06/01/2009

Career, Work, and Mental Health: Integrating Career and Personal Counseling

Book Review by Gary W. Peterson

Book Review

Vernon G. Zunker, Career, Work, and Mental Health: Integrating Career and Personal Counseling, Sage Publications, 2008.

In the broad field of human services, there has been a long standing gulf between those who counsel individuals with career issues and those to treat persons with personal and social concerns.  On college campuses for example, the student services center is often located separately from the career center.  In human service training programs, these two domains are often represented by different knowledge bases, degree programs, and ultimately certifications and licensure.  Career and mental health practitioners are further separated in terms of missions of professional societies and sub-divisions within societies.  Unfortunately, this seemingly clear demarcation of domains of services becomes blurred in professional practice when assisting individuals. Mental health counselors are often faced with unraveling career concerns with individuals who come for mental health counseling, and likewise, career counselors are faced with trying to understand mental health aspects of individuals who seek assistance with career development or work performance.  This book seeks to provide a comprehensive resource to human service practitioners who will inevitably be called upon to assist individuals who are faced with problems in which career, work, and personal adjustment are all interrelated. 

The Assumption of Holism

The author begins with the assumption of holism, or the whole-person approach to counseling, in which the variety of concerns clients present in counseling should be viewed as interrelated components of all life roles.  A second fundamental assumption is that one must take into account biological, psychological, and social/cultural influences to understand human behavior, which the author refers to as an integrative approach to human understanding.  This approach is necessary to fully understand clients with either career or mental health concerns-that is, there is a biological basis, a psychological basis, and a social or cultural basis to their behavior.  These two fundamental themes are interwoven through each chapter in the book.

True to tradition, the author divides the text into two parts: (a) Career Counseling Perspectives and (b) Mental Health Issues and Solutions.  The last chapter in the book, Interventions and Case Studies, could well be relegated to a third part, since it integrates both career and mental health domains as they come together in the treatment of three specific cases.  The respective chapters appear to be distinct content units and are written in a manner that is very comprehensible regardless of whether one's training, expertise, and experience is in either career or mental counseling.  Thus, the text can be used in initial or foundational learning, in which case, the book can be approached serially chapter by chapter.  It can also be used to accompany the application of foundational knowledge as in a practicum or internship where the sequence of chapters can be modified to fit the approach to applying and integrating knowledge and practice in the given human service specialization.  Finally, it can be used by experienced human service practitioners in on-going continuing education to expand one's knowledge and skills in either career or mental health foundations within one's specialization and practice.  The clear statements of purpose for each chapter, organized presentation of concepts, concise summaries, and practice exercises make each chapter valuable for initial learning or for review.

Part I, Career Counseling Perspectives

Part I, Career Counseling Perspectives, provides an overview of the foundations of career development and career counseling.  After the introductory chapter, mainline career theories are presented in Chapter 2 which includes trait-and-factor, person-environment correspondence, John Holland Typology, Krumboltz Learning Theory, Cognitive Information Processing in career decision-making , Social Cognitive, Life-span developmental, Circumscription, and Career Construction. Regarding the practice of career counseling, Chapter 3 presents a 7-stage career counseling process that represents a synthesis of selected literature by the author.  In Chapter 4 on the constraints in career choice and development, the author refers to American class structure and socialization practices, and self-efficacy.  The closing chapter of this section, Chapter 5, discusses labor market trends and the changing nature of work, alluding to such factors as career progression, globalization, technology, and organizational structure.

Part II, Mental Health Issues and Solutions

Part II, Mental Health Issues and Solutions, provides an overview of personal adjustment, abnormal psychology, and treatment.  Chapter 6, the first chapter in Part II, concerns depression and its impact on career development and work performance.  This chapter is followed by Chapter 7, a discussion of fear and anxiety disorders, substance abuse, and schizophrenia and their relationship to work performance.  Cultural and diversity influences on career choice, career development, and work adjustment are presented in Chapter 8.  This chapter describes cross-cultural issues related to definitions and interpretations of mental health, psychological abnormality, mood disorders, personality disorders, schizophrenia, and somatoform disorders. Chapter 9 concerns selected personality disorders (Axis II) as classified in the DSM-IV and their effect on career development.  Overviews of the 16PF and the NEO personality inventories are presented in Chapter 10 as examples of assessments of personality structure.  The nature and causes of work stress and coping mechanisms are presented in Chapter 11.

Interventions and Case Studies

The integration of Parts I and II is presented in Chapter 12, Interventions and Case Studies, the concluding chapter.  An overview of common mental health intervention techniques are summarized, which include cognitive behavioral therapy, problem solving, assertiveness training, systematic desensitization, cognitive rehearsal, positive self-talk, and restructuring, schema development, homework, and stress inoculation training.  In the three case studies, the first is a career counselor who treats a White male with anxiety as an important contributing factor in career choice, in the second, a mental health counselor works with an African American woman with symptoms of hypochondria who is formulating educational and career goals, and in the third, a clinical social worker treats a Hispanic woman with a borderline personality disorder who is trying to secure employment.

The strengths of this work lie in the author's thoughtful integration of two, heretofore independent domains of theory and practice into a single text.  While each of the chapters may be regarded as overviews in their own right, current and appropriate references are provided for further in-depth pursuit of related knowledge and skills.  The work will enable career counselors to become more sensitive in recognizing mental health issues, knowing one's limitations of practice in this area, and when and whom to refer for conjoint assessment and therapy.  Likewise, for human service workers treating individuals with mental health concerns, it will provide guidance regarding how career and work concerns may contribute to or exacerbate a mental health condition.  They may also refer a client for career counseling as part of a therapeutic regimen.  Limitations in the text are in the assessment arena.  For career counselors, assessments could be included that are related to personal adjustment, which may serve as effective screening measures that would signal a need for further diagnostic mental health assessment.  For example, career counselors could become familiar with measures of personal and social adjustment, such as the Beck Depression Inventory (BDI).  Likewise, for mental health counselors, career assessments could be included that would be useful in identifying the nature and depth of concerns in career adjustment.  For example, mental health counselors could become familiar with interest inventories such as the Self-Directed Search (SDS), or measures of dysfunctional thinking, such as the Career Thoughts Inventory (CTI).  Seemingly, if career counselors are to verge into assessing and treating mental health concerns interrelated with a presenting career issue, or if mental health counselors address accompanying career concerns, the acquisition of assessment skills and intervention techniques in the crossover domain would be essential.  This reviewer fully recognizes that crossing over into the complementary domain presents profound implications for training, practice, and certification and licensure of human service professionals.

In conclusion, I believe that this work is a significant contribution to the fields of career and mental health counseling and that it can serve as a very useful resource for trainees as well as practitioners. I commend Dr. Zunker for a formidable, ambitious, and worthwhile undertaking, and I highly recommend his work.

 Gary W. Peterson, Ph.D., is professor emeritus and formerly Clinical Training Director and Program Coordinator for the academic program Psychological Services in Education, College of Education.  He also served as chair of the Department of Educational Psychology and Learning Systems.  He continues to serve as a volunteer Senior Research Associate in the Center for the Study of Technology in Counseling and Career Development.  He authored several books and more than 50 professional articles.  His research interests include career problem solving and decision-making, career assessment, test construction, and program evaluation in educational and human service settings.  He may be reached at gpeterson@admin.fsu.edu.