Abstract
Developing skills in theoretical case conceptualization is often a
challenging task for students. A new counseling theories website offers
a promising means of integrating technology to enhance counselor
training in this area. This multifaceted site, created by Dr. Aaron
Rochlen of the University of Texas at Austin, is currently under
contract with Wadsworth Publishing Company. It is an excellent addition
to any counseling theories course.
As emphasized by several authors, learning the skills necessary for
theoretical case conceptualization presents significant challenges to
students (Caspar,
Berger, & Hautle, 2004;
Murdock, 1991). For many, the difficulty inherent
in developing proficiency in these skills is compounded by the fact that
beginning students lack opportunities to practice the application of
these theories in clinical work, which is often embarked upon only at a
later phase in their studies. Furthermore, many students have limited
opportunities to practice case conceptualization beyond introductory
counseling theories courses. Consequently, students’ conceptualization
skills may be underdeveloped, a fact that may ultimately be to the
disadvantage of novice therapists and their prospective clients.
Repeated and deliberate practice have been cited as integral components
in the development and mastery of therapeutic and case conceptualization
skills (Caspar
et al., 2004). Likewise,
Faust (1986)
asserted that increased feedback in
counselor training leads to enhanced therapeutic skills. More recently,
Caspar et al. recommend computer-based methods of
counselor training as a means of offering the systematic feedback and
increased practical experience necessary in building appropriate
therapeutic skills.
In an
effort to improve existing methods of counselor training through the
utilization of computer technology,
Dr.
Aaron Rochlen at the
University of Texas at Austin has developed a unique and innovative
project integrating case conceptualization practice exercises and
internet based enrichment. The result is an interactive website designed
to serve as an adjunct to classroom instruction that allows students to
practice the application of theory and case conceptualization in a
realistic and enjoyable format. The project encourages students to
deepen their understanding of counseling theories while simultaneously
practicing therapeutic skills that will be essential in work with future
clients. This website allows students to develop their own
conceptualization of three distinct cases from fifteen possible
theoretical orientations. They may then compare this material to
conceptualizations of the same cases made by professional psychologists
drawing from each of the featured theoretical perspectives. Within this
online format, students can email their completed conceptualization to a
classmate or instructor, allowing for more immediate and detailed
feedback and instruction.
An
advantage of the site is that it is simple to use and navigate. Once a
user logs on, cases can be reviewed immediately by clicking on the Case
Studies navigation bar. A brief overview of three simulated cases is
offered, including client name, age, problems endorsed, and referral
source. Once a specific case is
selected, the student can review a page of demographic information for
each client including the following: a client description, presenting
concerns, and family and developmental background. Students may then choose to listen to a portion of the
client’s clinical interview via Quicktime audio links with corresponding
text. The Quicktime links are streamed in question/answer segments,
allowing students to listen to the entirety of the interview or selected
portions. It is in these interviews that the client’s presenting
problems are expanded upon.
The sample
clients vary in age, ethnicity, and presenting problems. There is the
case of “Darnell,” a 25-year-old African American male who reports
feeling depressed and anxious since returning to college after an
attempted career as a professional athlete. The case of “Roberta” refers
to a 34-year-old White female who experiences social awkwardness and
difficulty in interpersonal relationships. Finally, the case of “Audrie”
features a first year Asian American college student who adheres to a
strict regimen of diet and exercise and reports increasing conflict with
her parents. A noteworthy strength of the project is the distinctiveness
of these three cases, which challenges students to individually tailor
their analyses to each client and to factor multicultural considerations
into their conceptualizations. Additionally, students may practice with
the program as many times as they wish.
At the
end of the clinical interview text the student may click on a button to
submit the case analysis. Prior to beginning the analysis, the student
must select one of the three cases and identify which theoretical
orientation will guide the conceptualization. The student is asked to
choose from the following fifteen theoretical perspectives from a pop-up
window: Freudian/Psychoanalytic, Self-Psychology, Object Relations,
Jungian, Adlerian, Existential, Person-Centered, Gestalt, Cognitive
Behavioral, Cognitive, REBT, Reality Therapy, Feminist, Solution
Focused, and Constructivist.
After
selecting a case and theoretical orientation, the student’s analysis is
guided by a series of questions. Such a model encourages the integration
of various sources of information ranging from client presentation,
theoretical assumptions, and therapeutic goals and interventions.
Initially, the student must cite evidence for the preliminary
conceptualization. They are asked if there is any additional information
they would gather that would be helpful in working with a particular
case or within a specified theory. The student is then asked to reflect
and account for multicultural considerations, provide preliminary
treatment goals, and to speculate on the role of the therapist/client
relationship.
Finally, the student is
asked to identify aspects of the theory that do not fit with the
particular case and to consider how they might account for what is
missing. By doing so, students are not only asked to comment on the
strengths of a given approach, but also to consider a theory’s
limitations. Once completed, the analysis can be distributed via email.
A disadvantage of the site is that the “Submit your analysis” page does
not have a save function. Consequently, students must complete an
analysis in one sitting. Likewise, if students refer back to a
particular case study for review, they may risk losing any part of the
analysis that they have already completed. It is therefore suggested
that students take careful notes, or print out the client information
and interview to refer to while crafting their conceptualization.
After
sending their response to a selected email recipient, the student may
opt to read an expert response, try another case, or return to the site
home page. Perhaps one of the most exciting features of the site is the
first option that allows students access to expert responses to the same
simulated cases.
While students are
advised that there is not a single, correct answer to a particular
theoretical conceptualization, the expert responses offer further
insight into the process of theoretical integration and application from
the perspectives of experienced therapists. The experts represent each
of the fifteen orientations featured in the project and comprise an
impressive group of scholars and licensed practitioners. The experts are
affiliated with a range of educational and professional institutions
including the
University of Maryland, the
University of Oregon, the
University of Chicago, the
Albert Ellis Institute, the
Institute for the Advancement of Self-Psychology, the
Beck Institute for Cognitive Therapy and Research, the
Center for Reality Therapy, and the
Jean Baker Miller Training Institute. Students can link to a
biographical page for each expert, which includes the professional
affiliations of the contributors as well as their self-described
approach for working with clients from their particular orientation.
Two
additional features of the project include related links and a
discussion component. The Links page offers theory-related web resources
for the inquiring student for each of the fifteen theoretical
perspectives detailed on the site.
The
discussion board, supported by
Wadsworth Publishing Company, provides an additional opportunity for
students to ask questions, post responses, and communicate with other
students regarding classroom and professional issues.
Dr.
Rochlen’s Counseling Theories project is owned by Wadsworth, the
publishers of many texts in counseling theory such as those by
Corey, Wedding/Corsini, Sharf, St. Clair, Prochaska, Bankart, and Harris.
The website is being marketed as an active companion to these texts and
may also serve as a model for future educational sites from other
disciplines. Future directions may also include interviews with selected
theorists as well as the incorporation of video. The site is password
protected and is permanently located at
http://theories.brookscole.com.
References
Caspar, F., Berger, T., & Haultle, I. (2004). The right view of your
patient: A computer assisted, individualized module for
psychotherapy training. Journal of Clinical Psychology, 41(2),
125-135
Faust, D. (1986). Research on human judgment and its application to
clinical practice. Professional Psychology Research and
Practice, 17(5), 420-430.
Murdock, N.L. (1991). Case conceptualization: Applying theory to
individuals. Counselor Education and Supervision, 30,
355-365.
Author's Biography
Emily Hall is a doctoral candidate in counseling psychology at the University of Texas at Austin.
