Psychotherapy and career counseling: toward an integration for use with college students

The authors suggest that psychotherapy and career counseling with college students can be identified as potentially concurrent and interactive processes. They seek to increase awareness of this connection and underscore the value of its application when it is appropriate to do so. Selecting a career is a crucial developmental task for young adults and is, to varying degrees, an integral part of their psychosocial adjustment. The literature is reviewed from five perspectives: the psychodynamic model of career counseling; case examples; integration of career counseling and psychotherapy; a review of the developmental theories of Erikson, Farnsworth, Chickering, and Medalie; and empirical justification. The authors discuss the rationale for merging student psychotherapy and career counseling and offer case examples.     

The College Student-Athlete: Psychological Considerations and Interventions

Abstract

This article reviews the literature dealing with problems brought by student-athletes to college counseling and mental health centers. Among the issues discussed are fear of success; identity conflict; social isolation; poor athletic performance; academic problems; and career or vocational concerns. In addition, the authors examine the paradox that although athletes experience as much or more psychological distress as non-athletes, research indicates that athletes use professional services less often than nonathletes. Finally, the authors review approaches to psychological intervention, including short-term psychotherapy, very brief interventions, cognitive behavioral therapy, and career/vocational counseling, and discuss special considerations for conducting therapy with athletes.     

Career and Personal Concerns Expressed by Career Counseling Clients

In this study, the authors used case notes to classify client concerns that surfaced during career counseling with adults in a university-sponsored community counseling center. A two-stage classification system was developed and used to estimate the frequencies of occurrence for career and personal issues that surface during career counseling. The authors concluded that a substantial overlap exists between the content of career counseling and that of psychotherapy.     

Quality Assessment Study of Brief Psychotherapy at a University HMO Setting

Abstract

This paper describes the results of a short-term psychotherapy (four to fifteen sessions) quality assessment study conducted at the University of Massachusetts Mental Health Service. The outcome measures devised and the process of their administration are described. The positive outcome results of this study are encouraging and supportive of the impression that high quality brief psychotherapy can be provided at university counseling services. Student and health maintenance organization (HMO) member consumer evaluation opinions were positive and their utilization of services was found to be psychologically sophisticated and appropriate. A frequency table lists the most common presenting problems of this population. Practical modifications are suggested for future quality assessment research of brief psychotherapy.     

Integrating Sexual Orientation in Career Counseling: Acting to End a Form of the Personal-Career Dichotomy

Ignoring sexual orientation in career counseling practice is presented as a specific case of failing to integrate an aspect of the personal dimension into career counseling. Three case examples illustrate specific actions that career counselors must take to integrate this important aspect of the personal dimension into career counseling. The actions suggested involve three general areas: (a) signaling lesbian and gay affirmation in career counseling practice, (b) enhancing the development of a positive gay or lesbian identity in the context of career development work, and (c) recognizing and integrating the reality of anti-gay stigma in career counseling.     

Career Counseling With Clients Who Have a Severe Mental Illness

Individuals who are diagnosed with a serious mental illness encounter a variety of barriers that can impede their career development. In this article, the career barriers of clients who have a severe mental illness are reviewed, and a developmental approach to career counseling with this population is described. A case example is provided to illustrate the complex process of developmental career counseling with people who are seriously impaired by a psychiatric illness.     

Expanding Career Options and Optimizing Abilities: The Case of Laura

The authors present a case of a 15‐year‐old Mexican American adolescent girl who is uncertain about her educational and career future. The ecological model of career development (E. P. Cook, M. J. Heppner, & K. M. O'Brien, 2002) is applied to the case. The authors suggest career counseling interventions for this client and discuss potential concerns and issues that may arise in career counseling with this client.     

Informed Consent: Provider Responsibilities in Psychotherapy

Abstract

When a psychotherapist and patient meet for the first time, there may be a multiplicity of assumptions on both sides about expectations and goals. This paper describes that crucial relationship and the work that must take place in order that a patient gives a relatively informed consent about the therapeutic process. Due to the many variables and unknowns, there is no such thing as an absolute informed consent in psychotherapy. A relatively informed patient, however, is one who is better prepared to enter into a therapeutic alliance. These important concepts are illustrated with case examples.     

The college student-athlete: psychological considerations and interventions

This article reviews the literature dealing with problems brought by student-athletes to college counseling and mental health centers. Among the issues discussed are fear of success; identity conflict; social isolation; poor athletic performance; academic problems; and career or vocational concerns. In addition, the authors examine the paradox that although athletes experience as much or more psychological distress as nonathletes, research indicates that athletes use professional services less often than nonathletes. Finally, the authors review approaches to psychological intervention, including short-term psychotherapy, very brief interventions, cognitive behavioral therapy, and career/vocational counseling, and discuss special considerations for conducting therapy with athletes.     

The Self‐Directed Search as a Stand‐Alone Intervention With College Students

The Self‐Directed Search (SDS; Holland, 1994 ) is sometimes administered to large student groups outside of counseling to address common career development needs. This study evaluated the effectiveness of the SDS as a stand‐alone intervention by comparing a general sample of college students who completed the SDS (n = 39) with a no‐treatment control group (n = 41) on several outcomes. Completion of the SDS related to an increase in the number of career alternatives being considered 4 weeks later but did not relate to career exploration, career decision‐making self‐efficacy, career indecision, and seeking of career counseling services. If the SDS is used outside of counseling with broad student samples, the authors suggest providing additional intervention to ensure that it promotes exploration of any additional careers being considered.     

Successful Aging in the Middle-Aged Gay Man

Abstract

Successful aging into middle age is impeded by internalized ageism in the gay man. Developmental theory inadequately details the tasks at this stage. Lesbian and gay human developmental theory is now being conceptualized to encompass the entire lifespan. This article identifies and elaborates specific developmental tasks for the middle-aged gay man based on psychotherapy clients who successfully aged into midlife. Focusing on the elimination of internalized ageism and the development of a positive attitude towards aging, the author provides a human developmental model for successful aging at midlife.     

The Career‐O‐Gram: A Postmodern Career Intervention

The authors examine the usefulness of postmodernism in career counseling. Specifically, a case is made for broadening career counseling theories and techniques to feature the contextual influences inherent in each individual's unique career history. A career intervention, titled the Career‐O‐Gram, is introduced as a tool for exploring contextual influences on career development. A case study is presented to demonstrate the application of the Career‐O‐Gram.     

The Thematic-Extrapolation Method: Incorporating Career Patterns into Career Counseling

One of Donald Super's most important contributions of career counseling was the career model, the idea that one person's sequence of work positions constitutes a whole and unique career. In 1954, he advocated a method for predicting career patterns called the Thematic-Extrapolation Method (TEM). TEM is described and summarized in three identifiable steps. Recent writings from developmental, psychodynamic, and narrative approaches to career counseling suggest innovative revisions and elaborations on the original method. A modified TEM remains a promising, but largely untried, career counseling technique.     

Two accounts of the management of racial different in psychotherapy

Abstract

In this paper, the authors present material from their clinical work, in which racial difference impinges directly on the psychotherapeutic encounter. They examine the primitive origins of racism from a psychoanalytic view point and discuss their management of related issues within the framework of psychoanalytic psychotherapy.

Part of a session from a psychotherapy group is described by Sue Davison, in which one member is excluded as part of a dramatisation entered into by all the group members for defensive purposes. The therapist, by calling attention to the painful reality which was banished from awareness, enabled the group members to recover their capacity to think, rather than re-enact the trauma.

The case study by Fakhry Davids describes work with a woman whose struggle in life is against a racist, intolerant mother. This mother is projected onto her black therapist, and a session is described in which the dynamics of this projection begin to be unravelled. Her therapist is experienced as an intolerant, oppressive mother to whom the patient's own hatred and intolerance has become attached, and the patient is enabled to take back some of these projections. The defences she uses illustrate a common way in which so-called “liberals” disown their hidden racism.     

Cross Cultural Perspectives in Treating the Gay Male Trauma Survivor

Summary

In recent years, there has been an increased emphasis on cultural considerations in psychotherapeutic treatment. Sound psychotherapy is ideally culturally sensitive and concerned with the context within which the client developed and exists. At the same time it is often difficult for many clinicians to navigate the cultural within the psychological framework. When both patient and clinician share more than one language in common, there are a variety of subtle issues that surface. In psychotherapy, “coordinate bilinguals,” those who learn their languages separately, during different developmental stages and contexts, tend to have greater access to their emotional experiences within their first language. When the client presents with a sexual trauma history, the language spoken during the abuse will also have an effect on the language used in the psychotherapy. The case history of Lucio, a Latino gay male, is discussed in terms of the cultural and psychological elements of his treatment by a bilingual North American therapist. This therapist's psychotherapeutic conceptualizations and treatment approaches are examined and reviewed in a written dialogue/ discussion with a Latino psychologist.     

The Psychology of Working: A New Framework for Counseling Practice and Public Policy

The authors present the psychology‐of‐working perspective (D. L. Blustein, 2006; N. Peterson & R. C. González, 2005; M. S. Richardson, 1993) as an alternative to traditional career development theories, which have primarily explored the lives of those with choice and volition in their working lives. The major historical and conceptual features of the psychology of working are reviewed, with a focus on how this framework provides a more inclusive and, ideally, more just vision for the career counseling field. Implications for career counseling and a case presentation are provided to examine how this new perspective can inform counseling practice. A brief overview of public policy implications concludes the article.     

Career Counseling With Black Men: Applying Principles of Existential Psychotherapy

Counselors may benefit from applying principles of existential psychotherapy to career counseling with Black men. Existential psychotherapy asserts that there are 4 issues that all people experience: death, freedom, isolation, and meaning. The life experiences of Black men, including difficulty with their careers, suggest that they may struggle with these existential concerns, particularly finding meaning in their lives. Because work and issues in other domains of life (e.g., family, community) often intersect, an existentially based career counseling approach may prove useful. An overview of existential psychotherapy is presented, followed by a discussion of its applicability to career counseling with Black men. In addition to suggestions for career counselors, recommendations for training and professional development are offered.     

Culture-Centered Counseling Skills as a Preventive Strategy for College Health Services

Abstract

All learning occurs in a cultural context. Successful counseling can be achieved by training healthcare providers to interpret behaviors in their cultural context. The author describes a culture-centered approach, using a cultural grid that matches same/different behaviors with same/different expectations. Clients with shared positive expectations may display dissonant and apparently negative behaviors. Culturally accurate knowledge and culturally appropriate skills provide a three-level developmental sequence for more accurate and more appropriate healthcare guidance in such multicultural settings as those met on the college campus.     

Supportive Psychotherapy for Borderline Patients

SUMMARY

An imagined conversation between a clinician/teacher and a beginning therapist conveys the concept of a psychoanalytically informed supportive psychotherapy for borderline patients and incorporates the major hypotheses as to the origin of the disorder. Within a basically developmental point of view, the treatment recognizes the contributions of genetics, animal studies, neuroscience, early interpersonal relationships and the object relations that derive from them. The psychodynamics of a typical case are considered from all of these viewpoints, while the student-therapist is encouraged to keep in mind the basic concepts of psychoanalysis. These include: unconscious mental activity, transference, and the internalization of the therapist's attitude of respectful listening, which leads to the capacity to listen in that way to oneself and others.