In this archival study the authors sought to determine the relationship, if any, between counseling outcomes and the topical focus in career counseling. Twenty-two counselors saw 46 adult clients at a community-based clinic for an average of eight sessions. Counseling outcome and topical focus (the extent to which the actual content of counseling sessions reflected relatively more vocationally or personally focused topics) were assessed from follow-up questionnaires to former career clients and from trained raters' evaluations of the counselors' written progress notes. Results showed that, from the counselors' perspective, outcomes were better when the focus of the sessions was relatively more vocational than personal and when relatively more interviews were held. Client satisfaction, on the other hand, was predictable only from the counselor's level of experience. Satisfaction with occupational status was not associated with any of the client, counselor, or treatment factors. Discussion focuses on the contribution of the results to career counseling practice and on the feasibility and validity of retrospective, archival research.
Brain-injured individuals often experience problems with aggression which can prevent full community reintegration. Two cases involving individuals (one 4 years, one 17 years post-injury) who had been placed in a state psychiatric hospital due to aggressive and/or self-injurious behaviours are discussed. Utilizing medication dosages and behavioural acuity indicators over a 2 year period, the authors demonstrate the efficacy of lithium carbonate in treating aggressive behaviours. Lithium, in concert with other medications, not only led to a decrease in the frequency of aggressive outbursts and in the need for restrictive and costly behaviour control techniques, but also allowed for a significant reduction in the use of neuroleptic medication in one case. The authors conclude that the use of lithium, within the context of an intensive, behavioural rehabilitation programme, may yield positive effects in the control of aggressive behaviour even in long-term post-injury cases.
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