The subject of medical psychology and sections of medical psychology. ●Medical psychology

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Introduction

1. The concept of medical psychology

Conclusion

Literature

Introduction

Medical psychology is relevant and one of the leading branches of modern psychology. Medical psychology is characterized by a close connection between its theoretical foundations and their practical use in solving a wide range of problems of protecting and strengthening the health of the population.

In modern conditions of aggravation of social problems in our country, deterioration of health indicators of the population, there is an increasing objective need to solve interrelated problems of a medical and social nature at a qualitatively new level. Objectively, there is a need for active introduction of new forms and methods of social work into the practice of health authorities.

In the 90s 20th century a new direction of social work and a type of professional activity - medical and social work - began to take shape and will be actively introduced into healthcare practice. A feature of medical and social work is that it, as a type of professional activity, is formed at the junction of two independent industries.

Social protection of the population and public health. This nature of medical and social work requires special approaches to the training of social work specialists aimed at forming the foundations of knowledge in the field of medicine and medical psychology.

The close relationship between medical psychology and psychiatry is based on the common object of study, a common understanding of mental illness, manifested by disorders in the reflection of the real world and, as a result, disorganization of behavior or its changes.

In solving theoretical and practical problems, a medical psychologist relies on subject knowledge, which consists of two interconnected parts. On the one hand, these are the ideas accumulated to date about the nature, structure, brain mechanisms, the main patterns of individual development and manifestations of the human psyche, i.e. what is called general psychology, on the other hand, is knowledge of one's own subject, reflecting the psychological patterns of violations and deviations in cognitive (cognitive) processes and a person's personality, due to a specific disease. In this case, we are talking about medical psychology and, above all, about pathopsychology as one of its branches, formed within the framework of clinical psychology. But at the heart of the approach to understanding pathology (anomalies, deviations in the psyche) is a system of views on the nature of mental reflection in a healthy normal person.

The problem of the structure and dynamic characteristics of the psyche is solved in different ways by different psychological schools and is interpreted differently by representatives of various directions within the framework of their own conceptual ideas about a person as a subject of reflection of the surrounding world. This is also directly related to the solution of practical problems, since the psychological concept determines the methodology for studying a person, followed by a system of specific methods for identifying the desired features of the psyche in normal and pathological conditions. In this sense, psychological methods are not neutral, they are created and implemented to identify and evaluate those components of the psyche that are adequate to the accepted psychological concept (or scientific paradigm). The choice of methodology is, first of all, a meaningful choice of a certain system of views on the essential components of the human psyche.

1. The concept of medical psychology

Medical psychology is a branch of psychology devoted to the study of the influence of mental factors on the occurrence and course of diseases, the diagnosis of pathological conditions, psychoprophylaxis and psychocorrection of diseases. It is customary to distinguish two main areas of application of medical psychology: neuropsychiatric and somatic diseases. Based on the data obtained in medical psychology, productive hypotheses can be constructed about the process of normal development of the psyche.

Medical psychology (from Lat medicus - medical, healing) is a branch of psychology that studies the psychological aspects of hygiene, prevention, diagnosis, treatment, examination and rehabilitation of patients. The field of study of Medical psychology includes a wide range of psychological patterns associated with the occurrence and course of diseases, the impact of certain diseases on the human psyche, providing an optimal system of health effects, the nature of the relationship of a sick person with the macrosocial environment. The structure of Medical Psychology includes a number of sections focused on research in specific areas of medical science and practical health care. The most common of these is clinical psychology, including pathopsychology, neuropsychology and somatopsychology. The branches of medical psychology associated with psychocorrectional work are intensively developing: psychohygiene, psychopharmacology, psychotherapy, and mental rehabilitation.

Among the most important problems of Medical psychology are the interaction of mental and somatic (bodily, physiological) processes during the onset and development of diseases, the patterns of formation of the idea of \u200b\u200bhis disease in a patient, the study of the dynamics of awareness of the disease, the formation of adequate personal attitudes associated with treatment, the use of compensatory and protective mechanisms personality for therapeutic purposes, the study of the psychological impact of therapeutic methods and means (medicines, procedures, clinical and instrumental studies, surgical interventions, etc.) in order to ensure their maximum positive impact on the physical and mental state of the patient. An important place among the issues studied by medical psychology is occupied by the psychological aspects of the organization of the medical environment (inpatient sanatorium polyclinics, etc.), the study of the relationship of patients with relatives, staff and with each other. In the complex of problems of organizing therapeutic measures, it is of particular importance to study the patterns of the psychological impact of a doctor in the course of his diagnostic, therapeutic, preventive work, the rational construction of relationships between participants in the treatment process, and the prevention of iatrogeny.

2. Sections of medical psychology

medical psychology science

Medical psychology, includes the following sections:

1.) Pathopsychology, a branch of psychology that studies the patterns of disturbances in mental activity and personality traits based on comparison with the patterns of their formation and course in the norm.

The development of pathopsychology is closely intertwined with the development of psychiatry. The first experimental psychological laboratories in neuropsychiatric institutions were created at the end of the 19th century. German psychologist W. Wundt, Russian psychoneurologists V.M. Bekhterev and S.S. Korsakov.

At the beginning of the 20th century the first manuals on the use of experimental psychological methods for the study of mental patients began to be published. In the development of pathopsychology in Russia, the ideas of L.S. Vygotsky.

Pathopsychological studies are of great importance for a number of general methodological problems of psychology, for example, for resolving the issue of the relationship between biological and social in development. psyche. The data of these studies show that a violation of the personality does not mean the "release" of its biological instincts and needs, but is characterized, first of all, by a change in the very human motives and needs. It is also established that the regularities of the disintegration of the psyche do not repeat the stages of its development in reverse order.

The data of pathopsychological studies are used in psychiatry: as diagnostic criteria; when establishing the degree of intellectual decline; during the examination (judicial, labor, military); when taking into account the effectiveness of treatment, especially when using psychopharmacological agents; in the analysis of violations of mental activity in the case of harmful working conditions; when deciding on the restoration of lost performance.

Pathopsychology uses experimental research methods, the main principle of which is a qualitative analysis of mental disorders as a mediated and motivated activity. The pathopsychological experiment provides an opportunity to update not only mental operations, but also the motives of a sick person. The pathopsychology of childhood received special development, in which, on the basis of Vygotsky's position on the "zone of proximal development", special methods were developed, in particular, the method of a teaching experiment.

Methods of medical psychology, not differing in principle from the methods of general psychology, are specified depending on the nature of the disease. Particular attention is paid to medical psychology history- analysis of the patient's past experiences from infancy to the moment of illness.

2). Anamnesis (Greek anamnesis - recollection), information about the patient's living conditions that preceded this disease, as well as the entire history of the development of the disease.

Anamnesis is an integral part of every medical examination, often giving the necessary indications for the diagnosis of the disease. Distinguish between a general history and anamnesis of the disease. The general history includes answers to the following groups of questions: diseases of parents and close relatives (hereditary diseases, malignant tumors, mental illness, tuberculosis, syphilis, etc.); previous diseases and operations, lifestyle (marital status, nutritional conditions), habits (alcohol consumption, smoking), sexual life, working conditions, all living conditions.

The anamnesis of this disease concerns the onset of the disease, the course and treatment of it until the day of the study. The anamnesis is collected from the story of the patient himself or those around him.

In veterinary practice, anamnesis is collected by interviewing animal caregivers, studying documentary data (case histories, etc.). The origin of the animal and the state of health of its parents, the presence of diseases in the farm to which the animal belongs, the conditions of care and maintenance (characteristics of feeding, watering, premises for the animal, operating conditions) are established. They find out previous diseases, the time of occurrence of this disease, its signs, cases of a similar disease in the household, information about the treatment used.

3). The painful nature of the experience, the insolubility of the pathogenic situation, the duration of the psychotraumatic stress- all these factors can be understood and explained only taking into account the individual characteristics of the personality and character of the patient.

Stress (from English stress - pressure, pressure, tension),

1) in technology - an external force applied to an object and causing its deformation.

2) in psychology, physiology and medicine - a state of mental stress that occurs in a person during activities in difficult conditions (both in everyday life and in specific circumstances, for example, during space flight). The concept of stress was introduced by the Canadian physiologist G. Selye(1936) when describing adaptation syndrome.

Stress can have both positive and negative effects on activity, up to its complete disorganization, which sets the task of studying a person’s adaptation to difficult (so-called extreme) conditions, as well as predicting his behavior, especially in such conditions.

Further development of medical psychology leads to the allocation of such branches as clinical psychophysiology (clinical psychosomatology) and clinical psychology. neuropsychology, psychological problems of defectology and pathology. Medical psychology is the foundation psychotherapy and mental hygiene.

4) Neuropsychology, a branch of psychology that studies the brain basis of mental processes and their relationship with individual systems brain; developed as a division neurology.

For centuries, idealistic psychology proceeded from the idea of the parallelism of brain (physiological) and conscious (mental) processes or from the idea of the interaction between these two areas, which were considered independent.

Only in the second half of the 19th century. in connection with the success of the study of the brain and the development of clinical neurology, the question was raised about the role of individual parts cerebral cortex in mental activity. Pointing out that when certain areas of the cortex of the left (leading) hemisphere are affected, individual mental processes (vision, hearing, speech, writing, reading, counting) are disturbed, neurologists suggested that these areas of the cerebral cortex are the centers of the corresponding mental processes and that "mental functions" are localized in certain limited areas of the brain. This is how the doctrine of the localization of mental functions in the cortex was created. However, this teaching, which bore a "psychomorphological" character, was simplified.

Modern neuropsychology proceeds from the position that complex forms of mental activity that have formed in the process of social development and represent the highest forms of conscious reflection of reality are not localized in narrowly limited areas (“centers”) of the cortex, but represent complex functional systems, in the existence of which the complex takes part. working areas of the brain. Each part of the brain makes a specific contribution to the construction of this functional system. Thus, brain stem regions and reticular formation provide energy tone of the cortex and are involved in maintaining wakefulness. The temporal, parietal and occipital regions of the cerebral cortex are an apparatus that provides the receipt, processing and storage of modal-specific (auditory, tactile, visual) information that enters the primary sections of each zone of the cortex, is processed in more complex "secondary" sections of these zones and combines, is synthesized in the "tertiary" zones (or "overlap zones"), especially developed in humans. The frontal, premotor and motor areas of the cortex are an apparatus that ensures the formation of complex intentions, plans and programs of activity, implements them in a system of corresponding movements and makes it possible to exercise constant control over their course.

Thus, the entire brain is involved in the performance of complex forms of mental activity.

Neuropsychology is essential for understanding the mechanisms of mental processes. At the same time, by analyzing mental disorders that occur with local brain lesions, neuropsychology helps to clarify the diagnosis of local brain lesions (tumors, hemorrhages, injuries), and also serves as the basis for the psychological qualification of the resulting defect and for restorative education, which is used in neuropathology and neurosurgery.

In Russia, problems of neuropsychology are dealt with at the Department of Neuropsychology, Faculty of Psychology, Moscow State University, in a number of laboratories and neurological clinics. A great contribution to the development of neuropsychology was made by scientists from other countries: Kh.L. Teuber and K. Pribram (USA), B. Milner (Canada), O. Zangwill (Great Britain), A. Ekaen (France), E. Weigl (GDR). The special journals "Neuropsychologia" (Oxf., since 1963) are devoted to the problems of neuropsychology. Cortex (Mil., since 1964) and others. There is an international society for neuropsychology.

5) Psychotherapy (from psycho... and Greek therapia - treatment), a system of mental influences aimed at treating the patient. The goal of psychotherapy is to eliminate painful deviations, to change the patient's attitude towards himself, his condition and the environment. The ability to influence the human psyche was noticed in antiquity. The formation of the scientific began in the 40s. 19th century (the work of the English physician J. Brad, who explained the effectiveness of mental influence by the functional features of the human nervous system). The theoretical substantiation and practical development of special methods of psychotherapy are associated with the activities of Zh.M. Charcot, V.M. Bekhterev and many others. A certain influence on the development of psychotherapy was exerted by the method psychoanalysis increased attention to the world of internal human experiences, to the role they play in the origin and development of diseases; but Freudianism(and earlier - in the 1st half of the 19th century - the school of "psychics" who considered mental illness as a result of the "oppression of sin") an irrational approach to understanding the nature of mental illness is inherent. Psychotherapy in the USSR is based on data from medical psychology and physiology higher nervous activity, clinical and experimental research method.

There are general and private, or special, psychotherapy. General psychotherapy is understood as a complex of psychological influences that strengthen the patient's strength in the fight against the disease (the relationship between the doctor and the patient, the optimal psychological climate in the institution, which excludes mental trauma and iatrogenic diseases, prevention and timely elimination of secondary neurotic layers that can be caused by the underlying disease). General psychotherapy is a necessary component of the treatment process for all forms of diseases. Private psychotherapy is a method of treating patients with the so-called borderline forms of neuropsychiatric disorders ( neuroses, psychopathy etc.), using special methods of psychotherapeutic influence: rational (explaining) psychotherapy, suggestion in the waking state and hypnosis distraction psychotherapy, autogenic training, collective psychotherapy, etc. (in combination with medication and other methods of treatment). Psychotherapy is impossible without positive emotional contact with the patient.

6) Mental hygiene, a section of hygiene that studies the measures and means of forming, maintaining and strengthening the mental health of people and preventing mental illness. Theoretical basis Psychohygiene - social and general psychology, psychotherapy, social psychiatry and physiology higher nervous activity. The first special work "Hygiene of Passions, or Moral Hygiene" belongs to Galena. The original idea for Psychohygiene of the dependence of people's mental health on the conditions of their social life was put forward by J.Zh. Cabanis. The founder of Psychohygiene in Russia, I. P. Merzheevsky, saw the most important means of preserving mental health and increasing the productivity of activity in the high aspirations and interests of the individual. Psychohygiene in Russia is characterized by predominant attention to such social measures as improving working and living conditions, the consistent formation of active socially valuable attitudes in adolescents, professional orientation that contributes to the implementation of these attitudes, as well as to psychohygienic education and training in special methods of managing one's own mental state. and well-being. An Important Method of Mental Hygiene-- clinical examination persons with neuropsychiatric disorders. The actual tasks of P. include the prevention of mental trauma in children and the development of ways to rationalize the learning process in secondary and higher schools (in order to prevent neuropsychic overload). In connection with the consequences of the scientific and technological revolution, the importance of managing the psychological climate in large and small social groups, as well as methods of increasing the mental stability of workers in professions of increased complexity, is growing. Sections of Psychohygiene: industrial (Psychological occupational hygiene), mental work, sexual life and family relations, children and adolescents, the elderly.

Conclusion

Thus, the branch of psychological science, which is designated as medical psychology, takes part in solving the practical problems of psychiatry. the context of general psychological knowledge necessary for a doctor and constituting a significant part in the content of curricula for training specialists in the field of medicine.In contrast, the sphere of scientific and practical activity of a psychologist in the health care system is designated abroad as clinical psychology.This situation of the transitional period of name change is characterized by the use in the domestic literature and normative documents of the concepts "medical" and "clinical" psychology as synonyms). Having its own subject and logic of development, it participates in solving the problems of diagnostics, examination, in the implementation of psycho-correctional, psychotherapeutic and rehabilitation measures aimed at adapting the patient to life in society. At the same time, psychological research contributes to the solution of the theoretical problems of modern psychiatry.

Literature

1. Luria A.R. Fundamentals of neuropsychology, M., 1973;

2. Shklyar V.S. Diagnosis of internal diseases. K., 1960

3. Introduction to clinical neuropsychology, L., 1973;

4. O. V. Kerbikov, Izbr. works, M., 1971, p. 300--11: About psychohygienic work at school.

5. Platonov K.I., Word as a physiological and therapeutic factor, 3rd ed., M., 1962;

6. Psychology Dictionary. / Ed. A.V. Petrovsky, M.G. Yaroshevsky. - 2nd ed. M., 1990

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The subject of study of medical psychology

According to the direction of psychological research, general and private medical psychology can be distinguished.

General medical psychology studies general issues and includes the following sections:

1. The main patterns of the psychology of a sick person, the psychology of a medical worker, the psychology of communication between a medical worker and a patient, the psychological climate of the department.

2. Psychosomatic and somatopsychic relationships, that is, psychological factors affecting the disease, changes in psychological processes and the psychological make-up of the personality under the influence of the disease, the influence of mental processes and personality traits on the onset and course of the disease.

3. Individual characteristics of a person and their changes in the process of life.

4. Medical deontology and bioethics.

5. Mental hygiene and psychoprophylaxis, that is, the role of the psyche in promoting health and preventing disease.

6. Psychology of the family, psychohygiene of persons during the crisis periods of their lives (pubertal, menopausal). Psychology of marriage and sexual life.

7. Psychohygienic education, psychotraining of the relationship between the doctor and the patient.

8. General psychotherapy.

Private medical psychology studies:

1. Features of the psychology of specific patients with certain forms of illness, in particular with borderline neuropsychiatric disorders, various somatic diseases, the presence of defects in organs and systems;

2. Psychology of patients during the preparation and conduct of surgery and in the postoperative period;

3. Medico-psychological aspects of labor, military and forensic examination;

4. The psyche of patients with defects in organs and systems (blindness, deafness, etc.);

5. The psyche of patients with alcoholism and drug addiction;

6. Private psychotherapy.

Tasks of medical psychology:

psychocorrectional work (psychotherapy)

mental hygiene

psychological expertise related to social and labor rehabilitation of patients

medical-diagnostic and medical-rehabilitation.

Medical and diagnostic unit includes pathopsychological, neuropsychological, somatopsychological, psychophysiological, socio-psychological diagnostics.

Treatment and rehabilitation unit includes psychotherapeutic, psychocorrective, psychoprophylactic and sociotherapeutic measures.

The main methods of research in medical psychology:

observation of the patient's behavior,

experiment: laboratory and in vivo,

questionnaire - questionnaire survey

conversation with the patient (collection of facts about mental phenomena in the process of personal communication),

interview,

study of the products of the patient's activity (letters, drawings, diaries, crafts, etc.)

clinical diagnostic tests.

Observation:

outside surveillance is a way of collecting data about the psychology and behavior of a person by direct observation of him from the side.

Internal Surveillance, or self-observation, is used when a psychologist-researcher sets himself the task of studying a phenomenon of interest to him in the form in which it is directly represented in his mind.

Free observation does not have a predetermined framework, program, procedure for its implementation.

Standardized Observation pre-determined and clearly limited in terms of what is observed, is conducted according to a pre-thought-out program and strictly follows it, regardless of what happens in the process of observation with the object or the observer himself.

Included Surveillance characterized by the direct participation of the observer in the process under study.

Third Party Surveillance does not imply the personal participation of the observer in the process that he is studying.

Poll is a method by which a person answers a series of questions asked of him.

oral questioning used in cases where it is desirable to observe the behavior and reactions of the person answering questions. This type of survey allows you to penetrate deeper into human psychology than a written one, but it requires special training, education and a lot of time spent on research.

Written survey allows you to reach more people. The most common form is the questionnaire. But its disadvantage is that, when using the questionnaire, it is impossible to take into account in advance the reactions of the respondent to the content of her questions and, based on this, change them.

Free Poll- a kind of oral or written survey, in which the list of questions and possible answers to them is not limited in advance to a certain framework. A survey of this type allows you to flexibly change the tactics of research, the content of the questions asked, and receive non-standard answers to them.

Standardized Poll- with it, the questions and the nature of the answers to them are usually limited to a narrow framework, it is more economical in time and in material costs than a free survey.

Tests are specialized methods of psychodiagnostic examination, using which you can get an accurate quantitative or qualitative characteristic of the phenomenon under study. The tests imply a clear procedure for collecting and processing primary data, as well as the originality of their subsequent interpretation.

Test questionnaire is based on a system of pre-thought out, carefully checked in terms of their validity and reliability questions, the answers to which can be used to judge the psychological qualities of the subjects.

Test task involves assessing the psychology and behavior of a person based on what he does. The subject is offered a series of special tasks, based on the results of which they judge the presence or absence and the degree of development of the quality being studied.

projective test- it is based on the projection mechanism, according to which a person tends to attribute unconscious personal qualities, especially shortcomings, to other people.

Most Common Personality Tests

Method for researching the level of claims. The technique is used to study the personal sphere of patients. The patient is offered a number of tasks, numbered according to the degree of difficulty. The subject himself chooses a feasible task for himself. The experimenter artificially creates success-failure situations for the patient, while analyzing his reaction in these situations. To explore the levels of claims, you can use the cubes of Koos.

Dembo-Rubinstein method. Used to study self-esteem. The subject on vertical segments, symbolizing health, mind, character, happiness, notes how he evaluates himself according to these indicators. Then he answers questions that reveal his idea of the content of the concepts “mind”, “health”, etc.

Rosenzweig's frustration method. With the help of this method, reactions characteristic of the individual in stressful situations are studied, which allows us to draw a conclusion about the degree of social adaptation.

The method of incomplete sentences. The test belongs to the group of verbal projective methods. One version of this test includes 60 unfinished sentences that the subject must complete. These sentences can be divided into 15 groups, as a result, the relationship of the subject to parents, persons of the opposite sex, superiors, subordinates, etc. is examined.

Thematic Aperception Test (TAT) consists of 20 plot pictures. The subject must write a story for each picture. You can get data on perception, imagination, the ability to comprehend the content, the emotional sphere, the ability to verbalize, psychotrauma, etc.

Rorschach method. Consists of 10 cards featuring symmetrical monochrome and polychrome inkblots. The test is used to diagnose the mental properties of a person. The subject answers the question what it might be like. Formalization of answers is carried out in 4 categories: location or localization, determinants (shape, movement, color, semitones, diffuseness), content, popularity-originality.

Minnesota Multidisciplinary Personality Inventory (MMPI). Designed to study personality traits, character traits, physical and mental state of the subject. The subject must react positively or negatively to the content of the statements proposed in the test. As a result of a special procedure, a graph is constructed that shows the ratio of the studied personality traits (hypochondria - overcontrol, depression - tension, hysteria - lability, psychopathy - impulsivity, hypomania - activity and optimism, masculinity - femininity, paranoia - rigidity, psychasthenia - anxiety, schizophrenia - individualistic, social introversion).

Adolescent diagnostic questionnaire. It is used to diagnose psychopathy and character accentuations in adolescents.

Luscher test. Includes a set of eight cards - four with primary colors (blue, green, red, yellow) and four with secondary colors (purple, brown, black, gray). The choice of color in order of preference reflects the focus of the subject on a certain activity, his mood, functional state, as well as the most stable personality traits.

Experiment - with it, an artificial situation is purposefully and thoughtfully created in which the studied property is distinguished, manifested and evaluated in the best way. The experiment allows more reliable than all other methods to draw conclusions about the cause-and-effect relationships of the phenomenon under study with other phenomena, to scientifically explain the origin of the phenomenon and development.

natural experiment- is organized and carried out in ordinary life conditions, where the experimenter practically does not interfere in the course of ongoing events, fixing them in the form in which they unfold on their own.

Laboratory experiment- involves the creation of some artificial situation in which the property under study can be best studied.

Modeling - creation of an artificial model of the studied phenomenon, repeating its main parameters and expected properties. This model is used to study this phenomenon in detail and draw conclusions about its nature.

Mathematical modeling is an expression or formula that includes variables and relationships between them, reproducing elements and relationships in the phenomenon under study.

Logic Modeling based on the ideas and symbolism used in mathematical logic.

Technical Modeling involves the creation of a device or device, in its action reminiscent of what is being studied.

Cybernetic simulation is based on the use of concepts from the field of informatics and cybernetics as elements of the model.: 1 - method clinical guided conversation, 2 - method observations 3 - experiment 4 - psychodiagnostic examination 4. Methods medical psychology Method ... .3 Thing, tasks medical psychology Table...

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medical psychology

Clinical psychologists can work with adults or children individually, with couples and families, and with groups, as shown in the illustration.

Clinical psychology- an extensive section of applied psychology (at the junction with psychiatry), which studies individual characteristics in terms of related medical reactions and phenomena.

The field of clinical psychology includes the assessment of mental health, the organization and conduct of scientific research to understand mental problems, and the development, implementation and evaluation of psychological correction and assistance (psychotherapy). Psychotherapeutic methods of clinical psychology: counseling, individual psychotherapy, family psychotherapy, family counseling and various forms of support for people experiencing adaptation problems.

The term "clinical psychology" was coined by the American psychologist Lightner Whitmer (1867-1956), who narrowly defined it as the study of individuals through observation or experiment with the intention of producing change. According to the American Psychological Association's modern definition:

The field of clinical psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort, as well as promote adaptation, adjustment, and personal development. Clinical psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning throughout life, across cultures, and at all socioeconomic levels.

Subject of Clinical Psychology

Clinical psychology is a broad specialty that has an intersectoral character and is involved in solving a set of problems in the healthcare system, public education and social assistance to the population. The work of a clinical psychologist is aimed at increasing the psychological resources and adaptive capabilities of a person, harmonizing mental development, protecting health, preventing and overcoming illnesses, and psychological rehabilitation.

In Russia, the term " medical psychology”, which defines the same field of activity. In the 1990s, as part of bringing the Russian educational program to international standards, the specialty "clinical psychology" was introduced in Russia. Unlike Russia, in which medical psychology and clinical psychology often actually represent the same area of psychology, in international practice, medical psychology usually means a narrow sphere of psychology of the relationship between a doctor or therapist and a patient and a number of other highly specific issues, while time, as clinical psychology is a holistic scientific and practical psychological discipline.

The subject of clinical psychology as a scientific and practical discipline:

Mental manifestations of various disorders.
The role of the psyche in the occurrence, course and prevention of disorders.
The impact of various disorders on the psyche.
Developmental disorders of the psyche.
Development of principles and methods of research in the clinic.
Psychotherapy, conducting and developing methods.
Creation of psychological methods of influencing the human psyche for therapeutic and prophylactic purposes.

Clinical psychologists are engaged in the study of general psychological problems, as well as the problem of determining the norm and pathology, determining the relationship between the social and biological in a person and the role of the conscious and the unconscious, as well as solving problems of the development and decay of the psyche.

History of clinical psychology in Russia

The prerequisites for the emergence of clinical psychology were laid by the psychological research of French and Russian psychiatrists at the end of the 19th century. In France, R. Ribot, I. Taine, J.-M. Charcot, P. Janet. In Russia, pathopsychological studies were conducted by S. S. Korsakov, I. A. Sikorsky, V. M. Bekhterev, V. Kh. Kandinsky and other psychiatrists. The first psychological laboratory in our country was founded by V. M. Bekhterev in the city at the psychiatric clinic of Kazan University. In the 20th century, numerous studies were carried out on the base.
An important role in the development of clinical psychology as a science was played by the ideas of L. S. Vygotsky, which were further developed in general psychology by his students and colleagues A. N. Leontiev, A. R. Luria, P. Ya. Galperin, and others.
The development of clinical psychology in Russia was seriously promoted by such outstanding domestic scientists as V. P. Osipov, G. N. Vyrubov, I. P. Pavlov, V. N. Myasishchev. A significant scientific and organizational contribution to the development of clinical psychology in Russia in recent years has been made by Myasishchev's student B. D. Karvasarsky.

Sections of clinical psychology

Pathopsychology and clinical pathopsychology

Pathopsychology deals with the issues of human mental disorders, disorders of adequate perception of the world due to lesions of the central nervous system. Pathopsychology studies the patterns of disintegration of mental processes in various disorders (diseases), as well as factors that contribute to the creation of effective corrective methods of treatment.

The practical tasks of pathopsychology include the analysis of the structure of mental disorders, the establishment of the degree of decrease in mental functions, differential diagnosis, the study of personality characteristics and the study of the effectiveness of therapeutic interventions.

There is a difference between pathopsychology, or the consideration of the human mental sphere from the point of view of the methods of psychology, and psychopathology, which considers the human psyche from the point of view of nosology and psychiatry. Clinical psychopathology investigates, reveals, describes and systematizes the manifestations of disturbed mental functions, pathopsychology, on the other hand, reveals by psychological methods the nature of the course and structural features of mental processes leading to disorders observed in the clinic.

B. V. Zeigarnik and S. Ya. Rubinshtein are considered the founders of Russian pathopsychology.

Neuropsychology

Neuropsychology is a broad scientific discipline that studies the role of the brain and the central nervous system in mental processes, touching on issues of both psychiatry and neurology, as well as philosophy of mind, cognitive science, and artificial neural networks.

The Soviet school of neuropsychology was mainly concerned with the study of causal relationships between brain lesions, their localization, and changes in mental processes. Its tasks included the study of impaired mental functions as a result of brain damage, the study of the localization of the lesion and the restoration of impaired mental functions, as well as the development of theoretical and methodological problems of general and clinical psychology.

The leading role in the creation of neuropsychology as an independent discipline was played by Soviet scientists A. R. Luria and L. S. Vygotsky, whose research has received worldwide recognition.

Psychosomatics

Psychosomatics explores the problems of patients with somatic disorders, in the origin and course of which the psychological factor plays an important role. The scope of psychosomatics includes issues related to oncological and other serious diseases (diagnosis notification, psychological assistance, preparation for surgery, rehabilitation, etc.) and psychosomatic disorders (when experiencing acute and chronic mental trauma; problems include symptoms of coronary heart disease, peptic ulcer diseases, hypertension, neurodermatitis, psoriasis and bronchial asthma).

Psychological correction and psychotherapy

Psychological correction, or psychocorrection, is associated with the peculiarities of helping a sick person. Within the framework of this section, the development of the psychological foundations of psychotherapy, psychological rehabilitation as a systemic medical and psychological activity aimed at restoring personal social status through various medical, psychological, social and pedagogical measures, mental hygiene as a science of maintaining and maintaining mental health, psychoprophylaxis, or a combination measures to prevent mental disorders, as well as medical and psychological examination (examination of working capacity, forensic psychological examination, military psychological examination).

Clinical Psychology and Psychiatry

Although clinical psychologists and psychiatrists share a common fundamental goal - the treatment of mental disorders - their training, views and methodologies are often very different. Perhaps the most important difference is that psychiatrists are medical doctors with at least 4-5 years of medical training and a few more years of internship, during which they can often choose to specialize (eg, working with children or the disabled). A consequence of this is that psychiatrists tend to use the medical model to evaluate psychological problems (i.e., they treat clients as patients with illnesses), and their treatment is often based on the use of psychotropic drugs as the main method of achieving a therapeutic effect (although many psychiatrists and use psychotherapy in their activities). Their medical training allows them to make full use of all the medical equipment of a modern clinic.

Clinical psychologists, on the other hand, generally do not prescribe drugs, although in recent years there has been a move in some US states to allow psychologists to prescribe drugs with some restrictions. To do this, they need to undergo additional special training, and medications are mainly limited to psychotropic drugs. Typically, however, many clinical psychologists work in collaboration with psychiatrists to meet all their therapeutic needs.

Methods of clinical psychology

In clinical psychology, many methods are used to objectify, differentiate and qualify various variants of the norm and pathology. The choice of technique depends on the task facing the psychologist, the mental state of the patient, the education of the patient, the degree of complexity of the mental disorder. There are the following methods:

Psychophysiological methods (for example, EEG)
Exploring the products of creativity
Anamnestic method (collection of information about the treatment, course and causes of the disorder)
Experimental psychological method (standardized and non-standardized methods)

Psychotherapy

Psychotherapy is the main method of psychological correction carried out by a clinical psychologist, in general terms, it is a set of techniques and methods used by a psychotherapist to change a person’s psycho-emotional state, his behavior and communication patterns, improve his well-being and improve his ability to adapt in society. Psychotherapy is carried out both individually and in groups.

There are many different areas of psychotherapy: psychodynamic psychotherapy, cognitive psychotherapy, humanistic psychotherapy, family psychotherapy, Gestalt psychotherapy, body-oriented psychotherapy; in recent decades, there has also been an emergence of transpersonal types of psychotherapy, as well as gradual recognition of NLP psychotherapy.

The problem of mental norm and pathology

Clinical psychology deals with the problem of determining what is the mental norm and pathology. Within the framework of the nosological approach, it is customary to distinguish two states of a person - health and illness.

Typical features health the structural and physical safety of the nervous system and human organs, individual adaptability to the physical and social environment, the preservation of a stable habitual state of health are considered.

Disease characterized by a general or partial decrease in adaptability, while the following possible outcomes of the disease are distinguished: complete recovery, recovery with the presence of residual effects, disability (obtaining a defect) and death.

Also allocate pathological mental state, due to the etiology of the process and having no outcome.

The issue of determining the norm and pathology is extremely complex and affects various areas of human activity - from medicine and psychology to philosophy and sociology. A number of attempts were made to derive the criteria for a mental norm, which included maturity of feelings corresponding to a person’s age, an adequate perception of reality, the presence of harmony between the perception of phenomena and an emotional attitude towards them, the ability to get along with oneself and the social environment, flexibility of behavior, a critical approach to life circumstances , the presence of a sense of identity, the ability to plan and evaluate life prospects. In many cases, the mental norm determines how much an individual is adapted to life in a social environment, how productive and critical he is in life.

When making a diagnosis, psychiatrists and clinical psychologists use both personal experience and general recommendations, as well as the International Classification of Diseases (ICD) and the Diagnostic and Statistical Handbook of Mental Disorders (

The subject of medical psychology and sections of medical psychology. ●Medical psychology

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Literature

1. Luria A.R. Fundamentals of neuropsychology, M., 1973;

2. Shklyar V.S. Diagnosis of internal diseases. K., 1960

3. Introduction to clinical neuropsychology, L., 1973;

4. O. V. Kerbikov, Izbr. works, M., 1971, p. 300--11: About psychohygienic work at school.

5. Platonov K.I., Word as a physiological and therapeutic factor, 3rd ed., M., 1962;

6. Psychology Dictionary. / Ed. A.V. Petrovsky, M.G. Yaroshevsky. - 2nd ed. M., 1990

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Notes

see also