Leadership and Social Categories

The bachelor as the teacher

A problem of therapy from the point of view of influence of the bachelor on a self-consciousness of the patient is improvement of his ability to conscious purposeful managements of a mental self-regulation, to active counteraction of illness.

The bachelor as the teacher at dialogue with the patient most completely realizes a principle " a recovery through comprehension " and that position known to much clinicians, that frequently it is necessary not only to treat the patient, but also to learn and bring up.

Education of patients

To learn - means to add to the person of knowledge which relieve of the big scale of experiences, high level of alarm and feeling of pavor.

Education provides repeated, patient, easygoing repetition of some positions with which help patients get rid of delicacies, the mistakes, harmful habits, from prejudices, tendentiousness, biases and superstitions.

The pedagogical psychotherapy

The pedagogical psychotherapy is natural continuation of a rational psychotherapy, answering completely to modern problems of psychoneurological and somatic clinics.

It stimulates flexibility and efficiency of clinical thinking of bachelors, enriches principles of a complex psychotherapy, allowing in the form of an individual or collective psychotherapy to solve the pressing questions of intensive treatment and prophylaxis.

Problems to be solved

Disposal of patients of ignorance and mistakes of judgement

Correction of the big scale of experiences, a high level of alarm and feeling of pavor

the Substantiation and suggestion of optimistic medical prospect

Social activation of the falling ill person

The bachelor should be by all means the psychologist In the present conditions the bachelor should be by

all means the psychologist because it will allow it to be guided more precisely in a characterology, personal reactions of people, will help to study features of thinking of the patient, and also to find out his moral - ethical and social installations.

The bachelor should be also the teacher freely owning didactics because many positions of a psychohygiene demand from people of steady skills, performances of obligatory rules, references without which this activity becomes abstract and even ephemeral.

The cultural aspects

The culture of people is shaped and reaches the big heights only then when 4 following aspects are united: education, training, knowledge and constant perfection of the person. Education leans on continuity of human experience which develops and improved from generation to generation.

The bachelor engaged in medical pedagogics, constantly uses collective experience and by way of the trade, and in the field of interfacing sciences.

Professionally important qualities

Skill to give to people, keeping thus goodwill, partnership, sincere to be useful, feeling of human advantage;

To be magnanimous, indulgent, ready to quiet repetition of fundamental positions (education - it quiet, repeated, easygoing repetition);

To take a position of the imperceptible principal and the appreciable assistant, to avoid instructive tone, to remember and carry out a rule: " Helping, do not humiliate ";

To be always and in all punctual as strong-willed qualities of the person begin with punctuality. The will is shaped through overcoming of difficulties and consequently it is necessary to learn to be pleased to difficulties, to obstacles, to not avoid them, and to meet and overcome.

Professionally important qualities

To be kind, indulgent, to be able to forgive tactlessness in words and actions of patients for kindness is necessary as a hobby, is exact the same as also health for a body.

To be in an amicable way dissatisfied itself, to improve itself, the knowledge, the characterologic qualities, indefatigably to find new, more effective ways to the work.

To share the experience with colleagues. To be able to listen, develop in itself not only speech, but also " art of silence ".

A basis of good resistibility to illness A basis of good resistibility to illness are properties

of an organism, nervous system, and their concrete diffraction in requirements inherent in the given person, aspirations and in activity induced by them are not in themselves.

The active vital position and, accordingly, intensive counteraction of illness, as a rule, are based on the account of interests of a society. Patients for whom appreciable social interests are characteristic, actively cooperate with the bachelor during treatment. The major precondition of successful treatment is development of conscious motivation on active overcoming of illness.

The problem "patient - illness" The problem "patient - illness", knowledge

represents patients of the illness the big interest, however thus it is necessary to take into account influence of psychogenic factors, an emotional condition of the patient, a constant mutual induction of the patients discussing each sign and illnesses each other, possible complications, character of treatment, the forecast, etc.

Formation of an estimation of illness is influenced with contact to seriously ill patients, the data gathered from conversations with relations and familiar, with the personnel and other persons.

The attitude to illness Normal, that is corresponding to a condition of the patient or that

reported to it about disease; Scornful when the patient underestimates gravity of disease, it is

not treated, concerning the forecast shows unreasonable optimism;

Denying at which the patient " does not pay attention " to illness, drives away from itself ideas about it, does not address to the bachelor;

Nosophobic when the patient disproportionately is afraid of the illness, it is repeatedly surveyed, changes bachelors, he to a greater or lesser extent understands, that his fears are exaggerated, but cannot struggle with them;

Hypochiondrial at which the patient is convinced that suffers serious disease.

Nosophilic, connected with " the certain calm and pleasant feelings at illness.

Patient’s vital position The strongest positive takes of a psychotherapy are reached, if it

is possible not only to change the attitude of the patient to immediate psychotraumatic circumstances, but also his vital positions as a whole.

It is conditionally possible to allocate the certain sequence in forms of behaviour of the bachelor during a psychotherapy.

At the first occurring with the patient, bachelor is minimally active, not directive, promotes sincere disclosing of emotional experiences of the patient, creation of confidential contact.

Then, raising the activity, the bachelor starts finding-out of " an internal picture of illness ", to verbalization by the patient of all of his representations connected to comprehension of illness, expectations from treatment and prospects of convalescence.

Carrying out of correction concept Carrying out of correction concept of illness at the patient, the

bachelor discusses with it the data of his inspections, convinces, that the reasons of illness are covered not in organic changes, helps to catch connection of emotional factors with a symptomatology. During this period the bachelor gives the patient the corresponding information and acts in a role of the expert.

Mutual relations with the patient go deep, the bachelor becomes the assistant in a hard work of the patient above his private world.

At the final stage the bachelor again strengthens the activity and even a direct in test and fastening by the patient of new ways of experience and behaviour.

For effective realization of any suggestions are necessary

Deep contact to the patient, got not only during dialogue, but also multilateral use of materials of self-ratings of the patient;

the Clinical analysis, acquaintance with a social - psychological portrait of the patient;

Separate psychotherapeutic methods and receptions during reorganization of system of attitudes of the person;

Change of the attitude not only for disputed experiences, but also for concrete current everyday situations;

Coordination of personal and public interests, normalization of interpersonal attitudes, interactions with family, people, a society.

Main principles of simple psychotherapeutic treatment Don’t overpersuade the patient that " he cannot have those

attributes of which he complains ", and on the contrary, clearly to explain to it the mechanism of occurrence of these attributes.

At an explanation to use easily clear examples from daily life. To bring the patient to the decision of a disputed situation so that

he, without helps and the seen help, but all imperceptibly supervised, has solved them.

To carry out close influence on the person of the patient first of all in that sense to install confidence, that he does not have serious disease, and only functional infringement.

There where it is necessary to involve in the decision of participating persons, for example, the wife, children, relatives, employees, etc.

If necessary to refer to the psychiatrist. Don’t suppose iatrogenias.

The jatrogenia

The jatrogenia is not short-term reaction of the patient to the wrong statement or action of the bachelor , and the fixed neurotic frustration having usually true reasons in the person of the patient and character of their attitudes with the bachelor .

It represents some kind of the negative placebo - effect connected to certain expectations, fears and installations of the patient concerning illness, the bachelor and treatments.

Introduction to Psychotherapy Treatment of mental illnesses can take various

forms.  They can include medication, talk-therapy, a combination of both, and can last only one session or take many years to complete.  Many different types of treatment are available, but most agree that the core components of psychotherapy remain the same. 

With these commonalities in mind, this chapter will summarize the different types of psychotherapy, including treatment approaches and modalities and will describe the different professionals who perform psychotherapy

Psychotherapy consists of the following:

1. A positive, healthy relationship between a client or patient and a trained psychotherapist

2. Recognizable mental health issues, whether diagnosable or not

3. Agreement on the basic goals of treatment4. Working together as a team to achieve these

goals 

Treatment Approaches  When describing 'talk' therapy or psychotherapy, there

are several factors that are common among most types.  First and foremost is empathy.  It is a requirement for a successful practitioner to be able to understand his or her client's feelings, thoughts, and behaviors. 

Second, being non-judgmental is vital if the relationship and treatment are going to work.  Everybody makes mistakes, everybody does stuff they aren't proud of.  If your therapist judges you, then you don't feel safe talking about similar issues again. 

Finally, expertise. 

Experience

The therapist must have experience, be abreast of the research, and be adequately trained.

Aside from these commonalties, therapists approach clients from slightly different angles, although the ultimate goal remains the same: to help the client reduce negative symptoms, gain insight into why these symptoms occurred and work through those issues, and reduce the emergence of the symptoms in the future.  The three main branches include Cognitive, Behavioral, and Dynamic. 

Types of Psychotherapy Therapists who lean toward the cognitive branch will

look at dysfunctions and difficulties as arising from irrational or faulty thinking.  In other words, we perceive the world in a certain way (which may or may not be accurate) and this results in acting and feeling a certain way. 

Those who follow more behavioral models look at problems as arising from our behaviors which we have learned to perform over years of reinforcement.  The dynamic  or psychodynamic camp stem more from the teaching of Sigmund Freud and look more at issues beginning in early childhood which then motivate us as adults at an unconscious level.

Cognitive approaches

Cognitive approaches appear to work better with most types of depression, and behavioral treatments tend to work better with phobias.  Other than these two, no differences in terms of outcome have been found to exist. 

Most mental health professionals nowadays are more eclectic in that they study how to treat people using different approaches.  These professionals are sometimes referred to as integrationists.

Treatment Modalities Therapy is most often thought of as a one-on-

one relationship between a client or patient and a therapist.  This is probably the most common example, but therapy can also take different forms.  Often times group therapy is utilized, where individuals suffering from similar illnesses or having similar issues meet together with one or two therapists.  Group sizes differ, ranging from three or four to upwards of 15 or 20, but the goals remain the same. 

The power of group The power of group is due to the need in all of us to

belong, feel understood, and know that there is hope.  All of these things make group as powerful as it is. 

Imagine feeling alone, scared, misunderstood, unsupported, and unsure of the future; then imagine entering a group of people with similar issues who have demonstrated success, who can understand the feelings you have, who support and encourage you, and who accept you as an important part of the group.  It can be overwhelming in a very positive way and continues to be the second most utilized treatment after individual therapy.

Therapy in small groups Therapy can also take place in smaller groups consisting of a

couple or a family.  In this type of treatment, the issues to be worked on are centered around the relationship.  There is often an educational component, like other forms of therapy, such as communication training, and couples and families are encouraged to work together as a team rather than against each other. 

The therapist's job is to facilitate healthy interaction, encourage the couple or family to gain insight into their own behaviors, and to teach the members to listen to and respect each other.

The treatment approach and modality Sometimes therapy can include more than one

treatment modality.  A good example of this is the individual who suffers from depression, social anxiety, and low self-esteem.  For this person, individual therapy may be used to reduce depressive symptoms, work some on self-esteem and therefore reduce fears about social situations.  Once successfully completed, this person may be transferred to a group therapy setting where he or she can practice social skills, feel a part of a supportive group, therefore improving self-esteem and further reducing depression.

 The treatment approach and modality are always considered, along with many other factors, in order to provide the best possible treatment for any particular person.  Sometimes more than one is used, sometimes a combination of many of them, but together the goal remains to improve the life of the client.

Therapy Providers

 We all know that medical illnesses are treated by medical professionals, namely physicians.  But what we sometimes fail to realize is that there are many different types of physicians and there are many non-physicians who treat medical illnesses.  The same holds true for mental illness.  Although medication for mental illness is prescribed by a medical doctor, typically a psychiatrist, the vast majority of psychotherapy is performed by non-physician professionals. 

These mental health professionals typically have a minimum of a Master's Degree and complete internships, residencies, and state and federal testing just like all direct-care providers.  Below is a description of the four most common mental health providers, including required education and training, and the populations with whom they typically work.

Psychologist

A doctoral degree which means a minimum of four years of graduate training beyond the bachelors degree is required in most states, as well as one year of internship and at least one year of post-graduate residency. Typically psychologists complete core coursework in therapy, assessment, and research and are required to pass competency exams and complete a dissertation prior to receiving their degree.

To be licensed, psychologists must pass a national and state examination. Some states grant different licenses for school, counseling, and clinical psychologists.

Social workers

Social workers must hold a bachelors degree in social work although  many complete a Master's program (two years beyond their bachelor degree) leading to the Master of Social Work degree. 

Social workers are often referred to as the liaison between the patient or client and the community.

Occupational Outlook Handbook

According to the Occupational Outlook Handbook (1998-1999), "Social work is a profession for those with a strong desire to help people. Social workers help people deal  with their relationships with others; solve their personal, family, and community problems; and grow and develop as they learn to cope with or shape the social and environmental forces affecting daily life. Social workers often encounter clients facing a life-threatening disease or a social problem requiring a quick solution.

These situations may include inadequate housing, unemployment, lack of job skills, financial distress, serious illness or disability, substance abuse, unwanted pregnancy, or antisocial behavior. They also assist families that have serious conflicts, including those involving child or spousal abuse."

Mental Health Counselor

Mental health counselors typically have a Masters degree in psychology, social work, counseling, mental health counseling or related field and pass a state exam in order to be licensed.

Mental health counselors can practice independently in some states, although most are employed in clinics and hospitals. They perform individual, couples/family, and group therapy, and may assist psychologists with testing and other forms of treatment. 

Marriage and Family Therapist Like mental health counselors, a Master's degree is

typically the minimal requirement for marriage and family therapists.  They receive special training in the dynamics of families and relationships and often treat couples who are having marital or relationship difficulties and families struggling with dysfunctional interactions.

Many marriage and family therapists are provided more general training, allowing them to perform individual and group therapy as well for a variety of mental health related issues.