Relevance. Contemporary clinical practice and recent scientific research indicate an expanding use of psychotherapy within medical settings, where it is increasingly applied to the treatment and rehabilitation of patients across diverse clinical groups. However, the advancement of psychotherapy in medicine is constrained by insufficiently developed methodologies and techniques for its clinical application. Progress in this field requires the establishment of a system that reduces the number of psychotherapeutic methods and ensures justified clinical use of existing therapeutic tools and achievements. This task is complicated by the tendency to apply isolated psychotherapeutic methods, the number of which is estimated in some sources to exceed 800.
The aim of the study is to conduct an expert analysis of the results and prospects for implementing the clinical–psychotherapeutic approach in work with patients from various clinical groups and to outline directions for its further refinement.
Methodology. A series of scientific and practical conferences with international participation served as the platform for expert analysis of the concept of clinical psychotherapy and the experience of its application in different clinical populations. The goal was to improve the clinical-psychotherapeutic approach and to create conditions for developing a framework for applying psychotherapy in the treatment and rehabilitation of patients with consequences of psychological trauma.
Results and Discussion. The study presents the conceptual foundations and general approaches to advancing the clinical–psychotherapeutic approach in medical practice. Core principles of clinical psychotherapy are examined, along with the essential requirements for psychotherapeutic diagnostics. These requirements include the formation of a functional diagnosis, the development of a psychotherapeutic hypothesis, the identification of therapeutic targets for each specific psychotherapeutic case, the formulation of an Individual Psychotherapeutic Program (IPP), and methods for improving psychotherapeutic practice. Expert analysis of the concept and its implementation under real clinical conditions demonstrated the need for further refinement of the proposed system and its components to enhance the clinical-psychotherapeutic approach, particularly in the treatment and rehabilitation of patients affected by psychological trauma.
Conclusion. Overall, the concept of clinical psychotherapy has met expectations and offers substantive potential for the development of a medical model of psychotherapy within healthcare. The clinical-psychotherapeutic approach constitutes an important resource for strengthening the role of psychotherapy in medicine. Expert evaluation of the concept has identified key directions for its continued development, including the elaboration of approaches for treating and rehabilitating patients with psychological trauma.

Introduction. The issue of neurotic disorders in childhood and adolescence remains one of the most debated topics today, as there is no unified perspective on neurotic pathogenesis. This is primarily due to an insufficient understanding of the psychosocial factors underlying its mechanisms. A deeper understanding of parent–child relationships in adolescents with neurotic disorders makes it possible not only to identify targets for psychotherapeutic intervention but also to monitor treatment dynamics in clinical practice.
Objective. To identify the targets for further psychotherapeutic work with adolescents with neurotic disorders, based on an assessment of their parent-child relationships and quality of life.
Material and methods. The study involved 80 male respondents of middle adolescence (aged 14 to 16 years). The main group consisted of 40 adolescents with neurotic disorders, and the control group included 40 healthy adolescents. In accordance with the research objectives and the characteristics of the variables analyzed, the normality of the data distribution was tested using the KolmogorovSmirnov test. A comparative analysis of the empirical data was performed using the Mann-Whitney U test. Spearman’s rank correlation coefficient was applied to identify correlational relationships.
Results and their analysis. The study examined the quality of life indicators of adolescents with neurotic disorders included an analysis of parent-child relationships. The results showed that adolescents with neurotic manifestations are characterized by reduced social and psychophysiological activity. Most often, however, this is associated with the activation of destructive psychological defenses in response to maternal expectations and demands. This defensive position, on the one hand, reduces tension in the mother-son relationship, but on the other hand, it triggers the development of somatic symptoms.
Conclusion. The study results revealed that mothers of adolescents with neurotic disorders employ destructive parenting strategies. A directive and hostile maternal parenting strategy provokes the activation of regressive psychological defense mechanisms, such as “withdrawal into illness”. In contrast, an unstable strategy, constantly fluctuating between love and trust to alienation and cruelty, leads to psychosocial dissonance, which results in neurotic disorders and the onset of deviant behavior.

Relevance. Codependency is now becoming an independent unit of not only psychological, but also clinical practice. Codependent individuals frequently experience a decline in overall well-being, which can manifest as chronic fatigue. However, due to the heightened tension of psychological defense mechanisms, they more often seek help with concerns related to significant others while ignoring their own needs. The aim is to examine the relationship between chronic fatigue and dispositional optimism in codependent individuals.
Methodology. The research was conducted at The Russian Christian Academy for the Humanities named after Fyodor Dostoevsky, in several support communities for relatives of individuals with addictions, and via the online platform Google Forms. A total of 253 participants aged 18 to 71 were assessed using clinical-psychological methods. Codependency levels were measured using the Codependency Relationship Scale (J.L. Fischer, L. Spann). To determine the degree of chronic fatigue of the participants the method “Degree of chronic fatigue” (A.B. Leonova, I.V. Shishkina) was used. Expectations regarding the future were evaluated with the “Dispositional optimism test” (T.O. Gordeeva, O.A. Sychev, E.N. Osin). Empirical data ware analyzed using descriptive statistics
and mathematical statistical data processing methods.
Results and discussion. The study established that codependency level, chronic fatigue, and dispositional optimism are interrelated. Higher levels of codependency correspond to more pronounced symptoms of chronic fatigue, accompanied by a decrease in dispositional optimism.
Conclusion. The results may be applied in the development and planning of clinical-psychological intervention programs for individuals with codependency, with an emphasis on early identification and prevention.

Relevance. Among individuals who have recovered from COVID-19, anxiety, depression, sleep disturbances, and asthenia are highly prevalent; these symptoms are observed both during the acute phase of the disease and after recovery. Asthenia is characterized by exacerbation of emotional and motivational dysfunction, impaired cognitive performance, pain symptoms, and autonomic dysregulation.
Intention: to investigate the prevalence of the asthenic component of anxiety and its associations 2 years after recovery from COVID-19.
Methodology. 70 people (51.4 % women) aged 56 ± 9 years in 3 and 12 months after recovery from lung damage COVID-19 were examined. Data included structured interview, scores on the GAD-7, PHQ-9 and personality anxiety subtest of the IAT scale, results of examinations by a psychiatrist and a cardiologist.
Results and discussion. The asthenic component of anxiety exceeded the norm in 32.9 % of the examined patients, asthenia symptoms were detected in 71.4 %, affective symptoms - in more than 40 %. There were intensive manifestations of anxiety, depression and subjective disturbances of cognitive processes in patients with the asthenic anxiety above the norm. The prevalence of asthenia (p = 0.002, 87.0 % and 47.8 %) and the severity of depression manifestations (p = 0.030, 6.60 [4.00; 9.00] and 5.00 [3.00; 8.00]) decreased by a year in this group. Attention deficits correlated with heart rate 3 months after recovery (r = 0.532, p = 0.034) and depression severity with heart rate 9 months later (r = 0.474, p = 0.022). In the subjects with normatively expressed asthenic anxiety the severity of manifestations of affective disorders, asthenia (p = 0.006, 63.8 % and 34, 0 %) and adaptation disorders (p = 0.012, 21.3 % and 4.3 %). In addition, there were the inverse correlation between anxiety and diastolic arterial pressure (r= −0.353, p = 0.015), emotional lability and heart rate (r = −0.318, p = 0.029), impaired attention and diastolic arterial pressure (r = −0.308, p = 0.035) remained during the observation period. First, clinically expressed symptoms of asthenia are used to form in individuals with asthenic anxiety, who are constitutionally more sensitive to stressful events. In both groups of subjects, somatisation is a compensatory mechanism based on regression and reactive formations. In patients with normative asthenic anxiety, somatisation is based on the suppression of over-expressed experiences, on denial and compensation. There is a representation of a special personality predisposition in patients with excessive asthenic anxiety.
Conclusion. Assessing the severity of asthenic personal anxiety is crucial in patients with somatic disorders. Regardless of its intensity, when working with individuals prone to elevated blood pressure, clinicians should attend to personality characteristics and the specific interplay between emotional and somatic domains.

Relevance. Premature birth is currently a pressing interdisciplinary problem that requires a comprehensive approach involving specialists from various fields. It is worth emphasizing that scientific works focusing on the study of the emotional state, including anxiety symptoms in mothers of premature babies, are much less common. Investigating the dynamics of anxiety symptoms is both relevant and practically significant for identifying at-risk groups and providing timely, comprehensive medical and psychological support to this category of women.
Purpose: to identify the dynamics of anxiety symptoms in mothers of premature infants.
Methodology. The longitudinal study involved 83 women aged 19 to 41 years (M = 33.69; SD = 4.10). The following instruments were used: the author’s questionnaire, a questionnaire on the presence of unfavorable life circumstances, the Perinatal Anxiety Screening Scale adapted by M.A. Korgozha and A.O. Evmenenko. The analysis of empirical data included descriptive statistics methods, and the Wilcoxon T-test (W) was used to calculate the differences in indicators at the first and second stages of the study. Statistical processing of the study results was conducted using IBM SPSS Statistics 26.
Results and Discussion. The present study revealed that 12–14 weeks after the birth of a premature baby, the emotional state of mothers includes anxiety symptoms of various specifics. They demonstrate signs of generalized anxiety and perinatal anxiety, as well as pronounced difficulties with adaptation.
Conclusion. The data obtained emphasize the importance of studying various aspects of the emotional state of women in the situation of the birth of a premature baby. The findings of the study substantiate the need to implement a comprehensive approach to providing medical and psychological assistance to mothers of premature babies.

Relevance and scientific novelty. Currently, post-COVID cognitive disorders and neurological consequences of the new coronavirus infection (NCVI) are being actively investigated. These studies reveal a wide spectrum of dysfunctions, including deficits in memory, attention, and emotional regulation. However, issues of psychocorrective intervention in the treatment of these conditions are extremely rarely considered.
Objective. To identify psychological and neuropsychological intervention targets for the rehabilitation of patients recovering from a new coronavirus infection.
Object. Patients who experienced mild or moderate NCoVI.
Subject. Cognitive functions and emotional functioning in patients who have had NCoVI in mild and moderate degrees.
Methodology. A comprehensive neuropsychological assessment was conducted with 50 participants who had recovered from mild or moderate NCoVI no more than six months prior. To evaluate cognitive functions, the MoCA, FAB, Clock Drawing test and other methods were used. The emotional state was assessed using the MFI-20 asthenia scale and the HADS – hospital anxiety and depression scale, SAN test.
Results and analysis. The main deficit-related factors identified were spatial and regulatory, manifested in impaired sustained attention, reduced verbal fluency, and decreased semantic memory performance. Elevated anxiety and asthenia were observed against the background of preserved motivation.
Conclusions. The key targets for cognitive rehabilitation were identified: regulatory praxis, voluntary attention and quasi-spatial representations. It is important to pay attention to the anxious experiences of patients and conduct primary psychoprophylaxis to prevent depressive disorders. Maintaining motivation through recognition of successes and keeping dynamics diaries contributes to the active involvement of patients in the rehabilitation process.

Relevance. Relevance of the research problem is determined by the need for psychological support for people living with HIV infection in the context of the chronic disease course accompanied by cognitive and emotional impairments. Although highly active antiretroviral therapy (HAART) has transformed HIV infection into a manageable chronic condition, the issue of quality of life and psychological adaptation in HIV-positive patients remains highly acute. The development and implementation of a comprehensive psychological technology – cognitive-emotional training – represents a current direction in clinical psychology, aimed at enhancing the adaptive resources of HIV-infected patients, strengthening their motivation for treatment, and improving overall quality of life. The program is based on the integration of cognitive-behavioral, activity-based, and neuropsychological approaches and is the result of empirical research conducted by the author, during which a system of exercises adapted to the needs of this group was tested.
Purpose. The aim of the study is to develop and test a psychological correction program aimed at improving cognitive functioning and stabilizing the emotional state of HIV-infected patients. The study confirmed the effectiveness of the developed cognitive-emotional training, which allows it to be recommended for implementation in psychological care practice and to present the results to the scientific community.
Materials and methods. To identify cognitive and emotional characteristics of HIV-infected patients, a set of psychodiagnostic methods was used, including: the ten-word memorization test for short-term memory assessment, the Schulte tables for measuring attention stability and selectivity, and the “Complex Analogies” method for logical thinking analysis. Emotional state was assessed using the SCL-90-R symptom checklist, A. Ellis’s irrational beliefs diagnostic, and the Life Satisfaction Index (adapted by N.V. Panina). To achieve the study’s objectives, a cognitive-emotional training program was developed and implemented, aimed at correcting cognitive deficits and reducing emotional distress in HIV-positive patients. The program included a system of group sessions with elements of cognitive stimulation, mnemonic exercises, logical tasks, and self-regulation techniques, accompanied by dynamic assessment of effectiveness using individual indicators.
Results. Implementation of the cognitive-emotional training program in HIV-infected patients led to positive changes in cognitive and emotional domains. Significant improvements were observed in short-term memory, attention, and logical thinking, as well as a reduction in anxiety, depression, and psychoemotional distress. Participants demonstrated increased life satisfaction and self-esteem, improved stress resilience, and partial correction of irrational beliefs. The program showed a high degree of effectiveness both individually and in group dynamics, making it a promising approach.

The relevance of the study is determined by the increasing prevalence of Internet-addictive behavior among adolescents, which leads to social maladaptation.
Purpose. The aim of the research is to empirically identify and evaluate the diagnostic potential of indicators of psychological boundaries of personality for predicting the risk of desocialization and Internet-addictive behavior in minors exhibiting deviant behavior.
Methodology. The empirical study was conducted from 2020 to 2024 in closed-type educational institutions of the Leningrad and Vologda regions and included 63 male adolescents with deviant behavior. The subject of the study concerned the relationship between the characteristics of psychological boundaries and Internet-addictive behavior in this population. To achieve the research objectives, a set of psychodiagnostic tools was applied, including Caplan’s Problematic Internet Use Scale (modified by Gerasimova A.A. and Kholmogorova A.B.), Nartova-Bochaver’s “Sovereignty of the Psychological Space” questionnaire, Levi’s “Psychological Boundaries of Personality” method, and Pantileev’s Self-Attitude Assessment technique. Data were processed using descriptive and correlation analysis.
Results. The results indicate that dysfunctional psychological boundaries in adolescents are expressed in reduced autonomy and impaired emotional regulation, which reflect personality immaturity. These characteristics contribute to the development of Internet addiction, facilitating rapid psychological withdrawal into virtual reality. The authors found that maintaining the integrity and protection of an adolescent’s personal space, which ensures a sense of safety and control, is critically important for preventing Internet-addictive behavior and underscores the role of autonomy in healthy psychological development. Adequate self-esteem and a consistent motivation for self-improvement reduce the risk of Internet addiction, highlighting the importance of critical self-reflection and internally driven behavioral regulation. These conclusions are consistent with existing research on the role of self-regulation and goal-directed activity in preventing addictive behavior.
Conclusion. The findings demonstrate the necessity of integrating targeted psychological interventions into the work of educational institutions. Such interventions should aim to develop functional psychological boundaries, enhance self-regulatory competence, support adolescents’ sense of personal security both offline and online, strengthen adequate self-esteem, and cultivate motivation for self-improvement and critical thinking regarding digital content and online interaction. Implementing these measures may help reduce the prevalence of Internet-addictive behavior and improve adolescents’ psychological well-being, which is of particular relevance for individuals exhibiting deviant behavior and is essential for their successful social integration.

Relevance. Rehabilitation occupies one of the leading positions in healthcare. The special military operation (SMO) and the the subsequent partial mobilization affected many Russian families, increasing stress and tension levels, undermining fundamental human needs for safety, trust in the world, protection, and a sense of future stability. The number of post-traumatic stress disorders has increased. Medical rehabilitation and psychological support for the participants of the SMO and their family members have become a priority within the healthcare system.
Intention. To present a system of outpatient psychological assistance for marital couples participating in the SMO using clinical examples.
Materials and methods. The presented system of psychological assistance includes approaches, methods and means of psychological impact in medical rehabilitation provided in the Republican Hospital for War Veterans. Clinical, psychological methods and questionnaires were used in the rehabilitation of three married couples using the International Classification of Functioning.
Results and discussion. Upon completion of the rehabilitation course, positive dynamics were observed in spousal relationships, including improved mutual understanding, increased communicative competence, and changes in communication patterns within the couple and in parent–child interactions from the husband’s side. The biopsychosocial model grounded in ICF domains was employed within a multidisciplinary rehabilitation team, integrating psychological techniques for working with couples. Special training of psychologists in crisis psychology, psychological support in extreme situations, and trauma-focused interventions is essential.
Conclusion. The presented system of psychological work with married couples participating in the SMO has shown its effectiveness in providing psychological and correctional care to patients at the outpatient stage of medical rehabilitation in a Hospital for war veterans and can be recommended for implementation in specialized institutions.

Relevance. The study of the mental state of persons in a prolonged stressful situation is undoubtedly relevant for medical psychology, since such stressful situations, due to the accompaniment of pronounced emotional disorders, can lead to intrapersonal tension and a decrease in adaptive capabilities. At the same time, many patients turn to the help of doctors with somatic complaints and avoid the help of psychologists, which leads to prolonged independent experience of a stressful situation, intrapersonal tension and difficulties of recovery in the subsequent period. Therefore, timely identification of problem areas in the mental state of such persons is a priority for developing strategies for individual psychologically corrective programs.
Methodology. Thirty-four people in a prolonged stressful situation (23 women, 11 men, aged 18 to 44 years) presenting numerous complaints were studied. The participants’ mental state was assessed through clinical observation and a set of standardized psychodiagnostic tools aimed at evaluating memory, attention, and emotional-personality functioning. A questionnaire “Subjective Self-Assessment of Condition” was developed to obtain individual self-reports.
Results. The findings demonstrate that the mental state of individuals exposed to prolonged stress is characterized by mild impairments in cognitive and emotional domains, manifesting primarily as elevated anxiety and hostility, as well as difficulties in personality adaptation.
Practical significance. The results may be applied in the development of psychocorrection programs. Understanding the characteristics of the mental state of a person in a protracted stressful situation will allow monitoring the success of the measures taken and making timely adjustments to the process.

Relevance. Professional burnout remains one of the most acute problems faced by helping professionals. Emotional exhaustion, depersonalization, and reduced motivation can lead to serious consequences for both the specialists themselves and the quality of care they provide. This drives the growing interest in prevention methods that combine an evidence base with practical applicability.
Intention. To conduct an analytical review of contemporary scientific research in order to systematize data demonstrating the effectiveness of Balint groups as a method for preventing professional burnout among helping professionals.
Methodology. The review analyzed contemporary Russian and international publications on professional burnout and group-based prevention methods, including studies evaluating the outcomes of participation in Balint groups. The search was conducted in the databases eLIBRARY, PsyJournals, PubMed, and Google Scholar using keywords: professional burnout, helping professionals, Balint groups, emotional exhaustion, group psychotherapy, psychological support, professional identity, stress prevention. Publications from 2018–2024 that met the criteria of scientific validity and thematic relevance were  included.
Object. Scientific approaches to the prevention of professional burnout, with a focus on group reflection and emotional support. The theoretical framework integrates psychodiagnostic models of burnout and the principles of Balint group work.
Results and discussion. The analysis confirmed that participation in Balint groups contributes to reducing the main symptoms of burnout and promotes the development of empathy, reflective skills, and professional identity. However, data on personal accomplishment remain inconsistent, and the long-term effectiveness and universality of the method require further research.
Conclusion. Balint groups demonstrate effectiveness in reducing key burnout symptoms and developing reflective skills. Further research is required to verify the long-term outcomes, crossprofessional applicability, and methodological stability of this approach.

Introduction. Coxarthrosis (osteoarthritis of the hip joint) is a socially significant degenerative and dystrophic disease characterized by chronic pain syndrome, progressive limitation of mobility and a significant decrease in the quality of life of patients. Within the modern healthcare system which is oriented toward short-term hospitalization, the effectiveness of treatment is influenced not only by medical parameters but also to a large extent by a range of psychological factors.
The purpose of the study: systematization and analysis of modern scientific data on the influence of psychological factors (including personality traits, emotional and behavioral characteristics, socio-psychological features, and subjective illness perception) on the effectiveness of treatment of coxarthrosis, including surgical interventions and rehabilitation measures, followed by the evelopment of evidence-based recommendations for optimizing the treatment process.
Methodology. A systematic analytical review of 46 peer-reviewed Russian and foreign publications for the period 1999–2024 was conducted, selected from the databases eLibrary, CyberLeninka, PubMed, Scopus and Web of Science. The inclusion criteria were: scientific validity, representativeness of the sample, validity of methods and relevance to the research topic. The analysis was performed within the framework of the biopsychosocial model and the principles of evidence-based medicine.
Results and their analysis. Significant psychological predictors of treatment effectiveness were identified, such as personality factors, emotional disorders, cognitive characteristics, and sociopsychological aspects.
Conclusion. The findings confirm the necessity of implementing a comprehensive multidisciplinary approach to the treatment of coxarthrosis. Promising areas of further research include the development of standardized psychological support protocols and the assessment of their effectiveness in Russian healthcare.