Head of the Department of Personality Psychology of the Faculty of Psychology of St. Petersburg State University, President of the St. Petersburg Psychological Society, Doctor of Psychology, Professor Svetlana Nikolaevna Kostromina made a presentation “I am a psychologist! Are you a psychologist! Normative regulation of psychological assistance in Russia” at a meeting of the series of meetings of the scientific section “Psychological counseling” of SPbPO.
The problem of normative regulation in the field of activity of a psychologist, in my opinion, is connected, among other things, with the fact that the profession of a psychologist has become a mass profession. Today we are approaching the ratio of a psychologist to a general practitioner as 1 to 4. The number of psychologists, of course, is not comparable to the pedagogical community, which is approaching 1,5 million professionals, but it shows that the psychologist is no longer a piece profession
According to data for 2018, even before the pandemic, according to the most conservative estimates, about 40000 psychologists worked in the psychological services market. Of these, a significant number worked in the public sector: most of all in the field of education, there were 16141 psychologists, in health care — 9500 specialists, in the Ministry of Defense — about 2000. These are quite large numbers, but even in 2018 these specialists did not cover the existing need , which at that time was about 44000 psychologists. For comparison, there are almost three times as many psychologists in the United States.
At the same time, state structures reflect only a part of the psychological services market. There is also a private practice, which is almost impossible to count. On the other hand, it is possible to fix the need for personnel; in 2018, in most regions, half of the vacancies were not filled. In small towns and rural areas, psychological assistance is generally difficult to access. Even before the pandemic, public opinion polls showed that there were not enough psychologists. Those. it is difficult to find not just a good psychologist, but a psychologist in principle.
The pandemic has made its own adjustments, putting psychological help on a par with medical care in terms of demand. According to online resources aggregating supply and demand for various services and goods, the growth in requests during the pandemic was 69%. And in 2020, compared to 2019, it increased by another 89%. In the fall of 2021, the growth in requests compared to the spring of 2021 amounted to 32%. Moscow, St. Petersburg, the Urals, and Siberia became the leaders in terms of applications.
The growing demand for psychological help does not go unanswered. According to the Avito-Services aggregator, the growth in offers of psychological services compared to the fall of 2020 amounted to 65%. At the same time, according to the resource, the share of professional psychologists in these proposals is less than 50%. Professional psychologists are people with a basic psychological education. When it comes to private psychologists, there were no more than 10%. Of course, this data must be considered from the perspective of who places their offers and where. But when people are looking for information, including using Internet resources that post offers of psychological help, the presence of “specialists” who do not have a psychological education or who consider themselves psychologists, but who are not, cannot but disturb the professional community.
This aspect entails a new problem: where to find a good psychologist?
In this case, I am not saying that a psychologist with a basic education is necessarily better than a psychologist without a basic education. But psychological education entails the understanding that the knowledge system is based on evidence-based practice. And this evidence-based practice, although it is not a guarantee of high-quality psychological assistance, gives hope that the damage will be much less. In a situation of mass training of psychologists, which sometimes implies additional education to the already existing non-psychological (for example, legal or economic), the lack of uniform requirements for the profession, the content of the activity that is opaque to the population, but at the same time the high demand and our understanding of responsibility for the quality of assistance provided draws the attention of the professional community to the development of mechanisms for the regulatory regulation of psychological assistance.
I would say that all the regulation of psychological assistance that exists at the moment, and the regulation that we have been trying to build for the past 15 years, has three main goals: professionalism, accessibility, transparency.
We would like professionals to work in the market of psychological services (who would guarantee the quality of psychological assistance) and that this assistance be accessible. Accessibility implies not only a sufficient number of specialists, but also the creation of certain registries: i.e. people receive objective information about who they turn to and what psychological services they could receive. And the third important point is transparency, so that it is clear what, how, to whom and by whom it turns out. To prevent the mythologization of the process of providing psychological assistance.
Based on the existing regulatory framework, there are two grounds that allow a person to be called a psychologist.
Firstly, the concept of «psychologist» can be considered as a qualification assigned when acquiring education in the relevant profession. For example, in the diploma of a graduate in the program «clinical psychology» will be written «clinical psychologist». There is a question with bachelors and masters who are awarded the qualification «Master of Psychology» or «Bachelor of Psychology». However, despite this name, which emphasizes the level of psychological education, it also says that their training is assessed as a psychological qualification.
Secondly, the concept of «psychologist» can be considered as a position, as a unit in the staff list: what functions does the employer give to a person hired for a particular position. The position of a psychologist implies the performance of labor functions that are associated with the provision of psychological assistance or psychological services.
People often ask: how does psychological and pedagogical education differ from psychological education? It differs in that the qualification «teacher-psychologist», and not «psychologist» is awarded. Those. according to the requirements of psychological education, such a specialist is not a psychologist. But when hiring, an employer can hire any person with a higher education as a psychologist. Including a teacher-psychologist. Or a person with a higher education who has retrained in advanced training courses in the field of psychology.
Why is this happening? Professional and educational standards are two separate areas of regulation.
The educational standard regulates the training of future specialists, and the professional standard regulates the work of a specialist in specific positions. At the moment, there are only two professional standards at the level of federal legislation: a psychologist in the social sphere and a psychologist in education. Although, in principle, there can be as many professional standards as you like. We can create professional standards both for areas of activity (health care, the Ministry of Emergencies, the Ministry of Internal Affairs, etc.), and for each type of activity. At the same time, drafts of a professional standard for a clinical psychologist and a counseling psychologist are being developed. But neither one nor the other has yet been accepted, so we cannot rely on them when applying for a job.
What to do when there are no requirements for a position at the level of a professional standard? Our colleagues in different departments get out of this situation by creating their own regulatory local acts. Those. The Ministry of Education and Science or the Ministry of Education issues local regulations on how a psychologist works in the field of education. True, there is a professional standard «psychologist in education.» Therefore, when developing their regulatory documents, they, among other things, are guided by it. The documents developed by the ministry say what functions a psychologist should perform in this area, what services to provide, how long his working day takes, what kind of interaction he has with the administration of institutions. The same regulations are, for example, psychologists in the Ministry of Emergency Situations. In this area, the activities of psychologists are regulated in their own way. The situation is similar in healthcare. There are regulatory documents of the Ministry of Health regarding who a clinical psychologist is and what functions he has.
It is clear that since these are different departments, then the requirements for psychologists are different. These requirements sometimes conflict with each other. For example, everyone is well aware, especially clinical psychologists, that a psychologist is not involved in psychotherapeutic assistance, because, according to the normative regulation, only doctors, psychotherapists, are engaged in psychotherapy in the healthcare sector. Therefore, a psychologist can conduct diagnostics, counseling, but not psychotherapy. But this is a departmental order. Therefore, it applies only to the health sector. This means that if, as a psychologist, I work in the field of the Ministry of Emergency Situations, or in the field of education, or in the social field, or in private practice, then I can engage in psychotherapeutic practice. There is no federal ban on psychologists practicing psychotherapy. It is only in departmental regulations of the Ministry of Health.
A separate problem is created by the conjugation of educational and professional standards, as well as departmental regulations.
I said that the educational standard assigns a certain qualification. For example, in psychological education — the qualification «psychologist». In psychological and pedagogical education, this can be a “teacher-psychologist”. But psychologists hire specialists with both educations. However, the situation may change at any time. For example, if a decision is made on the requirement for the education of employees who occupy the positions of psychologists in a certain department.
10 years ago we saw such a situation in the healthcare sector. When specialists who worked for a long time, some for 10–15 years or more, were forced to quit or go to get a basic psychological education at the next certification, because before that they did not have it. When they were hired 20 or 25 years ago, they didn’t need a college degree in psychology or clinical psychology. It was enough to have only retraining in the field of clinical psychology.
Now there is a clear law in the healthcare sector: a person with a clinical psychologist education or a retraining in the field of clinical psychology can work at the rate of a medical psychologist, but before that he must have a diploma in psychology.
Another important point that exists in our state. This is the certification process. It is also planned to introduce an accreditation procedure.
The appraisal procedure requires the practitioner to periodically reaffirm his or her qualifications, i.e. their level of preparation. Also, this procedure is used so that an employee of a state institution can move to the next category: from the first to the highest, for example.
A special commission has been set up under the St. Petersburg Education Committee to certify psychologists in the field of education. The Health Committee has its own commission that certifies medical psychologists. As you understand, the requirements for certification of psychologists in different departments are also different. This interdepartmental disunity, on the one hand, takes into account the specifics of the work of a psychologist in a particular area, and on the other hand, blurs the general rules and requirements for the provision of psychological assistance, although the types of psychological activities are the same: psychological diagnostics, examination, counseling, etc.
But this year, the Ministry of Health has already issued a regulatory document that we should soon prepare for accreditation procedures for non-medical professionals working in the health sector.
How is the accreditation procedure different from the attestation procedure? The accreditation procedure will involve admission to the profession. This means that if a young specialist has received a diploma in clinical psychology, in order to be “allowed into the profession”, accepted for a position, he must pass a qualifying exam — i.e. go through the accreditation process.
It hasn’t happened yet, but it’s moving towards it. Now we are preparing to develop special tasks, including test ones. And to the need to bring the state final exam closer to the requirements of the accreditation procedure, so that the transition from education to a profession is minimally laborious. So that it doesn’t happen that at first we teach one thing, and at the accreditation procedure they ask another.
At the same time, work continues on the development of new professional standards. For example, a draft professional standard for «consultant psychologist» is currently being developed. The professional psychological community, and our Moscow colleagues, and St. Petersburg State University, are against the adoption of this professional standard. Not because the professional standard of a counseling psychologist is not needed. And in connection with the requirements for education that it contains.
Let’s look at the required skill level — it is indicated as level 6 I.e. A person with a bachelor’s degree can work as a consultant psychologist. (Although in all existing professional standards — a psychologist in the field of education and a psychologist in the social sphere, as well as in the draft professional standard for a medical psychologist — the requirement for a qualification level is 7, i.e. a master’s degree or a specialist.) Further, the requirements for education psychologist-consultant — just a higher education, not even a specialized one. And to it — additional professional education under the program of professional retraining in the field of psychological counseling. It turns out that any person with a higher education can work as a consultant psychologist for this project. Enough to retrain in psychology. The professional psychological community, which is responsible for its activities, the psychological health and safety of citizens, cannot agree with such requirements.
Such a project was prepared by our colleagues from the All-Russian Professional Psychotherapeutic League, who promote the idea that any person with a higher education can engage in psychological counseling. Therefore, today one of the main tasks facing the professional community is either to prepare alternative professional standards or work on a federal law on psychological assistance, which will contain uniform requirements for psychologists both in terms of education level and functionality.
I come to my final part, which concerns specifically the federal law, the general regulation of the activities of psychologists.
First of all, we would like these three principles: professionalism, accessibility, transparency, not to be regulated within the framework of separate normative acts of departments, so that psychological practice would be recorded as a special type of activity.
In Russia, there is the All-Russian Classification of Economic Activities (OKVED), which does not yet provide for psychological activity. This means that all psychological activities that go beyond state institutions and official duties are not regulated at all.
The idea of the federal law is to cover both private practice and state work in the field of psychological assistance. So that regulation is based on the same basic psychological principles.
The current project, which was developed jointly by Moscow State University and St. Petersburg State University with the participation of psychologists and universities in other cities, was developed precisely for this purpose. It has passed legal expertise and is of a framework nature. But most importantly, it contains fundamental articles.
For example, an article about who a psychologist is… The rights and obligations of persons receiving psychological assistance… An article related to psychological secrecy, designed to protect both clients and psychologists who work, for example, in law enforcement agencies or in educational institutions. In these areas, it can be difficult for a psychologist to follow the ethical principles of work, to resolve ethical dilemmas. Often, the administration or parents, due to the fact that the psychologist works with minors, require disclosure of the contents of the consultation.
The proposed bill also regulates the types of psychological assistance and forms of psychological assistance.
We would like a definition of what psychological assistance is to be fixed at the federal level.
Psychological assistance is a qualified professional activity carried out in the provision of assistance in the forms and types provided for by this Federal Law, in the course of psychological examination, as well as for scientific, educational and other purposes, by persons who meet the requirements of this Federal Law.