Paternalism and directivity. Between psychotherapy and counselling – an attempt to problematize the concepts and approaches on the example of Soteria
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Abstract
The main purpose of the article is to problematize paternalism and directivity in the context of the differences between psychotherapy and counselling. It is often assumed that psychotherapy deals with mental disorders, while counselling deals with developmental crises and other problems of healthy people. Accepting such a perspective and psychotherapeutic ethics is equivalent to adopting a medical intervention discourse and involves treating the patient in a paternalistic and directive manner. This is problematic because the category of "mental disorders" itself, as well as the diagnostic criteria for particular diagnoses, are criticized from many different standpoints. The example of Soteria, a therapeutic approach for people with a diagnosis of psychosis or schizophrenia, shows that even in the case of such a "severe mental illness," a model of support closer to counselling, which allows greater autonomy and subjectivity of the patient, can be equally, if not more, effective than conventional medical and psychotherapeutic approaches operating in the axiology of medicine. The article can thus serve as a starting point for considering the formulation of the proper area of interest for counselling and psychotherapy, the related goals of these interventions and the ethical implications of such decisions.
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