Career Counseling LMHC

Discussion questions last chapter, this chapter, and next chapter is tied together so please read instructions.

Last week you explored the intersection of personal and career counseling. Keep this in mind as you dive into the career counseling process, starting with the intake interview. After reading the chapter, the Career Counseling Application Assignment : Intake Interview- Chapter 5 -Helper Studio Angela’s Self vs. Family will help you apply the material through open-ended questions AND recording your counseling skills in the form of a response to the client vignette linked to this assignment. WRITE IT OUT I WILL RECORD. In MindTap, you will submit both your written responses to open ended questions and video recorded verbal response to the client. Your video recorded verbal response should be as if you are actually in session with the client; this should NOT be “I would help the client explore….” but rather SHOULD BE “You feel ….. It sounds like……” as if you’re actually responding to the client. If you don’t think your first (or second, etc.) try is satisfactory, you can re-record before you submit the assignment. Further instructions are in the assignment.

When completing this assignment, keep in mind personal issues that affect career, including family influences and values. You job is NOT to problem solve or to direct Angela in any one direction, but rather to meet her where she’s at, listen to her dilemma, and help her explore how her values, career goals, and family might be influencing her career decisions.

Chapter 4 Introduction

Chapter Highlights

· The call to integrate career and personal counseling

· The biopsychosocial model of interacting influences

· Biological, psychological, and social/cultural forces that drive behavior

· Development of a personality disorder

· Observing symptoms of a personality disorder

· Career work connection to anxiety

My focus in this chapter is on a counseling approach that addresses both personal and career concerns. The point was made in chapter 1 that the role and scope of career counseling have been and continue to be influenced by an ever-changing society in which the workforce and workplace have also experienced significant changes. How to effectively address career-related concerns in a world that is rapidly changing has been the subject of numerous research projects and debates over several decades. In the meantime, the more sophisticated career development approaches and counseling interventions developed since the latter part of the last century have dramatically expanded the role and scope of career counseling in contemporary society. As pointed out in chapters 2 and 3, career development theorists currently address a wide range of client concerns, including multiple life roles, learning deficiencies, cognitive difficulties, emotional problems, multicultural issues, and social restraints.

Historically, career and personal domains were viewed as separate entities and, as a result, studies of career development were approached as a distinct domain (Spokane, 1991). Following this perspective, counselor training programs also considered career and personal concerns as separate domains. The relationship and interplay of personal and career concerns, however, have focused more attention on strategies that integrate them. Some may complain that the counseling profession has been too cautious in addressing the position of integrating career and personal concerns. In the 1970s, for example, Osipow (1979) put forward the idea of blending vocational development with mental health when working with adults in the workplace. He labeled this effort occupational mental health. Counselors were to address work maladjustment, work-related stress, depression, and other concerns that might involve an interplay between work, personal concerns, and all life roles. Keep these suggestions in mind as I address the rational for a holistic approach in career counseling next.

The Rationale for a Holistic Approach

In the 1990s, there was considerable dialogue as to whether career counseling should devote more attention to the interrelationships of personal and career problems and how they affect multiple life roles. This debate is not new to the counseling profession. Some researchers have suggested that career and personal concerns should be dealt with separately (Crites, 1981), whereas others, believing that career and personal concerns are intertwined, have promoted a more holistic counseling approach (Betz & Corning, 1993; Krumboltz, 1993). Moreover, Richardson (1996) prudently suggests that the pervasive nature of work in each person’s life needs to be researched by several academic disciplines to clarify its position and role in the counseling process. What we have here is a reinforcement of the position that work is a core element of an individual’s everyday existence. It gives meaning to many facets of each person’s life and as such should be addressed more aggressively in the counseling profession. Conversely, this position also suggests that a client’s personal concerns can significantly affect work roles and career development over the life span. Thus, personal concerns that evolve from different life roles and interfere with career development should not be ignored in career-related programs and in counseling interventions. The important question here for the practice of career development is how to effectively integrate an individual’s career and personal concerns.

What is being suggested is a holistic counseling approach that is much more inclusive when addressing client concerns. This stance is underscored by the ever-expanding role of career counseling, from its early focus on career choice and placement of young adults to today’s greater emphasis on the concerns of adults in multiple life roles. The interrelationship of personal and career problems has become more apparent in the lives of adults as they experience changes in work environments and difficulties associated with other life roles. Work maladjustment, career transitions, job loss, work stress, changing work requirements, concerns of older adults, and changing values and interests are examples of career-related problems that can affect all life roles. In more inclusive counseling models, however, counselors are also to address the concerns of some clients who, for example, present symptoms of depression, dysfunctional thinking, behavioral problems, a lack of cognitive clarity, and affective domain concerns of inner conflicts that restrict or interfere with career choice and development.

The Call to Integrate Career and Personal Counseling

The call for the counseling profession to integrate career and personal counseling was heightened in the 1990s, underscored by a profusion of articles in professional journals. In 1993, the Career Development Quarterly (Vol. 42, pp. 129–173) contained articles that supported the integration of career and personal counseling. Different points of view were expressed, including those predisposed toward a need to integrate career and personal counseling by expanding the role of counseling to address problems of a personal nature that are incurred in multiple life roles over the life span (Gelso & Fretz, 2001).

Super (1993) suggested that “there are two kinds of counseling, situational and personal, and they are not dichotomous but rather a continuum” (p. 132). Counselor and client are to work together to develop the client’s self and situational knowledge as shaped in person-in-environment interactions. Clients who are aware of their own needs are empowered to effectively begin an independent exploration that leads to decision making. In this process, career and personal concerns are integrated and not dichotomized.

Krumboltz (1993) strongly advocates integrating career and personal counseling. He suggests that the terms career counseling and personal counseling convey the impression of a dichotomy that has been reinforced by different training courses and certification. His major point is that personal problems cannot be separated from career problems as they are inextricably intertwined. He illustrates his point with some case examples, such as, “Linda is depressed because she has lost her job and doesn’t think she can ever find another one. Is this a career problem? Or a depression problem?” (p. 144). According to Krumboltz (1993), compartmentalizing client concerns limits our ability as counselors to help them understand, for example, how belief systems and interests are interrelated in the career counseling process.

Davidson and Gilbert (1993) approach career counseling as a highly personal matter that includes the multidimensional self and its relationship to life and work. Counselors, therefore, are to acknowledge and recognize the personal and contextual realities that clients bring to counseling. Career is seen as a personal identity and as such is interrelated with multiple life roles over the life span, including dual-career roles. Finally, these authors conclude that career and personal counseling are the same.

Career issues that engage aspects of the total person are the theme of a research project by Haverkamp and Moore (1993). Their conclusions suggest that the supposed dichotomy of personal and career counseling was exaggerated by career counseling’s narrow focus on career choice with young adults. They also argue that more attention should be paid to work adjustment and personal aspects of the whole person. Finally, they conclude that there is little question that career and personal issues are intertwined in adult development.

Betz and Corning (1993) viewed career and personal counseling as inseparable and recommended a “whole person,” holistic philosophy of counseling, a belief apparently shared by an increasing number of counselors (Farmer, 2009; Gelso & Fretz, 2001; Schultheiss, 2000; Zunker, 2008). The overwhelming rationale is that career and personal issues are inseparable and intertwined. The most effective mind-set when using a holistic approach is one that views each client from a total person perspective. In a collaborative relationship, client and counselor uncover all problems—not just career ones, nor just personal ones, but both—and more important, how they interrelate.

The call to integrate career and personal counseling underscored a need for an effective counseling model that could address all client concerns that interfere with career choice and development. An extension of career counseling suggests an increased focus on addressing such personal concerns as severe anxiety and apprehension, mood disorders of depression, faulty cognitions, and a host of psychological disorders. What we have here is the recognition that mental health concerns present potential problems for clients who are engaged in the initial career choice process and choices that follow as well personal interactions in the workplace and the ability to perform appropriately. Clearly what are needed are comprehensive methods for identifying factors that influence behavior and development. What is suggested is that counselors are to view behavior as being influenced by multidimensional forces as suggested by a biopsychosocial model of development (Durand & Barlow, 2013; Kail & Cavanaugh, 2014; Sue et al., 2014).

Biopsychsocial Model

Over time the study of factors that influence behavior has emerged as an ongoing process that will continue to unlock multidimensional influences that affect human development. The contributions of cognitive science and neuroscience have underscored the position that the interplay of biological influencespsychological influences, and social/cultural influences are recognized as major forces that drive behavior. Behavior is no longer to be viewed as one dimensional but as multidimensional and multifaceted. Durand and Barlow (2013) clearly state this position as follows: “Behavior both normal and abnormal is the product of a continual interaction of biological, psychological, and social influences” (p. 26). This conclusion has led to what is referred to as a scientific method of determining influences that drive behavior and is labeled an integrative approach. What is suggested here is that what individuals think and do does not occur in isolation, on the contrary, there is an interaction of influences involved in career decision making, in one’s perceptions of a work role and other life roles, and in the development of cognitions and emotions that could lead to a psychological disorder. What is also suggested is that client concerns can affect all life roles including the work role. An integrative approach suggests that mental disorders are the product of a very complex interacting process involving three dimensions, biological, psychological, and social/cultural, as depicted in Figure 4.1.

Figure 4.1An Integrated Approach of Influences on Behavior

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Source: From Abnormal Psychology: An Integrative Approach, 5th ed., p. 32, by D. Barlow, and V. Durand, Copyright. 2009. Reprinted with permission from Wadsworth Cengage Learning, Belmont, CA.

To illustrate an interactive process, I use a stressful life event that triggers a number of biological reactions including an activation of neurons that transmits messages through neurotransmitters to the central nervous system and brain. Thus, a stressful life event can cause physiological responses including cardiovascular system reactions such as increased heart rate and high blood pressure, Psychological reactions include learned conditioned responses such as negative cognitions, self-defeating thinking, and excessive emotional responses. In the social/cultural dimension unique social and cultural experiences influence each person’s reaction to stressful life events. This is a process that involves the interaction of three dimensions that could result in an anxiety response followed by a panic reaction. Anxiety and panic, which are closely related, are often considered precursors for development of a psychological disorder. As one would suspect, a psychological disorder involving anxiety and panic can have long-term effects on one’s ability to function in all life roles. Counselors are to be aware of multiple influences involved in the development of behavior that can lead to pathology as well as the complexity of the process itself. Behavior is not the product of one dimension, but a combination of interacting influences; there is reciprocity. The following paragraphs contain brief summaries of three dimensions in the integrative model. For more information, see Ashford and Lecroy (2013); Durand and Barlow (2013); Goldstein (2011); Kail and Cavanaugh (2014); Sue and colleagues (2014); and Zunker (2008) among others.

The assumption that behavior is the product of multiple interactive influences suggests that counselors are to focus on multipath models of development in the process of building an understanding of a client’s interrelated concerns. Furthermore, the complexity of mental health concerns suggests the involvement of more than one dimension in an integrative model. Multiple interactive influences are most likely to contribute to the development of a mental health concern or concerns, but this does not imply that all dimensions have contributed equally to a disorder. Finally, one must be reminded that individuals react differently when exposed to identical events and stressors (Sue et al., 2014). Biological, psychological, and social/cultural influences that drive behavior are discussed next.

Biological. Biological vulnerability is very complex as well as inclusive. Biological explanations of human behavior have focused on brain functions as well as functions of the central nervous system. The brain, for example, contains billions of interconnected cells called neurons that communicate with each other (Goldstein, 2011). Complex processes involving functions of the brain emphasize that there is much about behavior that we do not know. What we do know is that psychological interventions can alter brain functions but so can stressful life situations. Biological vulnerability also includes genetically inherited predispositions to develop psychological disorders. There are indeed higher rates of depression found in relatives of individuals who have experienced mood disorders. Some relatives, however, may not suffer from depression (Zunker, 2008). Keep in mind that inherited predispositions, sometime referred to as tendencies, are not certainties or one’s destiny (Schulz & Schulz, 2013) but are part of the equation that has many interconnections. Yet there are also biochemical imbalances that are a part of the interaction process; for example, the neurotransmitter serotonin is believed to influence behavior; thus, drug therapy is used to either increase or decrease serotonin levels. Obviously, there is much more to be learned about biological functions and their influences on human behavior. Counselors should remain alert to the results of continuing research.

Psychological. Psychological vulnerability is also a very broad-based force that “includes all internal perceptual, cognitive, emotional, and personality factors that affect development” (Kail & Cavanaugh, 2010, p. 6). What is implied in the previous description of psychological vulnerability is a strong endorsement for evaluating each person as a unique individual. An individual client’s psychological vulnerability could be heightened, for example, by a severe emotional reaction to a stressful life event. The counselor may view this client as being very fragile, as having a poor self-concept, and who tends to fall apart when faced with stressful conditions. In this case the client is likely to have difficulty functioning in a work role, especially one that is stressful. This client would more than likely experience problems in all life roles. Also observed in this case is the interconnection to biological and social vulnerability. Distorted beliefs and poor self-concept, chemical imbalances, and perceptions of isolation from peers are interacting forces that are very problematic. Clients who have tendencies to react emotionally may find their problem to be exacerbated by chemical imbalances and poor interpersonal skills. High serotonin levels, for instance, can influence the development of distorted beliefs that interfere with all life roles. Vulnerable psychological characteristics and traits can be reinforced by biological factors and social contexts. What is emphasized here is the often mentioned interaction between dimensions that influence behavior; one’s emotions and faulty cognitions are either reinforced or diminished in the interaction processes that drive behavior (Durand & Barlow, 2013; Kail & Cavanaugh, 2014; Sue et al., 2014).

Social/Cultural. In the social/cultural dimension counselors should recognize that much of what one learns is through social contexts that include cultural beliefs, values, and worldviews. Social contributions to the development of anxiety, for example, can include social pressure to succeed, a lack of social support, and prior experiences in social interactions. Poverty, social inequality, discrimination, and oppression can diminish one’s sense of control; one’s self-concept and self-esteem can be adversely affected. Social vulnerability also includes experiences of being rejected by authority figures and diminished feelings of well-being when one does not have social support. On the other hand, social support is a most important weapon in combating a number of psychological problems including depression. Recently more attention has been directed to the importance and relevance of one’s environmental experiences in the search for solutions to both career and personal concerns and their interrelationships. Self in situation is indeed an important factor in research of influences that drive behavior. Life-course events are one of the influential driving forces of human development (Kail & Cavanaugh, 2014).

The point was made very early in this discussion that behavior is the product of multiple influences that are very pervasive. The function and structure of the brain, the nervous system, and genetic endowments are but a part of biological influences involved in this very complex process that defies our desire for simplicity. Researchers continue to uncover more information concerning the complexity of biological functions, for example when studying the effects of genetic inheritance, Nobel Prize winner Eric Kandel (1983) concludes that environmental influences can diminish the effects of genetic tendencies. He observes that in the process of learning there is a change in the genetic structure of cells, suggesting that situational experiences may indeed modify the influence of genetic endowments (Durand & Barlow, 2013). More recently, researchers strongly suggest that there appears to be a social connectivity to the re-engineering of new cells, suggesting that social experiences can become a part of one’s biology (Rutter, 2010).

What is most important for counselors to learn here is that environmental influences can alter brain functions (Kolb, Gibb, & Robinson, 2003). This position calls attention to the impact of social/cultural influences on both biological and psychological factors. Counselors should also be aware that positive thinking and subsequent behavior can increase the effectiveness of the immune system (Durand & Barlow, 2013). These examples can serve to solidify the position that behavior is influenced by the interaction of multidimensional forces that are interconnected. Furthermore, Sue and colleagues (2014) suggest that one-dimensional perspectives of observing behavior are overly simplistic. Counselors are to recognize the important contribution of reciprocal influences in the development of mental disorders. I will continue to explore interrelationships by observing the potential development of such traits as irresponsibility, impulsiveness, deceitfulness, and disregard for the rights of others.

Development of Dysfunctional Personality Dimensions

I have selected some personality factors to illustrate their development by biological, psychological, and social/cultural influences as shown in Figure 4.2. The interactions of influences in this illustration suggest that the development of one’s personality typically begins in early childhood. The chronic nature of development is characteristic of most personality disorders. The significance of this observation suggests to counselors that early detection of the influences that could lead to the development of a psychological disorder is of the utmost importance. There is little evidence at this time of success in moderating behavior associated with personality problems that have developed over time. Typical behavior patterns of an individual who is considered severely antisocial, for example, suggest a lack of respect for the concerns of others and one who is likely to be involved in overt criminal acts. Extreme aggressiveness and little or no concern for the violation of the rights of others can be the driving forces that lead to vandalism, stealing, and chronic criminal behavior. Poor emotional control and a nonconformity attitude present serious problem for interpersonal relations in all life roles, especially in the work role. In the next section we examine a case of poor emotional control. I will introduce a model for career counselors that consists of four domains, one of which is the career domain. Keep in mind that we have discussed a multipath model for understanding the development of behavior. We now focus on how we can use that information in the career counseling process. The goal is to integrate personal and career concerns and their interrelationships.

Figure 4.2Development of Personality Dimensions

Source: From Abnormal Psychology: An Integrative Approach, 5e, by D. H. Barlow and V. M. Durand, 2009. Reprinted with permission of Wadsworth Cengage Learning, Belmont, CA.

Conceptualizing Concerns in Four Domains

What follows is a good example of interacting influences that have led to a serious disorder that has long-term consequences. All life roles are adversely affected by personality factors that could lead to psychological disorders; the interrelationships of career and personal concern are quite obvious. There are clients, however, who will present symptoms that are considered antisocial but do not meet the criteria for a full-blown psychological disorder. Such is the case of Irv, a 17-year-old Caucasian male, who informs the counselor that he “has difficulty keeping a job.” Further explanations by Irv revealed that he has the tendency to lose his temper and get into arguments with fellow workers. On two occasions he was fired because of his inability to control his emotions. During the interviews that followed the counselor learned that Irv grew up in a neighborhood that was known for its high crime rate. His father was a day laborer and as Irv put it, there was never enough money to sustain the family. He admits to stealing items from neighbors on several occasions, but he was never charged or arrested. He stated he becomes “stressed out” when thinking about future opportunities; Irv felt that he was doomed because of his background. Irv was able to express himself very well and it was noted that his achievement test scores were very close to average for his age group even though he dropped out of high school. The counselor concluded that Irv does not meet all the criteria necessary for a diagnosis of a personality disorder at this time but does have some symptoms that are most troubling. Irv’s concerns were conceptualized by using the representing strategies and four domains as described in Table 4.1.

Table 4.1

Representative Strategies and Client Concerns in Four Domains


Trait-oriented counseling, developmental counseling, social learning and cognitive counseling, person-in-environment counseling

Assessment of traits, clarifying interests, self-concept development, vocational identity development, awareness of developmental stages and tasks, rational decision making, self-directed career maintenance, interpersonal skills development, sources of job satisfaction, work adjustment variables, coping with job loss, and preparing for retirement.


Indecisive, deficiencies in basic skills, career maturity issues, poor work identity, work impairment, work maladjustment, adjusting to career transitions, balancing life roles, job loss, stress, violence in the workplace, relational problems, failure to adapt to changing work requirements, loss of work identity, and adjustment to retirement.


Cognitive-behavioral interventions, client-centered therapy, existential therapy, psychodynamic therapies

Empathy, active listening, awareness techniques, dignity and worth of individual, ventilation and catharsis, self-regulation, wholeness of individual, insight, and awareness, meaning in life, positive regard, and internal frame of reference.


Emotional instability, sad, anxious, angry, panic attacks, impulsivity, poor self-esteem, feelings of inferiority and helplessness, depressed mood, lethargy, fatigue, and poor personal relationships.


Behavioral counseling, cognitive restructuring, rational-emotive therapy, reality therapy, Beck’s cognitive therapy

Counterconditioning, bibliotherapy, reframing, A_B_C_D_E analysis, systematic desensitization, modeling, contingency management, homework assignments, assertiveness training, problem-solving techniques, contracting, and social skills training.


Faulty thinking, inappropriate behavior, self-destructive behavior, cognitive distortions, maladaptive behavior, faulty beliefs, overgeneralizations of negative experiences, poor information-processing skills, and problems in decision making.


Culturally based interventions, multicultural counseling

Focus on level of acculturation and worldview, cultural identity, cultural orientation, work-related values, culturally appropriate assessment techniques and resources, adjustment techniques to new socioeconomic system. Use indigenous helpers, alternative counseling procedures, and expanded repertoire of helping responses.


Deficiencies in the use of English language and basic skills, poor adjustment to the dominant cultural values, collectivist worldview, cultural shock, lack of job skills, difficulty with assimilating new lifestyle, restrictive emotions, level of cultural identity, effects of discrimination and oppression, and relating to others.

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Table 4.1 is modeled after Hackney and Cormier (2001) and contains counseling strategies and corresponding client concerns. This perspective provides a means of observing interrelationships of client concerns from four domains: Career, Affective, Cognitive-Behavioral, and Cultural. In the career domain, client concerns are very inclusive including the following examples: career decision making, inadequate basic skills, career identity, indecisiveness, poor problem-solving skills, work-related stress, job loss, school-to-work transitions, lack of occupational knowledge, poor self-concept, and self-knowledge. The affective domain encompasses problems—frequently emotionally driven—that affect mood, self-concept, self-awareness, and feelings of inferiority, impulsivity, and helplessness, among others. The cognitive-behavioral domain focuses on cognitions and cognitive schemas that influence behavioral reactions. The rationale is that faulty cognitions can lead to inappropriate behavior. In the cultural domain the client’s level of acculturation is assessed; worldview is weighed, especially the constructs of individualism versus collectivism. The cultural context of a client’s development is considered an important factor in the counseling process. The use of this model is illustrated by the conceptualization of Irv’s concern in four domains as follow.

Career: Irv has given little attention to finding an optimal career. His focus has primarily been on survival and he has resorted to criminal acts of stealing. His decision-making skills are practically nonexistent and his ability to accurately process career information is very questionable. His career development needs are many, including identification of his abilities, interests, and values through appropriate standardized assessment instruments. In addition, how to locate and process career information, learn career decision-making techniques, and find the means and motivation to complete high school are essential. Career development should be accompanied by addressing the interrelationships of a multitude of personal needs. The rationale here is that progress in the career domain will enhance progress designed to moderate personal problems and vice versa.

Affective: Irv needs help in learning to control his emotions. He is emotionally unstable, impulsive and resorts to criminal acts with little thought given to the consequences of his actions. Some of his emotional responses are driven by an attitude of nonconformity. His poor emotional control also adversely affects his ability to focus on future needs, including career information and decision making. His focus appears to be only on short-term interests in that planning for the future is at best a vague concept. The evidence of poor emotional control and accompanying underlying anxiety suggests that interventions should focus on the interrelationship of concerns. This recommendation is based on the premise that what happens in one life role affects other life roles; there is a spillover effect.

Cognitive-Behavioral: Irv’s view of the world has been colored by inconsistent parental discipline, a lack of social support, and other negative environmental experiences. He appears to believe that the way one gets ahead is to be very aggressive regardless of the effect one’s actions have on others. His aggressive behavior is driven by immediate rewards with little thought given to future consequences. Cognitive restructuring should focus on faulty cognitions involving negative self-talk and negative cognitions that reflect self-concept and self-efficacy deficits. To help Irv with interpersonal relationships, assertiveness training and behavioral rehearsal should focus on the differences between aggressiveness and assertiveness. Behavioral rehearsal should target interpersonal relationships, especially one’s lack of concern for others. Irv should participate in several selected roles which will be followed with discussions of real-life experiences and their consequences. A major emphasis will be placed on addressing cognitive schemas and their influence on behavior. Dysfunctional thinking will be assessed by the Career Thoughts Inventory (Sampson et al., 1996a) and My Vocational Situation (Holland et al., 1980) (see chapter 6). Homework assignments will focus on preparing for taking the test for a GED and learning and practicing relaxation techniques.

Cultural: Irv was born into a white working-class home. Although he was exposed to the individualistic view which champions individual accomplishment, an appropriate role model in the home was definitely missing. The environment in which he was raised did not provide a model of consistency; on the contrary, there were constant mixed messages which left Irv confused. In fact, his development appears to include negative perceptions of all life roles accompanied by socioeconomic status disadvantages. Irv’s situational conditions are a good example of how one’s expectations of the future can be quite limited as a result of contextual experiences. Irv is in need of exposure to more positive life roles and the benefits of a balanced lifestyle; self-awareness will be stressed in interventions designed to enhance self-knowledge.

The counselor was very aware that Irv needed immediate attention in order to moderate symptoms that, left unchecked, could develop into a psychological disorder. Although his symptoms were very troubling, there were indications that he was sincere in addressing them. Clients of this ilk, however, can be deceitful and are effective con artists. The road ahead could be perilous, but well worth the effort. The tightly woven connection between career and personal concerns suggests that interventions should address concerns simultaneously. Thus, interests, values, and aptitudes will be evaluated and addressed as well as career decisions techniques. In a working consensus counseling relationship, counselor and client agree on the purpose of all interventions in order for the client to be an active participant in setting goals and selecting the content of interventions. Irv has many needs and among them is the need to learn that structure and consistency can be achieved through his own efforts that are supported by others. Other interventions to restructure his thinking process are to be accomplished through the above planned use of cognitive-behavioral techniques. Hopefully, Irv will recognize that future perspectives can be positive and filled with opportunities. What is important to recognize here is that addressing interrelationships of concerns can enhance the meaning of counseling interventions. Another case example is used next to illustrate significant interrelationships of concerns.

The Career-Work Connection to Anxiety

Susie, a 28-year-old Hispanic female, stated, “I want to find a different job—something that’s easier for me to do.” She explained that her current job as an appliance salesperson was not what she liked, and she felt incompetent. Susie was appropriately dressed and expressed herself well. Susie has never been married and lives with her elderly parents. She has three older married sisters who are living nearby but has little personal contact with them. Susie was considered to be a good student in high school, but a loner. After she graduated from high school, she stayed home to help her parents. Eventually her parents convinced Susie to seek work and she reluctantly applied for a job at a local department store. She was put through a training program to prepare her for dealing directly with customers. Susie, however, seemed to worry about every aspect of her job. She explained that her worries were about making mistakes and if she could meet all the demands of the job. The counselor realized that many workers focus on meeting the demands of a job, but in Susie’s case the concerns seemed excessive. Susie’s expressions indicated a great deal of underling anxiety that will need to be addressed. There also appeared to be a spillover effect in that Susie not only worries about her work but also worries about other activities and life events. She constantly worries about relationships with her older sisters. As an example, she stated, “They don’t like me I’m not one of them.” In addition, the counselor learned that Susie has few friends, and when she rarely dated, she worried intensely about being an appropriate and adequate date. Susie’s world was filled with anxiety including what the future would hold in store for her. The counselor realized that some of Susie’s worries were shared by others her age, but the difference in Susie’s case was the intensity of the anxiety she experienced. The examples of constant worrying illustrate how anxiety can consume an individual and more importantly destroy one’s ability to function in all life roles. Susie’s concerns are conceptualized in the following four domains.

Conceptualizing Concerns in Four Domains

The counselor recognized that there was much more to learn about Susie, but at this point it was clear that personal concerns of anxiety need to be addressed first. Anxiety and tension can often result in confusion and increase one’s vulnerability to develop a psychological disorder. Susie’s negative self-talk and faulty cognitions can interfere with her ability to make appropriate decisions about future needs. Readiness for career counseling will be determined later. In the meantime, the counselor will investigate the focus of Susie’s anxiety in order to determine the purpose and goals of intervention strategies. There appeared to be a general sense of uncontrollability in response to stress that triggers inherited and/or conditioned tendencies to overreact to life events and circumstances. The focus of interventions will address faulty perceptions and negative cognitive schemas. Difficulties with interpersonal relations will need to be moderated and more social support from family members is to be encouraged. What was known about Susie’s concerns at this time was conceptualized as follows.

Career: Susie’s ability to make optimal career choice decisions at this time is very questionable. There seems to be sufficient evidence that she has given little thought to establishing a work identity. Self-knowledge, career information, and the ability to process information are among important goals for interventions. Career readiness will be evaluated by the following standard assessment instruments: Career Maturity Inventory—Revised (CMI-R) (Crites & Savickas, 1995) and My Vocational Situation (Holland et al., 1980) (see chapter 6). In the meantime, interventions will focus on interpersonal relations in the workplace.

Affective: The anxiety Susie is currently experiencing can result in severe emotional reactions and panic attacks. In addition, the overwhelming and constant worry she experiences leave little time for other considerations such as establishing a work role and becoming involved in social activities. Susie’s feelings of helplessness and poor self-esteem are important factors to be addressed in counseling interventions. In short, excessive emotionally driven behavior needs to be moderated.

Cognitive-Behavioral: Susie’s feelings of anxiety associated with fear of the future can make rational decision making difficult. She tends to overgeneralize negative thoughts in all life situations including the work role. Cognitive distortions associated with high levels of anxiety will be addressed through cognitive restructuring as well as negative self-talk. It appears that Susie’s poor self-concept is reinforced by cognitive distortions and poor self-esteem. In addition, demeaning self-talk will be addressed by interventions that are designed to generate self-enhancing thoughts.

Cultural: Susie is a second-generation Hispanic. She self identifies as a Mexican American and embraces many traditional values. Although she is family and community oriented, her relationships with her three older sisters is estranged. In collectivist-oriented Hispanic families, it is most important for each family member to embrace the welfare of the family group rather than one’s individual goals. Family support and approval are sought by all its members. The lack of social support from family members can contribute to the anxiety Susie is currently experiencing. Thus, another major goal for the counselor is to unite the family in offering support of Susie’s efforts to overcome anxiety.

Susie’s case is a good example that illustrates the connection of career and personal concerns. Counselors may find that career counseling is best delayed with some clients until some or most personal problems are moderated. This is a call that counselors must often make, but there are also situations when career and personal concerns can be effectively dealt with simultaneously. In the case of Susie, the decision to delay career counseling was determined by the severity and pervasive nature of an anxiety disorder. Interventions can include discussions of interactions in the workplace; successful experiences in the work environment can be very therapeutic. An example of an intervention in Susie’s case is described as follows:

Addressing an Anxiety Disorder with Systematic Desensitization

Systematic desensitization is a progressive muscle relaxation technique. One reduces anxiety through muscle relaxation while visualizing anxiety-provoking events; a relaxed state of mind inhibits severe reaction to stress. The client is encouraged to construct a hierarchy of events, arranged in order of least to most intense, that heighten anxiety reactions. Susie’s hierarchy included the following events involving a workday and her work environment:

1. Take a bus to work

2. Check in

3. Discuss day with work associates

4. Enter meeting room

5. Leader calls meeting to order

6. Discussion of current sale priorities

7. Report to work area

8. Meet with first customer

Clients begin by imagining that they are in the first situation twice without increasing muscle tension. They are to stop when they are unable to visualize a situation without becoming tense. Clients recycle through the hierarchy until they are able to move forward without tension. This exercise is usually followed with homework assignments such as practicing muscle relaxation.

Susie will also participate in practicing methods of enhancing self-thoughts and moderating self-talk that is demeaning. Drug therapy may be used in conjunction with other interventions. Social support provided by her family and other members of the community such as church groups should help Susie prepare for the future through effective career counseling. Establishing a work identity will require Susie to view the future in a much more positive manner. The counselor will attempt to remove all barriers to career choice by addressing both career and personal concerns. Early detection of anxiety and panic provides the counselor with opportunities to address those concerns in an effort to halt the development of a full-blown psychological disorder. Susie will be given the opportunity to select a career with an increased knowledge of her interests, abilities, and values, and more importantly, the ability to adequately process career information.

In both of the case examples, counselors are to select career counseling models that provide opportunities for systematic and consistent plans and actions. Integration of career and personal concerns suggests

· (1) that technical eclecticism involving valid techniques from different approaches to address personal concerns would be used with

· (2) career counseling techniques from career development theories that provide consistency of procedures.

In these two cases, cognitive-behavioral approaches were used to address personal concerns; similar techniques and supportive assessments instruments are used in social learning and cognitive career development theories discussed earlier. In the chapters that follow, more case examples will illustrate the integration of career and personal concerns.


1. The pervasive nature of work should be the subject of research by several academic disciplines to clarify its position in counseling programs.

2. Career development theorists address a wide range of client concerns including cognitive difficulties, emotional problems, and social restraints.

3. Historically, career and personal domains were viewed as separate entities.

4. The call to integrate career and personal counseling was heightened in the 1990s.

5. The biopsychosocial model suggests an interactive process that includes the interplay of biological, psychological, and social/cultural forces that influence behavior. Biological influences include inherited genetic vulnerability, immune system responses, central nervous system responses, and biochemical imbalances. Psychological influences include emotional, cognitive, and behavioral responses. Social/cultural influences include events and situational influences, lack of social support, oppression, discrimination, and poverty.

6. The chronic nature of development is typical of most personality disorders. Symptoms that present the lack of respect and concerns for others and overt criminal acts require effective cognitive-behavioral interventions.

7. The client Irv illustrates behavioral patterns that are similar to behaviors of someone who has been diagnosed as having severe personality problems. Interventions addressed faulty cognitions and career concerns simultaneously.

8. Career work connection to anxiety required the counselor to determine that readiness for career counseling would be evaluated later. In the meantime, interventions focused on negative self-talk and negative cognitions, poor self-esteem, and feelings of helplessness. Fear of the future associated with anxiety can make rational decision making difficult.

Supplementary Learning Questions and Two Case Studies

1. Describe how you would inform a client about how a personal problem of anxiety is interfering with career choice.

2. The career counseling profession has been criticized for devoting most attention to initial choice for young adults. Do you agree or disagree? Justify your conclusions.

3. What do you see as the major obstacles to managing a holistic counseling approach?

4. Defend or criticize the position that career and personal needs are to receive equal attention.

5. Do you think counselor training programs should include a broader perspective of counseling needs?

Case 4.1

The Case of Indecision

Jim, a 19-year-old Caucasian male, told the counselor that he is looking for “the kind of work in which I can do my job without any hassle.” When asked what kind of work he was referring to, he replied, “something I can do on my own.” These and similar statements made it very clear that Jim preferred working alone. The counselor learned that Jim’s previous job had been on an assembly line at a local cannery. He was required to coordinate his responsibilities with a small group of fellow workers. It appeared that Jim was able to meet the demands of his work role but disliked required meetings. Everyone was encouraged to participate by making recommendations to solve problems that had been encountered in the workplace. Jim rarely said a word but when he was challenged by the group to at least express an opinion, he never returned to the work site—he received a notice in the mail that his job had been terminated.

Not only did his fellow workers have difficulty in getting Jim to respond, but so did the counselor. Jim is very shy and makes little eye contact, noted the counselor, and answers questions with a short, abrupt response or usually yes or no. She also noted that when he is pressed to respond he appears confused and very anxious.

Jim grew up in small town and moved to a large city in which he now lives when he finished high school. His father is a plumber and he has one older brother whom he rarely sees. He lives alone and claims he has few friends. He has not dated since moving to the city. His hobbies are listening to musical records and going to an occasional movie or sporting event. He reported average grades in high school. He was unable to identify a preferred occupation but once again made it clear he preferred to work alone.

Questions and Exercises for Discussion

1. How would you conceptualize Jim’s career concerns?

2. What are your conclusions concerning Jim’s reactions to group meetings?

3. What is the significance of Jim’s desire to work alone?

4. How would you describe Jim’s major problems in the cultural/social domain?

5. Conceptualize interrelationships of career and personal concerns in the case of Jim.

Case 4.2

The Case of the Confused Decision Maker

Kris, a 19-year-old high school graduate, asked for help in choosing a college major. She reported to the counselor’s office with one of her older brothers. Kris was neatly dressed and well groomed. Her speech was fluent, and she tended to speak very softly. When questioned about work experience, she informed the counselor she was “let go” from a retail sales job in a local clothing store. The counselor noticed that Kris seemed to be somewhat anxious when questioned directly and she constantly looked to her brother for approval.

In the top 10% of her class, Kris had a record of being a very capable student. She had good rapport with teachers as well as with her peer group. She strongly identified with several girls her age at the high school. Kris has five brothers, and her father was a meat inspector in a local plant. He worked hard to maintain the family. Her mother has never worked outside the home.

When the counselor asked Kris to come into his office, she seemed to be very uncomfortable and asked if her brother could attend the session with her. The counselor reassured her that they would have ample time to talk with her brother later. She reluctantly agreed to begin the interview.

From the description Kris gave of her home environment, the counselor assumed it was very traditional. Moreover, the chores assigned to the children typically were based on what the parents considered appropriate work for boys and for girls. There seemed to be strict stereotypical roles embedded in Kris’s perception of traditional work roles for women. She appeared to be very passive and gave the impression that she expected someone else to make decisions for her.

When discussing future objectives, Kris seemed quite confused when the counselor suggested she consider all careers, including nontraditional ones. At one time she had expressed an interest in architecture but considered it to be only for men and therefore decided against it as a possible choice.

Kris’s behavior pattern reflected little confidence in her abilities, and she deferred to others for decision making. She constantly referred to her brothers as giving her good advice and reassuring her of what was best for her.

Questions and Exercises for Discussion

1. How would you characterize Kris’s emotional state?

2. How would you address Kris’s dependence on others?

3. How would you explain to Kris that her personal and career concerns are interrelated?

4. What does self-efficacy have to do with Kris’s current status?

5. Which, if any, assessment instruments would be most helpful?

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