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are drawn on in an eclectic fashion by many different types of counse-
lors and therapists.
5. Family and group therapy
Family therapy
has proven effective in treating a number of emo-
tional and adjustment problems. While the client’s immediate complaint
is the initial focus of attention, the ultimate goal of family therapy
is to
improve the interaction between all family members and enhance com-
munication and coping skills on a longterm basis (although therapy itself
need not cover an extended time period).
Group therapy
,
which is often
combined with individual therapy, offers the support and companionship
of other people experiencing the same problems and issues. Therapy is
finished when the treatment goals have been met or if the client and/or
therapist conclude that it isn’t working. It can be effective to phase out
treatment by gradually reducing the frequency of therapy sessions. Even
after
regular therapy has ended, the client may return for periodic fol-
low-up and reassessment sessions.
6. The pedagogical psychotherapy used by doctors
The goal of therapy, from the perspective of doctor’s influence on
patient’s self-consciousness, is the improvement of patient’s ability for
self-management and mental self-regulation in order to actively counte-
ract the illness.
Doctor should be by all means a psychologist because this will
allow him to understand better the character and patient's individual
reactions. Doctor should also be a teacher
who possess didactic skills
because some aspects of the psychohygiene demand this quality.
Pedagogical psychotherapy (individual or collective)
can be succes-
sfully applied in any medical establishment, and it will help solve the
following problems:
–
Decrease of patients’ level of ignorance.
–
Decrease of the intensity of alarm feelings (like anger, guilt, sha-
me, depression).
–
Substantiation and suggestion of an optimistic medical prospect.
–
Social involvement of the ill person.
During the sessions of pedagogical psychotherapy, mutual encoura-
gement or so-called "psychotherapeutic mirror", experiences sharing and
empathy are stimulated.
145
In order to be successful in the field of medical pedagogics, psy-
chohygiene, psychoprophylaxis and psychotherapy it is necessary to
develop some
professionally important qualities
:
–
To be generous, indulgent and remain calm when there is a need
to repeat something several times (education implies a lot of repetition).
–
To take the position of an assistant, to avoid instructive tone, to
remember and carry out a rule: "Help, do not humiliate".
–
To be always punctual and strong-willed. The will is shaped
through overcoming of difficulties and consequently it is necessary to
learn from difficulties and obstacles, not to avoid them, but to meet and
overcome.
–
To be kind, to be able to forgive patients’ tactlessness.
–
To improve oneself: the knowledge, the personal qualities, inde-
fatigably to search for new, more effective strategies for work.
–
To share the experience with colleagues. To be able to listen, to
develop in oneself not only the art of speech, but also the "art of
silence".
A basis for
good resistibility to illness, according to N.I. Rejnval-
da's (1978), are the properties of the organism, the nervous system. The
active vital position and, accordingly, intensive counteraction of illness,
as a rule, are based on the account of interests of a society.
Patients, for whom appreciable social interests are characteristic,
actively cooperate with the doctor during treatment. The major
precondition for successful treatment is the development of conscious
motivation for active overcoming of illness.
When talking about the relation "patient-illness" it is necessary to
take into account the influence
of psychogenic factors, the emotional
condition of the patient, the disscusions between patients, the possible
complications, the character of treatment, the forecast, etc. The estima-
tion of illness is influenced by contact with seriously ill patients, by the
information gathered from the conversations
with acquaintances and
family, or with the personnel. Quite often patients interpret tendentious-
ly "cases from practice" - from educational films and magazines like
"Health". Negative influences come from hospital conditions, isolation
from habitual social medium and ceasing of work activities.
Carrying out correction of the patient’s "concept" of illness, the
doctor discusses with him the results of his inspections, convinces him,
that the underlying
causes
of illness aren’t the
organic changes, helps the
146
patient to catch the connection between emotional factors and sympto-
matology. During this period the doctor gives the patient the correspon-
ding information and acts as an expert.
Mutual relations with the patient go deep; the doctor becomes the
assistant of the patient during his hard work in his private world.
At the final stage, the doctor strengthens the
activity again and even
direct it towards testing and fastening of the new ways of experience and
behaviour by the patient.
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