Dear Dr. Friedman:
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
Distance:
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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