Abstract Career counselling, career guidance, and career interventions are terms in the process of evolution. Historical and contemporary factors in the US experience that have changed and expanded the needs for career counselling and related career interventions are discussed. For many work-adjustment problems, in particular, there is a growing acknowledgement that career and personal counselling must fuse. Where this fusion occurs, on a continuum from choice, indecision, and situational concerns to change, indecisiveness, and personal concerns, is analysed.