possibility of altering the initial decision; they are completely devoted to the idea they
have reached (probably after considerable effort and without the initial hope of certainty),
but not flexible enough to make changes on the way to see their idea fulfilled. Reverie
and consistency are the positive aspects, while pathos and stubbornness are the flip-side.
To each situation in the typology above we can match various counselling interventions.
One fact is however common and must be held in mind by counsellors: the client’s
interest and general welfare created by accepting the good results and by a critical
understanding of momentary dissatisfactions. Clients must move on with a clear image of
what needs to be done from then on and with an improved self-perception.
Examples, case studies^11 , exercises
A couple (he a student, she already working) seek counselling for the following problem:
“He (X) is about to graduate from the medical school and must decide on residency
specialization. His choice wavers between emergency medicine (E M ) and
obstetrics-gynaecology (O-G), leaning towards the second. He is undecided but
nevertheless certain to succeed with the residential exam in either specialty.
The counsellor asks what attracts X in obstetrics-gynaecology and finds out he enjoys the
work itself. The counsellor derives that for the other specialty X would need to find
another residency vacancy. What does he like in the emergency medicine? The 50-hour
workload compared to the 80 hours in obstetrics-gynaecology; this would allow him to
spend more time with his family. Neither client admits other values involved in the
decision.
The counsellor invites the clients to draw a diagram of the decision:
Residency Nature of work Workload
E M 0 0 +
O-G + + 0
In the decision table above, the line E M is the option for a career in emergency
medicine, and O-G represents the option for obstetrics-gynaecology. The first column is
the quality of the experience anticipated as a resident in each specialty, the second is the
quality of the work experience anticipated; the third column is the weekly engagement
anticipated at work. The pluses are good results and the zeros are acceptable results. A
significant factor for the importance of the decision is the duration of the impact. After a
residency of 3-4 years, a 40-year career is expected. The counsellor that the nature of
work and the workload are 10 times more important than the residency period, since they
are features lasting ten times longer.
(^11) Taken over from Anderson (2002).