Integrating life design counseling and psychotherapy: Possibilities and practices.

The debate on the relation between career counseling and psychotherapy revealed the close relation between psychosocial and career issues. The connection between these two approaches paves the way for the integration of career counseling into psychotherapy. One of the key challenges of integrating career counseling into psychotherapy is to avoid discontinuities and inconsistencies in the psychotherapeutic intervention. The aim of this article is, therefore, to present the Systematic Treatment Selection perspective as a framework for an effective integration of psychotherapy and career counseling. Then, Life Design Counseling is described, highlighting its possibilities to fit the psychotherapeutic approach. Finally, an illustrative case is presented and discussed.

Life Design Counseling process and outcome: A case study with an adolescent

This article aims to explore the relationship between clients´ narrative transformation and the promotion of vocational decidedness and career maturity in a mid-adolescent case of Life Design Counseling (LDC). To assess LDC outcomes the Vocational Certainty Scale and the Career Maturity Inventory – Form C were used before and after the intervention. To intensively analyze the process of LDC change two measures of narrative change were used: the Innovative Moments Coding System (IMCS), as a measure of innovation emergence, and the Return to the Problem Coding System (RPCS), as a measure of ambivalence towards change. The results show that the three LDC sessions produced a significant change in vocational certainty but not in career maturity. Findings confirm that the process of change, according to the IMCS, is similar to the one observed in previous studies with adults. Implications for future research and practice are discussed.

Integrating Life-Design Counseling and Psychotherapy: Possibilities and Practices

The relationship between career counseling and psychotherapy is not a new subject. The debate allows the affirmation of career counseling as a dimension of personal counseling and recognizes the close relationship between psychosocial and career issues (Blustein & Spengler, 1995). The connection between these two approaches paves the way for the integration of career counseling with psychotherapy. Indeed, the inseparability of mental health and career issues frequently leads psychotherapists to help their clients to deal with work satisfaction, underemployment or unemployment through psychotherapy. Moreover, when working with specific populations (e.g., people with intellectual disabilities and people with addiction or mental health problems), psychotherapy calls for occupational integration to consolidate and enhance therapeutic gains (Blustein, 1987; Jordan & Kahnweiler, 1995; Leff & Warner, 2006).

Life Design Counseling: A study on client's operations for meaning construction

This study evaluates the adequacy of the micro-theory of client operations to explain meaning construction in Life Design Counseling. Four adolescents were interviewed on their second counseling session. Their recollections were stimulated through the replay of counseling videotapes and the resulting transcribed interviews were qualitatively analyzed. Results confirmed a sequence of client operations evolving from the symbolic representation of experience and reflexive self-examination towards making new realizations and revisioning self. Moreover, clients reported negative and positive session moments evidencing that clients’ attention and activity during the session was not restricted to meaning construction operations. Practical implications for life design counseling are derived from the results and discussed.

Life Design Counseling Group Intervention With Portuguese Adolescents

This article examines the process and outcome of a life design counseling group intervention with students in Grades 9 and 12. First, we applied a quasi-experimental methodology to analyze the intervention’s effectiveness in promoting career certainty, career decision-making, self-efficacy, and career adaptability in a sample of 236 students. Second, focus groups comprising 33 participants were conducted, examining participants’ perceptions of the intervention process and outcome. Our findings showed that the intervention had a significant effect on both career certainty and career self-efficacy, but it had no effect on career adaptability. Our results also showed that My Career Story (MCS) had a stronger effect on Grade 12 students. Focus group participants reported on the usefulness of MCS, as well as on its benefits, which include increased information as well as a sense of direction, self-discovery, connection, and increased self-awareness. Grade 9 participants expressed more difficulties in narrating self-experience than Grade 12 participants did. Implications for future research and practice are discussed.

Adesão ao tratamento em pacientes com depressão major: A influência da percepção de doença, suporte social, espiritualidade e do estado emocional

Este estudo teve como finalidade investigar a relação entre alguns factores psicossociais e a adesão terapêutica, utilizando como variáveis preditoras, as representações de doença, a ansiedade e depressão as previsões de suporte social, e a espiritualidade e como variáveis de resultado, a adesão ao regime terapêutico, através da avaliação da adesão à medicação. Pretendeu-se testar quatro hipóteses: (1) Prevê-se que as representações de depressão nas suas dimensões da consequências, duração e controlo pessoal e de tratamento, identidade, preocupação, emoções e compreensão da doença sejam preditores significativos da adesão ao tratamento medicamentoso; (2) Prevê-se que os níveis de ansiedade e depressão dos doentes depressivos estarão significativa e negativamente correlacionados com os níveis de adesão ao tratamento medicamentoso; (3) Prevê-se que os níveis de suporte social percebido estarão significativa e positivamente correlacionados com os níveis de adesão ao tratamento medicamentoso e (4) Prevê-se que os níveis de espiritualidade se encontrem significativa e positivamente correlacionados com os níveis de adesão ao tratamento medicamentoso. Tratou-se de um estudo transversal, com desenho correlacionai e foi desenvolvido num Hospital da Região do Alentejo, mais especificamente, num Departamento de Psiquiatria a saúde Mental, com uma amostra não aleatória de 15 pacientes com o diagnóstico de Depressão. Os resultados confirmaram parcialmente a primeira hipótese, sendo as representações de doença, nas suas dimensões controlo pessoal, controlo do tratamento e emoções preditores significativos da adesão (mais especificamente das alterações das doses da medicação). A segunda hipótese também foi confirmada parcialmente, sendo a depressão preditora da adesão (tanto na dimensão do esquecimento, quanto na alteração das doses da medicação). A terceira hipótese foi, também, parcialmente confirmada sendo a aliança fiável preditora significativa da adesão (na dimensão do esquecimento da toma da medicação). Por último, a quarta hipótese foi igualmente confirmada parcialmente sendo a esperança/optimismo preditora significativa da adesão (tanto na dimensão do esquecimento, quanto na alteração das doses da medicação). Nas análises exploratórias verificou-se a influência da variável sócio­ demográfico “sexo” nas representações cognitivas e também na depressão. A "idade" também demonstrou algum efeito nas alterações à medicação e nas provisões sociais. O "estado civil" mostrou efeito no aconselhamento e na oportunidade de prestação de valores. As variáveis clínicas também mostraram ter influência. O "tempo de doença" mostrou efeito significativo nas representações emocionais, nas crenças, esperança/optimismo e no esquecimento da medicação. A "duração do tratamento com medicação" mostrou efeito na compreensão da doença e no esquecimento da medicação. Por fim, são apresentadas algumas implicações da depressão, bem como algumas sugestões para estudos futuros. /ABSTRACT: This study aimed to investigate the relationship between some psychosocial factors and the adherence, using as predictor variables, the representations of illness, the anxiety and depression, the social support predictions, and spirituality, and as outcome variables, adherence to treatment regimen, through the assessment of medication adherence. lt was intended to test four hypotheses: (1) lt is expected that the depression representations in its dimensions of consequences, duration and personal control and treatment, identity, concern, emotions and disease understanding are significant predictors of adherence to therapy; (2) lt is expected that anxiety and depression levels in depressed patients are significantly and negatively correlated with the levels of adherence to therapy; (3) lt is expected that the levels of perceived social support are significantly and positively correlated with the levels of adherence to drug treatment and (4) lt is expected that the levels of spirituality are significantly and positively correlated with levels of adherence to therapy. This was a cross-sectional study with correlational design and was developed in one Hospital of the Alentejo Region, more specifically, in a Department of Psychiatry and Mental Health, with a non¬random sample of 15 patients diagnosed with depression. The results partially confirmed the first hypothesis, being the representations of disease, in its dimensions of personal control, treatment control and emotions, significant predictors of adherence (more specifically, of the changes in the doses of medication). The second hypothesis was also partially confirmed, with depression being a predictor of adherence {both in the extent of oblivion and in the changes of medication doses). The third hypothesis was also partially confirmed, being the trustable alliance a quite significantly reliable predictor of adherence {in the dimension of the medication oblivion). Finally, the fourth hypothesis was equally partially confirmed, being the hope/optimism significant predictor of adherence (both in the extent of oblivion and in changing doses of medication). ln exploratory analyzes, it was verified the influence of socio-demographic variable "sex" in the cognitive representations and also in depression. The "age" also had some effect on changes to medication and social provisions. The "marital status" had effect in the counseling and in the opportunity to provide values. The clinical variables also proved to have influence. "Time sickness" had a significant effect on emotional representations, beliefs, hope/optimism and medication oblivion. The "treatment duration with medication" had effect in the disease understanding and the medication oblivion. Finally, are presented some implications of depression as well as some suggestions for future studies.