Lmhc Career Counseling

This is part 1 and part 2 discussion question, very detailed, please read.

Week 5 / Chapter 5 Announcement

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 3: 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.  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. Good luck and let me know if you have any questions or concerns.

Chapter 5 Introduction

Chapter Highlights

· Rationale for career counseling intake interviews

· Suggested sequence for an interview

· Suggestions for interviewing multicultural groups

· Identifying strengths and assets

· Identifying career development constraints

· Identifying some psychological and personality disorders

· Key standardized assessment instruments

The call for integrating career counseling to include personal concerns clients bring to counseling suggested a more comprehensive and inclusive role for the intake interview. Focusing on both career and personal concerns and their interrelationship is the key factor in current career counseling programs. This is not a new position. As you may recall some of the counseling models discussed in chapter 3 included suggestions for addressing personal concerns that interfere with the career choice process. A client’s dysfunctional thinking, for example, is a most legitimate concern as discussed in the previous chapter. In the whole person approach to career counseling, I emphasized that one is to address both career and personal concerns aggressively and how the interrelationships of concerns can affect the career choice process as well as career development. What was suggested is that counselors are not only to focus on a client’s measures of ability, assets, and interests for instance, but also on symptoms of psychological disorders that could present barriers to making an optimal career choice. The position that behavior is the product of multidimensional influences suggested that not only are abilities, assets, values, and interests involved in the career choice process, but also so are many other important factors including socioeconomic and mental health issues. All information obtained in an intake interview is used with other data to develop the content of interventions that address both personal and career concerns.

5-1 Identifying Strengths and Assets

We begin the interview with an informal evaluation of the client’s strengths and assets. The counselor is to focus on identifying positive traits as well as negative ones. A balanced view of human functioning includes subjectively measured feelings of well-being that could include a discussion of a client’s relationship with others, a sense of meaning and purpose in life, job satisfaction, happiness, contentment, hope, self-determination, and optimism for the future (Compton & Hoffman, 2013). The position of using positive traits in the career choice process can be traced back to Parsons’s (1909) very perceptive conceptual framework for helping a person choose a career. He focused on a client’s resources including aptitude and ability as a first step in the career choice process. The emphasis was on identifying positive individual traits. Currently, the strength-based approach to career counseling supports and underscores the important focus on exploring one’s existing resources. A most important goal in positive psychology is to identify and enhance an individual’s strength and resilience (Seligman, 2011). Wellness concepts are to be recognized and serve as a major role in the career counseling process. What is clearly suggested here is that career counselors are to balance their counseling approach by spending sufficient time focusing on individual positive characteristics (Harrington, 2013). The emphasis on individual strengths does not cancel the need to identify and address client concerns that are problematic. One could emphasize that a stable sense of well-being, however, could serve as a barrier to halt the influence of negative emotions. In essence, the counselor uses the client’s positive assets to counteract feelings of anxiety, worry, and fear (Shmotkin, 2005). The results of numerous research projects suggest that optimal human functioning includes such qualities as happiness, optimism, resilience, hope, courage, ability to cope with stress, self-actualization, and self-determination (Sue et al., 2014). Client and counselor greatly benefit by addressing the interrelationship of positive traits as well as negative concerns in the counseling process.

Later in this chapter I briefly review a well-known standardized personality inventory, the NEO-PI-3 (Costa & McCrae, 1997), also known as the big five-factor model. The results of this personality inventory are straightforward and provide useful information for use in the career counseling process as well as measures of a client’s subjective feeling of well-being. Ten determinants of well-being in the workplace are introduced next.

5-2 Determinants of Well-Being in the Workplace

Ten determinants of well-being in the workplace that have been paraphrased from Warr (1987, 2005) are contained in Box 5.1. Counselors who are aware of work environments that can determine one’s feeling of well-being and fit are in a better position to foster discussions about the give-and-take associated with one’s workplace. It should not be surprising to find that many workers seek security, interpersonal contact, and a valued social position that can be job related. In addition, one usually desires to be challenged with tasks that can be mastered in order to experience competence and the satisfaction of a job well done. Variety of tasks, supportive supervision, and environmental clarity are other examples of important subjects one can discuss and clarify in the counseling process. I continue with a discussion of the intake interview.

Box 5.1

Well-Being in the Work Environment

1. Opportunity for control. Work environments that promote opportunities for workers to control some work tasks enhance mental health and feelings of well-being. This logical conclusion suggests that when individuals are able to make decisions concerning their work procedures, they are in a better position to predict the consequences of their actions.

2. Opportunity for skill use. The ability to make use of one’s skills promotes and provides opportunities for growth and self-satisfaction. Successful use of skills enhances one’s feeling of competence.

3. Externally generated goals. Organizational goals should be clearly stated with obtainable objectives that are reasonable. Sufficient resources are to be available for meeting the requirements of job demands. Individual workers should be able to experience the satisfaction of a job well done.

4. Environmental variety. The challenge of learning new skills creates an interesting environmental variety of tasks and reduces boredom. The opportunity to successfully learn different and effective work procedures promotes personal growth.

5. Environmental clarity. Clarifying role assignments for each worker should also include opportunities for feedback of job performance. The worker’s feelings of well-being are greatly enhanced by the certainty of the future for a job well done.

6. Availability of money. Job satisfaction is to some extent measured by one’s level of pay. Workers who can provide sufficient funds for the welfare of their families are likely to experience satisfaction and self-esteem. In addition, satisfaction with one’s income is often related to a comparison of what others make who do the same job.

7. Physical security. Pleasant and safe working conditions enhance feelings of well-being. Workers who experience healthy work environments and safety on the job can experience positive reinforcement in the workplace.

8. Supportive supervision. Workers especially respond positively to effective leadership, support, and encouragement. Managers who provide support and offer constructive advice create work environments that offer workers the opportunity to fulfill work goals and experience the feeling of well-being.

9. Opportunity for interpersonal contact. An important aspect of job satisfaction is the opportunity of interpersonal contact with fellow workers. Workers usually respond positively to the opportunity for social support in the workplace. The opportunity to socialize with others reduces feelings of loneliness. Mutual goals that are shared with others provide the potential for forming relationships.

10. Valued social position. Work has a long history of being valued in our society. When a worker feels that his job is appreciated by others, there is indeed a sense of life purpose, a belief that his or her job makes a difference, and a feeling of accomplishment (Compton & Hoffman, 2013; Harrington, 2013; Warr, 1987, 2005; Zunker, 2008).

5-3 An Intake Interview for Career and Personal Concerns

Be aware that I make the assumption that users of this text have been thoroughly trained in interview techniques. Thus, the purpose of this chapter is to present a suggested sequence for an interview that addresses the interrelationships of career and personal concerns. You will recognize that this outline contains the same or similar components that are used in other sequences for an interview. What is different here, however, is a focus on interrelationships of concerns and their effects on all life roles—not just career concerns, but personal ones as well. Counselors are to uncover barriers to career choice including personal concerns that can interfere with the choice process. A very inclusive interview also addresses behaviors that can lead to work maladjustment and in addition the potential of a spillover effect to other life roles. One is to focus on dysfunctional thinking and its effect on all life roles. The whole person approach to helping is very inclusive; career and personal concerns are viewed as sets of needs that are interrelated. In sum, the purpose of the interview is to learn as much as we can about an individual and use this information to unravel the tightly bound connection between career and personal concerns. The intake interview outlined next was adapted from a number of sources including Brems (2001); Cormier, Nurius, and Osborn (2013); Ivey and colleagues (2014); and Sue and colleagues (2014).

1. Identifying Information

Name, address, age, gender, marital status, occupation, university, school or training facility, and work history can be taken orally or by written response on a preinterview form. Direct questioning has the important advantage of being able to observe behavior and emotional responses. Therefore, even if a written self-report is used, a discussion of this information could be included in the interview.

2. Presenting Problem

Reason client has come to counseling

3. Current Status Information

Affect, mood, attitude

4. Health and Medical Information

Including substance abuse

5. Family Information

Current status and past history

6. Social/Cultural issues

Cultural identification

7. Some Career Choice and Career Development Constraints

Contextual experiences

Changing nature of work

Negative cognitions

Psychological disorders

Contextual experiences

8. Clarifying Problems

Counselor and client collaborate

State problems clearly and concretely

9. Strength and Wellness

10. Identify Client Goals

Determine feasibility of goals

Establish subgoals

Assess commitment to goals

Most human service providers typically provide client information forms in which the information in Parts I through VI is self-reported with the exception of current status information and social/cultural issues. As suggested previously, the discussion of self-reported information may provide important observations of the client’s current status. One may also want to clarify the reasons clients have given for coming to counseling. In addition, discussions of self-reported information can be used to establish rapport with one’s clients. Before continuing our discussion of the remaining parts of the intake interview, I will offer some suggestions for interviewing multicultural groups next.

5-4 Suggestions for Interviewing Multicultural Groups

Developing a greater sensitivity to culturally diverse clients has become increasingly important for career counselors; one must foster specific counseling techniques to accommodate the human diversity that exists in our society. The core dimension of interviewing is effective communication between clients and counselors, especially with multicultural groups. Also, during the interview, counselors form opinions and assumptions about clients from both verbal and nonverbal communications. Because of cultural and ethnic differences between counselor and client, the counselor must be alert to a wide spectrum of ethnic and cultural characteristics that influence behavior. Some cultural groups conceptualize their problems differently from those of the dominant culture and seek solutions based on these assumptions. For instance, a client who believes he is being ostracized because of race might be much more interested in finding immediate employment than in pursuing a program for identifying a long-term career goal. Another client might be reluctant to share her personal problems with someone outside the family circle and, in fact, might interpret direct questioning as an infringement of her privacy (Paniagua, 2005; Sue et al., 2014).

Although it is difficult to generalize techniques suggested for different cultural groups, it seems feasible to first determine the level of acculturation including the following: socioeconomic status, language preference, place of birth, generation level, preferred ethnic identity, and ethnic group social contacts (other measures of acculturation will follow) (Matsumoto & Juang, 2013). Questions must be carefully selected and presented to avoid offending clients who may be quite sensitive to the questioning process. Directness, for example, may be judged as demanding, intrusive, or abrupt by some cultural groups. Furthermore, an “open” person may be seen by some cultures as weak, untrustworthy, and incapable of appropriate restraint. Some other factors to remember when interviewing people from other cultures are offered by Cormier and colleagues (2013), Ivey and colleagues (2014), and Ponterotto, Casas, Suzuiki, and Alexander (2010) and are paraphrased as follows:

· General appearance can be quite distinctive for some subcultures and should be accepted on that basis.

· Attitude and behavior are considered difficult to ascertain. Major belief themes of certain cultures influence members’ attitudes about themselves and others. Their perceptions of the world may be quite different from those of the counselor.

· Affect and mood are also related to cultural beliefs and to what is considered appropriate within a culture. The meaning given to gestures often differs by culture. Work experience may be quite limited because of lack of opportunity. Also, in some cultures, it is considered immodest to speak highly of yourself and the skills you have mastered.

· Life roles, and particularly relationships, are unique to cultural socialization. In some cultures, females are considered equal to males, whereas in others, females are expected to be subservient.

These examples of cultural differences are given here to underscore the necessity of building an extensive body of resources for interviewing ethnic minorities. Other general recommendations include

· (1)

using straightforward, slang-free language,

· (2)

becoming familiar with cultural life-role models,

· (3)

identifying a consultant who can provide helpful information, and

· (4)

becoming familiar with support networks for different cultural groups (Matsumoto & Juang, 2013; Ridley, 2005).

Most important to remember is that cultural groups are not to be stereotyped as homogeneous. Thus, with our focus on the uniqueness of individuals, one should begin by establishing a collaborative working relationship with each client: A trusting relationship is essential for productive interviewing. The multicultural career counseling model for ethnic women (Bingham & Ward, 1996) discussed in chapter 3 suggests that a Multicultural Career Counseling Checklist that is counselor self-administered (Ward & Bingham, 1993) and a Career Counseling Checklist (Ward & Tate, 1990) for clients are to be administered as an aid in establishing rapport. Selected items from the client’s checklist can be used as an entry to discuss problems that are related to cultural diversity.

The acculturation level of the client should be assessed to help determine the client’s cultural transition and adaptation to life in a different culture. In chapter 6, I discuss achieving equity in assessment that includes a list of contextual assessment areas that should help assess a client’s cultural transition, adaption, and acculturation. Please refer to the section of chapter 6 that discusses achieving equity in assessment for more information about this very important subject.

The information one receives from an assessment of acculturation may be used to determine the individual’s level of assimilation in the transformation process of balancing values, beliefs, and traditions brought from the country of birth with new ideas of lifestyle and traditions of the host country. The stage of identity development should also be evaluated. Additional focus should include the following:

· Neighborhood contextual experiences

· Quality of housing

· Experiences with racism

· Religious beliefs

Interviewing culturally different individuals requires a variety of techniques and skills. Ivey and colleagues (2014) among others have developed a list of suggestions. Each technique has been listed with an explanation, an illustration, or both; this is an outstanding resource for interviewing culturally diverse clients. The following suggestions for managing an interview with a culturally diverse individual should be used in conjunction with the previously suggested sequence for an interview.

Eye Contact. In Native American and Latino/a cultural groups, direct eye contact, especially by the young, is considered disrespectful. Okun, Fried, and Okun (1999) note that in many cultures’ individuals are forbidden to look directly at others who have more power. It is inappropriate in Muslim cultures for women to make direct eye contact with a nonfamily male. Obviously, direct eye contact is interpreted differently among cultures; some cultures consider it to be an invitation to a sexual liaison, whereas others consider it an invitation to conflict (Paniagua, 2005; Sue et al., 2014).

Touch. Guidelines for touching across gender lines are clearly defined in some cultures. For instance, in many societies, especially in the Middle East and among Asian groups, women do not touch or shake hands with unrelated men. The counselor should let the client initiate the greeting and ending of a counseling session.

Probing Questions. In some cultures, especially among some Asian groups, asking for more in-depth information is considered to be very rude and intrusive. Being aware of this potential problem, counselors restructure their questions to focus on the topic the client has initiated, as shown in the following samples:

Counselor:

How do you think you could best help the situation with your brother?

Counselor:

What can you tell me about the relationship?

The counselor has a delicate balancing problem with Asian groups that respect individuals who demonstrate proficiency in their profession but resent those who appear to be too intrusive.

Space and Distance: Be alert to cultural differences in what is considered to be an appropriate distance from another individual when interviewing. Remember that the British prefer more distance than do North Americans (more than an arm’s length), Latino/a people like being closer, and those from the Middle East prefer to be “right in your face.”

Verbal Style: “I” is not a word in Vietnamese; individuals are defined by their relationships: Son (I) asks Father (you) for permission, Mother speaks to children (them).

Restrictive Emotions: Many cultural groups are taught to mask their emotional feelings. Thus, they might appear to be disinterested and preoccupied. This is particularly true of Native Americans who consider masking emotional responses a sign of maturity. In most cases you can expect African Americans and Latino/a people to openly express emotions.

Confrontation Issues: Ivey and colleagues (2014) suggest that one must be very sensitive to the cultural orientation of each client if confrontation is used in the interview. What is suggested is that extreme confrontational statements may not be helpful with certain groups, especially in the opening stages of interviewing. Counselors must remember that personal and family honor are almost sacred among some cultural groups, especially in Asian cultures. Thus, direct confrontation may be perceived as being ill-mannered by some groups. Counselors are to be very careful and most flexible when they construct questions, such as, “Tell me more about your feelings when that event took place,” or “What is your son’s typical story of that behavior?” In short, use the principles of supportive, empathic confrontation to construct questions. Skilled counselors have learned that at times silence can be very helpful in that it provides the client time to struggle with a problem.

Self-Disclosure: This technique is quite paradoxical in that it is most essential when establishing rapport for a trusting client–counselor relationship and can be most damaging to the counseling relationship if the counselor is perceived as being immature. For instance, self-disclosure at the initiation of the interview can be helpful for building trust: “I grew up in the South and I’m white and you are an African American. Do you think we can work together?” However, counselors who focus too much time on their own personal lives and intimacies can lose face with their clients (Matsumoto & Juang, 2013; Paniagua, 2005). Again, a delicate balance must be maintained.

5-4a Focus on Self-In-Relation and Self-In-Context

The point has been made that in North America we tend to focus on the “I.” In many other cultures, the focus is on family or solidarity of groups. In making career decisions, the focus can be directed to include the family. The individual perceives himself or herself as a self-in-relationship and makes decisions that meet the needs and approval of the family. Family honor and loyalty may be the driving forces that the counselor must recognize (Matsumoto & Juang, 2013; Ponterotto et al., 2010).

In sum, what one is expected to remember about the differences between cultures and what are considered to be acceptable and culturally appropriate verbal and nonverbal techniques can be overwhelming. This points out, however, the necessity of preparation for counseling and interviewing encounters, especially with individuals from culturally diverse groups. Counselors must also remember that they are interviewing unique individuals who share some cultural values with others but who have also been shaped by nonshared experiences. The techniques we have just reviewed are generalized suggestions that might not apply to all members of a particular culture. Nevertheless, the career counseling profession must prepare itself for diversity to be effective in the 21st century. I continue our discussion of the intake interview beginning with step VII in the interview sequence.

5-5 Step VII Some Career Choice and Career Development Constraints

The focus on constraints and/or barriers to career choice and development in step VII has been the centerpiece of research for a number of decades. Career choice and development share many common barriers; a client’s negative cognitions, for example, would more than likely affect initial career choice and those that follow as well as one’s development. I will make some distinctions between career choice and development in the discussions that follow, but my primary focus will be on the connection between career and personal concerns. Be aware that the constraints listed are not all inclusive but provide the counselor with examples of specific barriers that can hinder one’s ability to make an optimal career choice as well as constraining one’s career development. Contextual experiences have had an important role in both career and personal counseling. One’s values and core beliefs influenced by environmental experiences and life-course events are the driving forces behind significant life decisions. We are in many respects a product of our environment; people are active information processors. Recall that life events can trigger anxiety reactions that could foster the development of a full-blown anxiety disorder for example. I am suggesting that contextual experiences are very important influences on the development of one’s worldview, the development of cognitive schemas, and subsequent behavior. Influences on behavior that emerge from contextual experiences are a major focus of the interview. What I am discussing here is a socialization process involving situational influences from which one absorbs their culture, develops a basis for identity, and establishes a personality. Socialization takes place in ecological systems which are very inclusive; people learn without reinforcement (Bandura, 1986). Uniqueness emerges from individualized and shared experiences. What counselors should take from these statements is that contextual experiences greatly influence how each individual views the world; people internalize values, beliefs, and expectations of the future (Sue et al., 2014; Zunker, 2008). A representative list of career barriers that may be the result of contextual experiences follows.

· Discrimination against and oppression of career ideals

· Lack of educational and occupational opportunities

· Lack of quality educational experiences

· Lack of openness to career selection

· Poor role models

· Socioeconomic disadvantages

· Unstable familial experiences

The lack of access to educational and occupational opportunities may force some clients to search for the best job opportunity currently available rather than engage in counseling to find a work environment that is considered to be the best fit. Clients with a poor educational background are most likely to view the future quite differently than someone who has experienced enriched educational experiences and plans to attend a university. Counselors may find that some clients have been conditioned to believe that they are destined to take jobs that do not require a strong educational background; it is their fate to work in lower level jobs. Socioeconomic disadvantages can limit one’s ability to obtain a college education and/or attend a professional school. Although there are many examples of individuals who have succeeded in moving from working class to middle-class status, research tell us that most people remain in the social class of their origin (Andersen & Taylor, 2013). Poor role models and unstable familial experiences that can be found in most class status groups can negatively affect an individual’s self-esteem as well as future expectations. What is most important for the counselor here is the recognition of how contextual experiences can influence one’s view of the future. Self-perceptions are particularly significant for discovering pathways to form a career identity.

5-5a Changing Nature of Work

Establishing a work identity and having a job that sustains one’s family have been and remain part of the American dream. The changing nature of work in America has been ongoing and will continue to present new opportunities for the American worker. Many in the workforce today are known as knowledge workers who maintain their position by staying up to date in their field of work (Drucker, 2002). More workers are now required to manage their own career development and are encouraged to become lifelong learners. Current workers and individuals who are in the process of making an initial career choice currently experience the challenges that are created by a diminishing number of jobs and workplaces. In current economic times many workers have lost the guarantee of a lifetime job. In many work environments job security is threatened. Not only do current workers have concerns about their future long-term interests but so also do those who are making an initial career choice (Feldman, 2002). There appears to be a growing distrust among some workers of those who employ them and in the strength of our economy in general. These feelings have been exacerbated by the loss of millions of jobs during the recession in 2009 and the outsourcing of jobs in the 1990s. Counselors can expect to find that many of their clients will experience serious career and personal concerns when their source of income has disappeared. I will discuss more about work and the workplace in chapters 713, and 14.

5-5b Negative Cognitions

Faulty beliefs and assumptions have been a primary target of human service practitioners over time. Practitioners have come to recognize the pervasive nature of negative cognitions. Negative views of the future, about self, and about the world of work, for example, suggest that a client has low self-esteem as well as self-concept and self-efficacy deficits. Negative cognitions usually increase the level of demeaning self-talk that can lead to indecision and negative overgeneralizations; one’s view of life can be almost completely negative. It should surprise no one that faulty beliefs and assumptions can lead to an identity crisis that could affect a person’s ability to function in all life roles (Cormeir et al., 2013; Zunker, 2008). Negative beliefs and assumptions can also lead to severe anxiety, fear, and panic attacks. One may become so overwhelmed with worry that they are unable to accomplish even daily tasks. Indeed, negative cognitions have the potential to severely diminish ones’ ability to make appropriate life decisions that have long-term consequences (Durand & Barlow, 2013). Thus, interviewers should be alert to any indications of dysfunctional thinking when involved in dialogue with their clients. Finally, early detection of negative cognitions is essential. Assessment instruments that can provide an objective appraisal of dysfunctional thinking will follow in the discussion of psychological and personality disorders.

5-6 Psychological Disorders

At this point it should be clear to the reader that psychological disorders can affect all life roles including the work role. Someone with an anxiety or a mood disorder or both, for example, will have difficulty in choosing a career and maintaining employment as well as functioning in other roles. Human service practitioners address a variety of client problems including concerns that are identified by symptoms of psychological disorders. Examples of groups of psychological disorders include: anxiety disorders, development disorders, mood disorders, personality disorders, schizophrenia and other psychotic disorders, somatoform and dissociative disorders, substance-related and impulsive control disorders, and many others. Symptoms of psychological disorders are contained in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. text revision) (American Psychiatric Association, 2013).

The point was made earlier that helpers are to detect early symptoms of disorders in an attempt to prevent the development of psychopathology. What is suggested here is that counselors are to sharpen their skills for detecting symptoms of disorders during the interview and learn more about assessment instruments that could assist them in the identification process. Let me be clear. The counselor is more interested in determining symptoms of psychological disorders for the purpose of developing interventions to moderate their severity rather than for labeling a client with a particular disorder or disorders. In the case of a mood disorder of depression for example, typical symptoms include the observation that the client appears to be lethargic, sad, and anxious and displays feelings of helplessness. One can expect depressed clients to be indecisive and have serious relational problems. They tend to be slow to respond to questions and have trouble recalling past events. One can also expect to find work impairment and poor work identity. There can be strong indications of emotional instability and most often clients with symptoms of depression are consumed with negative self-evaluations (Durand & Barlow, 2013; Sue et al., 2014). What is clear is that clients with symptoms of depression will need interventions designed to modify negative cognitions as well as relaxation exercises. In addition, self-talk will have to be modified and closely monitored. Some clients with these symptoms are able to participate in personal and career counseling simultaneously. This decision, as you would expect, is based on the severity of the client’s condition. In the following paragraphs, a career counselor and a mental health counselor are involved in an intake interview with their respective clients.

Using good listening and observation skills, a career counselor detects symptoms of depression. Although the severity of depression is unknown, the client’s demeanor could be described as someone who is rather sad and emotionally unstable. The counselor wanted to verify her tentative conclusions of mild depression. Most helpers will want to use effective standardized assessment instruments to confirm their observations during the intake interview. Helpers are particularly interested in measuring the severity of symptoms. The career counselor in this case had dealt with a limited number of clients who had similar symptoms and she wanted objective data to confirm her observations. She chose the Beck Depression Inventory (BDI-II) (Beck, Street, & Brown, 1996) that measures the severity of symptoms of depression.

In another counseling situation, a mental health counselor also detected symptoms of depression in a client she interviewed. This particular mental health counselor had considerable experience with clients who had symptoms of depression and she also chose to use the results of the BDI-II. In addition, the mental health counselor was also most interested in becoming more familiar with standard measures of interest to assist her client in the career choice process. She chose the Self Directed Search (SDS) (Holland, 1994a) as an interest measure and My Vocational Situation (Holland et al., 1980) in order to observe possible causes of vocational difficulties including lack of vocational identity, lack of information or training, and environmental or personal barriers. It is likely that both helpers would use all three inventories. In addition, more information on dysfunctional thinking could assist both counselors in addressing negative cognitions so prevalent in cases of depression. One of the instruments that could be used for this purpose is the Career Thoughts Inventory (CTI) (Sampson et al., 1996a), which is designed to measure negative thinking. The CTI provides scores for three scales, Decision-Making Confusion, Commitment Anxiety, and External Conflict plus a total score. Both the career and the mental health counselor chose specific assessment inventories to confirm their observations in order to prepare for problem identification in the next step of the interview process. In both counseling cases, the focus was on identifying the interrelationship of career and personal concerns. In the next section of this chapter, I will provide a brief description of some selected psychological disorders, including anxiety, mood, somatoform, and personality disorders. Much more information on the psychological disorders discussed in this chapter and other psychological disorders not discussed here can be found in abnormal psychology textbooks including Durand and Barlow (2013) and Sue and colleagues (2014).

5-7 Identifying Symptoms of Psychological Disorders

The brief review of some psychological disorders that follows will hopefully be used as a quick reference for identifying potential client problems in the intake interview. Keep in mind that there are many other psychological disorders that are not discussed here. Counselors who are alert to symptoms of psychological disorders will be in a much better position to identify potential barriers that can constraint one’s career choice and interfere with one’s career development as well. More importantly, problem identification provides a pathway to effective interventions. Counselors focus on symptoms of disorders when engaging clients in discussions involving goal selection. When a clinical assessment is necessary, counselors are to refer clients to determine if presenting problems meet the criteria for a specific psychological disorder (Durand & Barlow, 2013). I begin with anxiety disorders.

5-7a Anxiety Disorders

Apprehension, worry, fear, and panic characterize anxiety disorders. In most of the disorders that follow, anxiety is usually persistent and intense and accompanied by fearfulness and even terror that can impair normal functioning. Currently there are seven anxiety disorders.

· Panic disorder consists of episodes of panic attacks with and without agoraphobia (fear of leaving one’s house). Individuals with a panic disorder are focused on avoidance of situations that are considered unsafe.

· Agoraphobia is fear of places such a mall or theatre and/or avoidance of feared situations and people. In extreme cases people will not leave their home.

· Specific phobia is a fear of specific objects such as a spider or some or most animals. In addition, there is extreme fear of closed spaces such as a cave, tunnel, or even a closed room and also heights.

· Social phobia is a fear of being judged harshly by others when performing or making a speech or even when interacting with others. Fear of being watched by others may result in a panic reaction.

· Generalized anxiety disorder is characterized as excessive worry that persists for at least six months. In this disorder, anxiety is focused on minor everyday events. One is consumed with worry and anxiety.

· Obsessive-compulsive disorder is characterized by recurrent obsessions (persistent or uncontrollable thoughts) or compulsions (an overwhelming need to repeatedly wash one’s hands, for example). One can be so involved in rituals that all life roles are affected.

· Post-traumatic stress disorder is characterized by re-experiencing an extremely traumatic event. One focuses on avoiding images or thoughts about a traumatic experience. Some war veterans, for example, experience daily stress for years after they have retired from the service (Sue et al., 2014).

Like most other psychological disorders, anxiety and panic attacks are very pervasive in the lives of those who are afflicted with these disorders. Anxiety is considered one of the building blocks that can lead to disorders that are very debilitating (Durand & Barlow, 2013). An individual’s reaction to excessive anxiety can be overwhelming and take an enormous toll on one’s lifestyle.

5-7b Somatoform Disorders

This group of disorders is characterized by concerns with the physical body and its functions. Imagined illnesses and physical complaints that have no medical bases are good examples of this disorder. One may fear they have a terminal illness that will come forth at any time. Others constantly complain about numerous physical conditions that are undocumented. In extreme cases an individual can actually become paralyzed without a medical basis. Yet another individual believes that he has a physical condition that is so horrible that everyone who sees it is appalled. There are four disorders in this group (Durand & Barlow, 2013; Sue et al., 2014) as follows:

· Hypochondriasis is characterized by anxiety about a preoccupation with an imagined illness or serious physical condition that is nonexistent. A hypochondriac is certain that he or she has a serious physical condition even though a physician may conclude there is no evidence of one.

· Somatization disorders are characterized by persistent complaints of multiple physical conditions that have no medical basis. An individual can be convinced that they are afflicted by serious multiple physical problems and are not able to focus on anything else.

· A conversion disorder has somewhat of a different twist. In this case the client actually has a serious physical problem such as blindness or paralysis, but there is no apparent physical cause. The distinct difference here is that one actually is experiencing a physical problem yet no medical basis for the problem can be found.

· Body dysmorphic disorder is a diagnosis used to identify individuals who falsely believe that he or she has a physical defect that is apparent to everyone. In addition, the individual is convinced that the imagined defect is hideous and disgusts everyone who sees it.

Somatoform disorders are good examples of how distorted thinking can adversely influence one’s existence. These disorders develop over time and are considered chronic in nature. Counselors who are able to detect early symptoms of dysfunctional thinking that is so common among somatoform disorders should help their clients learn how to cope with stressful events with the use of cognitive-behavioral techniques. In most cases of somatoform disorders, support groups are used to provide reassurance whereas counseling emphasizes methods to resolve conflicts and reduce stress (Durand & Barlow, 2013).

5-7c Mood Disorders

Emotional states are usually associated with mood disorders in that there are types of depression that are defined by “high” or “low” states of emotion. Mood can also change rapidly in that there are mood “swings” that alternate between depression and mania. To fully understand the significance of mood disorders, one must become familiar with two types of mood disorders labeled depression and bipolar.

Depression disorders consist of major depressive episodes that are most severe, can come about very suddenly, and can last for months and even years. Over time one can experience repeated episodes and may develop long-lasting symptoms. On the other hand, symptoms of mild depression that are also long lasting are known as dysthmia. One can also be diagnosed as having double depression when one experiences alternating periods of severe depression and dysthymia (Durand & Barlow, 2013).

Bipolar disorders, as the name implies, include a depressive phase and a manic phase. This diagnosis is characterized as a roller coaster ride of ups and downs. In the depressive phase, one is unable to enjoy pleasurable experiences, is often described as having difficulty in concentrating, and appears to be experiencing significant loss of self-esteem. In the manic phase, to no one’s surprise, there are elation, joy from every activity, self-assurance, and grandiose plans for the future. There appears to be no in-between, but there are serious functional problems for individuals in both the depressive state and the manic state. In the depressive state, one may experience even suicidal thoughts and in the manic state exaggerated feelings of euphoria and excitement can lead to poor decision making that has long-term consequences. There are three types of bipolar disorders:

· Bipolar I—major depression and full mania

· Bipolar II—major depression and mild mania

· Cyclothymia—mild depression with mild mania that is chronic and long term (Durand & Barlow, 2013)

Helpers recognize that a mood disorder such as depression can negatively impact all life roles, including the work role. People with depression have difficulty processing information and the meaning associated with life events that are critically important in the decision-making process. Negative self-appraisals so common in depression can disrupt job performance and career development. There are certainly personal concerns as well such as inappropriate behavior, feelings of helplessness, and overgeneralization of negative experiences. Long-term interests can be grossly affected by decisions influenced by reckless behavior during a manic phase of a bipolar disorder (Sue et al., 2014).

5-7d Personality Disorders

In chapter 4, a case example was used to illustrate how symptoms of a personality disorder can interfere with one’s career development as well as one’s ability to function in all life roles. Counselors who discover symptoms of a personality disorder are challenged to develop intervention goals to aggressively address a client’s concerns. Research informs us that personality disorders develop over time; thus, the chronic nature of their development presents tremendous challenges to counselors. As I briefly discuss symptoms of personality disorders in general terms, one should remember that a client’s perceptions of multiple influences and experiences over time are an individual matter. What is suggested here is that the severity and the length of time symptoms dominate one’s behavior are most significant. I will briefly review symptoms that can dominate one’s behavior and corresponding work role projections in Table 5.1. In the brief discussions that follow, the focus will be on six personality disorder types from the Diagnostic and Statistical Manual 5 (DSM-5) (American Psychiatric Association, 2013; Sue et al., 2014). It is most important for all counselors to recognize that the diagnostic process involved in identifying a personality disorder requires rigorous training and professional supervision. I repeat, counselors are to refer their clients to a qualified clinician if necessary.

Table 5.1

Personality Type Disorders—Symptoms and Work-Role Projections

Symptoms Disorders Work-Role Projections
Avoidant
Clients who lack social skills and are socially isolated—sit alone, eat alone, and prefer isolation. Nonresponsive and aloof, flat affect. Clients with these symptoms are usually very indecisive, vague about future, and very aloof. Prefer solitary activities; may work well in an environment that provides social isolation. There is a tendency to not seek out close relationships—group work is difficult.
Schizotypal
Clients who are viewed as eccentric and have bizarre ways of dressing. Believe they are the center of all events—odd thoughts and unusual actions. Clients with these symptoms are usually very suspicious of others, have very poor interpersonal relationship skills. They are likely to be shunned by work associates due to bizarre behavior and dress.
Antisocial
Clients who are antisocial fail to conform to social norms and are guilty of aggressive acts against others. They harbor a disregard for the rights of others. Clients with these symptoms tend to behave inconsistently, especially in the work role. There is typical nonconformity to social norms, poor emotional control, and extreme aggressiveness that may result in truancy and stealing. Clients are likely to have difficulty in sustaining productive work.
Borderline
Clients who have poor control over their emotions and show definite signs of instability. Severe mood swings interfere with consistent patterns of behavior. Expect client with these symptoms to have a poor self-concept, difficulty with career choice, career maintenance, and establishing long-term goals. Impulsive behavior can interfere with work-role functioning and other life-role commitments. It is not unusual for clients with these symptoms to experience significant problems with relationships including those with work associates.
Narcissistic
Clients who have a strong desire and need for admiration especially from someone they view as important. They consider themselves to be ultra-special and extremely unique. Client’s with these symptoms will likely attempt to exploit others, expect favorable treatment, and possess excessive feeling of self-importance. Be aware of unrealistic goals and and the exploitation of others.
Obsessive-Compulsive
Clients who are obsessive-compulsive desire complete control of everyone and everything; they are perfectionist and desire order.   The avoidance of decision making is often associated with these symptoms. Clients are often subject to stress due to indecisiveness and a strong need to work within highly structured and organized tasks. Clients with these symptoms are preoccupied with trivial details and seek perfection to the point that task completion is constantly delayed. On the other hand, they are able to function well in work roles that require highly organized activities.

Enlarge Table

Source: Durand and Barlow (2013) and Sue, Sue, Sue, and Sue (2014).

Clients with an antisocial personality disorder are characterized as having a pervasive disregard of the rights of others. There is usually repeated involvement in illegal behavior and a substantial record of unlawful acts. All life roles are affected, particularly the work role.

Clients with an avoidant personality disorder tend to avoid occupational activities that require interpersonal contact. They live with fear of being rejected. There is low self-esteem and avoidance of situations in which they are subjected to criticism. There is a tendency to be very dependent upon others.

Instability and impulsive behavior characterize the borderline personality disorder. Emotional instability is accompanied by brief, but intense, episodes of depression and anxiety. Individuals with this disorder have a deep sense of abandonment.

A sense of self-importance is the major characteristic of clients who have been diagnosed with a narcissistic personality disorder. Some clients may consider themselves as ultra-special and extremely unique. As a result, they constantly seek excessive admiration, especially from others they view as “high-status” individuals. In addition, they have little regard for others and, if given the opportunity, will exploit anyone who stands in their way of grandiose plans.

An obsessive-compulsive personality pattern is characterized as one in which there is preoccupation with rules and details to make certain that every activity is done correctly. Perfectionism and overly strict standards interfere with task completion. There is a need to control all aspects of most situations and there is a tendency to focus on fears associated with failing to do the right thing.

Individuals with schizotypal personality disorder have odd beliefs and peculiar ideation; for example, they may believe in clairvoyance and magical thinking. It should surprise no one that clients with a schizotypal personality disorder are often viewed as very eccentric. More information on personality disorders can be obtained from abnormal psychology textbooks including references in this chapter.

I continue our discussion of personality by reviewing a measure of personality labeled the NEO-PI-3 (Costa & McCrea, 2010), also known as the big five-factor model. This instrument is used to measure dimensions of personality that can be used to build rapport, understand the client’s worldview and insight, and provide measures of positive and negative characteristics. Although it was not designed to measure symptoms of personality disorders, the authors of this instrument make the point that personality traits are very relevant factors in determining personality disorders. The five-factor model includes the following dimensions of personality and facets for each factor:

Neuroticism A measure of psychological distress and emotional stability
Facets anxiety, hostility, depression, self-consciousness, impulsiveness, vulnerability
Extraversion A measure of the tendency to be sociable and feel happy and optimistic
Facets warmth, assertiveness, active, excitement seeking, positive emotions
Openness to Experience A measure of the degree of openness to experience and emotional expressiveness
Facets fantasy, aesthetics, feelings, actions, ideas, values
Agreeableness A measure of the degree of compassion and hostility to others
Facets trust, straightforwardness, altruism, compliance, modesty
Conscientiousness A measure of self-control and the ability to plan and commit to personal goals
Facets competence, order, dutifulness, achievement striving, self-discipline, deliberation

The NEO-PI-3 reports interpretations of both low and high scores of these personality dimensions. Thus, a client who presents emotional instability can be further evaluated to learn the degree or severity of instability. In addition, the counselor is now in the position to evaluate five personality dimensions that describe measures of such variables as depression, impulsiveness, assertiveness, positive emotions, compliance, and achievement striving, among others. Schultz and Schultz (2013) present the highlights of their research of the five factors of personality as follows.

· Neuroticism, extraversion, openness, and conscientiousness have a strong heredity component.

· The factor of agreeableness has a strong environmental component.

· All five factors have been found in diverse cultures.

· Most factors remain stable over the life span.

· Women report higher levels of neuroticism, extraversion, agreeableness, and conscientiousness than men.

· We tend to see others as being more conscientious and less neurotic than ourselves (p. 231).

In addition, Schultz, and Schultz (2013) found that individuals who score high in extraversion tend to be high in emotional stability, are successful in coping with stress, and do exceptionally well in college. High scores in conscientiousness suggests that one is realistic, efficient, and punctual, gets better grades, is well organized, creates friendships, and sets high personal goals.

Engler (2014) suggests that many of the personality traits measured by the five-factor model are related to positive achievement in work. She also suggests that the personality traits measured by the five-factor model are associated with other work-related behaviors. For example, an individual who has a high score in openness to experience will tend to seek work in which one is to assume responsibility, find meaning, autonomy, and responsibility. The individual high in neuroticism will likely stress the importance of a good salary and care less about other job satisfaction factors. Engler strongly endorses well-structured personality questionnaires that do not discriminate against people with disabilities, women, the elderly, and minority groups.

Harrington (2013) suggests that the five-factor model can also be used as a measure of resilience. The factor Extraversion is a measure of good feelings, happiness, positive affect, and subjective well-being whereas the factor Neuroticism is negatively associated with subjective well-being. Other factors associated positively with subjective well-being are Conscientiousness (responsible, hardworking, self-disciplined), Openness, and Agreeableness.

Counselors are to use objective standardized assessment instruments to confirm their observations of clients they are interviewing. This step may be necessary to distinguish between clients who present some symptoms of a personality disorder with no previous history of abnormal behavior. Counselors are likely to find that healthy, functional individuals may be somewhat suspicious of others, lack self-esteem, and be somewhat dependent (Zunker, 2008). Establishing the level of severity and the length of time a client has symptoms of one or more personality disorders can be essential information for both career and personal counseling. In the next section, I briefly review screening instruments for substance abuse and standardized checklists that focus on a client’s self-report of as many as 90 symptoms of disorders.

5-8 Standardized Instruments for Substance Abuse Screening

Alcoholism and drug abuse in the workplace have not only been a hot topic of discussion over several decades but also continue to be major foci of concern by personnel offices worldwide. Industrial and civic organizations have invested considerable funds for substance abuse programs that are designed to prevent one from using alcohol and drugs and also for those who are in need of help to kick a habit. There appears to be significant evidence that workers continue to lose their jobs because of substance abuse whereas for others there are job impairment and excessive absenteeism (Aamodt, 2013; Muchinsky, 2003). The results of a drug and alcohol abuse survey indicated that 8.2 % or more than 9 million working adults reported using illicit drugs in the past month of when the survey was taken and more than 8.8% or 10 million reported heavy use of alcohol in the past month. In addition, 18.6% of unemployed adults used illicit drugs within the past month and 13.6% of unemployed adults admitted to heavy use of alcohol (Substance Abuse and Mental Health Administration, 2007). The point here is that most human resource practitioners are certainly aware of the significant substance abuse problem in this country as well as the professional training needed to qualify as a substance abuse counselor. What I am suggesting here is that career and personal counselors can screen their clients for substance abuse and refer them to qualified substance abuse counselors.

The following are two examples of standardized assessment instruments for assessing substance abuse:

· Substance Abuse Subtle Screening Inventory 3 (SASSI-3) (Miller, 1997)

· Adolescent Substance Abuse Subtle Screening Inventory A2 (SASSI-A2) (Miller, 2001)

Although there are a number of other standardized screening instruments for substance abuse on the market, these instruments are good examples of what is available. The important point here is that substance abuse screening inventories are available to help counselors during the interview to identify and confirm their client’s problems with substance abuse. Client information obtained from screening instruments can help prevent the counselor from addressing issues that are a result of the client’s substance abuse (Whiston, 2013). Being arrested for unlawful behavior, for example, may or may not be connected to one or more personality disorders, but more related to one’s abuse of alcohol and/or drugs. Substance abuse is a very pervasive factor in one’s life as described by Wilson (2003) as follows:

When a person begins to use a drug, that drug use is sporadic and voluntary. But after an addiction develops, the addicted individual is compelled to seek out the drug and consume it. This compulsive drug use is the hallmark of addiction. Addicts lose control of their drug intake. They have a difficult time thinking of anything else but acquiring the drug, and they forsake all kinds of social obligations (including family and work) in order to obtain and use the drug. We still do not know how an addiction develops, but research in this area has given us some clues (p. 402). For more information on substance abuse, use the following website: Substance Abuse and Mental Health Services Administration (SAMHSA)

(http://guide,helpingasmericasyouth.gov/)

5-9 Standardized Checklists for Client Symptoms of Disorders

In the final section of this chapter, I discuss standardized checklists on which clients report their current symptoms. Two instruments that stand out among many others are The Symptoms Checklist-90-Revised (SCI-90-R) (Derogates, 1994) and the Brief Symptoms Inventory (BSI) (Derogates, 1993). On the SCI-90-R there are 90 symptoms listed and, on the BSI, there are 53. On both of the instruments, clients are to respond to a list of symptoms by using a 5-point scale of distress ranging from 0 (not at all) to 4 (extremely). Both inventories can each be completed in 15 minutes or less. These instruments provide measures of nine scales as follows: Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism. In addition, there are three composite scores: global severity index, positive symptom total, and positive symptom distress index. The composite scores can be compared to nonpatient adults, nonpatient adolescents, psychiatric outpatients, and psychiatric inpatients (Whiston, 2013). Clearly, counselors can use the results of these two checklists to determine interventions for their clients or to refer them for further evaluation and treatment. Counselors can also scan the results of the checklists to determine the most distressing symptoms the client has checked. Finally, counselors are to become familiar with the myths and reality of the mentally disturbed as explained in Box 5.2.

Box 5.2

Stereotypes about People who Are Mentally Disturbed

Myths versus Reality

Myth:

People who are mentally disturbed can always be recognized by their abnormal behavior.

Reality:

People who are mentally disturbed are not always distinguishable from others on the basis of consistently unusual behavior. First, no sharp dividing line usually exists between normal and abnormal behavior. Second, even when people have some form of emotional disturbance, their difficulties may not always be detectable in their behavior.

Myth:

People who are mentally disturbed have inherited their disorders. If one member of a family has an emotional breakdown, other members will probably suffer a similar fate.

Reality:

The belief that insanity runs in certain families has caused misery and undue anxiety for many people. Heredity does play a role in some mental disorders, such as schizophrenia and mood disorders. However, even though heredity may predispose an individual to certain disorders, mental problems are the result of an interaction of biological, psychological, social, and cultural factors.

Myth:

Mentally disturbed people can never be cured and will never be able to function normally or hold jobs in the community.

Reality:

This is an erroneous belief. Nearly three fourths of people who are hospitalized with severe mental disorders will improve and go on to lead productive lives.

Myth:

People become mentally disturbed because they are weak willed. To avoid emotional disorders or cure oneself of them, one need only exercise will power.

Reality:

Needing help to resolve difficulties does not indicate a lack of willpower. In fact, recognizing one’s own need for help is a sign of strength rather than a sign of weakness. Many problems stem from situations not under the individual’s control, such as the death of a loved one or loss of a job. Other problems stem from lifelong learning patterns of faulty learning; it is naive to expect that a single exercise of will can override years of experience.

Myth:

Mental illness is always a deficit, and a person who has it can never contribute anything of worth until “cured.”

Reality:

Many people with mental illness were never “cured,” but they nevertheless made great contributions to humanity. Ernest Hemingway, one of the great writers of the 20th century and winner of the Nobel Prize for Literature, experienced lifelong depression, alcoholism, and frequent hospitalizations. The famous Dutch painter Vicent van Gogh produced great works of art despite the fact that he was severely disturbed. Others, such as Pablo Picasso and Edgar Allan Poe, contributed major artistic and literary works while seriously disturbed.

Source: From Essentials of Understanding Abnormal Psychology, 2nd ed., p. 11, by D. Sue, D. W. Sue, D. Sue, and S. Sue. Copyright 2014. Reprinted by permission from Wadsworth Cengage Learning.

Over the years there have been mergers of publishing companies including those that publish standardized testing instruments. Counselors are advised to contact their professional association for an updated list of test publishers. One fact is clear, however: Updated versions of older tests and inventories plus the development of new ones will continue to occupy the attention of most test publishing companies. In the meantime, computer-assisted and online career counseling programs and testing will continue to update programs, interventions, and supply the most recent information concerning the job market. Professional associations have issued guidelines and more will surely follow. The increased use of advances in technology will likely provide more valid information for counselors to use when addressing the interrelationships of personal and career concerns. More information that could be accessed by counselors concerning the identification of psychological and personality disorder symptoms would be most helpful. More valid positive and negative information about each client could insure a greater balance in the counseling process. I provide some suggestions for problem identification next.

5-10 Clarifying Problems

A most important stage in the career counseling process is client problem identification. You will recall that all five career counseling models in chapter 3 emphasized methods and procedures that identify problems and concerns clients bring to counseling. Counselors are to clarify client concerns and needs into a format that is straightforward and concrete. This step often requires in-depth probing. A client’s presenting problems, for example, may be the client’s way of “testing the waters” before a trusting relationship is established. Counselors, therefore, use their interviewing skills to uncover the “real problems.” The following questions adapted from Brems (2001) and Cormier and colleagues (2013) are examples that can be used:

· In what circumstances does this problem arise?

· How intense is this problem and how often does it occur?

· When and where does this problem arise?

· Could you please describe some of the things that disturb you?

Whiston (2009) suggests that the counselor is to

· “(1)

explore the problem from multiple perspectives,

· (2)

gather specific information on each problem,

· (3)

assess problem intensity,

· (4)

assess degree to which client believes the problem is changeable, and

· (5)

identify methods the client has used to solve the problem previously” (p. 119).

Thus, the importance of clarifying problems is obvious in that it suggests criteria from which one selects counseling goals and effective interventions. In order to be most effective, problems are clarified into concrete statements that clearly state specific examples of the client’s environmental influences, emotions, thinking, and behavior. Keep in mind that problems are usually multidimensional. Some examples for clarifying problems follow.

Kent’s presenting problem was “difficulty in getting along with the people I work with.” Instead of labeling the problem as one of “poor interpersonal relationships,” the counselor wisely probed for more specific information. Kent’s private beliefs included the feeling that “no one really cares for me.” His expressed self-criticism indicates that he tends to reject people first so that they will not have the chance to reject him. Kent also revealed that early interactions with his family were very unpleasant and stressful, which resulted in poor self-regard and feeling that he was misunderstood. He seemed convinced that his chances of getting hurt would be less in the future if he ignored others.

Instead of developing interventions from the vague presenting problem, the counselor was now in the position to use specifically stated real problems and subsequent behaviors. The counselor zeroed in on the client’s perceptions, feelings, and actions and developed a collaborative relationship in which they agreed jointly on strategies. In this case underlying reasons for poor personal interrelationships were addressed as well as strategies in how to effectively relate to others. Client and counselor explored how problems of this type are very pervasive and can affect all life roles. As discussed in chapter 4, career and personal concerns are often inseparable and intertwined.

Carla was referred as an anxious client who was unable to make a career decision. Considerable time was spent with Carla to establish rapport and trust. Eventually, after a number of probing questions, Carla identified her overriding problem as conflicts with her family over career choice. She wanted a career in engineering, but her family wanted her to work in a local factory. She was torn between her loyalty to family and what may be best for them and her own individual goals. Carla was raised by a family that expected each member to do what is best for their collective survival as a group. The real problem in this case was a conflict between the influences of an American individualistic view versus another culture’s collectivist view. This case points out that some client concerns involve culturally shaped relationships that may be different than the dominant society’s. The major problem for Carla was embedded within cultural contexts of her environment.

In sum, counselors use all the information gathered in the intake interview to determine counseling strategies. The rule of thumb is to not overlook the smallest detail that at times may be expressed by the client in a rather cavalier manner. A health problem, for example, may be the clue to an underlying emotional situation. As we discovered in the previous examples, presenting problems do not always tell the whole story. Counselors must have the skills to ask probing questions in a manner that will encourage clients to reveal the real problems that have been held back. Finally, counselor and client are to clarify problems in specific concrete terms and agree on intervention strategies that will meet the client’s needs and concerns.

5-11a Summary

1. The sequence for an interview includes an informal assessment of well-being, assets, and strengths, identifying information, presenting problems, current status, health and medical information, family life, social/development history, life roles, problems that interfere with career choice, problems that interfere with career development, clarifying problems, and identifying goals.

2. An informal evaluation of the client’s feeling of well-being focuses on the identification of a client’s assets and strengths. The client is to recognize that positive as well as negative factors are to be unearthed in the interview. Clients are to recognize the importance of resilience in the career choice process; a discussion of both positive and negative factors provides a more balanced counseling approach.

3. Counselors must develop a greater sensitivity to culturally diverse clients when conducting an interview. Technique issues include eye contact, touch, probing questions, space and distance, verbal style, restrictive emotions, confrontation, self-disclosure, and focus on self-in-relation and self-in-context.

4. Career choice and career development constraints include contextual experiences, changing nature of work, negative cognitions, and psychological and personality disorders.

5. Examples of standardized assessment instruments for substance abuse screening are listed.

6. Standardized checklists for symptoms of disorders are discussed and listed.

5-11b Supplementary Learning Exercises and Two Case Studies

1. Why is it a good procedure to have a client verbalize their presenting problem? Give an example of a presenting problem and why you would want this client to verbalize their problem.

2. Explain the necessity of having a client clarify their problems before goal selection.

3. How could one’s socioeconomic status affect career choice?

4. When and why is it a good idea to administer a substance abuse screening inventory?

5. List as many reasons that you can think of for using a checklist of symptoms that could indicate a psychological disorder.

Case 5.1

A Divorced Mother Who Frequently Changes Jobs

The following are excerpts of what a client told a counselor in an intake interview.

My name is Inez and I am a divorced mother with three children whose ages are 23, 17, and 16. I am currently employed by a grocery chain that specializes in health foods. Currently I oversee the coffee, tea, and chocolate section in the store. I like my work, but I haven’t always been happy in a working situation. In the past I have gone from one job to another including the following jobs: working in a cleaning business, wreath making, waitress, nurse’s aide, cook, teacher’s aide, truck driver, and health care assistant for disabled individuals. As you can observe I have difficulty sticking to a job and I tend to procrastinate. I seem to be searching for something I can’t find or really identify. Sometimes I feel that I could identify what I want to do in the future, but I am afraid to try for fear of failure once more. It is hard for me to generate the confidence and energy to get started on a project.

My main problems have been depression, feelings of anger, helplessness, and fear of leaving my home. There are times when I feel happy and enthusiastic and other times, I feel very depressed. It is during the feelings of depression that I cannot focus and function well. Often, I cannot complete even simple tasks. On the other hand, when I feel well, I can relate to other people, but I resist becoming involved in close relationships.

I am now 44 years old. My father was in the armed services and we moved quite often. I have lived in Colorado, Virginia, Louisiana, Texas, Germany, and Italy. I have two younger brothers. My parents divorced soon after I graduated from high school. My marriage also failed, and my children have become quite discouraged with my mental health problems. One of my major goals is to give them a better home environment.

When I have been able to work, I have had hope for the future. I am currently seeing a therapist and taking antidepressants. I have never had any career counseling even when I was enrolled in college, but work has been very important to me. I feel much better when I can function well on a job, and this feeling of well-being has fostered my lifestyle and other life roles. I still have a secret ambition of owning my own business. I would welcome the opportunity to explore some options. I know from past experience that my personal problems will hinder my progress toward upgrading my vocational skills, but I am willing to try to find a pathway to a more fulfilling work role.

Questions and Exercises for Discussion

1. What do you consider to be the major career problems for Inez?

2. How does Inez’s emotional instability affect both career and personal concerns?

3. What is the significance of the statement, “I can relate to other people, but I resist becoming involved in close relationships”?

4. Conceptualize the interrelationships of career and personal concerns.

5. What are your counseling recommendations for Inez including the use of assessment instruments?

Case 5.2

Cal’s Faulty Reasoning

Cal’s career counseling took place in a community mental health agency. A brief summary of his intake interview provides some significant background information. Cal reported for his appointment on time. He was very neatly dressed, in freshly pressed clothes that were well coordinated, and his shoes looked as though they had just been polished. Cal was very verbal and expressed himself well. He was overly precise with his answers, adding much more information than was asked for. He reported no significant physical health problems. Eye contact was appropriate.

Cal grew up in a small town in which his father had owned a hardware store. He has no siblings. He is now 36 years old. Cal described his father as being very strict and his mother as too judgmental. Cal was divorced after three years of marriage. He has no children and remarked that he felt incapable of being a good parent. He further explained this comment by stating that it was difficult to raise children properly today. Cal’s wife asked for a divorce because they had “different beliefs and lifestyle.” He explained that his wife stated she could not live up to his expectations and there was always tension between them. Cal lost his job as a bank clerk when the regional office was shut down. He currently lives with his parents.

Cal’s stated reason for coming for help was to find a job and to solve some “personal problems.” He had worked for his father for several years and then obtained a bank clerk’s job, which he held for three years, after his father’s store was closed. He was not always pleased with his bank job; as he put it, “I make too many mistakes.” Cal viewed his personal problem as a failed marriage. Cal claimed that he tried to be a good husband, but his wife complained that he tried to control her every move. Cal reported periodic episodes of depression, for instance, “I felt helpless and slept a lot.” He appeared to be fearful of leaving his parents’ house for help, but they insisted that he find a job. Currently, his demeanor suggests a very poor self-concept. He admits feeling guilty about his failures and is confused about his future.

The counselor made several notations as follows:

· Poor self-confidence and self-image

· Difficulty in making decisions

· Negative expectations of others

· Attempts to control important others

· Perfectionist attitude

· Exhibited dependency needs

· Faulty reasoning

Questions and Exercises for Discussion

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

2. How would you characterize Cal’s emotional demeanor?

3. What are your tentative conclusions?

4. Conceptualize interrelationships of career and personal concerns.

5. Which type of assessment instruments would you chose in Cal’s case?

5-11b Supplementary Learning Exercises and Two Case Studies

1. Why is it a good procedure to have a client verbalize their presenting problem? Give an example of a presenting problem and why you would want this client to verbalize their problem.

2. Explain the necessity of having a client clarify their problems before goal selection.

3. How could one’s socioeconomic status affect career choice?

4. When and why is it a good idea to administer a substance abuse screening inventory?

5. List as many reasons that you can think of for using a checklist of symptoms that could indicate a psychological disorder.

Case 5.1

A Divorced Mother Who Frequently Changes Jobs

The following are excerpts of what a client told a counselor in an intake interview.

My name is Inez and I am a divorced mother with three children whose ages are 23, 17, and 16. I am currently employed by a grocery chain that specializes in health foods. Currently I oversee the coffee, tea, and chocolate section in the store. I like my work, but I haven’t always been happy in a working situation. In the past I have gone from one job to another including the following jobs: working in a cleaning business, wreath making, waitress, nurse’s aide, cook, teacher’s aide, truck driver, and health care assistant for disabled individuals. As you can observe I have difficulty sticking to a job and I tend to procrastinate. I seem to be searching for something I can’t find or really identify. Sometimes I feel that I could identify what I want to do in the future, but I am afraid to try for fear of failure once more. It is hard for me to generate the confidence and energy to get started on a project.

My main problems have been depression, feelings of anger, helplessness, and fear of leaving my home. There are times when I feel happy and enthusiastic and other times, I feel very depressed. It is during the feelings of depression that I cannot focus and function well. Often, I cannot complete even simple tasks. On the other hand, when I feel well, I can relate to other people, but I resist becoming involved in close relationships.

I am now 44 years old. My father was in the armed services and we moved quite often. I have lived in Colorado, Virginia, Louisiana, Texas, Germany, and Italy. I have two younger brothers. My parents divorced soon after I graduated from high school. My marriage also failed, and my children have become quite discouraged with my mental health problems. One of my major goals is to give them a better home environment.

When I have been able to work, I have had hope for the future. I am currently seeing a therapist and taking antidepressants. I have never had any career counseling even when I was enrolled in college, but work has been very important to me. I feel much better when I can function well on a job, and this feeling of well-being has fostered my lifestyle and other life roles. I still have a secret ambition of owning my own business. I would welcome the opportunity to explore some options. I know from past experience that my personal problems will hinder my progress toward upgrading my vocational skills, but I am willing to try to find a pathway to a more fulfilling work role.

Questions and Exercises for Discussion

1. What do you consider to be the major career problems for Inez?

2. How does Inez’s emotional instability affect both career and personal concerns?

3. What is the significance of the statement, “I can relate to other people, but I resist becoming involved in close relationships”?

4. Conceptualize the interrelationships of career and personal concerns.

5. What are your counseling recommendations for Inez including the use of assessment instruments?

Case 5.2

Cal’s Faulty Reasoning

Cal’s career counseling took place in a community mental health agency. A brief summary of his intake interview provides some significant background information. Cal reported for his appointment on time. He was very neatly dressed, in freshly pressed clothes that were well coordinated, and his shoes looked as though they had just been polished. Cal was very verbal and expressed himself well. He was overly precise with his answers, adding much more information than was asked for. He reported no significant physical health problems. Eye contact was appropriate.

Cal grew up in a small town in which his father had owned a hardware store. He has no siblings. He is now 36 years old. Cal described his father as being very strict and his mother as too judgmental. Cal was divorced after three years of marriage. He has no children and remarked that he felt incapable of being a good parent. He further explained this comment by stating that it was difficult to raise children properly today. Cal’s wife asked for a divorce because they had “different beliefs and lifestyle.” He explained that his wife stated she could not live up to his expectations and there was always tension between them. Cal lost his job as a bank clerk when the regional office was shut down. He currently lives with his parents.

Cal’s stated reason for coming for help was to find a job and to solve some “personal problems.” He had worked for his father for several years and then obtained a bank clerk’s job, which he held for three years, after his father’s store was closed. He was not always pleased with his bank job; as he put it, “I make too many mistakes.” Cal viewed his personal problem as a failed marriage. Cal claimed that he tried to be a good husband, but his wife complained that he tried to control her every move. Cal reported periodic episodes of depression, for instance, “I felt helpless and slept a lot.” He appeared to be fearful of leaving his parents’ house for help, but they insisted that he find a job. Currently, his demeanor suggests a very poor self-concept. He admits feeling guilty about his failures and is confused about his future.

The counselor made several notations as follows:

· Poor self-confidence and self-image

· Difficulty in making decisions

· Negative expectations of others

· Attempts to control important others

· Perfectionist attitude

· Exhibited dependency needs

· Faulty reasoning

Questions and Exercises for Discussion

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

2. How would you characterize Cal’s emotional demeanor?

3. What are your tentative conclusions?

4. Conceptualize interrelationships of career and personal concerns.

5. Which type of assessment instruments would you chose in Cal’s case?

 
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