Ethical problems of preparing clinical psychologists in the context of their internet use for psychological diagnosis and correction

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In the second decade of the XXI century clinical/ medical psychology has become a widely spread profession and various issues of training and practice of these specialists are attracting more attention. In particular, research is being done into ethical issues [1, 2, 4]. At the same time, psychological diagnosis and correction by means of the Internet including on-line is getting more widely spread among practicing psychologists in Russia, the evidence of which is the scientific-practical journal «Psychological counseling on-line» that appeared in 2010. In some publications the authors consider ethical issues of using electronic media by «general» psychologists [3, 5]. However, students, as future clinical psychologists, also started using the Internet with this purpose. According to the anonymous questioning of 42 graduates of the Clinical Psychology department of the Volgograd State medical university in January 2019, 80,9 per cent of the 4th year students did the empirical part of their course paper exclusively on direct contacts with clients/patients, 14.3 per cent contacted their clients/ patients both directly and through the Internet, 4.8 per cent found difficulty in replying, though there were no answers that the empirical part of the course paper was done only based on contacts through the Internet. The same results were obtained concerning the empirical part of their graduation paper, 80.9 per cent of the students did it exclusively on direct communication with clients/patients; 15.7 per cent - both on direct contacts and through the Internet and 2.4 per cent could not answer if the empirical part of their paper was written exclusively on the ground of contact with clients/patients through the Internet. ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ 2 (24) 2019 48 So, at least every sixth or seventh graduate of the Clinical Psychology department used the Internet not only for reading theory (sources on the subject) but also to apply practical skills (psychological diagnosis, interpretation of the results, psychological correction of the disorders revealed/negative manifestations). Even the 2nd-year students who just start familiarizing themselves with the basics of psychological diagnostics, use a mobile phone to enter the Internet to question a single (!) person (this person turned out to be such a «rare» individual as a student). In fact, this is an evidence of institutionalization of social practice to use the Internet by future psychologists for psychological diagnosis and correction. The picture looks ironic: students whose major is clinical psychology study it full-time (at least at the Volgograd state medical university) but obtain practical skills by distance learning. Though, in other humanitarian specialties, in sociology in the first line, using the Internet while doing the empirical part of sociological researches in final papers is still much more widespread. The existing situation (doing empirical research work by students) using various Internet technologies seems evident: at present we see how our life is «internetizing», communication by means of the Internet seems more natural and routine to teenagers and young adults than direct face-to-face communication especially with strangers. A large part of the first-years students at the Clinical Psychology department feel a certain discomfort and even fear communicating directly with their fellows (some of them experience fear of communication in the 2nd year, too). At the same time, professional activity of the clinical (medical) psychologist requires a direct face-to-face communication with a client. However, if students of General Medicine, Pediatric or Dentistry departments start dealing with patients in the second term of the 3d year in all clinical subjects they study, the curriculum of Clinical Psychology department does not suppose this approach. Besides, there are 20-25 students in each group and it is difficult, though possible, to organize psycho-diagnostic work with each students. Psycho-correction is quite different: the instructor must receive the client’s consent to psychological correction session in presence of a large number of students and later he should assess psychological correction sessions conducted by the students. To some extent, this problem may be settled by showing video recordings of such sessions conducted by experts; after watching a video, 2-3 students would be able to reproduce some parts of it under the instructor’s supervision. In general, using various Internet technologies by students to obtain practical skills (carrying out empirical research) gives rise to psychological-pedagogical and ethical problems that overlap in many aspects and have not been analyzed in domestic sources yet. In particular, the following problems that are most urgent in undergraduate training may be considered. In the first turn, an important question arises if the students can use the Internet technologies to conduct psycho-diagnostics and psycho-correction. If they can, must they do it independently or under the instructor’s supervision? In which year of training i s thi s activity possible? Among the more special questions concerning Internet technologies we can mention that one of the key problems of bioethics, the problem of confidentiality of the data obtained which is not solved but, on the contrary, is getting more urgent, especially taking into consideration the fact that students widely use various virtual social media (when not only two people but a lot more have an opportunity to read something «curious»), though the students are unable to realize potentially serious consequences of such approach. Besides, it is possible that somebody will wish to get some information from social media concerning the person who is being examined. Most part of people who need psychologist’s advice are 50-60 years old and even older and many of them do not trust or are biased to modern «technical tricks». As a consequence, the main part of clients is limited exclusively by «advanced», relatively young people that makes studying basics of psycho-diagno stics and psycho-correction one-sided. An important, informatively significant component of psycho-diagnostics and psycho-correction is client’s behavior observation (liveliness of facial expression, manifestations of the autonomic nervous system, etc.) Internet technologies (even on-line) do not allow to master this skill. Besides, it is quite doubtful that psychodiagnostics could be conducted on-line with a visual control (e.g. the student could watch on Skype the client filling in the questionnaire for an hour). As a rule, the client is given a test and instructions to it and some time later (an hour, a few hours and even days) the client sends the answers to the statements in the questionnaire. But in this case there is no guarantee that the questionnaire was filled in by this very person and not somebody else. What are the restrictions concerning the offered methods of psycho-diagnostics on the Internet? In particular, is it justified to use many neuropsychological and projective techniques, pathopsychological approach that supposes active communication with a client especially while assessing their thinking and intellect? What exercises or assignments may be given in the process of psycho-correction and where are the borders of therapeutic interaction - these questions are also ambiguous. Clinical psychologist training is aimed at their work in the social or medical institutions, which is 2 (24) 2019 ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ most probable. There they are supposed to familiarize themselves with the patient’s / client’s histories before they start direct communication. It is reasonable (or necessary) to have information about real / possible problems of a certain person and would be able to more precisely make up the work tactics instead of proceeding from the version provided by the client. Internet technologies, on the contrary, make the clinical psychologist ignore this important aspect of their professional activity in the future. It was in 1951, when K. Levin noted that «it is easier to change individuals when they are in a group than each of them separately», though how can a student carry out a group psycho-correction if its basics were mastered only by means of Internet technologies? One should also keep in mind that during a session of psycho-correction the computer may fail and besides it is easy to cancel the session by the client (in case the client is displeased or the session lasts longer than expected and the client must do something else, etc.) Summarizing the foresaid, we can make the following conclusion: conducting psychological diagnostics and correction by means of the Internet by practicing (including clinical/medical) psychologists will gradually be more widely used. For this reason the students must have knowledge of ethics and specific character of Internet technologies application in these fields. This kind of knowledge may be obtained within the frames of the corresponding elective course in the 5th year (the 10th term) and earlier application of Internet technologies is not advisable.

About the authors

V. V. Delarue

Volgograd State Medical University

Email: vvdnvd@gmail.com

G. V. Kondratyev

Volgograd State Medical University

Email: socpsymed@mail.ru

Yu. S Navrotskaya

Volgograd State Medical University

Email: taranova.uliya@mail.ru

T. I. Guba

Volgograd State Medical University

Email: socpsymed@mail.ru

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