[A study of the 'effective' psychotherapist image and expectations about psychotherapy among the employees of hazardous occupations (policemen)].

Backgraund: The objective of the present study was to estimate the expectations about psychotherapy in terms of social and medical rehabilitation among the employees of hazardous occupations suffering from the consequences of a psychological trauma.

Material And Methods: A total of 100 subjects employed by various departments of the Russian Ministry of Internal Affairs (MIA) were recruited to participate in the study. Their age varied from 19 to 35 (mean 25.8±3.6) years. The mean age of the 56 men and the 44 women was 25.8±3.7 years and 25.9±3.5 years respectively. The methods of research included a questionnaire study for the elucidation of psychotherapeutic expectations and psychotherapeutic experience, the diagnostic test for the assessment of the interpersonal relationships, and the NEO five-factor personality inventory (NEO-FFI).

Results: The results of the questionnaire studies designed to obtain the profile of expectations about psychotherapy among the entire sample suggested the positive attitude of the responders toward the therapeutic interventions with no significant preferences given to their specific type providing that they proved efficient. However, the averaged estimates for the subscales that implied self-exploration (e.g. inward orientation and catharsis) for the general sample proved somewhat lower than those for such subscales as outward orientation including advice, defensiveness, support, the development and practicing of concrete specific skills and techniques needed to facilitate dealing with particular problems and symptoms. Generally speaking, the participants of the present study positively evaluated the effectiveness of psychological aid designed to resolve the problems associated with psychic traumatization based on the relevant personal experience dictating the necessity to avoid factors and situations either reminiscent of those that had resulted in the psychotraumatic event or symbolizing it. Moreover, the patients exhibiting the signs of post-traumatic stress disorders (PTSD) suffere a number of abnormal changes in the cognitive and emotional spheres in the combination with enhanced physiological responsiveness.

Conclusion: The results of the present study give evidence of the importance of taking into consideration the expectations of the patients suffering from the consequences of a psychological trauma as regards the results of psychotherapy as well as the mode of their personal interactions with the attending physicians which in its turn depend on the specific dynamics features of the disease and its overall clinical picture. In order to maintain a 'working alliance' between the patient of the given group and the psychotherapist, the latter should follow a certain pattern of interpersonal relationships with the patient which can be described by octants 2, 4-7 of the Interpersonal Relationship Diagnostics questionnaire. Also, the results obtained in the study can be used for the elaboration and implementation of the comprehensive psychotherapeutic and rehabilitative programs within the framework of health resort-based treatment programs for the employees of hazardous occupations who experience problems arising from the consequences of psychic trauma.