Present Situation and Problems
On the one hand the present situation is characterized by numerous positive changes in various ways. The public attitude towards psychology has changed. It is no longer “some kind of strange and funny profession,” but an undoubtedly necessary and respected one. This is proved by the number of applicants each year to the specialties of psychology, the popularity of psychological literature, and the willingness of people in other professions to cooperate with psychologists. Of course, these changes greatly facilitate the work of psychologists. On the other hand, clinical psychologists maintain that fear of stigmatization is still too strong; people still hesitate too much before seeking the help of a psychologist.
For clinical psychologists the present situation opens up countless possibilities for learning. Contacts with other countries have become easier; many new professional contacts are being made. Psychologists go to European countries and the USA to study and to gain experience. Specialists in various trends come to Lithuania with lectures and seminars at the invitation of professional organizations and universities.
Vilnius University trains the clinical psychologists of Lithuania. Psychologists who have a master's degree in clinical psychology are allowed to practice and psychologists with a doctorate may teach students.
The postgraduate training of clinical psychologists and psychotherapists is mainly the business of professional associations. In the mid-1990s there are over 10 professional psychologists' organizations in Lithuania, and almost all of them encompass clinical psychologists and psychotherapists. Most of these organizations have already become members of corresponding international organizations.
The Lithuanian Psychotherapeutical Society is a member of the International Federation for Psychotherapy and the European Association of Psychotherapy. Its aim is that our schemes of teaching psychotherapy and our certification procedures should correspond to European requirements.
The Lithuanian Association for Application of Psychoanalysis maintains close contacts with the psychoanalytic associations of other countries. The Finnish Association organized full instruction for six colleagues from Lithuania. At present, in 1997, they have finished the course, received the status of associate members and are beginning to get back to work in Lithuania. Other members of the Association are participating in long-term programs for teaching psychoanalysis which have been worked out together with the Dutch and German psychoanalytic societies.
The field of group analysis, the concern of the Lithuanian Association of Group Psychotherapy also has long-term teaching programs. This association is a member of the International Association of Group Psychotherapy. It not only seeks study opportunities for its members but also organizes training courses in which colleagues both from Lithuania and neighboring countries willingly participate.
The Lithuanian Association for Humanistic Psychology also pays great attention to training, and has gone so far as to found the Institute of Humanistic and Existential Psychology (headed by Dr. R. Kočiūnas). Training courses are also organized by the Lithuanian Association of Hypnosis and the Lithuanian Society of Jungian Analytical Psychology.
Of the professional associations, the Lithuanian Suicidological Association, which is a member of the International Association for Suicide Prevention, is probably the most interdisciplinary, like suicidology itself. The problem of suicides in Lithuania has grown dramatically during the 1990s, and the specialists in this area are the first to be alarmed. They in their turn are trying to draw the attention of both society and of governmental institutions to the problem, to inform the public, conduct investigations, and create suicide prevention programs (Gailienė, 1996).
At present psychologists and psychotherapists work in all Lithuanian mental hospitals and in the psychiatric departments of various clinics and general hospitals. Both professions are practicing psychotherapy. Even though the formal position of the hospitals has not changed—they are all state mental health hospitals—some shifts have taken place in attitudes to patients and their treatment. The inpatient departments of mental hospitals have often introduced the principles of the therapeutic community, and have opened day-patient departments. Treatment is mostly combined medication and psychotherapy. Three mental hospitals already have inpatient psychotherapeutic departments where the main method of treatment is psychotherapy, while medication is used to a minimal extent. Mental hospitals most often apply group psychotherapy, client-centered psychotherapy, psychodynamic therapy, cognitive-behavioral therapy, and Gestalt therapy.
Certainly it would be an exaggeration to speak of an unproblematic integration of psychiatry and clinical psychology. There are problems and tensions enough, but there is also progress.
The Clinical Psychotherapy Center has been opened in Vilnius, offering specifically psychotherapeutic help. The Center includes in-patient departments for adults and children, an outpatient department, a psychotherapy and rehabilitation department for torture victims, and a department for the prevention of mental disorder in adolescents and young people. The Center is subordinated to the health department of Vilnius municipality, but receives patients from the whole republic, for there are practically no such institutions to be found in other cities. The financial situation of the center is rather typical of the present Lithuanian health service which has not yet turned into a health insurance-based system. Psychotherapeutic help here is paid for, but children, adolescents, invalids, and others needing social support receive free help. The prices are established by the Minister of Health, and are low.
Thanks to the work of Dr. K. O. Polukordienė, the Youth Psychological Aid Center (YPAC) has been opened in Vilnius. This is a nonprofit, nongovernmental organization which gives free psychological help to young people. Psychologists and psychotherapists work there, as well as over one hundred specially selected and trained volunteers. The Center provides the “Youth Line,” a voluntary anonymous phone help service from other young people; professional psychological and psychotherapeutic aid; various clubs and groups (e.g., the Stuttering Problems Club), a youth discussion club, an art studio, and so on. The YPAC is a member of the International Federation of Telephonic Emergency Services and maintains close cooperation with Befrienders International, the international volunteer organization of the UK. The Center also assists all the new psychological help services being founded in Lithuania and employs both professionals and volunteers.
As a result of the persistent efforts of the child psychiatrist Dr. D. Pūras, the University Center for Children with Developmental Disorders began in Vilnius in 1991. Children with especially complicated psychosocial problems were, for the first time, treated not only biologically and by means of medication, but also by receiving far wider psychosocial help which was offered to them and their families by clinical psychologists, child psychiatrists, and social workers working as a team. Students of medicine, psychology, and social work are also trained at the Center, and, postgraduate courses are offered to specialists in these fields. The Center cooperates intensively with corresponding institutions in various foreign countries. The Center has created two models of service for children with developmental disorders which are being introduced in all the municipalities. The first is early intervention for children up to four years old with risk factors and for their families. It is carried out by physicians, clinical psychologists, social workers, physiotherapists, and speech therapists working as a team. The second model is that of child psychiatric help which also first involves planning various psychosocial interventions.
Help for alcoholic patients and those with addictive diseases has also broken out of the narrow medical framework. Although the number of institutions providing assistance to these patients is far from sufficient, in those that already exist, psychotherapy and psychosocial interventions are widely applied, and specialists of various professions cooperate.
Clinical psychologists also work in the field of health psychology: they investigate the risk factors for different disorders, organize teaching, write books (Gailenė, Bulotaitė, & Sturlienė, 1996; Lepeškienė, 1996) and edit the magazine Psychology for You (Dr. G. Chomentauskas).
However, qualified psychological and psychotherapeutic help is only available to the population of the few largest cities so far. In smaller settlements it is still lacking. Psychology has been introduced only to a small extent into other spheres of medicine beside psychiatry. This is conditioned by different factors. The economic situation of Lithuania is still rather unsteady. In the health service system even the most elementary needs of the patients are sometimes scarcely answered, so a more sophisticated kind of help, such as psychological aid, seems to be an unaffordable luxury. Moreover, the reform of the health service is proceeding very slowly. As already mentioned, there is no insurance-based medical system. Therefore as yet there is almost no private psychotherapy practice, since in this situation each payable service means that the client pays a double fee: once with his obligatory state taxes, and also when paying for the particular service.
Other acute problems also arise from the economic situation. For example, on account of the extremely poor salaries paid to specialists doing research or academic work, some capable people, especially the young, have to abandon these areas.
Bureaucratic reforms are also taking a long time. The legal status of the specialty of psychotherapy remains problematic. The certifying commission at the ministry decides upon the qualifications of psychologists and psychotherapists, assigning qualification categories according to which the salaries of these workers at governmental institutions are established. Previously this was a prerogative of the certifying commission for neurologists and psychiatrists which was far less competent, for that matter, than the present one. But probably in the future the task of certification of specialists will be taken over by professional organizations. For example, a licensing commission has already been formed at the Lithuanian Society of Psychologists which is working upon the licensing regulations for practicing psychologists.
Briefly speaking, the present situation of Lithuanian clinical psychology is more or less hopeful. One can expect that as the general situation of the country normalizes, the position of clinical psychology will improve as well, since the need for psychological help in this society is very great indeed.
Yalom's Perspective of Existential Therapy Essay
1094 Words5 Pages
Yalom's Perspective of Existential Therapy
Existential therapy through the eyes of Dr. Yalom is very fascinating. There is never a fixed life that each person is supposed to live. In his therapy the clients are allowed to find out for themselves what it is they need by receiving adequate questioning from Dr. Yalom. His questioning guides them down the existential path to freedom and responsibility. "If we affirm life and live in the present as fully as possible, however, we will not be obsessed with the end of life"(Corey p.153). This is the way of thinking for the existential theorist when it comes to patients who deal with death anxiety. Dr. Yalom dealt with this issue when he did a study on bereavement. He put an ad in the…show more content…
She told him that she never actually let herself believe that her daughter was going to die, even though it was as plain as day. And because of that, she never dealt with the real issues with her daughter. After several meetings Penny was finally able to see her own life and how this guilt she had was causing problems for the rest of the family. She had two sons. After finding out that neither of them lived at home, Dr. Yalom asked how Penny felt about it. This opened up doors for Penny and allowed her to take responsibility for the things in life that she could control. In the end, she had a good understanding of death and therefore was able to live life more fully by getting both kids back into the home and rejoining the family. Freedom and responsibility go hand in hand. We are put in certain situations that we have no control over, but we also have a choice in that situation as to what direction we are going to go. The ability to make that choice is freedom and going in the right direction, the one that benefits humanity and us is the responsible choice. This topic brings us to the chapter Fat Lady. In this chapter Dr. Yalom treats a woman by the name of Betty. This woman walked into his office for the first time weighing 250 lbs. She was not only overweight, but she was very depressed as well. This was a hard case for Dr. Yalom because he had never