Before 1991, clinical psychology as we know it in the West didn't exist in Russia. Psychologists primarily conducted research or testing, and the field was merely considered "supplementary to psychiatry," according to Russian psychologist Alexander Maknach, PhD.

Now director of the Moscow Center for Psychology and Psychotherapy and a fellow of the Institute of Psychology of the Russian Academy of Sciences, Maknach says the clinical practice of psychology has emerged in the last decade and is making slow but steady progress addressing the nation's needs.

"Psychology is a very necessary profession," says Maknach, who says life has been bleak for many Russians since the breakup of the Soviet Union.

Areas that demand psychologists' intervention include:

  • Divorce. The divorce rate in Russia is similar to that of the United States--about one in two marriages will end in divorce. But, say psychologists there, many divorced couples in Russia continue to live together because there is no other place to live; it's too expensive.

  • Alcoholism and drug addiction. Drinking is a major part of the culture in Russia, and alcoholism a major problem. Since 1990, alcohol consumption among males has doubled. Alcoholics Anonymous programs are available, but there is nothing similar to Western inpatient treatment for alcoholism.

  • Unemployment and poverty. In 1999, just under half the population of Russia lived below the poverty line.

  • Gangs and school dropouts. Forced to deal with poverty and little chance of finding decent jobs, many youngsters in Russia choose gang life over education.

Getting an education

Perhaps spurred by societal issues and a desire to help, more Russians are seeking clinical or practical psychological training. "Ten years ago, there was no department or university where we could even get training in psychotherapy," Maknach remembers. "Now we have several opportunities for training in Moscow and St. Petersburg."

Although psychology programs are still largely research-focused and located only in Russia's big cities, such as Moscow or Leningrad, says Maknach, that's a major improvement from the mere six psychology departments that existed in the entire Soviet Union before 1991. And now institutes can offer degrees in psychology, in addition to universities. But, according to Robert Solso, PhD, who taught at Moscow State University in 1980 as a Fulbright Scholar and has lectured there in recent years, there are some "fly-by-night" programs due to the lack of accreditation.

While the signs are good for the growth of psychological practice, one of the major obstacles is a lack of teaching resources. "There are not enough trained professionals who can teach psychology, so sometimes it is horrible," says Maknach.

"And there is little literature available," notes Janice Strength, PhD, a psychologist at Fuller Theological Seminary in Pasadena, Calif., who has been instrumental in establishing a graduate psychology program in Moscow.

When Strength first began visiting Russia in 1991, only Freud and a small portion of Jung's work had been translated into Russian, she says.

"Many authors commonly read in the West are still not available in Russian," she adds. "Most psychologists in Russia have read everything in the language. There's a finite amount of information available."

And then there's the "brain drain" problem, says Michael Cole, PhD, of University of California, San Diego, and editor of the Journal of Russian and Eastern European Psychology from 1969 until 2000. In the last five years, the Institute of Psychology has had to cut salaries by 40 percent. "Many professors will take on second jobs," says Solso. "One professor--a full professor and head of a laboratory--is working three jobs." Academically, there's been a sea change. Students were paid to go to school in the past; now many have to pay. So, some students and faculty leave the country to study or teach.

A wary public

Another problem for Russian psychology is the lack of licensing laws. "There is no regulation from the state," says Maknach. "Anyone can call him- or herself a psychologist."

"There are people hanging out a shingle claiming to be psychologists and they're really hurting people," adds Strength. Maknach compares these people to "magicians or tarot card readers." And to add insult to injury, according to Maknach, sometimes those kinds of services are more acceptable to people, even well-educated citizens, and they are more ready to seek this kind of help.

"Sometimes in the minds of the people, there is not much difference between them and psychologists," he says, adding, though, that in more urban areas the situation is not quite as dire.

"The whole discipline really hasn't come into its own," explains Strength. Few Russians seek psychological counseling. Many who lived in the shadow of the Iron Curtain remember "psychology" being used in nightmarish ways, such as forcing people to take psychotropic medications to change their political views. "Some people are afraid they'll be prescribed medications and they won't like it, or they'll be sent to a hospital and the records of their visit will jeopardize their future," says Maknach.

And for legitimate problems, there aren't enough medications. Strength tells a story of a Russian friend whose sister has bipolar disorder: "They picked her up off the streets and put her in a psychiatric hospital and gave her medications until she stabilized. But then they took her off the medications."

When people do seek psychological help, they try to find a place where it's affordable.

"The fee for psychological services is very high and people must pay for themselves," explains Maknach. There are no third-party payers--prior to 1991, medical help was basically free.

Although the situation for psychologists in Russia is far from ideal, things are getting better. More programs to train students and to help citizens are being developed. Women's shelters and domestic violence hotlines are being founded, for example. Foreign psychologists are stepping in to help facilitate training as well as social healing. According to Solso, the U.S. government and private organizations fund many opportunities for American psychologists to teach in Russia or for Russian psychologists to train in the United States. And, he says, there's a lot we can learn from Russian psychologists.

This article is part of the Monitor's yearlong series on psychology around the globe.