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| Consultation at a Distance
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I have been reading your worklife column since its inception. My
question is about telephone consultation for career counselors and for
career counseling clients. I am a career counselor. I live and work in a
small town about 200 miles from the nearest city. Do you think
phone-based supervision or consultation or career counseling are useful?
Although I am in the earliest stages of my professional development, as
a licensed counselor, I am about the most skilled career counselor for
100 miles. I would like to further develop my counseling skills without
refining my driving skills. I attend several professional conferences a
year. While I find these meetings helpful, I feel that they do not
provided me with the opportunity for professional continuity or
individual attention. I am wondering if you feel that phone consultation
would be useful.
On a related vein, a client to whom I provided career consultation found
a terrific job and relocated to another small town. Recently, he
contacted me requesting telephone consultation. I told him that while I
would like to be helpful, I would like the opportunity to think through
his request a bit before responding. What do you think?
Distance learner
You raise two interesting and important questions. I will address each
in turn. First, you about the effectiveness of phone supervision or
consultation. You wanted to know, what do I think of this as a format
for additional training? My exposure to this format has been as
follows. Recently, I have begun, on an experimental basis, to provide
phone-based consultation/supervision. Also, in the past, I have made
good use of phone-based, clinical supervision. Finally, I have queried
a number of colleagues who provided and/or received phone-based,
supervision.
My preliminary feeling is that while it can be enormously helpful,
phone-based, supervision is not nearly as useful as face-to-face
contact. I would encourage anyone using this modality for either
supervision or treatment, to begin by arranging several face-to-face
meetings. Although I realize that these meetings may entail a
significant additional expense, I suspect that in the end, they will
enhance the quality of the supervision considerably. Also, I would
encourage you to bolster the phone interaction with regular (perhaps
monthly) face-to-face meetings.
The second part of your question relates to the efficacy of phone-based,
career counseling. To my knowledge, there has been virtually no research
done on this important topic. Recently phone-based psychotherapy has
begun to be examined in the psychological literature, however, I could
find no literature on phone-based career counseling. You did not address
the issue of telephone psychotherapy, however since I feel that it bears
upon this question, I will address it. In the absence of any empirical
evidence, I will give you my opinion.
As an analytically-oriented, clinical psychologist, I have been asked on
numerous occasions to provide phone-based psychotherapy. While
typically, the requests have come from patients in psychotherapy who,
for personal or professional reasons, have chosen to relocate while in
the middle of a course of psychotherapy. Also, patients who live a
considerable distance from any city also have proffered these requests.
I have steadfastly refused to conduct phone-based psychotherapy. For
me, much of what happens in the conduct of psychotherapy is non-verbal.
An important part of the clinician's role is to help patients learn to
trust others and to put their feelings into words. Crucial information
is lost during phone interactions. Also, I feel that the phone can be
used to create a kind of pseudo-intimacy making it difficult to address
conflicts around actual intimacy and trust.
One might argue that career counseling does not require the same level
of intimacy and trust, so why not conduct it on the phone. However, I am
not sure that I concur with this contention. While career counselors
vary significantly with respect to background, training and perspective,
for me, at times, career counseling, or worklife consultation as I
prefer to call it, is simply another form of psychotherapy. The
presenting problem is: career difficulties. Over the years, I have found
that career counseling issues seldom exist in isolation. Like any other
issue, career struggles typically provide a window into the individual's
internal world. The career counseling client who struggles with
assertiveness difficulties at the work place may struggle with these
difficulties in marriage. Resolution of the assertiveness difficulties,
as they relate to work, may entail career-oriented psychotherapy aimed
at examining the individual's goals, dreams and beliefs.
On other occasions, the worklife consultation required may be more
behaviorally-oriented, career coaching. I would be less comfortable
providing the former over the phone and more comfortable providing the
latter on the phone. The problem is: typically the nature of the
individual's needs become clarified over time; also, their needs may
evolve. So, how does one go about assessing the nature of the
individual's needs at the outset. Also, even where the person needs
more of a sort of coaching, important information can be lost. To wit,
we have all had the experience of meeting someone after several months
of phone contact and the result can be quite surprising. It seems to me
that knowing how someone presents themselves is critical data in the
counseling process. At the very least, as with career
consultation/supervision, I'd urge anyone seeking phone-based,
counseling to arrange for several face-to-face meetings. Finally,
prior to embarking on this course, I'd urge any counselor to check with
their state licensing board, malpractice carrier and attorney to find
out whether there are any regulatory guidelines which govern these types
of activities, particularly when you cross state lines.
I'd be interested in feedback from anyone who has experimented with
either of these modalities. Also, feel free to ask this question again
in six months as experience will undoubtedly help me to refine my
opinion. Good luck. Please let me know how it works out.
Dr. Friedman
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