The current career understanding develops away from institutionally outlined career track to informal personal and socially shared career conceptualization. Richardson (2002, 1993) suggested that occupational counselling and psychotherapy should become more integrated and thus better address this issue. We propose that we need a new conceptualization which would see career and occupational projects as being constructed in the personal and social processes and could provide a new basis for counselling integrating occupational counselling, psychotherapy and dealing with joint processes on a basis common to all three views. The core of this conceptualization is the idea of goal-directed system processes organized in action, projects and career, which are related to a number of issues such as occupational career, but also mental and physical health and relationships (Domene, Valach, & Young, 2015; Valach, Young, & Lynam, 2002; Young, Valach, & Collin, 2002). This conceptualization will be outlined, several cases will be described in which the intertwining of various issues asking for occupational, therapeutical and family related intervention is visible and, finally, a brief quantitative and qualitative overview will be provided of the occurrence of the occupational, life and suicide related joint issues in 40 interviews with patients after a non-fatal suicide action (Valach, Young, & Michel, 1997)

The current career understanding develops away from institutionally outlined career track to informal personal and socially shared career conceptualization. Richardson (2002, 1993) suggested that occupational counselling and psychotherapy should become more integrated and thus better address this issue. We propose that we need a new conceptualization which would see career and occupational projects as being constructed in the personal and social processes and could provide a new basis for counselling integrating occupational counselling, psychotherapy and dealing with joint processes on a basis common to all three views. The core of this conceptualization is the idea of goal-directed system processes organized in action, projects and career, which are related to a number of issues such as occupational career, but also mental and physical health and relationships (Domene, Valach, & Young, 2015; Valach, Young, & Lynam, 2002; Young, Valach, & Collin, 2002). This conceptualization will be outlined, several cases will be described in which the intertwining of various issues asking for occupational, therapeutical and family related intervention is visible and, finally, a brief quantitative and qualitative overview will be provided of the occurrence of the occupational, life and suicide related joint issues in 40 interviews with patients after a non-fatal suicide action (Valach, Young, & Michel, 1997)

Objective: Breast cancer is frequently associated with psycho-oncological burden for the affected patients. Severity and temporal dimension are often not readily assessable, as many patients do not express their need for professional counseling. Monitoring usually ends together with the patients’ intensive medical cancer therapy. Thus, information on the longitudinal need for psycho-oncological support is limited. The aim of this questionnaire- based observational study was to identify breast cancer patients in need of psycho-oncological support and to monitor these patients in the long-term. Methods: A total of 94 patients treated in two oncological practices in Germany between May 2011 and July 2015 were included. 61 patients had primary breast cancer and 33 presented with recurrent/metastatic disease. To assess the patients’ burden, the standardized self-rating Questionnaire on Stress in Cancer Patients – short form (QSC-R10) was to be answered by each patient at different time points. Results: Of 41% (n=39) initially burdened patients treated either in a curative or in a palliative setting, 67% (n=26) still required psycho-oncological support at the time of the second survey. Conclusions: Psycho-oncological burden is common in breast cancer patients and the need for support persists over a long period of time. In the future, this temporal dimension has to be adequately addressed after the completion of their intensive medical cancer therapy. Thus, the long-term monitoring of cancer patients with the QSC-R10 is strongly recommended.

Objective: Breast cancer is frequently associated with psycho-oncological burden for the affected patients. Severity and temporal dimension are often not readily assessable, as many patients do not express their need for professional counseling. Monitoring usually ends together with the patients’ intensive medical cancer therapy. Thus, information on the longitudinal need for psycho-oncological support is limited. The aim of this questionnaire- based observational study was to identify breast cancer patients in need of psycho-oncological support and to monitor these patients in the long-term. Methods: A total of 94 patients treated in two oncological practices in Germany between May 2011 and July 2015 were included. 61 patients had primary breast cancer and 33 presented with recurrent/metastatic disease. To assess the patients’ burden, the standardized self-rating Questionnaire on Stress in Cancer Patients – short form (QSC-R10) was to be answered by each patient at different time points. Results: Of 41% (n=39) initially burdened patients treated either in a curative or in a palliative setting, 67% (n=26) still required psycho-oncological support at the time of the second survey. Conclusions: Psycho-oncological burden is common in breast cancer patients and the need for support persists over a long period of time. In the future, this temporal dimension has to be adequately addressed after the completion of their intensive medical cancer therapy. Thus, the long-term monitoring of cancer patients with the QSC-R10 is strongly recommended.

The evidence for EMDR (Eye Movement Desensitization and Reprocessing) ’s effectiveness in treatment usually employs subjective rather than objective measures. Salivary stress biomarkers are considered a useful objective measure of stress. In this study, three salivary biomarkers were examined during EMDR treatment: cortisol (Crti.) as a measure of hypothalamic–pituitary–adrenal (HPA) axis response; secretory immunoglobulin A (s-IgA) as an immune function measure; and chromogranin A (CgA) as a measure of the sympathoadrenal system. Subjects were four adult PTSD (Post-traumatic stress disorder) clients (28–37 years old) who were treated with standard EMDR therapy. Changes in biomarker data during the course of EMDR treatment provided objective evidence for the effectiveness of EMDR therapy. First, Crti. and CgA levels decreased gradually during treatment, indicating that psychological stress was reduced by EMDR therapy. The change in s-IgA was predictably small, showing that the immune system recovered slowly from PTSD. Second, changes in CgA during EMDR sessions reflected the PTSD type (e.g., hyperarousal type or avoidance type) as defined by IES-R subscores. In clients with hyperarousal-type PTSD, pre-EMDR CgA levels were higher than post-treatment levels. Conversely, in avoidance-type clients, levels were lower before than after treatment. These changes were considered to reflect clients’ responses to the requirement that they recall their traumatic memories. The current study successfully shows that changes salivary biomarkers provide physiological evidence of therapeutic mechanism of EMDR in different types of PTSD.

Health literacy is the ability to access, understand, evaluate, and communicate information that promotes, maintains, and improves health care in a variety of settings across the lifespan. Unlike general literacy, health literacy is considered a more dynamic and context-reliant ability because it is comprised of reading comprehension, reasoning, and numeracy skills.

In the Asian countries, the entry of baby-boomers into old age is a social policy issue . The Council for Economic Planning and Development predicted that elderly (more than 65 y/o) will reach 22.5% by 2028 in Taiwan. The population aged (more than 60 y/o) in China is projected to increase from 13.9 % in 2013 to 32.8 % by 2050 . A Taiwan National Health White Paper (2020) reported that the main factor influencing the higher life span was medical care . From a health perspective, older people tend to spend a greater proportion on health care than other sectors of the population . Thus, improving education or enhancing care services may be needed to ensure that elderly make wise decisions concerning medical care and their health.