Special cases of psychological counseling in special conditions. An example of a psychological consultation

A client came to me for a consultation, with whom we have been working very fruitfully for some time. He is in good contact with himself, his emotions, and therefore his work goes quickly and easily. We started the consultation by discussing the changes that have taken place since our last meeting. Then our conversation smoothly moved into the sphere of his relationship with the girl.

He said that he was not sure of his attitude towards her. On the one hand, he really likes a lot in her, on the other hand, he understands that they are not on the way. Then I decided to ask how exactly he understands that he is not on the way? What exactly is the evaluation criterion. After thinking for a while, the client replied that the girl accepts him as he is, which means that in the future he can relax, get lazy, get fat and not move anywhere, achieve nothing. I became interested. I continued to ask, and as a result it became clear what he expects from the girl, that she will set the direction for his development, raise the bar. Then I gave out the phrase that it is usually the pattern of excellent boys to expect others to know how to live for them. First, they do everything for their mother, then when they grow up, they need to find another “mother” so that she can tell them how to live and give them grades. He agreed with me and confirmed that I hit the mark. We decided to work with this topic, to help him figure out what he wants, to find his own goals.

The client looks great. That is, if he is asked to present something, he easily presents it. I'm a visual myself, so it's easy for me to work with other visuals. I asked him:

How long do you plan to live?

He replied:

Up to about 60.
Why not 80?
– I don’t know what I will do after 60.
– Watch Frank Pucelik's seminar sometime, maybe some idea will come up.
- OK.
– And now, please, imagine that you have come to the end of your life. How would it be if you were satisfied with your life, the way you lived it? What would you see if you looked back at the past years? What events is it filled with? What do you remember the most? What brings you the most joy? - here I have already spoken in a slightly trance voice, plunging the client into a light trance so that he imagines all these events as vividly as possible.
“But I am not satisfied with my life and the way it went.
– How would it be if you were satisfied? Or ask yourself what needs to be changed or added in this life in order to feel satisfied?

For a while he went into himself. Then the client told me that he imagined a beautiful wife, children, friends, how they spend time, where they relax, how he achieves goals and earns money, etc.

Convinced that this was what brought him satisfaction, I asked him to present his timeline and allow these events to be placed on it between the present and 60 years. The client thought for a while, and then said that he was not succeeding. What, as if, the line is separate, and these nice pictures are separate. And in general, after 30 years, he has darkness and emptiness on the time line. Up to 30 everything is bright and colorful, and at 30 there is some kind of jumper, behind which there is nothing. I offered to fill this void and send these events there. But no matter what he sent there, everything seemed to fall into a hole.

The client said:

- It feels like it's too late. It was as if I had to get all this before the age of 30, and now I'm already late and nothing can be done about it.
- And if you got all this before 30, what would happen then?
“Then I would just live.
– What exactly would you do? What would life be filled with?

I continued to ask questions, but they clearly did not clarify the situation. He was convinced that there are things that need to be done before 30, and if time is lost, if the foundation is not laid, nothing can be done. I understood that this was only an installation in his head, but neither my examples nor any justifications led to a change. Then the thought came to me that it was worth digging deeper, that something was missing, something I had not yet seen. I suggested that he unfold the timeline and enter it, imagining it as a road. When he did this, it turned out that he was on a colorful beautiful road. I suggested that he go ahead, but when he started to go, it became obvious that nothing was changing. He seemed to be walking in place. It was some kind of defense mechanism that kept him from moving forward, because if he really went further, he would fall into this void. I asked him to look for a way out, and he somehow lifted this beautiful "screen" to go further. As soon as he plunged into this emptiness, he immediately felt very lonely and lost. I asked him to move on. And he walked, approaching old age. As he walked, his strength melted away, but nothing changed in better side. Everything looked very pessimistic, but I knew that the solution was somewhere. Metaphors are always like a Rubik's cube, which, if skillfully twisted, sooner or later will be able to solve.

I asked him to describe this darkness and emptiness, what it is. He said:

It's like it comes from within me.
Then a wonderful question popped into my head that helped make the shift in this work:
What does this void want? Ask her.

He asked and got the answer that the void wanted to protect him.

What does she want to protect you from?
- From pain.
Who or what hurts?
- Other people.

Somewhere here he was able to look beyond this emptiness and saw there real world and some kind of cone that stuck out of it began to prick in the chest. It was painful, and this darkness protected, covered him from pain. And there are enough things like this cone in the world. “They are not evil,” he told me, “it’s just that they are there and will meet me. But they are dangerous, they can tear you apart.” And it became clear that something had to be done about it.

He found a solution. Seeing himself from the side, the client said that this little man (meaning himself) needs to strengthen, become stronger so that these cones cannot break him, so that he can pass through them, as people go through the leaves in the forest. In this case, the leaves can cut the skin, but can not cause serious harm.

To strengthen himself, he should have drunk some liquid that appeared there. But when he drank it, there was, as it were, some kind of separation. Something inside was separated from the shell. At the same time, the shell was made of soft-touch plastic. At some point, some mucus began to come out of it. He began to walk forward as the darkness opened before him. And as he walked, mucus came out of him, and he himself became stronger and stronger. And the world around became brighter. There came a moment when it was no longer necessary to go further, when all the mucus came out. Then he said that you need to remove it.

After cleaning it, the timeline became clear, and life was “manifested” on it. I again invited him to do what we did at the very beginning of our work, namely, to present all those wonderful moments that should fill his life and place them on the time line. This time everything turned out great and we finished the job.

A few words about what it was. Judging by the work that we have done, as a result of some kind of trauma, the client developed a protective mechanism with which he hid from life. As a result, he did not see his future, or rather did not want to see, did not plan anything special. Life just happened to him. That is, he went with the flow and had some kind of unconscious mindset that nothing good would come next. In our work with him, we transformed the defense mechanism, helped him start looking ahead and fill his life with his goals.

I'll post the results in a few months. Such profound changes take time.

FINAL WORK ACCORDING TO THE COURSE

« PSYCHOLOGICAL COUNSELING: FROM DIAGNOSTICS TO WAYS TO SOLVE THE PROBLEM»

1. Description of the child— Anna K.

Age 11, gender - female, class - 5 "A".

Family composition: father, mother, daughter aged 16 and daughter aged 11.

Social status - high.

The main problem: the aggravated course of the age crisis.

This problem manifests itself in the child's behavior in the form of conflicts with classmates.

2. meeting initiative.

The parent came himself and formulated the reason for the meeting as follows: “The girl grew up and conflicts with peers began. There are no conflicts at home. She is vulnerable, not greedy. There is a sister with whom they quarrel, and then reconcile.”

3 . The room where the consultation was held was a separate office, with a table by the window. At the table there is a chair and a chair in front of the table. The psychologist and the parent sat on chairs at the table. The distance between them is about 70-80cm

4. Description of the consultation.

Establishing contact with the parent through greeting and introducing yourself, short description consultation process and communicating the principle of confidentiality. The educational achievements of the child were also noted.

The parent was given the opportunity to speak out: “Tell me, please, what worries you about the child’s behavior?” During the listening, the techniques of pause, passive listening with verbal components, questioning, paraphrase and generalization were applied.

At the end of the parent’s story, she was asked the question “how do you feel when you are now telling me about this?” and, thus, the client's feelings and experiences were legalized (anxiety, concern for the relationship with the daughter, fear of a decrease in the daughter's academic performance, fear of a possible confrontation between the daughter and classmates, etc.).

Then an analysis of the content of the problem was made. The difficulty was in the conflicts that arose with classmates, which had not happened before, since the girl is calm, “more mature than her years.” The parent found out that her daughter does not talk everything about what is happening to her at school. I turned to a psychologist, as complaints began to come from class teacher on her daughter's behavior, and she herself feels that it has become more difficult for her to communicate with her daughter.

This situation arose at the beginning of this school year, when Anya moved to the 5th grade. Locus of complaint: The client identified the greatest difficulty as “she can’t hear me.”

Self-diagnosis: mother associates problems with difficult adaptation to new school when she entered it in the 4th grade, when the girl was “new” and often endured bullying from some girls from this class.

The primary formulation of the problem and request is that the child sometimes does not hear what the mother requires of him, the girl began to behave more aggressively towards some classmates.

Analytical step. The parent was explained that the difficulties he described could be caused by various reasons and the next step in the work would be to identify these reasons. At the end of the meeting, the client was asked to meet in a few days, to diagnose the relationship of the parent to the teenager and the teenager to the parent (the “Unfinished Sentences” technique), to observe the girl over the next week, meet and talk with her, as well as the final meeting upon completion of these activities with the parent.

The problem that worries the client could be caused by the following factors: the child is not satisfied with the nature of interaction with peers and adults (some classmates and some family members). As a result of the consultation, I put forward a diagnostic hypothesis about the parent's misconceptions about the patterns child development and ineffective ways of interacting with the child. The parent was asked to get acquainted with the features of adaptation during the transition to the 5th grade, as well as the features of adolescence.

organizational stage. In working with a teenager and a parent, the method "Unfinished sentences for parents and teenagers" (see Appendix 1, 2), a diagnostic meeting with a teenager, observing the behavior of a girl at school, and a conversation with her class teacher were used.

Next, there was a discussion of the results of the diagnostic stage, at which the client formulated a new request - how to properly communicate with youngest daughter? During the meeting, an informing technique was used, the purpose of which is to increase the psychological competence of the client (features of adolescence). Recommendation technique was also used. The recommendations were formulated in the form of rules for communicating with a teenager (see Annex 3).

Annex 1

Annex 3

PROBLEM - "My child does not HEAR me."

Rule 1. When addressing a child, speak less, not more. In this case, you increase the likelihood of being understood and heard. Why? But because children need more time to comprehend what they hear before answering something (they have a completely different speed of processing information than adults). Thus, if you ask your child a question or ask for something, wait at least five seconds - the child will perceive more information and, quite possibly, will give an adequate answer. Try to be concise and precise, avoid lengthy monologues. At this age, the child becomes more receptive if he knows that he will not have to listen to a whole lecture. For example: "Please clean the closet before you go for a walk", "Now you need to learn physics", etc. Sometimes one reminder word is enough: "Cleaning!", "Literature!".

Rule 2. Speak kindly, politely - as you would like to be spoken to - and ... QUIETLY. A lowered, muffled voice usually catches a person by surprise, and the child will definitely stop to listen to you. After all, it is not for nothing that teachers use this technique so successfully to attract the attention of a raging class.

Rule 3. Be an attentive listener, do not be distracted by extraneous matters when the child tells you something. Listen to him twice as much as you speak. Your growing child simply cannot become an attentive listener if he has no one to learn this from. Make sure you yourself can be an example of what you want from your child (pay attention to how you listen to your husband, friends, family and, of course, the child himself).

Rule 4. If you are very annoyed, you should not start a conversation. Your irritation, aggression will be instantly transferred to your child, and he will no longer hear you. This is due to the fact that one of psychological characteristics This age is emotional instability, largely due to hormonal changes occurring in the child's body.

Rule 5. Before you say anything, make eye contact with your child. First, make sure he is looking at you and not away (if not, then ask to look at you - this technique works with adults, such as husbands). When you look into each other's eyes - the child is at your disposal, you can formulate your request or question. Doing this all the time when you need your child's attention will teach him to listen to you.

Rule 6. It is often difficult for teenagers to immediately switch their attention to your question, especially if they are busy doing what they really like. Moreover, the child may not really hear you (such is the peculiarity of attention at this age). In this case, give warnings - set a time limit: "I want to talk to you in a minute, please digress" or "I need your help in two minutes." At the same time, the set time interval should not exceed five minutes, otherwise the teenager will simply forget.

I very rarely conduct consultations by correspondence. But occasionally there are such spontaneous consultations that were not planned, but simply turned out, because the client dropped in to ask a couple of questions, and I had a good creative mood, some free time and a desire to understand better .... and away we go…. I will post a couple of such consultations here with the permission of the people with whom I worked, so that it is clearer, but how it generally happens.

I want to make a reservation right away that this is not the whole consultation, but only part of it. The work itself required much more time, which was spent on collecting information, trying to work through other techniques, as well as discussing and checking the result after. I cut all this and post here only the main part.

Consultation:

T: What are you afraid of happening now?

K: I have a feeling that at 34 I'm like a newborn, and this can be seen from the outside
don't know where to go
those. real experience, knowledge - there is a lot
but still dumb
well, some kind of dissatisfaction with yourself
I can't make out
I can not yet

T: ok. how do you feel when you're not old enough?
Or you don't look good enough...

K: self-prejudice, disrespect

T: What's the feeling?
where in the body?
or not in the body?
what does it look like?
how do you feel about it?

K: something behind, behind the back of the head
as if holding by the collar
small
“don’t climb”, you are still small
“why are you climbing there”, etc.
what is this technique? I need to dig myself

T: imagine someone who treats you like that on an empty chair
and then tell him that you are not small, you are an adult
and keep saying that you are an adult, you are thirty something
you might want to yell at him
try

K: yes, today I had a similar situation, but I couldn’t bend the dude under me

T: yeah dude it's nothing to do with it
do the exercise
it's something from the past

K: I understand

T: something stuck
need to release it
sometimes you want to scream, beat, kick, etc.

K: strange, I don't want to offend him

T: what do you want?

K: there is only one desire - to say HOW TO understand

T: say

K: but just to say, confidently and calmly
so that he understands that I'm not joking

T: you can even ask why he treats you like that
And another question: who is holding you back?
turn around and look

K: I don't see
feel the hand

T: Whose hand is this?
what do you feel about her?

K: I want to get rid of
let go

T: so turn around and tell her: "I'm already an adult, go to hell"

TO: _

T: Loud and confident
and repeat until something changes

K: ok, got it
oh, apparently still clean and clean
I'm going to study

T: so you didn't?
just understood?
when are you going to do it?
i want you to do it now

K: damn
hand said

T: and?

K: let go, does not hold
but i feel it

T: and you can also do the following: step aside and look at the one who was held by this hand. what does he look like?

K: little frightened
.. hooks .. me

T: and now watching from the side, start making it more
make him older
and see what happens

K: I got a picture
that it was my mother who was holding me, preventing me from approaching adults who somehow frightened me

T: tell your mother that you can no longer keep

K: I fight off my mother so that she would let me go, I want to run up and hit adults

K: ..sausage..

T: knock them
you can beat them if you want
physically
until you release all the aggression
and tell your mother that you can no longer keep that you are an adult
she will understand

K: all
I protected her from my father drunk, and she protected me so that he would not hit
I had it often
both in childhood and later in adolescence

T: clear. What now?
what are the feelings?
what image?

K: calm, I have this often now
I realize, and immediately calmness

T: good. But think about how you will interact with people?
something has changed?

K: confidence

T: ok
Tell me, has that guy grown up?

K: and freedom
yes, grown up
there was a father and his friends, all drunk, and their mother drove them out of the house
everything is drawn, hmm

T: if this guy has grown up to your age, then it would be nice to accept him, become one with him

K: yes, I did

T: great, well done

Consulting a family psychologist sometimes leads to unexpected results

Sometimes a family psychologist's consultation leads to unexpected results, for example, a psychologist may reveal the need for individual work for only one partner.

In this article, I would like to show how the difference in the level of personal development of spouses negatively affects pair interaction and how individual psychotherapy for one of the spouses could help.

In most cases, such a difference lies not only in the typological features of the personality of each of them, but also in the level of formation of the necessary personal abilities. The more developed the individual, the more successful person copes with life's difficulties. Accordingly, the less developed a person's personality, the faster he "breaks" under the influence of difficulties. One of these abilities is the ability to independently determine when a person needs help and ask for it.

Here, in fact, and why, in his practical work pay great attention personal development and along with family counseling and psychotherapy, I conduct individual therapy and group sessions on personal growth.

A simple example of a family psychologist helping a young couple.

A young couple without children (spouses have been together for 7 years) have had constant financial problems for the past five years. A man cannot find a stable job in any way: either an unstable income, or an income insufficient to support a family, or, in general, there is no work at all. Tensions rise in the family - the wife is unhappy, complains that it is difficult for her to provide an acceptable standard of living alone, and then the husband insists on embodying his fantasy on the topic of threesome sex. Since such a relationship is unacceptable for a woman, she persuaded her husband to turn to a psychologist to resolve an acute situation. The main request was: "Tell us what to do?".

To clarify the request, the family psychologist turned to her husband, how does he react to his wife's proposal? The man responded with approval and support, because: "There were no quarrels in the relationship before."

On the one hand, we know from systemic family therapy that, as a rule, a family psychologist is approached by a symptom carrier (a person who cannot cope with the situation), but in practice it turns out that if one of the partners has a more developed personality and is able to assess, that needs help and ask for it, then most likely it speaks for health than for its absence. In this pair, the woman's personality is definitely better formed and turned out to be more developed. She has a stable job with an average salary, smooth relations at work, has close friends with whom she meets and communicates regularly. Despite life's difficulties, she keeps positive attitude and is ready to consciously respond to emerging problems. Emotionally stable. He maintains close, warm relations with his mother and sister. Correctly assesses what suits her and what does not and maintains the firmness of her position. Why does she keep this relationship? She grew up in complete family and the value of a relationship with a man, even psychologically unstable for her, is high: "I love him." In principle, she is satisfied with the relationship, because the couple has mutual understanding and love. However, it becomes difficult for her when she encounters her husband's "incomprehensible" desires, becomes nervous, and, accordingly, does not accept them, and her husband insists on their embodiment in reality.

On the other hand, the husband does not constant communication with friends - meet on occasion or communication is limited only to interactions with work colleagues and wife. The husband grew up in a complete family. However, the relationship with the parental family of the husband is complex and conflicting, which he is very worried about. The main cycle of life goes according to the principle - work - home - work. Stable work not for the past five years. He is very worried about the inability to provide a decent financial level. However, anxiety is not conscious, as is tension due to conflicts with parents (only anger is conscious). After a few clarifying questions, the man admits that “it is hard for him and there is tension.” However, he cannot differentiate anxiety, but emphasizes that thoughts about the future do not allow you to sleep peacefully at night, and also poorly differentiates his own. emotional states, draws attention only to strong emotions. At the moment of discussing the topic of relations with parents, he becomes emotional, speaks abruptly, the intonation of his voice rises noticeably, changes in his face. He began fantasizing about a threesome after some television program that struck him: “I was pierced.” Fantasies are cyclical, appearing and disappearing. As a rule, they appear at work when he is "on the clock" and is forced to spend a lot of time alone. It is in loneliness, as a rule, that obsessive fantasies appear, and this suggests that the level of anxiety rises, which is quite typical.

The meaning of the fantasies boils down to the fact that he watches how another man has sex with his wife. At the moment of fantasy, he experiences jealousy, fear that if this happens in reality, then the wife may become more interested in another man and leave him. However, when he imagines such a picture, along with negative experiences, he enjoys what the other man is doing with his wife. Sometimes in his fantasies, he simultaneously with another man takes possession of his woman: "... yes, orally and vaginally at the same time." When I asked him about how his wife might feel in this situation, he replied that he wanted her to be happy. Hypothetically, here it can be assumed that the husband has pronounced sado-masochistic tendencies, which may indicate a lack of self-confidence and self-affirmation. Clarifying my assumptions, I asked the man how he assesses himself as a professional. To which he replied that, from a professional point of view, he was satisfied with his achievements, but notes that he “fixes himself” on something all the time.

However, the wife says that she does not feel any pleasure from such fantasies of her husband: “It turns out that he is, as it were, a pimp, and I, as if, a prostitute, and he “puts” me under another man. I do not like it. Sometimes I think that if he does not stop, then the matter may reach a divorce. When I tried to clarify with the woman exactly what feelings caused her an unpleasant experience, she became withdrawn, which was a signal to me that she was very hurt by the current situation and could not openly express all her feelings next to her husband. When asked what prevents her from saying exactly what feelings she has, she replied that she was also not against something sharp, but within reason. In response to my comment, what feelings would I have in connection with this situation (anxiety: “what is happening?”, the situation would seem unsafe to me: I would feel fear, would think: “does my husband appreciate me personally and our relationship” , “does he love me?”, that is, the basic motivations of the relationship would be at risk for me), she said nothing. However, I considered it necessary to clarify that perhaps the husband would not have been so insistent on the realization of his fantasies if he knew the true feelings of his wife and could understand why she refuses to support him.

In response to a similar remark by his wife and my comment, the husband said that he was afraid of losing their relationship, because he loves his wife and does not want her to be unpleasant, but he cannot get rid of fantasies. Since the man himself was able to focus his problem, I was able to further narrow the problem and emphasize that, indeed, here it can be assumed that fantasies play the role of discharge (deflection is a mechanism for breaking contact in Gestalt therapy), with the help of which he can This is the time to get rid of tension and anxiety arising from real life events. The man clarified how anxiety manifests itself, I explained. After thinking, the man agreed that fantasies really save. Here we see a fairly common mechanism - the sexualization of anxiety.

Accordingly, for me, as a family psychologist, a Gestalt therapist, it was important to convey the following things to the couple:

1. Despite the differences, the spouses maintain good contact - they can almost openly discuss their problems, with the exception of recognizing the importance of voicing negative feelings, which would help them better regulate the couple relationship. I do not exclude the moment that embarrassment could manifest itself in the presence of a third person, a psychologist.

2. Spouses are ready to make concessions to each other and treat each other well. In a couple, everything is in order with respect - even insisting on the realization of his fantasies, the husband tries to listen to what his wife says, so he turned to a psychologist with her.

3. Level sexual compatibility high, no sexual aversion (disgust for each other on a sexual level).

4. It was also obvious to me that the husband’s obsessive fantasies play the role of psychological relaxation - relieving tension that appears due to high level anxiety about work and conflicts with parents, with which the man eventually agreed.

5. The husband was recommended personal psychotherapy to develop skills to manage anxiety and stress, as well as to increase psychological stability in moments of stress and to resolve the current situation with work and relatives.

The consultation lasted an hour, and I did not delve into the nature of my husband's fantasies, in which for me there were several interesting points that remained unspoken, in particular, the motive for competition and the desire to belittle my wife, apparently, as more socially successful. Deepening the study of fantasy was not possible due to the high level of embarrassment (shame) and the sensitivity of the topic, and is more suitable for individual psychotherapy. Also left behind is the fact of increased marital anxiety as a destabilizing factor that puts the relationship at risk of breaking.

Analysis of the need for individual psychotherapy.

However, it should be noted here that the low stress resistance of the husband, manifested in this moment time, suggests that the skills of self-support and self-regulation are not enough, which leads to additional tension in the relationship, since the proposed method of relaxation and behavior is not suitable for his wife and causes conflicts. It should be noted that by increasing the level of functionality of his own personality, a man could quickly cope with problems. social interaction and solve problems with work, including the parental family. Such important abilities, which manifest themselves as skills in self-soothing, self-support in moments of stress, reflect the level of maturity of the individual and increase the necessary stress resistance in moments of life crises. Seven years of partnerships are still characterized by an increase in the dynamics of emotional interactions and an aggravation of contradictions, taking into account the fact that, as a rule, the personalities of the spouses do not develop evenly.

Sincerely, Maria Romantsova, family psychologist, gestalt therapist

P.S. For all questions, please call +7 (926) 197 - 64 - 39

Family Therapy - 1950 - Views of the family as a whole. The source is the interdisciplinary interaction of psychology and psychiatry (Bowen, Minukhin, Jackson). Reorientation of psychoanalysis to work with the family (both child-parent and marital subsystems), development of a systematic approach (Ackerman), creation of attachment theory (Bowlby), spread of behavioral methods to work with the family, creation of joint family therapy (Satir) → rapid development practice→prerequisites for the creation of family counseling. In the USSR, the development of family therapy is in the 1970s, but Malyarevsky is considered the founder (the doctrine of family treatment, 19th century). Stages of development of therapy (we have):

psychiatric - the idea of ​​the family as a set of incoming individuals

psychodynamic - inadequate behavior patterns formed in childhood

systemic psychotherapy - the concept of pathological family inheritance. Mutual acceptance between therapist and family.

The history of therapy and counseling is closely intertwined, so there is no exact separation between them. BUT the fundamental difference is connected with the causal model of explaining the causes of difficulties and problems of personality development. Therapy is focused on a medical approach (the importance of hereditary and constitutional features). The psychotherapist is an intermediary between the client and the problem, plays a leading role in its resolution. The consultant creates conditions for the client's orientation in a problem situation, objectifies the problem and provides a "fan" of possible solutions. The client chooses and is responsible!!!

Currently, family counseling is a widely demanded type of psychological assistance among the Russian population. Family consultants work in psychological centers, in consultations, registry offices operating in the system of the Ministry of Social Protection and committees for the protection of families and children, as well as in other institutions.

The professional nature of the assistance. The assistance provided by a psychologist is built on the basis of professional training in the field of individual and family counseling, individual or group psychotherapy, as well as in the field of developmental psychology, personality psychology, social and medical psychology and other special disciplines.

In a situation of providing psychological assistance, a consultantrelies primarily on:

On the personal resources of your client and on your personal resources;

On the regularities and psychotherapeutic potential of communication both in the dyad consultant - client, and in a group, including a family. The counseling psychologist appeals to the client's mind, emotions, feelings, needs, and motives as well as his ability to communicate with people, while using various techniques that set the client's resources in motion.

Diagnostics. Sometimes in counseling, specific methods of psychological testing are used. However, the majority of family counselors evaluate family functioning without resorting to a standard form and testing, but only on the basis of a clinical interview. In the first interview, the therapist identifies patterns of interactions within the family, alliances and coalitions. Since painful symptoms tend to serve specific family goals, the counselor tries to understand those goals first. Among the questions that interest a counseling psychologist are often asked such as: “At what stage of life development is the family?”, “What stresses are most likely to have affected the family?”, “What tasks for family development should be solved?”

The standard psychological diagnosis of the family as a system is too complicated. First of all, this is due to the fact that the psychological tools commonly used for diagnosis and assessment are focused more on the individual characteristics of a person than on the family system. As follows from the provisions of systems theory, a simple summation of sets of individual indicators does not give an idea of ​​the family as a whole. In addition, the entire toolkit was traditionally focused on changing the pathology, which requires certain efforts from the psychologist in order to avoid sticking labels of a pathological nature.

For diagnosing relationships, somepsychological tests: analysis of the temperament of Taylor - Johnson; scale of changes in interpersonal relationships; The 16-factor Cattell questionnaire can also be used to identify compatibility in a relationship.

There are also some additional diagnostics technical techniques:

"Structured familyinterview". Many psychologists conduct structured interviews in order to assess family relationships consistently and reliably. In particular, the “Structured Family Interview” is very productive, because it allows you to collect important information within one hour. Using this technique, the counselor is able to observe and evaluate the person, the dyad, and the relationship. whole family. In a structured family interview, the family is asked to complete five tasks. The psychologist asks the family to plan something together. It can be, for example, a joint trip. The counselor observes how the family completes this task. Observation is carried out in order to determine the nature of interaction in the family, the way to solve problems, behavior in conflict situations, and much more. In addition, during such an interview, parents may be asked to come to a common point of view in the interpretation of a proverb or expression in order to explain its meaning to their children. Rather, valuable information comes from observing the extent to which parents allow disagreements, and how they involve children in the interpretation of the proverb, it does not matter at all how the proverb is interpreted. The Structured Family Interview allows comparison of families and facilitates scientific research due to the fact that the methodology is standardized and the scoring system is relatively objective.

"Family Inventory of Life Events". One of the methods that is used to study the characteristics of the family is the Family Questionnaire of Life Events. This questionnaire has a number of advantages, such as: express diagnostics, detailed analysis, comparative analysis of different members of the same family, identification of stressful (unexpected) events that forced the family to resort to therapy.

Genogram. The genogram (or “family tree”) is one of the most well-known methods for examining a family. It was developed by Murray Bowen and is used by many of his students. A genogram is a structural diagram of a system of relationships in a family over several generations. The use of the genogram represents an objectivity, thoroughness, and precision that is consistent with Bowen's overall approach. In many cases, the genogram can be viewed by the therapist as a "path map" through the family's emotional processes. Basically, the genogram allows you to understand why and how separated family members were involved in emotional problems and why and how others were less involved. And as the practice of family therapy shows, the most important questions aimed at clarifying relationships within and between generations, as well as at defusing repressed emotions.

Psychotechnical tools. Special tera peutic techniques

Video and audio recording. The use of video recording in family counseling can provide a number of advantages. Watching the video during a session can often help family members experience family life in a new way. Video recording provides a unique opportunity to collect objective data on behavior during counseling and check its adequacy. In this way, it can help to establish an optimal psychological distance and improve understanding of oneself and the communication patterns that exist in the family. The corrective effect of video recording also lies in the fact that clients have the opportunity to immediately see their behavior on the TV screen. Some psychologists advise each family member to demand immediate access to the videotape during the session in order to re-watch and re-evaluate what happened. It is important that it is difficult for participants to deny any of their own manifestations (words, actions) in the face of obvious facts recorded on videotape. Many counselors even show video clips from previous sessions to help guide the current session. With the help of video recording, the consultant can discover the nuances of communication that he did not pay attention to before, or even see how he himself behaved in the session. Because family counseling sessions are emotionally charged, video recording can provide important material for analysis. Of course, in the case of the use of video and audio equipment, ethical issues must be observed, such as, for example, the confidentiality of the family.

Family discussion - one of the most widely used methods in family psychocorrection. This is primarily a discussion in family groups. The discussion can pursue very many goals.

1. Correction of misconceptions: about various aspects of family relationships; about ways to resolve family conflicts and other problems; about planning and organizing family life; about the distribution of responsibilities in the family, etc.

Teaching family members methods of discussion, assuming the purpose of the discussion is not to prove one's case, but to jointly find the truth, not to come to an agreement, but to establish the truth.

Teaching family members objectivity (the desire to lead them to the same opinion or reduce the level of its polarization on topical family problems).

Noteworthy are the techniques of a family psychologist before holding a family discussion: the effective use of silence; listening skills; learning through questions, problem posing; repetition; summary.

Conditional Communication is achieved by introducing some new element into ordinary, habitual family relationships. Its purpose is to enable family members to correct violations in this regard. One of the tricks is the exchange of notes between family members. In this case, when discussing any issue, family members do not speak, but correspond. The goal is to slow down the communication process so that family members can observe and analyze it. This is an additional opportunity to come into an emotional background state for those who absolutely needed it in order to further reason on a rational level.

Often, as a new element (condition), certain rules of the "fair fight" or "constructive dispute" technique are introduced. It includes a set of rules of conduct that come into effect when spouses feel the need to express aggression towards each other:

a dispute can only be held after the prior consent of both parties, and relations should be sorted out as soon as possible after a conflict situation arises;

the one who starts the dispute must have a clear idea of ​​​​the goal that he wants to achieve;

all parties must take an active part in the dispute;

the dispute should only concern the subject of the dispute, generalizations such as “... and always you ...”, “you in general ...” are unacceptable;

“low blows”, i.e., the use of arguments that are too painful for one of the participants in the dispute, are not allowed.

Teaching such a technique, as a rule, provides stability against the expression of aggression, the ability to find the right line of behavior under these conditions.

Playing family roles These techniques include playing roles in various kinds of games that symbolize family relationships (for example, playing the "animal family"). This also includes "role reversal" (for example, games in which parents and children change roles); "living sculptures" (family members depict various aspects of their relationship). Role play comes naturally to the child and is one of the opportunities for correcting their behavior and their relationship with their parents. The use of this technique in adults is complicated by the fear of having to act in some other role than that to which they have been accustomed throughout their lives.

Techniques that form skills and abilities. In the course of studying a family, it is often found that its members do not have or are not sufficiently developed the skills and abilities necessary for a successful family life. This is the reason for the peculiarities of the methods of this group. In particular, the client is given a specific task (or a set of tasks). He is told about the skill or habit that he must develop, and a criterion is given by which he can judge the extent to which he succeeded.

The psychologist, by giving directions, by setting an example in problem solving, by leading a discussion, by introducing "conditional communication", seeks to make the correct forms of communication become a habit.

Of particular importance is the formation of versioned thinking. Classes are built as follows: the exerciser is informed about certain actions of some people. For example, a wife expresses dissatisfaction with her husband's sexual abilities; the mother fulfills all the wishes of her son; one of the members of a prosperous family suddenly makes a suicide attempt, etc. The client is required to put forward as many (at least 20) versions of the motives that led to such an act as possible. A skill is considered formed if the person practicing without much difficulty, "on the move", put forward a significant number of versions of various actions.

The ability to quickly put forward a variety of motives, formed in this way, turns out to be necessary for the correction of a number of family disorders.

Tasks for the family (homework). The family therapist may suggest various tasks or exercises for the family to complete during the session or at home. These tasks are mainly aimed at changing behavior. They are designed to: help the family learn new ways of interacting; break coalitions in the family; increase family viability.

For example, Minushin can give a family that is constantly faced with life's problems the following task: to choose one family member responsible for signing documents for the whole family at a housing agency. Satir uses "simulation" family games in his work to change communication patterns during a therapy session.

Psychodrama, role-playing games and other game methods. Dramatization methods are used to create empathic contact between family members. Psychodrama and role-playing game also help families realize that there are other types of relationships to each other than the ones they are used to. Family Sculpture is a non-verbal therapeutic technique. It consists in the fact that each family member makes up a living picture of other members, symbolizing how he or she perceives the family. The goal is to identify the characteristics of family relationships and experiences, as well as awareness of protective mechanisms, such as projection and rationalization. So, for example, depicting the situation in the family of a mother who is in a depressed state “in sculptural form”, she may be asked to lie on the floor, and the rest of the family to sit on top.

Attributing a sign, a paradoxical intervention. Paradoxical Intervention is a therapeutic technique using "double grip". It consists in the fact that the therapist gives the client or family an instruction, in relation to which he expects resistance. Positive change occurs as a result of the family ignoring the therapist's instructions.

The Symptom Assignment technique forces the family to increase control over their manifestations. Signs, therefore, lose their independence of manifestation because the family began to control them. A similar method is called “recurrence.” For example, a therapist might say to a client, “You have much better control over your addiction to alcohol now. So much better that there's a good chance you'll be back to your old habits next week."

Paradoxical intervention should not be used in crisis situations. For example, this approach will not give the expected effect and will even be harmful in cases of the client's intentions about murder or suicide. The use of paradox in psychotherapy raises many ethical questions that need to be discussed before starting therapy. Paradox should not be used as shock therapy. Although these methods may cause a shock reaction in clients, this is not the end of the paradox in itself.

Paradoxical methods can be misused, and their use must be justified not only intuitively but also analytically. There are three specific areas associated with ethical issues.

Determination of the problem and goals (therapist and client must define the problem, which should be subject to change).

Choosing a method that is not controlled by the client, the intervention should not be limited, but also controlled or imposed in any way.

Informed Consent: The paradox case is inconsistent with the client's knowledge of what effect is expected. Due to the fact that the awareness or knowledge of the client about what will really happen will lead to resistance or depreciation.

Increasing the number of therapists. There are a number of advantages to using co-therapists or multiple therapists when treating family groups. These include:

an increase in the number of role interaction models;

demonstrating successful interactions between the sexes (often important in the treatment of sexual deviations and problem marriages);

the presence of another therapist provides greater validity and an increase in objectivity in diagnosis and psychocorrection.

The disadvantages of this technique are associated with the need for additional costs of money and time that are required by cotherapists to consult and sort out conflict situations.

Education and training of family members. Targeted training in family therapy is very helpful. For example, the following questions might be considered: “What can a family expect after two years of marriage?” “What is the normal sexual response pattern for a woman?” “What are some other ways to discipline a child?” Family therapists can also specifically teach new skills, such as how to use the "I-statement" technique, or how to get some kind of relationship change from a spouse. The therapist can also teach the "fight worthy" method.

"Mimisio". Mimisis is a method of structural family therapy. The therapist intentionally imitates and mimics the style of interactions in the family in order to "rally" the family and bring about changes within the family system. This is a specific rallying technique that involves some activity by the therapist to become part of the family system and create a therapeutic unit. The therapist's adjustment to the style and rules of the family leads to the formation of certain relationships, and the family becomes more receptive to intervention from the therapist.

Renaming or restructuring. Renaming is a "verbal review" of the event in order to understand and understand the causes of dysfunctional behavior. Thus, it causes a change in attitudes towards the behavior of other family members. Renaming or restructuring usually produces a more positive side effect than directly labeling a symptom.

Family Gestalt Therapy. Closely related to the "systems" approach, family gestalt therapy is an attempt to influence the problems of individuals, considering them in the context of the family. In accordance with the principles of this therapy, the emphasis is on the present as opposed to the past (only real time is real). Particular importance is attached to the individual taking responsibility for his behavior. Thus, there is a counteraction to the resistance of the family and the desire to blame others. Techniques may include role playing and sculpting. In general, techniques are active, the therapist plays a directive role. One Gestalt family therapist, Walter Kempler, said, “Family therapy requires a lot of active participation by the psychotherapist if he wants to "survive."

In group couples therapy usually 5-7 couples participate. It uses the principles and methods of conventional group psychotherapy. The principles of this approach are the same as when working with an individual married couple, but the important point here is the possibility of learning from a living example, on the model of the relationship of others. The methodology is greatly enriched, since in such conditions it is possible to play out situations by distributing certain roles to clients. At the same time, one can not only talk about the situation, but also directly demonstrate alternative models of behavior; for example, another man will show her husband how he would behave in a particular situation. After reviewing several possible options, the wife can also choose a suitable alternative, which the husband can then lose several times. You can also change roles and try to uncover hidden motives for unsatisfactory behavior.

Group couples therapy allows you to better master various types of communication, for example, learn how to tactfully say things that are not very pleasant to your partner. In addition, it provides an opportunity to correctly assess the results of a constructive quarrel: each couple can experience it for themselves and get an assessment from others. You can learn cooperative agreements together, as well as hear from others (the same clients) their opinion on solving specific problems.

Forms of work with a married couple in a group. Before starting work with the whole group, several sessions of separate work are held with the men and women included in it (two subgroups). Finding contact and unleashing a free discussion is much easier, according to S. Kratochvil, in homogeneous subgroups, but then it is quite difficult to overcome some inhibition when they merge into one group. Some psychotherapists draw attention to the risk of increased defensive reactions in groups where both spouses are present. The dynamically oriented work of a group of married couples implies an atmosphere of communication security, overcoming habitual restrictions, self-stylization and established opinions. All this fails to be seen in groups of married couples, as the spouses in the group continue to maintain their defensive position. A typical "disclosure" of a client is only encountered when his partner begins to make excuses, although usually the client wants to get into groups just so that this information does not come out. Often there are adverse effects of group classes when partners come home together. Contatimically worked out conclusions after a group therapy session can become a source of escalation of family conflict. Therefore, many researchers believe that it is most expedient when conducting sessions of group marital therapy to focus not so much on dynamic group psychotherapy, but on an instructive analysis of issues related to the life of spouses (housekeeping, spending free time, raising children, etc.).

Therefore, the use of dynamic psychotherapy methods, which are common when working with a group, is quite controversial in cases where groups consist of married couples. Behavioral methods of marital therapy, focused on developing the skill of positive communication and the ability to solve problems, are becoming more popular.

Experienced psychotherapists recommend working with a group of 3-5 couples, selecting couples of approximately the same age and with the same educational level. Preference is given to closed (rather than open) groups. The work is carried out by two specialists. The group helps come up with models and situations that spouses can use; individual couples compare their behavior. In the group, various forms of communication and ways of solving problems are played and commented on, marital agreements are developed and compared, and their implementation is monitored.

It is known that the use of a rigid organizational framework during the sessions, married couples learn to clearly articulate their experiences, highlight the main wishes and specify their requirements regarding changes in the partner's behavior.

Experience has shown that group sessions can be a valuable source of information for working with a client in a group; This refers not only to information that allows finding ways to know a partner, but also to information received from him, and, above all, in knowing the client's interaction with him. The practical positive result of such sessions can be the improvement of real forms of communication. A group therapy course typically begins with participants being asked to describe themselves; It doesn't have to start with marital problems. Such group sessions should be more directive than regular group sessions.

Well-known and well-tested methods include topical discussions with couples, recorded dialogue, psycho-gymnastics, and the “date” model. Some techniques for working with couples in a group are described in more detail below.