Psychological consultation: "Master" is on the way
China News Weekly reporter/Du Wei
Published in the 988th issue of China News Weekly on March 22, 2020
Liu Qian is a preparatory consultant for the Internet platform One Psychology.
In July 2018, she started to attend the Master's Program of Development and Educational Psychology of the Institute of Psychology of the Chinese Academy of Sciences. She will finish in March 2020, and will take the National Examination of the same academic level in November. Now she is contacting her tutor.
The equivalent academic ability course seminar is a form of continuing education. After completing the course, you can take the equivalent academic ability national exam and thesis defense to have the opportunity to obtain a master's degree. The equivalent academic ability national exam is a unified national exam.
However, it is more difficult for Liu Qian to find a mentor than students who receive academic education and training.
She has to search on the official website of the Institute of Psychology of the Chinese Academy of Sciences, and send emails to the teachers on the page to introduce herself and ask if the teachers are willing to accept it.
So far, she has only contacted a tutor whose research direction does not match her professional direction.
In the past few years, she has participated in numerous psychological counseling training courses.
She does not deny the growth model through attending training courses, but she also admitted that if there is a more systematic learning and growth path for psychological counselors, it will be a better choice.
The development of China's psychological counseling industry is still in its infancy, and this industry has embarked on a standardized academic education path in foreign countries and Taiwan, China.
Qiao Zhihong, secretary of the Party Committee of the Department of Psychology of Beijing Normal University, told China News Weekly that if you want to become a psychological counselor in the United States, you must have at least two to three years of master’s education and training in psychological counseling. If you want to become a higher-level psychotherapist, After completing a doctorate degree and working full-time for one or two years, you can take another examination for a practicing license.
In Germany, if you want to be a psychotherapist, after graduating from university psychology students, you will have to receive a total of 4,200 hours of full-time training for three years.
It is precisely because of the serious shortage of academic education that psychological counseling training has a huge domestic market, and there is no corresponding access standard, the development of China's psychological counseling industry is in chaos and chaos.
In China, or on the way to China
After 1949, under the influence of Soviet academic circles, Western psychological counseling and treatment have been left out in China. At that time, Pavlov's theory of advanced neurological activity types prevailed in China.
After graduating from Shanghai Second Medical University in 1988, Zhang Haiyin became a psychiatrist at the Shanghai Mental Health Center.
He recalled that in the 1980s, there was no systematic training in psychotherapy in China. If you wanted to learn treatment techniques, you could only read books by yourself or listen to some sporadic lectures, and then rely on your own understanding and enthusiasm to give patients. Do treatment.
The university, another provider of psychotherapy skills, also failed to play a corresponding role.
Qiu Jianying is the director of the Psychological Counseling Department of the Shanghai Jingwei Center and the chairman of the Psychoanalysis Professional Committee of the Chinese Mental Health Association. She graduated from the Department of Psychology, East China Normal University, one of the earliest departments of psychology in China around the 1990s. She admitted that at that time the university China also rarely teaches clinical psychology, and more skills come from internships or practice at work.
Due to the almost barrenness of domestic psychotherapy, since 1988, Ma Jiali, a German scholar who studied in the Department of Psychology at Peking University, and Wan Wenpeng, a professor at the Yunnan Mental Hospital, introduced a team of top German psychotherapists and held seminars in Kunming, Qingdao and other places. Three "Sino-German Psychotherapy Workshop".
In 1997, the two sides also launched a continuous training program for Sino-German psychotherapists, which is the famous "Sino-German Class" in the industry.
The Sino-German program lasts for three years. The classes are held twice a year, and each intensive training is about 5 days. It is divided into three groups: psychoanalysis, cognitive behavior, and family therapy. It was a rare standardized training system from Europe at that time. .
There were about 130 students in the first period of Chinese-Durban, and Zhang Haiyin was the first class student.
Many leading figures in the field of psychological counseling and therapy have been born in the "China-Derban" class, which is known as the "Whampoa Military Academy" in the field of psychological counseling and therapy in China.
Qiu Jianying, who was once a student of the second "Chinese-German class" and is now the Chinese chief of the "Chinese-German class", said that the establishment of the "Chinese-German class" directly promoted the clinical practice of psychotherapy in China, and even for university talents. Cultivation has an impact.
After the "China-Germany class", "China-Norway class", "China-U.S. class", "Sino-French class" and so on have been opened.
In the nearly two decades since the National Psychological Counselor Vocational Qualification Examination was launched in 2002, various trainings have emerged one after another.
In contrast, domestic psychotherapy and counseling talents delivered through academic education have been insufficient.
Qiao Zhihong explained that this is because clinical and counseling psychology, as a tertiary subject under the secondary discipline of applied psychology, has very few teachers and cultivates more academic talents.
At present, there are about 100 institutions in universities across the country that have a master's degree in applied psychology, but only about half of them offer psychological counseling.
With the exception of Beijing Normal University, these colleges and universities train only two to three hundred psychological counseling talents each year. That is to say, the national academic education provides less than 500 psychological counseling talents each year, and the scale is very small.
At the other end, the employment situation of graduates in this direction is not optimistic.
Take psychotherapy as an example. In hospitals, psychotherapists only belong to the series of technician titles, not the series of physicians.
As psychotherapy is "talk therapy", there are no consumables and drug additions, so it is not to be seen.
There is no government department to purchase services, and there are few psychotherapy or counseling posts in the community.
From both ends of supply and demand, the motivation for cultivating psychological talents is insufficient.
The lack of academic education has made psychological counseling training, which should have been a "supporting role", become the main mode for entrants to receive education in China.
Qiu Jianying said that compared with the limited and transparent training market abroad, China's psychological counseling market is huge.
Back then, most of the faculty members of the "Chinese-Derman class" came to China with low pay and a charity spirit. Nowadays, foreign experts are coming for huge commercial interests.
These experts claimed to be sacred, "either already in China, or on the way to China". They cooperated with training institutions and started classes as soon as the admission notice was issued. The quality of the teachers varied.
On a public account called "China-Australia Gestalt CAGA", a 6-day course of 18,000 yuan taught by "Gestalt Master" Steve Wiener was repeatedly pushed.
Gestalt therapy, also known as Gestalt therapy, is one of the main schools of western modern psychology.
The public account’s introduction to Steve Wiener reads "The world’s top master in Gestalt psychology, the chairman of the China-Australia Gestalt Association, has persisted in meditation and meditation for more than 40 years and has been vegetarian, and 60,000+ hours of case consultation hours..." Lin Fang is a psychologist from a professional class on a certain platform. She told China News Weekly that Steve Wiener is not the best expert in this genre, and his training fees in other countries are also lower than in China. "And the country is like making gods."
Qiao Zhihong said that the development of psychological counseling in China is basically driven by the training of various genres. "Domestic bigwigs mostly receive short-term training from various genres, resulting in the domestic characteristics of focusing on genres." Everyone is easy to be caught. Kidnapped by the commercial interests of the training, there are a group of masters who claim to be in the genre.
An expert from the Chinese Mental Health Association, who did not want to be named, said that there are more than 2,000 psychological counseling schools and techniques in the world, and most of them have found a living ground in China, and even local schools have emerged, but these therapies are actually similar. .
A therapy called "NLP (Mind Body Linguistic Programming)" emerged in the United States in the 1970s and was later introduced to China. However, the core concept of this therapy-cognitive leading behavior, is actually the most basic consensus in psychology.
At the end of the last century, Beijing Forestry University professor Zhu Jianjun’s "image dialogue" therapy was actually born on the basis of psychoanalysis and "NLP therapy" and inspired by Chinese Confucianism, Buddhism, and Taoism.
"The direction of this subject has been developing vigorously in recent years, but in fact, no teachers can be found. Experts give lectures everywhere, and instead of doing case analysis and research, they have weakened the professional accumulation", presenting a false prosperity.
The aforementioned expert, who did not wish to be named, said.
In an interview with China News Weekly, Lin Chun, vice chairman of the Psychological Counselor Working Committee of the Chinese Psychological Association, referred to the talents cultivated by the academy as "vertical entry" and social enthusiasts as "horizontal entry".
Due to the insufficient supply of "vertical entry" talents, in his view, the training of psychological counseling talents in China will still be a combination of horizontal and vertical for a long time to come, but it will eventually move towards academic education.
Anomie and ethics
If the training system is not standardized and complete, the cost of the growth of the counselor will be passed on to the visitor.
Compared with overseas, the psychological consultation market in mainland China charges higher fees.
In Taiwan, because the market is mature, senior consultants who have been in the business for more than 20 years, each charge is only equivalent to the charge of mainland newcomers, about four to five hundred yuan.
Psychological consultants who work in China for one to two thousand hours can charge 700 to 800 yuan, while the maximum charge abroad is not more than 600 yuan.
"Part of the reason why the mainland is expensive is the growth cost of consultants and the higher cost of acquiring visitors," said Li Songwei, a psychologist.
Before Liu Qian planned to do psychological counseling, she had an internship at a psychological counseling institution called Jingshi Psychology for nearly a year to help the counselor conduct initial interviews.
But every time she had a pre-consultation, the agency asked her to guide the visitor to place an order. In the end, she had no choice but to leave the agency.
Psychological counseling is a kind of "talk therapy" that "does not sell the course of treatment". According to the regulations, a fee is charged for each consultation.
But Lin Fang has encountered some visitors, and they all have the experience of being prepaid 10 or 30 consultation fees by other consultants at a time.
When the visitor thinks that the consultation is invalid, the consultant will obstruct it in every possible way.
Qiu Jianying said that for visitors with severe mental illness, the psychologist should send them to a psychiatrist for diagnosis and treatment, or cooperate with a psychiatrist for treatment.
But as far as she knows, some counselors cannot identify symptoms, and some even stay with prospective visitors for the benefit of the patient, delaying the patient's treatment, causing the patient to commit suicide and other irreversible consequences.
In order to regulate the price and frequency, in Europe and the United States and other countries, psychotherapy and consultation will be included in the insurance payment.
"The charges are high, and the insurance company disagrees, and the charges are low. The entire consulting industry cannot survive, so it will find the most reasonable price." Qiao Zhihong said that because of insurance, individuals pay very little for psychological counseling abroad. "One time is possible. Just one or twenty dollars".
In the United States, because insurance payment emphasizes effectiveness, the efficacy of various schools will be evaluated.
Cognitive Behavioral Therapy (CBT) has become the most mainstream method in the insurance coverage genre due to its relatively fixed operating procedures, easy to use scientific paradigm research, the most sufficient clinical evidence and short duration of treatment.
In Germany, the theories, empirical research evidence, and curative effects of various schools must be evaluated by the German Psychotherapy Scientific Committee and the Social Security Committee before they will be included in the treatment items paid by the national health insurance. Currently, psychoanalysis and CBT are included. .
Zhang Haiyin said that in some areas of China, medical insurance is available for psychological treatment or consultation in hospitals.
Take Shanghai as an example. All medical institutions include psychological treatment and consultation in the scope of medical insurance payment. The cost of a treatment is more than 100 yuan, and medical insurance can pay part of it. However, there is no assessment of which genre can be included in medical insurance payment, and there is no assessment of visits. The limit on the number of times the person can use the medical insurance payment.
Qiu Jianying said that because of the limited medical resources, the hospital usually adopts short-term treatment for the visitors. If the visitors want a longer and in-depth experience, they often need to choose a social psychological counseling agency at their own expense.
As far as visitors are concerned, there is often a huge information mismatch in terms of what genre of treatment and consultation and how long it takes to receive.
"Many consultants do not have a plan for the consultation, nor do they regularly check whether the target is achieved, and just keep doing it. If the visitor has any objections, the consultant will say that we will discuss it again next time." Lin Fang said, for example, Cognitive-behavioral therapy generally can be completed more than ten times, while some post-modern therapies may be able to see some effects five or six times.
Simple Psychology data from an anonymous random sampling of paying visitors in 2019 shows that about 29% of the visitors will have 5-20 psychological consultations, and 23% of the visitors will have more than 20 medium and long-term consultations.
Zhang Haiyin emphasized, "We can't expect to use the consultant to make the visitor fully recover. The visitor can live the life first. With the accumulation of life experience and various insights, one day when there is a sudden touch, there will be a qualitative leap." Zhang Haiyin said that the counselor must understand the client without being over-satisfied with the other party.
Xiao Li is an intern consultant at Simple Psychology.
In her observation, many visitors received psychological counseling for one or two years. The counselor did not talk about the core issues, but only provided a good relationship.
The consultant is the only person in the world who is willing to respect the client and talk to him. “Sometimes it is not how effective the consultation is, but the relationship between the client and the consultant is enough to make the client willing to continue to invest”.
In reality, there are also instances where the visitor over-relied on the counselor, or was induced by the counselor, so that the two parties had a relationship outside of the consultation or even a sexual relationship that broke ethics.
At present, the "Three Associations and One Institute" of the Institute of Psychology of the Chinese Academy of Sciences, the Chinese Psychological Association, the Chinese Mental Health Association, and the Chinese Social Psychological Association have jointly launched the "Development of Standards for Evaluation of Psychological Counselors' Professional Levels". It is expected that the standards will be released this summer.
According to this standard, it is possible to carry out the national joint examination of the professional level evaluation of psychological counselors in the next two years, and issue the certificate of "Three Associations and One Institute" to regulate the admission of psychological counselors.
The Chinese Psychological Association is planning to launch the "Psychological Counselor Registration and Registration System", which will find out the existing 1.5 million people who have obtained the qualification certificate of psychological counselors, and evaluate and register competent counselors.
(In the text, Liu Qian, Lin Fang, and Xiao Li are pseudonyms, reference material "My Road to Psychotherapy")
China News Weekly, Issue 10, 2021
Statement: The publication of the "China News Weekly" manuscript is authorized in writing