The Role Of The Psychologist In The System Of Rehabilitation Of Chemically Dependent And The Main Urgent Problems Arising In The Course Of His Work

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Video: The Role Of The Psychologist In The System Of Rehabilitation Of Chemically Dependent And The Main Urgent Problems Arising In The Course Of His Work

Video: The Role Of The Psychologist In The System Of Rehabilitation Of Chemically Dependent And The Main Urgent Problems Arising In The Course Of His Work
Video: Dr. Katherine Wright | Rehabilitation Psychologist 2024, March
The Role Of The Psychologist In The System Of Rehabilitation Of Chemically Dependent And The Main Urgent Problems Arising In The Course Of His Work
The Role Of The Psychologist In The System Of Rehabilitation Of Chemically Dependent And The Main Urgent Problems Arising In The Course Of His Work
Anonim

1) The problem of determining the spheres of the psychologist's activity. The problem of motivation. Supervision problem.

1. In the rehabilitation center "Megapolis-Medekspress", the process of therapy for chemically dependent people is carried out using the "12 steps" program, defined by Professor V. V. Voronovich as a synthesis of the Philosophy of Narcotics Anonymous and the achievements of modern psychotherapy. We regard drug addiction as a fatal, progressive and incurable disease. It has 4 aspects: biological, mental, social and spiritual. This approach coincides with the approach to the study of man, which defines the Leningrad psychological school, namely its founder B. G. BG Ananiev argued the need for an integrated approach to the study of man, considering it also in 4 aspects: an individual, a subject of activity, personality, individuality. He also emphasized the continuity, mutual influence and interdependence of these aspects.

Historically, 12 Step treatment programs have been closely associated with recovery from heavy drinking and alcoholism. This connection is quite logical. Since the inception of the 12 Step program (1935), over 1,000,000 people have recovered through their participation in Alcoholics Anonymous (AA). In addition, research confirms that simultaneously, at any arbitrary time point, more than 100,000 men and women worldwide participate in the AA program (AA World Service Inc., 1986).

However, neither the 12 Step philosophy nor its procedures are specifically related to alcohol. A. A. has evolved many similar recovery programs that are effective for other addictions and emotional problems. Apparently, there is sufficient reason to believe that dependence has at least two aspects.

• One of them is associated with biological processes that arise as a reaction to chronic intoxication, and can be designated as abuse itself.

• The second, mainly psychological aspect, is expressed by specific features inherent in any addictive behavior. It is on the psychological-social-spiritual component of addiction that the complex of influences is oriented, built and designated as the 12 Steps recovery program.

Procedurally, virtually any situation can be resolved positively, using the appropriate lesson or lessons from more than 65 years of experience in honing and improving the philosophy of 12 Steps. In fact, these steps provide a gradual, evolutionary approach to recovering from chemical addiction. The steps are organized in a certain order: from the most important, main, basic, towards further changes that a person, motivated to recover, goes through and integrates into the process of his life. In fact, the 12 Step program, being at first a therapy program, becomes a rehabilitation program, and later the spiritual foundation of life. The experiences of other people who resist their addiction offer a certain perspective to the person seeking recovery. This helps addicts get rid of unwanted options for psychological protection, see their addiction (as well as other psychological problems) in the light of reality and realize the damage caused by the disease, both to themselves and to the people they care about.

This approach also requires addicts to acknowledge the existence of a Higher Power and a willingness to believe in it, guided at least by the fact that such a method of action has proven its usefulness in achieving a healthy lifestyle (Galanter). It is very important to remember that despite the frequent mention of God or a Higher Power, the 12 Steps is not a religious program. This is a spiritual program. The difference is that unlike any religious system that refers to the concept of deity, in the 12 Step Program God participates implicitly - “as we understand Him”. The program assumes that each participant can, if he wants, find support in God. What exactly this image will be, what concrete it can be embodied in is a purely personal matter. Moreover, even the concept of "God" can be replaced by the concept of "Higher Power", i.e. "The power is more powerful than our own." Thus, we are talking about certain psychological parameters of the personality, certain gnostic structures, similar to the one that in psychology is called the super-ego, the presence of which in human nature does not cause doubts even among inveterate materialists.

These considerations are essential, since among our patients there are many who are quite hostile or, at least, negatively related to attempts to involve them in religious practice. It is important to be able to explain that the 12 Step Program does not aim to make the addicted patient an adherent of any religion, Church, or denomination. Although there are no objections to such a decision, if it is made by the patient, the Program also does not contain. This is a matter of purely personal choice. The Program only points to the experience of many participants and emphasizes that many, having converted to faith, received the opportunity to significantly improve their lives and free themselves from chemical addiction.

2. Today we meet with constant conflicts between different therapeutic approaches and schools, both in psychotherapy in particular, and in chemistry therapy. dependence in general. Sometimes this is due to the ambitions of their representatives, sometimes an attempt to prove the need to obtain financial support from the state or one or another sponsor. In our opinion, such phenomena not only do not help the cause, but also discredit psychotherapy and spiritual practices, which are already sufficiently discredited in Russia. And this despite the fact that the need for psychotherapeutic help, as well as for a spiritual basis, support, we have today is quite high. The way out of this situation, in our opinion, is the desire to focus on a common task for all approaches - the sobriety and recovery of our patients, and not on differences in approaches or attempts to prove that this or that is a panacea.

The 12 Step Program is an integral part of recovery for most addicts

Experience shows that therapy and rehabilitation take a very long time, measured in years. At the same time, during the first 5-6 years, the risk of relapse remains extremely high, and in fact, a breakdown (relapse) in this disease is more a rule than just an annoying complication of the recovery process. Thus, to ensure sustained abstinence and relatively successful functioning

addicted subject, it is necessary to organize long-term supportive therapy. Thanks to participation in self-help groups, it is carried out quite adequately, effectively, and most importantly, affordable from an economic point of view, since visiting such groups is free (the only condition for membership in NA is the desire to quit drug use).

Many personality disorders of patients can be eliminated or compensated for only in the course of long-term psychotherapeutic work. This counseling model cannot claim such a result, although it is quite possible that this weakness can be compensated for by the patient's long-term participation in the self-help group (s). Thanks to the long-term support of the group and his own efforts to master the practice of the 12 Steps, the patient can achieve the same results as with prolonged psychoanalytic work.

And the last circumstance, especially important for those who practice in the countries of the former USSR. Understandably, the self-help group movement did not develop until recently. The first AA groups appeared in Russia in 1987, and in Ukraine in 1989. At about the same time they appeared in Latvia, Lithuania, Belarus. The AA movement began to develop quite actively, but still today the number of self-help groups in the CIS countries is incomparable with the countries of America or Western Europe. Unfortunately, not all, even large cities, have at least one self-help group, such as AA or NA.

The proposed model of psychological counseling loses its effectiveness to a large extent if it is not supported by anti-relapse supportive therapy. Therefore, turning to consultants, psychologists, psychotherapists interested in the development of therapeutic and rehabilitation programs for chemically addicted, we want to emphasize: there is, in our opinion, a lot of sense in being active and trying to organize such a group in your city. This sometimes requires significant efforts, but they pay off later, because it is possible to create an integral therapeutic cycle, thanks to which patients remain in the treatment program for a long time and, accordingly, the effectiveness of the therapeutic work is significantly increased.

3. The main urgent problems arising in the process of the work of a psychologist in the rehabilitation system of chemically dependent:

1) The main directions of the fields of activity of the psychologist.

- individual work on motivation at the initial stage of recovery

- work to unite a group of patients

- work with parents

- psychodiagnostics of states, personality traits of the patient.

And these areas are much more important than a deep analysis of the personality in the 1st year of sobriety, which is sometimes simply dangerous to engage in during this period of recovery of chemically dependent people. At the same time, it is important to emphasize that any psychodiagnostics should be preceded by careful motivation, the basis of the success of which is an understanding of the specialist himself, why he is conducting this or that research, and not neglect the preliminary establishment of personal contact with the subject. All tests, methods should be aimed primarily at enabling the program participant to identify with signs that correspond to the concept of the disease, to enable self-examination, to create an adequate, not low self-esteem, and only in this case can we talk about their sufficient validity and reliability, and therefore efficiency in terms of recovery.

And in conclusion, I would like to wish to remember to all specialists working in this field that our value is determined not by how much and whom we were able to investigate, convict of sin, force to take our point of view, but rather by how much we were able to adopt a different view to the world and to life, as far as we were able to accept the other as he is, whether he is a representative of another psychological school, philosophy, religion, or just a drug addict.

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