Case conceptualisation for career development

So what is case conceptualisation, and why is it important for career practice? Well, let's begin with case conceptualisation itself, which could be defined as "a process of diagnostic thinking" (Słysz & Soroko, 2021, p. 87), or case formulation (Haarhoff et al., 2011). It is both a process and an outcome (Słysz & Soroko, 2021); a particle and a wave, so to speak. It is defined as "process whereby [the practitioner] and client work collaboratively first to describe and then to explain the issues a client" wants to work through (Kuyken et al., 2009, p. 3). 

Normally a function of CBT or Cognitive-Behaviour Therapy (Gower, 2011; Haarhoff et al., 2011), case conceptualisation is often not deliberately taught, nor is it well-assessed (Haarhoff et al., 2011). Yet case formulation is very important.  As practitioners, our ability to clearly 'see' the issues which the client presents to us, will aid our practice "by ensuring that individual cognitive and behavioural processes are targeted, thereby maximising" the quality of client outcomes (Gower, 2011, p. 10). So the trick with case conceptualisation is for us to be very, very good at looking, and actually 'seeing'.

Research shows that we career practitioners who focus on client skills - rather than client barriers - are better able to help our clients to achieve sound results. Developing our observational and interview skills so we can help our clients to inventory their talents, and to put those talents into words which our clients can use to seek new work is a key career development super power (Gower, 2011). Often we practitioners may see the effects of a client action, and are likely to need to derive the process in order to effectively walk back from the client's endpoint (Słysz & Soroko, 2021).

If our clients understand that career development isn't a one-off session: that, like all good relationships, putting a puzzle together collaboratively over time has value for both the practitioner and the client. Experienced practitioners are adaptive with their clients, understanding and learning the nuances of client's story and goals over time (Gower, 2011). 

However, we career practitioners need to continually and intentionally work on our theory and methods growth. We must ensure we treat each client as a unique individual, and that we have a range of evidence-based, appropriate tools, activities and strategies which we can choose to help achieve those elusive client career goals (Gower, 2011). There is an excellent text which - although also focused on CBT - walks us through many aspects of case formulation (such as modes, beliefs, assumptions, strategies and thoughts), with chapters designed to deepen our understanding (Kuyken et al., 2009).

And it is worth building our skills, as competent case conceptualisation enables us to better select and arrange client interventions. Good quality interventions means our clients can hold their motivations to the light, improving their self-belief and outcomes.

Sam

References:

Gower, P. J. (2011). Therapist competence, case conceptualisation and therapy outcome in cognitive behavioural therapy. [Doctoral Thesis, University of Exeter]. https://www.proquest.com/openview/0f3d8f328faefd6cb4508d3845a7e83c/1.pdf?pq-origsite=gscholar&cbl=51922&diss=y

Haarhoff, B. A., Flett, R. A., & Gibson, K. L. (2011). Evaluating the Content and Quality of Cognitive-Behavioural Therapy Case Conceptualisations. New Zealand Journal of Psychology, 40(3), 104-114. https://mro.massey.ac.nz/server/api/core/bitstreams/39f41a0d-a882-43dc-a11d-357cd0cc5d93/content

Kuyken, W., Padesky, C.A., & Dudley, R., (2009). Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive-Behavioral Therapy. Guilford Press.

Słysz, A., & Soroko, E. (2021). How do Psychotherapists Develop a Case Conceptualisation? Thematic Analysis of Conceptual Maps. Journal of Contemporary Psychotherapy, 51, 87-96. https://doi.org/10.1007/s10879-020-09484-2