If he is not a member of any professional associations, then you will have nowhere to go in the event of a conflict. 2. Check whether the specialist has informed consent or consultation rules; their presence can prevent most conflict situations. 3. If dissatisfaction appears, first of all, discuss the problem with your psychologist. 4. If this does not help, then contact the ethics committee of the association in which your psychologist is a member. 5. Unfortunately, it is not always possible to report a potential violation to the association’s ethics committee. In this case, protecting yourself by attracting the attention of a wide circle of people may be practically the only way to get support, as well as understand the situation and warn potential clients of the psychologist. However, it is necessary to take into account that you may face judgment and insults from the psychologist's support group and the random public. Therefore, it may be worth first sharing what happened with a narrow circle of trusted persons and/or familiar psychological specialists who could comment on the situation with care towards you.
If you are a psychologist:
1. It is good if you are a member of a professional association with a functioning ethics committee. 2. Review your ethics committee's rules of procedure so you know what you'll face in the event of a complaint. 3. It’s good if you have informed consent or rules of consultation, where you prescribe rules of behavior, features of the setting, and procedures for resolving conflict situations. 4. Try to familiarize your client with the informed consent or rules at the beginning of the work. 5. Focus the client’s attention on the fact that you are grateful for any feedback, ask them to share their doubts and dissatisfaction with you. 6. If your conflict with a client spills over into the public sphere on social networks or becomes public knowledge with the help of journalists, be sure to contact lawyers and find out how you can protect your honor and dignity.”
Who becomes a client of a psychologist?
Typically, all mentally healthy people who require psychological help consult a psychologist. After all, a person cannot always cope on his own with the emotional load of a negative nature, experiencing difficulties when looking for a way out of an acute life situation.
Clients of a psychologist, and that is what is correct to call them, and not patients, are people in various psychological states, for example:
- the presence of obvious difficulties in communicating with strangers;
- a change in lifestyle leading to a feeling of mental discomfort;
- the occurrence of insoluble crises in the family, threatening divorce or separation;
- the emergence of problems in relationships with the child;
- various phobias and obsessive thoughts;
- internal conflicts, dissatisfaction with oneself, one’s way of life;
- self-determination in life;
- vocational guidance.
Moreover, each person behaves in different situations in a special way. Here it is the personal and individual characteristics that mainly determine his psychological state. But it may also turn out that a person occasionally acts differently from what is typical for him or what he would like. Then you should be wary and contact a specialist for clarification; you simply need psychological consultation.
And at best, the result will be a weakening of mental self-regulation of a temporary nature as a consequence of one-time stress. An abrupt change in a person’s behavior may be associated with a traumatic past experience or with a metabolic disorder caused by a psychoactive substance.
Understanding what is happening to a person is the task of a practicing psychologist. And here it is important to understand that the psychologist has a humanitarian, not a medical education, although he has the education of a medical (clinical) psychologist. Therefore, it is not advisable to consult a psychologist for drug therapy.
First meeting: introduction between psychologist and client
At the first meeting, an acquaintance takes place, during which the client’s life context is clarified, a psychological contract for work is negotiated, and an initial request is formulated. The first meeting is important from the point of view of establishing contact and collecting primary information, as well as agreements on the rules for further work. Any relationship begins with an acquaintance, and psychotherapy is no exception. During therapy, your relationship with the therapist will develop, you will become closer, and your communication will become more and more confidential.
I would especially like to draw attention to those cases when clients call to find out information and never call back, or sign up for a consultation for the first time and don’t show up without first notifying them, or warning them a couple of hours before the meeting.
On the one hand, one can understand the high degree of anxiety of people who, for the first time in their lives, decided to turn to and call a psychologist, but on the other hand, they want basic respect for themselves and their profession. When making an appointment with a specialist, future clients should understand that the appointment time is scheduled, the therapist is specially waiting for you, the premises are paid for, and by such actions you devalue both the work of the psychotherapist and himself. If from the very beginning of your acquaintance with a specialist (from the first call) you allow yourself to violate the agreements reached, then what kind of serious relationship can we talk about? You do not value others, their work and your agreements, you do not follow your intentions and are not ready to take on the minimum obligations (arrive on the agreed day and time)!
Psychological problems that a psychologist can solve
Let us remember that a psychologist is not a doctor, he has a humanities education. If obvious mental disorders are noted, it is better to immediately see a psychiatrist. And contact a psychologist if the following problems arise:
Firstly, it is difficult for you to communicate with strangers.
Secondly, the family is on the verge of divorce. The crisis in family relationships seems insoluble.
Thirdly, dissatisfaction with one’s lifestyle and one’s own character is growing, and other internal conflicts are noted.
Fourthly, misunderstandings and contradictions in the relationship with your child intensify.
Fifthly, it is difficult to determine oneself in life.
Sixthly, the lifestyle has changed, and now the person experiences severe mental discomfort.
Seventhly, various kinds of phobias haunt you and interfere with your normal life.
Eighth, you quit smoking and experience increased anxiety.
In principle , etc...
All these life problems can be solved if you turn to an experienced specialist in time. It is possible to prevent the development of manic disorders and depression and prevent relapse. Just don’t put off visiting a psychologist until later or tomorrow. If you read something here that resonated with you, then call and make an appointment now, and if you live in another city and cannot come to the psychological center, then there is such a service as a telephone consultation with a psychologist.
And don’t listen to some citizens who are convinced that they are able to cope with psychological discomfort on their own, and that only sick people should turn to a psychologist. This judgment is incorrect. At any moment, some event can occur that can become a turning point in life. And the participant in the event can no longer always psychologically cope with its consequences.
For example, an event is connected with the fate of a loved one:
- serious illness;
- treason;
- divorce;
- death.
Psychological trauma received at work is no less dangerous. These include penalties from management, joining a new team, and dismissal.
As a result, a person constantly feels unhappy, and the surrounding reality is perceived extremely negatively. Laughing depression develops, which does not clearly manifest itself and can last for many years.
Problems faced by professionals providing online consulting services
Firstly, most specialists have no understanding of how to properly conduct an online consultation, what its structure is, where to start and what steps to take next, how to complete the consultation. This is not taught in college when receiving basic education.
All additional educational programs also mainly equip specialists with approaches, techniques, methods, but not the technology for their application in an online format. As a result, psychologists, coaches, astrologers conduct their consultations “as it turns out” and then experience dissatisfaction with their activities and a feeling of guilt towards the client.
Secondly, many specialists are afraid to switch to the online format. They have a lot of experience in face-to-face counseling, but they are afraid to do their work online. It's scary that you won't be able to help the client. It’s scary that there might be technical problems and it won’t be possible to conduct a consultation. It’s scary what if the client doesn’t pay, etc.
Thirdly, specialists do not know and cannot apply the methods and techniques they own in an online format. There is a lack of understanding of how to do this, flexibility, and creativity.
Fourthly, there are very few face-to-face clients and, accordingly, the specialist earns little. Without using the capabilities of online consulting, specialists deprive themselves of the opportunity to expand their client base, consult clients from other cities and countries, while losing both potential clients and potential earnings.
Fifthly, clients devalue the work of psychologists, coaches and astrologers online. They say “what should I pay for? We were just talking!” Or they pay little, but want a lot from a specialist: they write and call him 24/7. Professionals have difficulty setting boundaries and rules for counseling with their clients.
Sixth, during the online consultation, the specialist, instead of focusing on the client and working with him, thinks about how he looks (since he sees himself in the camera), whether he says everything correctly, whether he is useful for the client, how much take him for a consultation, etc. As a result, the effectiveness of his activities is significantly reduced.
Seventh, they cannot take money for their work; they agree to free consultations. Specialists devalue themselves and their work!
Psychotherapeutic techniques used by psychologists
The task of a psychologist does not include making a diagnosis or prescribing medications. He is not a doctor, so he has to bring the patient out of an unstable mental state with the help of words or help him get rid of, say, depression, using exclusively psychotherapeutic techniques.
Each practicing psychologist uses special techniques that show the most effective results for him. Here is a list of psychotherapeutic techniques that are most common in our country today:
Symboldrama or catathimno-imaginative psychotherapy
The client creates speculative images on a specific topic, while being in a state of mild relaxation. Symboldrama helps well with diseases such as neuroses, depression, psychosomatic disorders, phobias, as well as with disorders associated with neurotic personality development.
Art therapy
The use of art therapy helps to identify personal situations of a traumatic or conflict nature. A person sometimes experiences mental torment, but cannot explain its origins in words. It is not clear to him what exactly oppresses him. When using act therapy, the psychologist, together with the client, works through unconscious thoughts and suppressed feelings. The clue is the non-verbal manifestations of particularly depressing experiences on the canvas.
Modern psychoanalytic psychotherapy
Together with the psychoanalyst, the client manages to explore his own personality. As a result, hidden mechanisms are released that unconsciously trigger personality conflicts. This leads to an improvement in living standards, self-esteem and overall psycho-emotional tone. With the help of psychoanalytic psychotherapy, you can get rid of fear, phobia, anxiety, increase self-esteem, break alcohol and tobacco addiction, and cope with psychosomatic diseases. Modern psychoanalytic psychotherapy is by far the most effective psychotherapy, providing the most stable results.
Cognitive behavioral therapy
The work is being carried out in the direction of developing a strategy focused on solving very specific problems, and short-term ones at that. The goal of cognitive behavioral psychotherapy is a conscious change in human behavior, the study itself, and a change in way of thinking. The use of this technique shows results only when the client expresses readiness to work specifically on his behavior. At the same time, he does not seek to remake the people around him or adjust the whole world to suit himself. A person sets a goal to acquire new skills that will help him establish himself in life. He learns new ways of responding to emerging events that have become familiar to him. This is an opportunity to break the vicious circle of endless failures and get out of it. Then you can look at life from a different perspective.
Hypnotherapy
The hypnologist introduces the client into a special state when the person is immersed in an atmosphere of psychological and physiological peace. Then it becomes easy and simple to influence consciousness using the method of suggestion. With the help of hypnotherapy it is possible to: change erroneous beliefs, direct consciousness in the right direction of its beliefs, eliminate ossified fears. Hypnosis helps to penetrate the unconscious and understand the origins of psychological problems.
Existential therapy (analysis) or logotherapy
Existential analysis (from the English word “existence” - existence) and logotherapy (logos - meaning) deprive the psychological problem of meaning, since a person transfers his attention and the meaning of his existence to the belief of being or existence “here and now”. In addition, logotherapy has identified 2 more techniques. The method of paradoxical intention (intention) works on the “wedge by wedge” principle, that is, a person is required to perform an action that is provoked by a problem. The dereflection technique (distracting attention or ignoring the problem) eliminates hyperreflection, that is, increased concentration on the problem.
Gestalt therapy
"Gestalt" means "form" in German. Form consists of figure and ground. The figure is a person, and the background is his problems (situation, environment). The Gestalt form includes a need and its satisfaction. If the gestalt consists only of needs (no satisfaction), then it is called an incomplete gestalt. Gestalt therapy helps a person see (realize) himself separately from his unresolved gestalts - this helps to resolve them or complete them (conversation with the problem). The principle of Gestalt psychology is the awareness of problems in the present, even if they were in the past (I can only solve what I feel here and now).
