In Russia, counseling is often not considered a substantial profession. Unfortunately, the same is true for any country that used to be a part of the USSR. A very limited number of nonmedical-model counseling centers exist, particularly in rural parts of the country. The sad truth, however, is that most of the Russian population doesn’t even know about such services.

Anton Ivanov (this article’s first author) grew up in Russia. After five years in the United States, and as a second-year student in a counseling program, he has become acutely aware of the substantial contrasts between the two countries when it comes to their perspective and practice of counseling. He has a desire to educate American counselors about his country and people.

Historical context: Residue of the Soviet regime

To grasp fully the mentality of the Russian people regarding counseling, one needs to look deep into the country’s history. In the Soviet era (1922–1991), counseling and psychological services were either not available or were rejected by the government and people. Thus, such services were extremely rare. Lacking counseling services, Russians with mental health problems or drug and alcohol addictions were historically treated by medical doctors through the use of medications.

Sigmund Freud’s works were translated into Russian during the Soviet era and were one of the few sources of learning about psychotherapy for Soviet therapists. However, his works were soon forbidden, as were many works of other Western practitioners. For those seeking a more thorough review of the history and current development of counseling in Russia, we suggest reading Christine L. Currie, Marina V. Kuzmina and Ruslan I. Nadyuk’s article, “The Counseling Profession in Russia: Historical Roots, Current Trends and Future Perspectives,” in the October 2012 Journal of Counseling & Development.

Historically, people diagnosed with severe mental health issues in Russia were often sent to medically oriented psychiatric hospitals where confidentiality rights were not generally considered. When records were disclosed, citizens were often stigmatized and disgraced, which limited their opportunities for employment and minimized their chances of living a life without scrutiny. In many Russian communities, simply mentioning that parents were seeking mental health services for their children or themselves could have negative consequences. When such information became public knowledge, families’ reputations were jeopardized, and they were often stigmatized as “dysfunctional.” Unfortunately, these attitudes remain prevalent today.

Further compounding the stigma, the government used psychiatry as a tool to suppress ideas that were different from the accepted ideology by labeling rebels as “mentally unstable.” Because the specter of mental health problems were used to dissuade dissent, terms such as psychology, psychiatry and psychotherapy came to arouse fear among the population.

To complicate matters further, the idea that social or environmental factors could cause certain mental health issues was strictly rejected; the only allowed stance was that all psychiatric disorders had a biological cause. As a result, people suffering from psychological issues often minimized their symptoms in an effort not to see a doctor. When Russian people are sick, they often quip that “the issue will disappear by itself” or “it is already too late to treat the issue; it is incurable.”

Throughout Russian history, its people have commonly sought counseling and psychological help from “healers” who are believed to possess “good” energy, holy powers, skills to fix people’s issues and the ability to foresee events. Healers often prescribe herbs that are believed to be helpful. Russians also practice balneotherapy, take mud baths and schedule spa visits to reduce their stress levels and treat physiological issues. Most Russians rarely see a doctor about their mental health issues. Instead, many Russians prefer to talk about their problems with their friends in the kitchen while sharing a bottle of vodka.

Both historically and today, Russians respect and trust the army, the church and the national leader. In times of crisis, the Russian people have been inspired and united through the hope that they place in their leaders and the church. People still rely on the Russian Orthodox Church to “solve” their issues. People go to the church to have all their questions answered by priests and in hopes of magically ridding themselves of their mental health issues by either drinking holy water or attending public worship. Russians view priests as authority figures and trust them much more so than they do mental health therapists. Unfortunately, priests have little or no training in counseling and rely on their own knowledge to assist people who are dealing with mental health issues.

Counseling challenges and concerns

Russians’ mental health problems are similar to those found in other countries, but these problems are exacerbated by deeply ingrained political policies and social attitudes that are coupled with severe socioeconomic hardship. High rates of depression, anxiety, drug and alcohol use, eating disorders, divorce, suicide and unemployment are all present. Other lifestyle factors contribute to high rates of cancer and AIDS, leading to a decline in the average life expectancy. Racism, local and international wars, and religious discrimination further add to the stress. In a country where much of the population lives below the poverty level, it appears little might be done to thwart the high levels of depression and apathy. Recent economic sanctions have intensified these problems.

In Russian culture, many men view marriage as a loss of freedom, whereas women generally see marriage as a significant step toward a happy life. Women are often viewed as an inferior gender that prefers dependency and dreams only of having a family, whereas men conduct themselves assertively and prefer independence. Many male children are raised in Spartan conditions under which displays of emotion and the questioning of parents are rarely allowed. Unfortunately, acting in an aggressive manner is too often reinforced. These factors, in combination, have resulted in high rates of domestic violence and an overall hostile culture throughout Russia, making family counseling an urgent need.

Although sexuality is widely discussed among Russians, parents, teachers and priests are skeptical about sex education and hesitate to utilize it. Unplanned pregnancies have resulted in high abortion rates. In a 2001 article in the Canadian Medical Association Journal, Barbara Sibbald noted that Russian women had six abortions on average during their lifetimes. The prevalence of unplanned pregnancies has also resulted in overflowing orphanages that house abandoned children and those taken away from their parents because of drug and alcohol addiction. Understandably, a substantial need exists for access to birth control, sex education, family counseling services and drug and alcohol treatment.

Current status and foundational needs

Generally speaking, counseling in Russia is decades behind the United States in terms of acceptance, education and theoretical development. Yet, as Currie, Kuzmina and Nadyuk noted, counseling has been recognized as a branch of social work and is starting to gain a presence in Russia. Still, counselor education programs such as those commonly found in U.S. colleges are extremely rare in Russia. Counseling is still several steps away from becoming a viable profession in Russia, and various issues need to be addressed before it is viewed as a legitimate, functioning entity.

For instance, the requirements for training and certification vary across the country and are not established or consistently regulated by any governing body. Unfortunately, this has resulted in numerous charlatans and unqualified practitioners claiming to provide “counseling.” Currently, very few facilities consider offering practicums or internships to students. This leaves many beginning counselors poorly prepared for real-life practice. In addition, outstanding students with college degrees are offered no assurance of employment unless they have the aid of social and administrative connections. In addition, the low income of counselors does not attract many students to the field.

After an American Counseling Association delegation visited Russia in 2006, a Counseling Today article reported that Russian counselors were prone to learning one theory and using it exclusively. There appears to be a limited amount of training across theories. Thus, the idea of counselors adapting approaches to the client’s individual personality and problems is not commonly practiced. It is apparent that expanded training in a wider array of approaches is strongly needed.

In a country where corruption is too often the norm and where ethical codes are not viewed as essential, adherence to the strict ethical standards present in the United States is not emphasized. In her article, Sibbald noted that sexual relationships between medical practitioners and clients are common, and ethical standards regarding such relationships are not enforced. In particular because of Russians’ historical distrust of mental health services, it is essential that formal ethical guidelines be established, taught and monitored. Until the Russian public learns to trust that its counselors will protect confidentiality, mental health services will not gain a foothold in Russia.

Potential counseling needs of Russian immigrants 

Many Russian immigrants would benefit from the counseling services offered in the United States, but counselors who underestimate the significance of cultural differences could inhibit the process. In a chapter in the 2004 book Culturally Competent Practice With Immigrant and Refugee Children and Families, Tamar Green described some of the primary psychological challenges that Russians encounter when coming to the United States. These challenges include cultural shock, which involves transitioning from a socialistic to a capitalistic society and from a nonreligious or Russian Orthodox atmosphere to the American spiritual environment. In addition, immigrants must manage language barriers, unemployment, basic shopping knowledge, navigation of the medical system, loneliness and isolation.

Although children adapt to the American environment faster, they still experience issues such as feeling neglected by parents, getting help with schoolwork and not feeling protected in a new environment. When going through the adjustment process, these youth can be psychologically traumatized. Green noted that they are searching for their new selves in an environment in which they have distinctly different names and accents. In addition, they are struggling to find new friends, striving to match American clothing styles and trying to develop new hobbies and interests, all of which are quite different from what they knew back home in Russia. At the same time, Russian parents adapting to this new environment are equally overwhelmed and cannot attend to children as much as they might wish. Yet, by virtue of possessing strong and persistent survival skills, Russians have learned to preserve their culture and identity while managing change and settling in other countries.

Russians usually view doctors as authority figures and readily hand their problems over to them. Similarly, if Russian clients decide to try counseling, they may expect the counselor to take responsibility for their problems and are likely to follow the counselor’s advice without question. Because of these characteristics, person-centered approaches to counseling are not likely to be suitable for these clients.

In addition, because of the harsh nature of Russian culture, empathy is not readily understood by most Russians. Olga Bondarenko, an associate professor of psychology at Nizhni Novgorod State University in Russia, points out in an article that Russians frequently mistake empathy in therapy for sympathy or pity, which is less acceptable to them (see bit.ly/23eZEZj). For this reason, directive techniques are much more suitable.

It might also be noted that Russian culture tends to be very philosophical, and Russians like to approach problems from philosophical perspectives. Existential approaches in counseling might best accommodate this cultural feature.

Another feature of Russian culture is a reluctance to wait. Hence, pacing in counseling can become a challenge because Russians expect immediate results. In addition, many immigrants simply cannot afford long-term treatment because of financial constraints. Likewise, the mindset of many Russians is that money should be invested in something tangible, such as electronics, clothes, cars or houses. Investing in counseling will likely seem foreign and even useless to them because of their inability to grasp its benefits and see the results immediately. Counselors will need to explain to Russian immigrants that counseling in the United States is a slower, more deliberate process.

Russian culture is communistic and collectivistic, and because a large percentage of the population lives in extended households, family is likely to be an integral part of these clients’ lives. In Russian schools and institutions, children are called by their last names, thus further promoting the ideology
that family comes first. In stark contrast to American culture, the familial emphasis of Russian culture strongly limits the idea of individuality, if not eliminating it altogether. Counselors should remain cognizant of this when attempting to construct problem solutions for Russian clients.

To better understand these clients, practitioners should bear in mind that Russians may appear to be grumpy, closed, secretive, suspicious, quiet, anxious and rather shy because they have often lived in a state of uncertainty. Many elders were traumatized by the division of the Soviet Union, which resulted in a loss of country, land, currency, political leaders and, most important, identity. It is not uncommon to encounter Russian elders who still hope and dream of one day again living in a socialistic society similar to the former USSR.

Because of a lack of experience with and understanding about counseling, counseling interventions remain novel to most Russian immigrants. If they were court ordered to attend counseling, they would likely find the process strange and present as exceptionally skeptical about its helpfulness. In addition, historical cultural attitudes toward mental health services may be ingrained in these clients, which might make them seem resistant to the process. Counselors should be aware of and prepared to manage this aspect of counseling Russians.

Similar to other cultures, Russians like to criticize and complain about the opposing mindsets and attitudes they encounter in other Russians and the Russian government. Incongruously, counselors may discover that some Russian immigrants are not close to or do not speak positively of other Russian immigrants. If such sentiments arise in counseling sessions, however, counselors should be careful in aligning with these perspectives in an effort to join with the client. Ironically, Russian immigrants might feel offended and disrespected by an American counselor who aligns with a negative attitude toward Russians and their motherland.

Overwhelming contrasts

To comprehend the essence of Russian culture and meet Russians’ counseling needs, one must understand the country’s history and the unique features of its people. This article was written to provide a glimpse into this often misunderstood world.

Being in the United States for five years has given me (Anton) an increased understanding of the usefulness of counseling and its eventual benefits for Russians. Being in a counseling program has intensified my desire to see the counseling field grow in Russia and be used by Russian immigrants. I believe that some information described in this article may also be applicable when working with immigrants from the countries of the former USSR or other Russian-speaking immigrants.

Yet counselors in the United States need to understand that counseling is foreign to most Russians. It is not something that meets the needs of those who come from or exist in a society in which the primary focus is survival, not personal growth. It is our hope that counseling services will progress in Russia and that through an understanding of Russian culture, counselors in this country will be better prepared to educate and counsel Russians.

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Anton Ivanov is from Orel, Russia, and is a second-year student in the clinical mental health counseling program at East Tennessee State University (ETSU). He hopes to seek residence in the United States, promote awareness of Russian culture among Americans and help Russian immigrants acclimate to American culture. Contact him at ivanova@goldmail.etsu.edu.

Clifton Mitchell is professor emeritus at ETSU and author of Effective Techniques for Dealing With Highly Resistant Clients. He travels the country giving seminars on the management of resistance in therapy and providing legal and ethical training in a game-show format. Contact him at cliftmitch@comcast.net, and visit his website at cliftonmitchell.com.

Letters to the editor: ct@counseling.org