Narrative and Clinical Change in Cognitive-Behavior Therapy: A Comparison of Two Recovered Cases

Psychotherapy research suggests that therapeutic change is associated with the emergence and development of innovative moments (IMs)—that is, exceptions to the problematic self-narrative that brought the client to therapy. This study compares two recovered cases of major depression, according to symptom measures, that presented contrasting profiles of evolution of IMs: one typical of successful therapy (Barbara), and another typical of unsuccessful therapy (Claudia). The core conflictual relationship theme (CCRT) was used to study narrative change independently of the innovative moments coding system (IMCS). The results suggest a high congruence between the IMCS and the CCRT profiles. Although Barbara presented changes in the IMCS and the CCRT in a similar way, Claudia's self-narratives (IMs and CCRT), despite symptom change, did not change. The results are discussed, considering the importance of narrative changes in recovery from depression and the maintenance of therapeutic gains.     

Innovative moments and change in Career Construction Counseling

This article presents an exploratory study of the process of change during Career Construction Counseling (CCC). The Innovative Moments Coding System (IMCS) and the Return to the Problem Coding System (RPCS) were used to an intensive analysis of a career counseling case — the case of Michael. Both systems are grounded in a narrative conception of the self which suggests that narrative change results from the elaboration and development of narrative exceptions to a client's core problematic self-narrative. The IMCS identifies and tracks the occurrence of five different types of narrative change and the RPCS tracks the ambivalence present in the clients discourse throughout the therapeutic process. This is the first attempt to use these methods with a career counseling case. The results suggest that the narrative elaboration progresses from the first to the third session. We discuss these results, emphasizing the process of change in career counseling with clients in which maladaptive repetition underlies career decision-making difficulties.     

Meaning Coconstruction in Group Counseling: The Development of Innovative Moments

This study discusses a model of group counseling, the narrative mediation path (NMP), which is a unique narrative, multimodal approach that combines four narrative modes (metaphoric, iconographic, writing, and bodily) and the narrative group. The purpose of the NMP is to foster reflexive processes with underachieving university students and to improve their academic performance. The study analyzes a single case of group counseling for seven underachieving economics students at an Italian university and the process of meaning construction among NMP narrative modes and the follow-up session. It applies the innovative moments coding system, a reliable method for studying change by tracking narrative innovations in sessions. More specifically, we focus on how innovative moments (IMs: action, reflection, protest, and reconceptualization) evolve during the four different narrative modes and the follow-up session. The findings suggest that the NMP fosters narrative innovations, mainly of a reflexive nature (reflection and reconceptualization). Moreover, during counseling and the follow-up session, the pattern of change is primarily characterized by reconceptualization IMs, the most complex form of narrative innovation.     

Life Design Counseling outcome and process: 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.     

Critical moments in career construction counseling

An important research need concerns identifying and describing factors that promote reflexivity and change in life-design career interventions. Career construction counseling, a primary life-design intervention, uses narrative methods in an interpersonal process of helping people design a work life through reflexive action. Using Interpersonal Process Recall (IPR), the present study examined what prompts reflexivity and change in career construction counseling. A single case analysis method involving a 24-year old Caucasian woman examined one client's experience of processes that prompted change and reflection about her current career transition. Post-counseling IPR with the client of her videotaped career construction counseling session indicated five major themes: (a) role models prompt identity reflection, (b) early recollections foster cohesion, (c) follow-up questions add depth to the story, (d) counselor as audience provides clarity and validation, and (e) career construction interview questions illuminate perspective and need for action. Results support prior research indicating the usefulness of career construction counseling for promoting reflexive action in life design.     

Innovative Moments in Humanistic Therapy I: Process and Outcome of Eminent Psychotherapists Working with Bereaved Clients

This project entailed an intensive qualitative analysis of six-session psychotherapies conducted by three eminent humanistic psychotherapists working with bereaved clients. The Innovative Moments Coding System (IMCS), rooted in narrative therapy, is designed to measure change across therapy orientations. Research using the IMCS suggests that the psychotherapy change process occurs through the emergence, elaboration, and expansion of identifiable change moments for a client—innovative moments (IMs)—which present as exceptions to a client's presenting problematic narrative. There are five identified types of IMs: action, reflection, protest, reconceptualization (RC), and performing change (PC). The current study aimed to inform theory regarding the patterns of IMs across three humanistic approaches—constructivist, person-centered, and existential—when working with bereaved clients, while linking these patterns to observable change in each client's functioning. The alliance between each client and therapist was also assessed across the therapy process, showing consistently strong alliances across the three cases. Findings from the current study reinforce the salience of reflection, RC, and PC IMs in successful grief therapy cases, and also suggest the importance of meaning-making interventions in grief therapy. Clinical implications and suggestions for future research are also addressed.     

La résilience dans les situations de licenciement économique : une étude de cas mobilisant les dialogues de conseil en life design

Professional breakdowns are numerous in today's world of work and can lead to psychological distress, precariousness and loss of self-esteem. Resilience gathers a set of psychological attitudes and processes that allow individuals to struggle in order to find life meaning and recover self-confidence after a traumatic event. This article proposes in a first part, a review of the literature on the concept of resilience in connection with career breakdowns and more particularly with layoffs. The second part is a case study that aims to highlight the role and interest of Life Design Counseling Dialogues (LDCDs) (Guichard, 2004) as a career counseling method supporting the implementation of psychological processes that contribute to resilience after a layoff. As part of a career counseling intervention, LDCDs were implemented in a case study. They were transcribed and analyzed using the methodology of innovative moments (Gonçalves et al., 2009). The analysis reveals an increase in the number of innovative moments showing a change in the person's life and it confirms the emergence of resilience processes during DCLDs. These results are discussed in relation to models of resilience and with the role of counselors and psychologists who accompany individuals who have met a layoff.     

Career counseling meets motivational interviewing: A sequential analysis of dynamic counselor–client interactions

Motivational Interviewing (MI) is a client-centered communication style with the aim to resolve client ambivalence within a change-related counseling. Its potential benefit for career counseling has been discussed by several scholars but no empirical research has investigated MI in this context so far. The current study used process measures from MI to investigate dynamic interactions within a career counseling intervention. Overall, we analyzed two videotaped sessions of 14 unique counselor–client dyads. Verbal behavior of counselors and clients were coded with two observational coding schemes from MI (one for counselors and one for clients, respectively). Behavior profiles of counselors were compared with benchmarks of good MI. Furthermore, client verbal ambivalence was compared between sessions. Finally, we conducted lag sequential analyses to analyze temporal dynamics between counselor behavior and immediate client verbal responses across N = 6883 behavioral events. Our results showed, first, behavior profiles of career counselors did significantly differ from recommended counseling benchmarks of good MI practice. Second, as assumed on the basis of past studies, client ambivalence decreased across sessions. Third, MI consistent counselor behaviors showed a positive sequential association with client positive career talk, whereas MI inconsistent counselor behaviors showed the reverse pattern. Our results suggest that counseling behaviors recommended from MI are facilitating career interventions. We discuss how trainings in MI could amend career counseling interventions and provide ethical implications when integrating MI into career counseling programs.     

Innovative Moments in Humanistic Therapy II: Analysis of Change Processes Across the Course of Three Cases of Grief Therapy

The current study is an extension of a complementary investigation examining links between process and outcome within six-session psychotherapies in which three eminent psychotherapists each worked with a bereaved client, using person-centered, existential, and constructivist approaches, respectively. The Innovative Moments Coding System (IMCS) was used in both studies to examine processes of change in the moment-by-moment unfolding of grief therapy. The initial study's findings help inform theory regarding the relevance of humanistic interventions when working with bereaved clients, particularly those that help promote meaning making in the wake of loss. The current investigation extends the original by offering a fine-grained analysis of the progression of innovative moments (IMs) in the context of good-outcome grief therapy, liking specific therapy procedures with positive indicators of client functioning, while providing case illustrations of each therapy dyad. Findings highlight the promise of humanistic approaches in grief therapy, and suggest directions for further research in this area. Implications for future use of the IMCS in psychotherapy process and outcome research are also discussed.     

Studying psychotherapy change in narrative terms: The innovative moments method

This paper aims to describe the Innovative Moments (IM) Coding System (IMCS), an idiographic and transtheoretical methodology that allows the identification of IMs—markers of changes in the client's initial maladaptive framework of meaning—throughout psychotherapy. The present study introduces the theoretical background underlying this methodology, along with the main empirical findings resulting from former studies that have applied this tool to clinical data. The IMCS application is also detailed: the coding phases, the training steps and inter‐rater agreement measures. In order to illustrate the application of IM coding, a case study is presented. Although a partial coding was used, the results are in line with previous research. Discussion is centred on the usefulness of the IMCS for the advance of process research in psychotherapy, and the potential use of this methodology in group format.     

The help-seeking in career counseling

This study examined help-seeking in career counseling by investigating factors that influence students’ intention to consult a career counseling center. Nine hundred and eighteen participants were given the Attitudes toward Career Counseling Scale (ATCCS), an information brochure about the career counseling center; the Intention to Consult a Career Counseling Center Scale (ICCCS), and the Counselor Rating Form-Phrases (CFR-P). The initial value ascribed by the potential client to career counseling more than the attractiveness of career counseling predicted the intention to consult a career counseling center. Some significant differences between high school and university students emerged. The results provide further incentive to continue to study help-seeking in career counseling.     

Unraveling the relationship between organizational career management and the need for external career counseling

This article unravels the relationship between organizational career management and the need for external career counseling. We conducted a path analysis using data of 803 Flemish employees. The results indicate a three-way relationship between organizational career management and external career counseling. First, experiencing organizational career management reduces the need for external career counseling by enhancing career satisfaction. Second, it also reinforces the need for career counseling by encouraging employees to invest in their external employability. Finally, organizational career management and external career counseling are complementary as well. The implications of the results and the directions to be taken in future research are discussed.     

Career construction counseling: A thematic analysis of outcomes for four clients

Thematic analysis was used in this study of career construction counseling with four diverse, purposively-selected participants. After the intervention, the participants who sought and received career construction counseling were interviewed to determine their experience of the intervention. The results showed the value of career construction counseling in bringing about change in the participants' career-life stories.     

The Individual Career Counseling Needs and Experiences of Female Survivors of Partner Violence

The impact of partner violence on women's employment and career development is profound. Career counselors may contribute substantially to these women's rehabilitation. This study examined employment and career counseling needs, barriers experienced, and counseling satisfaction of female survivors of partner violence (N = 71). The women participated in community‐ and research‐based individual career counseling services designed to promote their short‐ and long‐term career development. The authors conducted correlational, t‐test, and logistic regression analyses and found that barriers differed by race/ethnicity, age, number of children, and career service needs. Results provide important information about survivors' career counseling service access and needs.     

Psychological Change in Everyday Life: An Exploratory Study

The innovative moments model was used in a pilot study that aimed to explore the change processes involved in everyday change outside psychotherapy. According to this model, the emergence and development of innovative moments (IMs) as exceptions to a problematic pattern are closely associated with psychological change. A longitudinal design covering 4 months of interviews was implemented with 13 adults who were coping with significant personal problems without clinical psychopathological complaints. Semistructured interviews were used to explore participants' personal accounts of their problems, and change was assessed using a scaling task at the end of the study. A total of 114 interviews were analyzed using the innovative moments coding system. A general linear model showed that higher levels of change were associated with higher proportions of complex IMs over time. Moreover, lower levels of change were associated with an increase in elementary IMs. These results support the idea that successful psychological change in everyday life shares similarities with the change pattern found in psychotherapy using the innovative moments model.     

The role of problem-solving appraisal in the process and outcome of career counseling

Because problem-solving appraisal has been demonstrated to be a critical variable in psychological adjustment, this study examined its potential role as both a static and dynamic client attribute influencing the process and outcome of career counseling. Participants were 151 adults who received an average of five sessions of naturally occurring career counseling; data were collected before, during, and after counseling. The results indicated that: (a) in line with a static attribute model, clients' pre-counseling problem-solving appraisal scores predicted post-counseling career and psychological outcomes as well as career decidedness even after partialling out clients' pre-decidedness scores; (b) in line with a dynamic attribute model, clients who experienced positive changes in problem-solving appraisal in counseling were more likely to have more positive career resources to use in their career transitions as well greater goal directedness; (c) participation in career counseling related to positive change in problem-solving appraisal scores at a level similar to problem-solving training workshops; and (d) clients' changes in problem-solving appraisal related to changes in the working alliance over time.     

narrative‐based career counseling perspectives in times of change: an analysis of strengths and limitations

There is an ongoing movement in the career development counseling field that focuses on narrative‐based approaches. The purposes of this article are to analyze the factors that led to a turn to narrative career counseling, to examine the strengths of narrative, and to outline potential limitations. The literature review examined scholarly work in the career development field. Contributions from other disciplines (e.g., medicine) were integrated to provide complementary perspectives. The author contends that there is an appropriate place for narrative in career and employment counseling. Suggestions for addressing limitations and applications for career and employment counselors are highlighted.     

Career Research Interests and Training of Genetic Counseling Students

Research is important to validate clinical services, provide information on the effectiveness of practice techniques, and develop the knowledge base of a clinical profession. Genetic counseling students from American Board of Genetic Counseling (ABGC) accredited training programs were surveyed to determine their career research interests and interest in pursuing a hypothetical doctoral degree in genetic counseling. Genetic counseling program directors were surveyed to assess the emphasis on research training within their programs. A substantial number (46%, n = 92) of genetic counseling students are interested in performing research in their careers and many (40%, n = 80) would pursue a doctoral degree in genetic counseling if it was available. Students and directors from programs with a thesis requirement reported a significantly higher emphasis on career research preparation than those from programs without a thesis requirement. The results of this study indicate that future genetic counselors are interested in contributing to the research base that will advance the field. This study suggests a need to strengthen research training within ABGC accredited graduate programs and explore the development of a doctoral degree option in genetic counseling.     

Integrating motivational interviewing in career counseling: A case study

Motivational interviewing (MI) is receiving increasing attention in the field of career counseling. However, none of the previous studies have concretely presented how this method could and why it should be integrated in career counseling. Through the use of a single case study design, this paper illustrates how a brief MI (BMI) intervention can be integrated into career counseling interventions to help resolve career dilemmas. An analysis of the interactions between the client and his counselor using the Motivational Interviewing Skills Code 2.1 illustrates why this method can be useful for career counseling. Immediate and long-term effects of the global career counseling intervention on the client's career decision-making difficulties, as well as the specific impacts of the BMI intervention, are assessed. This case study shows that the BMI approach can be integrated in a career counseling intervention to help career counseling clients overcome career dilemmas and increase their readiness to make career choices.     

叙事取向团体辅导对大学生自我认同的干预研究

自我认同的发展与大学生心理健康水平及其今后的社会适应关系密切。本研究用叙事取向团体辅导对大学生自我认同进行干预。结果发现,叙事治疗强调的好奇、尊重、珍惜的态度,为成员创设了安全、温暖、支持的团体氛围;外化和解构使成员与问题拉开距离,探讨问题的影响力;寻找并丰厚特殊意义事件,让成员看到自身的正向力量和资源;局外见证人团队,进一步巩固成员身上的正向力量。结论：叙事取向团体辅导是促进大学生自我认同发展的有效途径。