Case Study
Patient Demographic:  Initial Intake: Age: 42 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: The client appears her stated age and is dressed appropriately for the circumstances. She identifies her mood as “somewhat anxious” and her affect is labile and congruent. She is noted to rub her hands together at times and she appears uncomfortable at times as she talks about herself. She demonstrates good insight, appropriate judgment, memory, and orientation. She reports no history of trauma, suicidal thoughts, or harm towards others.
Presenting Problem: You are a non-Hispanic counselor in a private practice setting.  Your client is a 42 year old female who reports that she has been working for the same accounting firm for 10 years and was recently laid off due to a downturn in the economy. She tells you that prior to this firm, she worked in a company doing managerial accounting that she joined right after college. She says that she has liked the people that she has worked with but over the past several years she has enjoyed her work less and less. She reports that she is upset to have lost her job but, in some ways, she sees it as an opportunity to find something else she is more passionate about, but she has no idea where to start. She does say that she wants a job and work environment that is a better fit for her personality. She also tells you that she is afraid that she is too old to begin again or that she doesn’t have “what it takes” to begin a new career.
Other Contexts: Family History:
The client reports no significant family history related to mental health issues or relationship problems. The client tells you that she chose accounting in college because she grew up in a small town and her parents told her that she needed a skill that would help her support herself. Additionally, she states that she has been married for 19 years and has a good relationship with her spouse. She tells you that he is supportive of her exploring new careers but that her income is helpful for the family and it is important that she works.

Question: Which of the following is the most appropriate to discuss with the client at the beginning of counseling?
(A): Career counseling can include personal issues that impact career and career decisions
(B): Career counseling focuses only on exploring career and occupational choices
(C): Career counselors are not mental health counselors
(D): Career counseling is a specialty area that only some counselors are trained to provide

Correct Answer: Career counseling can include personal issues that impact career and career decisions
Explanation: Career counseling focuses on career decisions and choices as well as any personal or mental health issue that impacts a client's career satisfaction or career decision-making. Career counseling, therefore, does not focus only on exploring career and occupational choices. Responses c and d are incorrect because all mental health counselors are trained in career counseling, and licensure exams require competence in career theories and career-oriented models for counseling. Therefore, the correct answer is (B)
Competency: counseling skills and interventions