我国心理咨询与心理治疗发展现状、问题与对策

Counseling and Psychotherapy in China: Current Status and Future Strategies

心理咨询与心理治疗作为"大健康"的重要工作部分,有助于维护和改善国民心理健康水平,减轻疾病负担,促进家庭和谐,构建良好社会氛围。我国的心理咨询与治疗始于20世纪80年代,主要在医疗系统、教育系统、社会机构这3种模式中发展。近10余年来,对应着我国国民心理健康需求的大幅增长,我国心理咨询与治疗的工作队伍规模快速扩大,初步呈现职业化趋势,一些专业标准与服务模式逐步形成。但在工作队伍的快速扩大中,出现了工作人员良莠不齐,专业工作水平参差不一的乱象。究其原因,在于对心理咨询与治疗工作的专业性认识不足,导致对这一高度专业化的工作规范化不足。具体包括:对工作伦理与标准流程的重视不足;对基础训练与实践技能的重视不足;对疗法疗效的科学研究重视不足;对专业工作的评估反馈机制重视不足等。为了应对我国未来继续发展的国民心理健康服务需求,文章提出了未来心理咨询与治疗发展的建议:(1)针对重点人群示范推广规范的工作方式;(2)在研究与实践中加强疗效评估;(3)完善并推行规范的专业教育培训;(4)借助互联网技术,促进优质资源支援落后地区。在规范发展心理咨询与心理治疗的基础上,将我国心理健康服务的各环节有机结合,提高国民心理健康水平。

Counseling and psychotherapy, as an important part of the service for holistic health, help to improve people＇s mental health status, decrease the burden of disease, increase the quality of family life, and build up positive social environment. Beginning from the 1980 s, counseling and psychotherapy in China have been developing mainly in medical system, educational system, and social institute. In recent decade or two, the need for mental health service increased dramatically, and the number of counselors and other mental health practitioners multiplied accordingly, taking the course to professionalization. A few professional standards and working pattern developed progressively. However, the rapid increasing of counselors and other mental health practitioners also bring about problems such as unqualified professionals and spotty mental health service. Part of the reason lies in wrong knowledge of counseling and psychotherapy. As a highly professional work, counseling and psychotherapy must be based on qualified professionals and strict professional standards. An analysis of present situation shows that the counseling and psychotherapy are in lack of development in several areas, including： not enough importance has been given to ethic code and standard process; not enough importance has been given to basic training and practice skills; not enough importance has been given to research on treatment outcome; and not enough importance has been given to the evaluation and feedback system of professional work. Thus, facing the increasing need of mental health service in the future, we should develop the counseling and psychotherapy in following ways：（1） promote effective evidence-based working patterns aiming at specific groups;（2） carry out more evaluation on treatment outcome both in research and practice;（3） improve the professional training to a more systematic and standardized level; and（4） using the Internet techniques to extend high quality professional resources to less developed areas. Developing the quality of counseling and psychotherapy to a higher level, the whole system of mental health service will integrate more effectively, thus to improve the mental health status of Chinese people.