When facing visitors, psychological counselors should first make psychological diagnosis, and then do psychological consultation.
? Psychological diagnosis is divided into five parts:
? 1. What's the problem?
First of all, we should ask visitors what problems they have encountered. All visitors with psychological problems come for what they do, but we can't directly answer what they do. There are two ways to ask questions, direct coercion and indirect interrogation. Indirect inquiry includes open inquiry (open inquiry technology means that there is no hypothetical answer to the question raised by the consultant, and the helper can't simply answer it in one or two sentences to collect as much relevant information as possible. Simply put, you can't answer directly with yes orno. If the other person talks a lot, you can use open-ended questions. Closed-ended inquiry (refers to the question raised by the consultant, with hypothetical answers, and the answer of the helper does not need to be expanded, so that the consultant can clarify some questions. If a person doesn't talk much, he can ask in a closed way.
Semi-open and semi-closed inquiry (to confirm whether the other party has bad habits), and direct coercion cannot be used in consultation.
? Second, the seriousness.
Judging from the course of disease, the degree of mental pain and the degree of social function damage.
? Course of disease: short course within 3 months, with a score of 1. Three months to one year is the middle grade, with a score of 2 points. More than one year is a different place, 3 points.
? Degree of mental pain: mild to 1 I can try to get rid of it; You can't get rid of yourself, you need help from others, or you can only get rid of it if the situation changes, which is a medium score of 2 points; I can hardly get rid of myself, even if others comfort and enlighten me, accompany him for entertainment or practice in different places, it will not help. The score for severe mental distress is 3.
? Impaired social function: those with slightly impaired social function have only slightly affected work, study and interpersonal communication, with a score of1; Moderate dysfunction, the efficiency of work, study or interpersonal communication decreased obviously, and they had to reduce their work or change their jobs, or they could only work partially or had to avoid it as much as possible in some social occasions, 2 points; People with severe dysfunction can't work and study, have to take sick leave or drop out of school, or completely avoid some necessary social contacts, 3 points.
? If the total score is 3, it can't be diagnosed as neurosis. The total score is not less than 6 points, which can establish the diagnosis of neurosis, and 4 ~ 5 points are suspicious cases, which need further observation and diagnosis. What needs to be added is that the assessment of mental distress and social function should consider at least the situation in the past three months, and the time involved in the assessment is too short and unreliable.
? Third, the reason
From the physical, psychological and social factors. Physiology refers to gender, age, body, disease, etc. The psychological level is cognition, that is, understanding, how to treat the past, future and present; Social factors include life events, interpersonal relationships, living environment, moral customs and so on.
Three factors: root cause, inducement and maintenance reason.
Prime factor: an unchangeable factor.
Change the maintenance factor among the three factors, and things will change.
? Fourth, psychological measurement.
Intelligence test, personality test, psychological and behavioral problem assessment, stress and related issues.
? Fifth, make a clear diagnosis.
First, judge whether the state of the helper is dead or alive. If the helper lives in the past for depression, it is remorse for the past, and living in the future for anxiety, it is panic for the future. The state of "past" and "future" is "dead", which leads to his "living" becoming a living state in "present". The "living" can respond to real stimuli and interact.
? Consultants must first ensure that they deal with "living" people. When you are sure that you are a "living" person, then judge whether your mind is normal.
? The distinction between psychological normality and psychological abnormality in nature judgment includes normative distinction and psychological distinction principle.
1. The standardization is divided according to Li Xintian's four standards (199 1):
1. Medical standard: Mental disorder is a physical disease. The reason comes down to brain dysfunction.
2. Statistical standard: determined according to the degree of deviation from the average. Whether the people asking for help are the same as most people.
3. Introspective experience standard: introspective experience of patients and introspective experience of observers.
4. Social adaptation criteria: whether the help-seekers meet social norms.
Second, the distinction principle of psychology Guo Nianfeng's three principles
1, the principle of unity of subjective world and objective world
Any normal psychological activity or behavior must be consistent with the objective environment in form and content.
2. The principle of internal coordination of psychological activities.
Knowledge, emotion and other parts are coordinated.
3. The principle of relative stability of personality.
If one does not conform, it is an abnormal state.
If people are in a normal state, then judge mental health and unhealthy from the degree.
First, Xu Youxin (1988) three criteria for evaluating mental health.
1, the experience standard refers to an individual's subjective experience and inner world, mainly including whether he has a good mood and proper self-evaluation.
2. The operating standard is to examine the process and effect of psychological activities through observation, experiments and tests, and its core is efficiency, which mainly includes personal psychological activity efficiency and personal social efficiency or social function. For example, the efficiency of work and study, the harmony of interpersonal relationships and so on.
3. The development standard focuses on the longitudinal investigation and analysis of individual psychological development.
When measuring mental health, we should link these three standards and make a comprehensive investigation.
Second, the ten criteria of mental health level are the ten criteria for evaluating mental health in Introduction to Clinical Psychology by Guo Nianfeng 1986.
1, psychological activity intensity; 2. Mental activity tolerance; 3. Periodic rhythm; 4. Consciousness level; 5. suggestive; 6. Rehabilitation ability; 7. Psychological self-control; 8. Self-confidence; 9. socializing; 10, environmental adaptability.
? Reasoning for mentally healthy people only mentally healthy people can understand the truth (directly); People who are psychologically unhealthy can only use psychological strategies to deal with it (conversely), changing declarative sentences into interrogative sentences; For people with psychological abnormalities, follow the trend; In the face of "dead" people, don't say anything (no matter what he says, he won't refute, so we don't say anything). It is our task to judge whether the helper is a person or a ghost.
? Psychological counseling after diagnosis is also divided into five aspects.
? First, build relationships.
The relationship is water. Putting ethanol into water is wine. No matter how much you spend on expensive wine, you mainly buy water. Putting acetic acid in water is vinegar, and the more expensive vinegar water is the main one; Putting psychological theoretical knowledge into relationships is psychological counseling. Help-seekers spend so much money on relationships, and relationships are the most important. Whether they can do it well depends on two factors, namely, help seekers and consultants. The five elements (attitude) of a counselor: respect, enthusiasm, sincerity, affection and active concern; Seven elements of seeking help: consulting motivation, cooperative attitude, expectation, understanding, self-cognition, behavior, response to consultants, etc.
? Second, make plans.
In other words, the agreement of negotiation objectives is very important, which determines the future evaluation. Seven elements of the goal: belonging to the category of psychology, positive, concrete or quantitative, feasible, evaluable, acceptable to both sides and unified at multiple levels.
? Third, the implementation plan
Learn to mobilize the enthusiasm of help seekers and support and encourage them through inspiration and guidance; Overcome the obstacles of psychological counseling.
Technology when implementing the scheme:
1. Participatory technology: Learn to use participatory technology to clarify problems, inspire and guide help-seekers to explore and practice themselves, and finally achieve the consulting goal and promote the growth and development of help-seekers. (Consultants participate, and help seekers are the main ones. Skills include listening, asking questions, encouraging, repeating, content response, emotional response, concretization, participatory overview and understanding and mastering nonverbal behavior.
2. Influential technology intervenes with visitors to help them solve their psychological problems and promote the realization of counseling goals.
Technology includes aspects, explanation, guidance, emotional expression, content expression, self-opening, influential overview and the use of nonverbal behavior.
3. Control the content and interview direction. Skills include explanation, interruption, emotional reflection and guidance.
Fourth, the effect evaluation
Six dimensions of evaluation: self-evaluation)； of the counseling effect by the help-seekers; The recovery of the social function of the parties (social function); People around the helper, especially family members, friends and colleagues' comments on the helper (other comments); Comparison of psychometric results before and after consultation (psychometric); Observation and evaluation of consultants (teacher evaluation); The improvement degree of some symptoms of help seekers (symptom improvement degree).
? V follow-up
After 3~6 months of psychological counseling, at the end of counseling and several years later, the curative effect should be evaluated to explain the short-term and long-term curative effect of psychological counseling.