Principles of psychotherapy. Basic principles of psychotherapy
Rendering psychological assistance has its own characteristics. The main one is that the client (patient) has complete trust in the psychotherapist. To establish open and secure relationships between them, a system for organizing psychotherapeutic interaction has been developed, based on the following principles:
1. Confidentiality. No client would like to have their personal problems discussed strangers, especially when we're talking about about intimate aspects of relationships and being. In addition, it is possible that the information received may be abused by persons who received it by accident or who acquired it on purpose. A professional psychotherapist never discloses the names of his clients anywhere. Even in his own notes, he must use abbreviations or pseudonyms that make identification impossible. When giving examples in lectures or articles, you should also adhere to this principle. Professional associations and associations exclude from their membership psychotherapists who violated it,
2. Zinc-free. A person who seeks help should not be perceived as intellectually limited, defective or sick, or treated with prejudice. After all, psychotherapeutic assistance is a service that a specialist provides for money, and the client is a person who does not have certain mental self-regulation skills. Most clients fear that openness to the therapist will inevitably lead to a devaluation of their personality and show their weakness. The anxiety and feelings of guilt that accompany contacting a psychotherapist, although irrational in nature, do not diminish from this. Therefore, at the first meeting, the therapist has to assure the visitor of his complete non-criticism. Among the clients there are evil, cruel, depraved people who also need help, and their negative qualities- a consequence of personal problems and troubles. The psychotherapist does not blame, evaluate or judge - he helps.
3. Empathy. This ability can be considered both as a basic installation and as a professional required quality therapist. Empathy- the ability to feel and experience the feelings and states of another, emotional understanding, cognitive decentering. It is one of the most important skills in psychotherapy. Without empathic understanding, it is difficult to implement an existential-humanistic approach or Dasein analysis; it plays an important role in Gestalt therapy and Rogerianism.
4. Attention, kindness and patience. These settings are characterized as general attitude therapist to the client, and the emotional coloring of his behavior during psychotherapeutic interaction.
Basic therapeutic guidelines form the code of ethics of a psychotherapist. compliance with them not only makes it easier for the patient to communicate with stranger(psychotherapist) in difficult life situation, but also serves as a guarantee of a professional attitude towards personal problems, asked for help.
Personality of the psychotherapist
The problem of a psychotherapist’s personality can be approached from two positions: to describe the requirements for such a specialist or to analyze personal qualities famous psychotherapists based on their works or the memories of colleagues. From them arise the ascetic 3. Freud, the hedonist F. Perls, the hermit philosopher K. Jung, the shocking J. Lacan, the merry fellow J. Haley, the prim M. Klein, the master of paradoxes M. Erikson. However, the second approach would lead to many contradictions - too different personalities there were classics of this science.
Among the requirements for a therapist, an important one is authenticity(Greek Authentikos - real) - the ability to be yourself, not to change your true essence, taking into account the situation. A true specialist must be so confident in himself that he does not resort to manipulation, cunning self-presentation strategies, and does not create the effect of an all-powerful sage. He is always authentic and sincere, real and frank, because these are the qualities that his clients lack. It is impossible to teach others what you cannot do yourself, because clients always notice the therapist’s weaknesses. And lost trust undermines professional reputation.
The required quality is congruence (Latin congruentia - correspondence) - the ability to correctly and accurately respond to the client’s words and actions, to “reflect” his aspirations and intentions. It is expressed in the ability to pose precise questions, not to rush and keep up with interpretations, to support the client in a timely manner or, conversely, to enter into confrontation with actions and thoughts. This trait is based on empathy and tolerance. Basically, it is congruence that determines the first impression of the therapist and influences the client’s decision about whether to deal with him.
An important role in professional activity speech skills play a role. According to Russian psychologist Alexander Bondarenko, the effectiveness of a psychotherapist’s speech is ensured by: clarity, eloquence, semantic richness, personal interest, rhythm, and influence.
Emotionally unstable, neurotic clients hope to achieve balance and harmony through therapy. Therefore, the psychotherapist must be harmonious personality. This applies to appearance, clothing, movements, communication style, and the interior of the office where he carries out therapy.
The therapist should adhere to a classic style of clothing and not overuse cosmetics, jewelry and household gadgets. The design of the office should indicate the reliability, self-confidence and professionalism of the specialist who works there. There should be extra things on the table, especially personal ones (photos of loved ones, souvenirs with inscriptions, etc.). Some hang awards and diplomas on the walls - this is bad form.
If the therapist has a computer on his desk, the area in which he speaks with clients should be separated. It is unacceptable to have a conversation when there is a monitor or laptop between the analyst and the patient; These devices can only be turned on when the session is over and the client has left the office. Voice recording of sessions occurs by mutual consent.
It is advisable to have hourglass for 55 minutes (this is the classic session duration proposed by Z. Freud), but he must stand in front of the analyst, and the patient can look at him only after finishing. You can also use regular Wall Clock, placed according to the same principle.
The age of the psychotherapist also plays a significant role: such a specialist cannot be young. Clients do not perceive even very successful and efficient young men and women in this role if they are under thirty. Ordinary people believe that only after forty years a person has sufficient experience to help others.
However, age should not be a barrier to work. In the West, the standards for professional training of a psychotherapist provide for training and internship for 10-15 years - which means that a specialist begins to work independently at 30-32 years old. Domestic young specialists can begin their activities with training work, work in social services or with teenagers, lead groups personal development, gradually gaining experience.
So, an exemplary psychotherapist is a calm, balanced middle-aged (or older) specialist who has a thorough vocational training, adheres ethical principles psychotherapy. Such a person is characterized by truthfulness, authenticity and inner harmony. She dresses classically, carries herself with gravity, has a fluent command of the language, and gives an impression of intellectual respectability.
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Treatment of neuroses
The pathogenetic method is psychotherapy aimed at resolving the neurotic conflict; drug therapy is auxiliary and symptomatic.
"Psychotherapy" ( psyche– soul and therapy– care, care, treatment) - “soul healing” or “soul healing.” The term “psychotherapy” was introduced in 1872.
Psychotherapy– directional system psychological impact on the individual, and through the psyche - on the entire organism and behavior. The impact may be verbal And non-verbal. Therapeutic effect psychotherapy is achieved by information and the emotional charge it carries.
The main models of psychotherapy are medical And psychological.
In the medical model psychotherapy is divided into general And special
General psychotherapy– a method that every doctor should know; it does not require special training. It includes:
1. Organization of a protective regime of a medical institution, creation of a psychotherapeutic atmosphere (medical institution starts with the registry or reception area; silence, smells, cleanliness, aesthetic design; differentiated care of patients according to their condition, a separate recreation area; conditions for meetings with relatives, walks; holding leisure evenings, cinemas, concerts, etc.).
2. Individual approach to the patient, taking into account his personal characteristics (Find contact, win over, create trusting relationships, instill confidence in recovery, form an adequate attitude towards the disease).
3. Prevention of iatrogenic (watch your gestures, facial expressions, words; carefully provide information about the disease, its causes and prognosis).
4. Training in personal psychohygienic regime (work and rest schedule - active, gentle, number of hours for sleep, watching TV, computer, etc.; diet, psychohygienic aspects of marital relationships).
Special psychotherapy- a method of treatment, therefore it is carried out by a doctor with special training in the field of psychotherapy. Separate medical specialty along with psychiatry and narcology.
Subject of influence – psychopathological symptoms and syndromes (usually borderline), painful personality anomalies.
Target– relief of painful manifestations.
Psychological model psychotherapy - area of activity practical psychologist . It does not require mandatory medical education. In this case, psychotherapy should be understood as “providing psychological assistance healthy people(to clients) in situations various kinds psychological difficulties, as well as in case of need to improve the quality of one’s own life.”
Psychotherapy is used both independently and in combination with other treatment methods.
Indications for psychotherapy:
neuroses, reactive states, psychopathy
· sexual disorders
· psycho somatic diseases
· somatic diseases (correction of incorrect personality reactions to illness)
· drug addiction diseases
· psychoses during remission or sluggish course
Contraindications to psychotherapy: acute psychosis.
Psychotherapy methods are varied. The choice of method is determined by: 1) Personal characteristics patient; 2) Psychological mechanisms of the disease; 3) Type of disease and stage of its course.
The methods used are largely determined by the paradigm in which the psychotherapist works. You can select 3 main directions , which are based on various theoretical ideas about personality and its mechanisms.
1. Psychoanalytic (psychodynamic) direction.
The cause of neurosis is the conflict between the demands of the subconscious and social prohibitions (Id ß àSuperego). A symptom of neurosis is the result of repressing forbidden desires - sexual, aggressive.
The goal of psychotherapy is awareness of the unconscious conflict (insight), which leads to the elimination of the symptom due to the release of tension (catharsis). The main representative is psychoanalysis.
2. Behavioral (behaviorist) direction.
From the perspective of this approach, personality is behavior. A symptom of neurosis is maladaptive behavior. No pathological behavior - no neurosis. In this sense behavioral psychotherapy is symptomatic. The causes of maladaptive behavior are incorrect learning. To cure neurosis means to retrain the patient, to teach adaptive forms behavior. This is achieved by positive reinforcement of desired behavior and negative reinforcement of unwanted behavior. Methods flood/immersion, systematic desensitization, paradoxical intention, functional training, (operant conditioning in children).
Psychological correction – This is a directed psychological impact on certain psychological structures in order to ensure the full development and functioning of the individual.
There are several points of view on the relationship between the concepts of “psychological correction” and “psychotherapy”. One of them is to recognize the complete identity of these two concepts, but this does not take into account that psychological correction, as a targeted psychological impact, is implemented not only in medicine. In medicine, two main areas of its application can be identified: psychoprophylaxis And psychotherapy. Another point of view is based on the fact that psychological correction is designed to solve the problems of psychoprophylaxis at all its stages. However, limiting the scope of psychological correction is not correct. For example, in the field of neuroses, it is quite difficult to completely separate the concepts of “mental correction” and “psychotherapy”, “treatment” and “prevention”, since neurosis is a disease in dynamics, where it is not always possible to separate the pre-illness state from the disease itself, and the treatment process itself largely includes secondary prevention. Currently in rehabilitation treatment system various diseases, an integrated approach is being implemented more widely, taking into account the presence in the etiopathogenesis biological, psychological and social factors, each of which requires therapeutic or corrective effects f corresponding to his nature.
If, say, a psychological factor in a particular disease acts as one of the etiological ones, then its correction largely coincides with the content of psychotherapy. The importance of the psychological factor in the etiopathogenesis of a particular disease determines the focus of psychological correction methods on solving the actual psychotherapeutic problems.
The objectives of psychological correction can vary from focus on secondary and tertiary prevention underlying disease and primary prevention possible as its consequences of secondary neurotic disorders in somatic pathology to their almost complete identity with the tasks of psychotherapy for neuroses. For example, within the framework of various person-oriented systems of psychotherapy.
It must be emphasized that both psychotherapy and psychoprophylaxis do not limit their practice only to methods of psychological correction, which indicates the multi-level, dynamic nature of the relationship between tasks and methods of psychological correction, psychotherapy and psychoprophylaxis, which intersect.
Psychotherapy includes a differentiated and sensitive approach to the patient, the influence of the regime, but most importantly - a set of measures aimed at influencing the word - logotherapy.
Psychotherapy – This is a complex therapeutic verbal and non-verbal effect on a person’s emotions, judgments, and self-awareness in many mental, nervous and psychosomatic diseases.
The history of psychotherapy goes back centuries - to ancient Egypt, India, Greece. Systematic study of the phenomena of suggestion and hypnosis began at the end of the 18th century.
In general, psychotherapy is considered as the doctor’s involvement of all possibilities of therapeutic influence on the patient, influencing through his emotional reactions, using intellectual capabilities and conditioned reflex connections with the primary and secondary signal meaning. In every therapeutic effects There must also be a psychotherapeutic component.
But psychotherapy also exists as an independent method of treatment. In some diseases it plays a decisive role. For example. In the Ebers medical papyrus (16th century BC), along with 900 recipes for healing potions and potions, the words of spells are given that must be pronounced when applying medicine to sick members. The Viennese physician A. Mesmer tried to scientifically explain mental treatment methods at the end of the 18th century. He explained the mental impact by the action of a “magnetic fluid” - a special liquid, as if spilled in the universe and having the ability to be transmitted from one person to another.
The development of psychotherapy as a scientifically based method begins in the 19th century and is associated with the names of V. A. Manassein, S. P. Botkin, G. A Zakharyin, S. S. Korsakov, Levenfeld, Moebius, who expressed an opinion on the possibility of mental influences in treatment various diseases. Subsequently, psychotherapy developed in close dependence on the study of hypnosis. Hypnosis is a Greek word meaning sleep. This name was proposed by the English surgeon James Brad in 1843 and became firmly established in medical practice.
At this time, psychotherapy is not a uniquely understood area of scientific knowledge and practical approaches, but represents their combination and partially interaction. Psychotherapy is distinguished by various psychological, medical, anthropological, socioeconomic, environmental and philosophical attitudes and is extremely wide range applications.
The term “psychotherapy” was first introduced at the end of the 19th century. Tuke in his book Illustrations of the Influence of the Mind on the Body, published in 1872. The term “psychotherapy” became commonly used only in the 90s. XIX century in connection with the development of hypnosis techniques.
Psychotherapy, considered as a part of medicine, claims to cover the costs of treating patients through health authorities and health insurance companies. The result of this understanding of psychotherapy in modern German-language literature has been a frequently used definition: “Psychotherapy is the interaction between one or more patients and one or more psychotherapists (who have undergone appropriate training and training) for the purpose of treating behavioral disorders or painful conditions (mainly of a psychosocial nature) by psychological means. (including through communication, both verbal and non-verbal) using techniques available to patients, with a very specific purpose and based on the theory of normal and abnormal behavior.” In English literature this term also has medical significance. This concept is used to designate methods of treatment that do not use the techniques of psychoanalysis and differ from psychoanalytic methods of therapy by refusing to attempt to study the deeper layers of the patient’s psyche. And for psychotherapy using techniques and methods of working with the deep layers of the psyche, the term is used "psychoanalysis".
The term “psychotherapy” has not become a purely medical concept. Psychotherapists who are not doctors by education or occupation put forward a different philosophical and psychological model of psychotherapy. This model is based on the primary meaning of the word – “healing by the soul.” The main goal of this approach is not a cure for mental disorders, but assistance in the process of formation of consciousness and personality, in which the psychotherapist appears as the patient’s companion, friend, mentor. The conditions necessary for the successful work of a psychotherapist are not so much the presence of a special (medical) education, but rather a non-judgmental attitude towards the patient and acceptance of him as he is, compassion and empathy for him, as well as sincerity and honesty of behavior. The consequence of this understanding of psychotherapy is the spread of its methods in various fields in pedagogy, social work, practical psychology, etc.
This is evidenced by the content of the Declaration on Psychotherapy, adopted by the European Association of Psychotherapy in Strasbourg on October 21, 1990. According to this declaration: 1) psychotherapy is a special discipline from the field of humanities, the practice of which is a free and independent profession; 2) psychotherapeutic education requires a high level of theoretical and clinical preparedness; 3) a variety of psychotherapeutic methods is guaranteed; 4) education in the field of one of the psychotherapeutic methods should be carried out integrally; it includes theory, personal therapeutic experience and supervised practice, while gaining a broad understanding of other methods; 5) access to such education is possible subject to extensive preliminary training, in particular in the field of humanities and social sciences.
Psychotherapy differs from other treatment methods in at least three features: 1) when it is carried out, psychological means of personality change are used, associated with the use of the fundamentals of psychology (as opposed to those used in medicine, pharmacology, pedagogy, sociology and jurisprudence); 2) these means and methods are used professionally, that is, by trained specialists and personnel who act consciously and purposefully, who are able to scientifically substantiate their actions, reproduce them during psychotherapy with various patients and evaluate them; 3) with the help of psychotherapy, people suffering from mental disorders are treated.
Psychotherapeutic treatment is specific, it is based on psychological methods of influencing clinical phenomena and partly suffering and therefore becomes a point of intersection of a number of fields of knowledge: medicine, psychology, sociology, pedagogy, etc.
We can say that there is an expansion of psychotherapy into the non-clinical environment (readaptation and rehabilitation after a stay in a medical institution, rooms for socio-psychological assistance, family relations, etc.).
It must be said that given the diversity of concepts, approaches, methods, organizational models, sociocultural phenomena, we can talk about the existence of psychotherapy in three main spheres of public consciousness:
1) academic, which involves the development of scientifically based approaches based on the scientific worldview;
2) alternative, which is based on various historically determined esoteric teachings and religious systems;
3) intuitive, which is the result of the influence of the first two on the everyday consciousness of the majority of society and is expressed in the phenomena of psychological culture, in relation to the existing practice of providing psychotherapeutic assistance, in public opinion, as well as in the practice of everyday psychotherapy and assistance in solving psychological difficulties.
With the modern level of development of medicine and the widespread use of psychotherapy in somatic clinics, the principle of integration of psychotherapeutic, psychological, sociotherapeutic and biological influences in the patient’s treatment system becomes decisive.
The leading trends in the development of psychotherapy fully reflect the general scientific content of the concept of integration. On the one hand, this is a tendency towards the separation of psychotherapy into an independent field of medicine, primarily from psychiatry, on the other – integrative trends, the active use in its development of not only medical, but also psychological, pedagogical and other sciences, as well as the integration in medical practice of various psychotherapeutic directions, approaches, methods and techniques.
Taking into account the main factors of psychotherapy outside its specific directions and forms, we can distinguish emerging models of integrative psychotherapy: humanistic, instrumental-interactional and instrumental-technical (Tashlykov V. A., 1992). In the humanistic model of integrative psychotherapy, the decisive factor in its effectiveness can be recognized empathic communication between psychotherapist and patient. In the instrumental-interactional model, preference is given not to technical techniques, but to the use of the psychotherapist-patient relationship as a therapeutic tool, however, the psychotherapist takes a more active position and takes on a certain share of responsibility and initiative. The instrumental-technical model of integrative type psychotherapy, in comparison with the previous one, is characterized by a further increase in the activity of the psychotherapist in the relationship with the patient, a more structured process of psychotherapy. This model emphasizes the use of a variety of techniques and methods. In this case, alternative forms of treatment are discussed with the patient, the goals of psychotherapy and its methods, treatment plan, duration and expected results of therapy are agreed upon.
V. E. Rozhnov (1983) divided psychotherapy into general and private, or special.
General psychotherapy is understood as the entire complex of mental factors influencing a patient of any profile in order to increase his strength in the fight against the disease.
General psychotherapy includes a complex of mental influences on the patient, aimed at increasing his strength in the fight against the disease, at creating a protective and restorative regime that excludes mental trauma and iatrogenicity.
In this case, psychotherapy is an auxiliary tool that creates a general background against which other types of treatment are applied.
Special, or private, psychotherapy is used in the clinic for diseases in which mental treatment methods come first and constitute the main treatment used by the doctor.
For this purpose, various psychotherapy techniques are used. B. D. Karvasarsky divides psychotherapy into: 1) methods of personality-oriented psychotherapy; 2) methods of suggestive psychotherapy; 3) methods of behavioral (conditioned reflex) psychotherapy.
It is common to view psychotherapy as symptom-oriented and person-oriented. The first is traditionally referred to hypnotherapy, autogenic training, various types of suggestion and self-hypnosis etc. Psychotherapy, focused on significant personal changes, is based on the main trends of modern psychology, and accordingly they are allocated dynamic, behavioral and humanistic directions.
At this time in Russia there is an increasing integration of psychotherapy into healthcare, the main systems for providing psychotherapeutic assistance are being developed, which provides for the development of three main forms of organizing psychotherapeutic services: 1) a psychotherapeutic office, 2) a psychotherapeutic department; 3) psychotherapeutic center.
The choice of a specific method of psychotherapy, the setting and implementation of psychotherapeutic goals and objectives in the case of its medical model are determined by the mutual influence of specific clinical indicators of the patient and the disease, the characteristics of his personality and other psychological characteristics, as well as the level of socio-psychological adaptation of the patient, and the structural and organizational form of psychotherapy .
An option for conducting psychotherapy and related advisory and diagnostic activities for visiting patients or at home without hospitalization.
In the conditions of the staged form of organization of the psychotherapeutic service, outpatient psychotherapy is mainly carried out in psychotherapy rooms of outpatient treatment and preventive institutions as a general profile (territorial clinics, medical units of large industrial enterprises), and specialized (psychoneurological dispensaries, territorial psychotherapy centers). Another form of organizing outpatient psychotherapy is semi-stationary psychotherapeutic departments, organized at territorial psychoneurological dispensaries, mental health centers, and psychotherapy centers. Outside of territorial psychotherapeutic services, outpatient psychotherapy is carried out in the offices of private practicing doctors, medical cooperatives and diagnostic and treatment institutions of non-municipal (non-state) forms of ownership.
The peculiarity of the psychotherapeutic specialty involves conducting psychotherapy specifically in outpatient setting. Therefore, unlike other medical specialties, outpatient psychotherapeutic care is the main option.
The advantages of outpatient psychotherapy compared to inpatient psychotherapy are: maintaining the existing level of social adaptation, changing the system of relationships within actually existing relationships and relationships with the social environment, the absence of the phenomena of hospitalism, especially likely in neuroses due to the adaptive nature of clinical manifestations and the tendencies to restrictive behavior in patients. behavior, accessibility and proximity to people.
Inpatient treatment is provided for patients with chronic and severe forms of neuroses, complicated by organic pathology of the central nervous system and somatic diseases, or such patients whose social environment represents a constant source of decompensation and such severe emotional stress that outpatient psychotherapy is impossible.
Rehabilitation of a patient is often a complex process that requires a lot of willpower from both the doctor and the patient. Often it is the patient’s psychogenic reaction to a defect that causes greater disability than the defect itself. Not every patient can easily come to terms with a defect, get used to it, or find ways to compensate for themselves. During the Great Patriotic Wars and other wars one could see how strong natures, through an effort of will, overcame significant defects. The description of such facts is reflected even in fiction.
To successfully work with patients, it is necessary to use all types of mental influence: books, magazines, movies, psychotherapeutic conversations, but always take into account the patient’s capabilities, his interests, intellectual level and life attitude.
Improving the provision of psychotherapeutic care is expected to be based on the development of special medical technologies that, using a flexible management structure and coordination, will significantly improve the quality of psychotherapeutic services and overcome the fragmentation and disintegration inherent in the organization of psychotherapy in institutions and doctors providing psychotherapeutic assistance. However, the latter's systems require well-trained specialists.
In 1995, the Federal Center for Psychotherapy of the Ministry of Health developed requirements for an educational standard that defines the minimum terms for established types of training and supervision, with a transition in the education system of psychotherapists from predominantly informational training to more advanced forms: skill-based training; training in the clinical application of psychotherapy; training that takes into account the individual characteristics of the psychotherapist.
The activities of Russian psychotherapists almost fully include all methods and approaches known in world psychotherapy. An important success in the field of psychotherapy was the introduction in the late 90s. the last century of teaching psychotherapy and medical psychology in medical universities, the movement towards improving psychotherapy through the use of team forms of work in the provision of psychotherapeutic assistance with the participation of a psychiatrist, psychotherapist, and medical psychologist.
The use of psychotherapy for a wide range of disorders is generally accepted.
First of all, this concerns neurotic conditions and other borderline disorders of psychogenic etiology, some forms of psychosomatic disorders, maladaptation reactions, and crisis conditions.
Psychotherapy is also used in patients with personality disorders, mental disorders at the stages of drug remission, with alcohol and other forms of addiction. Although psychotherapy is used for a wide range of diseases, it acquires etiopathogenetic significance mainly when psychogenies, the occurrence and course of which is determined by mental (psychological) factors. In this group of diseases, psychotherapy can act as the only treatment method or be included in a comprehensive treatment system.
With regard to the prescription of psychotherapy, it is customary to talk about three levels of its implementation: 1) professional psychotherapy is carried out by a psychotherapist, who is the attending physician and independently manages the patient; 2) psychotherapy as an auxiliary method can be carried out either by a professional psychotherapist or by a specialist; 3) psychotherapy in general medical practice is carried out by all doctors, which makes it possible to implement a biopsychosocial approach in medicine.
A clear definition of the level of psychotherapy contributes to the reasonable formulation of its goals and objectives, while both underestimation and overestimation of the capabilities of psychotherapy negatively affect the effectiveness of treatment and the image of the psychotherapist and psychotherapeutic service.
A common distinction is between “major” and “minor” psychotherapy. The first includes the methods of psychoanalysis and schools close to it, the second includes rational psychotherapy(conversations with the patient), as well as methods based on the suggestion of relaxation.
Depending on the conditions in which psychotherapy is carried out and the medical training of the psychotherapist, a distinction is made between psychotherapy carried out by a medical specialist and psychotherapy carried out by a family doctor and a general internist.
A distinction is made between psychotherapy carried out on an outpatient basis and psychotherapy carried out in a hospital setting (the latter presupposes characteristic treatment conditions and the use of certain methods of influence). In practice, the difference between group and individual psychotherapy is also important, since each of them is associated with certain prerequisites
regarding indications, training of the psychotherapist and technique of conducting sessions.
None of the existing methods is the best, different methods pursue different goals and are applicable not to all patients, but to certain groups of patients. Their choice depends on the psychotherapist - on his personality, level of training and theoretical orientation.