CAREER VISIONS PROJECT: Supporting Self-Determination and Enhancing Career Development for

1. CAREER VISIONS PROJECT: Supporting Self-Determination and Enhancing Career Development for Young Adults with Mental Health Diagnoses Casadi Marino, MSW Graduate Research Assistant Jo-AnnSowers, Ph.D. Principle Investigator

2. BACKGROUND& RATIONALE • It is estimated that between 70% and 80% of adults with mental health diagnoses are unemployed. • They constitute the largest and most rapidly growing subgroup of Social Security beneficiaries. • The National Longitudinal Transition Study (NLTS) found that only about 63% of students who received special education services for an “emotional” disability had held a job in the four years after leaving high school. Research & Training Center for Pathways to Positive Futures, Portland State University

3. INCREASED UNDERSTANDING OF THE IMPORTANCE OF WORK • There has been a long-held belief that work is too stressful and may be harmful for people with mental health issues. • Given the lack of a valued work role, the stress of low income and lack of resources, and general social disenfranchisement, a context is created that leads to further disability • Through the leadership of people who have mental health diagnoses, and in conjunction with a paradigm shift to a “recovery” model, there has been a growing recognition that work can be key to a persons’ recovery. Research & Training Center for Pathways to Positive Futures, Portland State University

4. IS ANY JOB BETTER THAN NO JOB? • Growing understanding that work can promote recovery. Pendulum has swung from no work to any job is good for the person. • Research and experience suggests that some jobs promote mental health and others do not. • A focus of Career Visions is to help the young adults identify job situations that will promote their health and success. • Career Visions supports the young adult’s engagement in exploring interests, talents, and options and with reattachment to past goals or visions that may have been lost sight of over the years. Research & Training Center for Pathways to Positive Futures, Portland State University

5. EMPLOYMENT & SELF-DETERMINATION • Self-determination has been found by investigators to be a key predictor of post-secondary success, including employment for youth with disabilities. • Self-determination involves individual choice and direction, personal investment in educational and career goals, and taking action. • The focus of much of the intervention research and literature has been on youth with developmental disabilities. Research & Training Center for Pathways to Positive Futures, Portland State University

6. EMERGING ADULTHOOD:UNIQUE CHALLENGES & OPPORTUNITIES Young adults in their early to late 20 and who experience significant mental health conditions have characteristics and experiences which are unique : • They are at a developmental stage which has been described as “emerging adulthood” (Arnett, 2004) when the expectation is for them to more fully adopt independent adult roles than during adolescents. • This is the time when most “typical” young adults begin to seriously think about, plan for and take steps that will establish their career path and trajectories. • There is a lack of available role models and mentors who are able to offer support and information about the process of establishing a career. Accordingly, networking opportunities and certain pathways to career development may not be readily available. • Many received their diagnoses and/or began seeking assistance for mental health issues for the first time during their 20s—their career dreams, plans, and activities may have been disrupted. • Others may have been “treading water” since leaving high school and/or the child system, and now recognize the need for assistance in order to move forward. Research & Training Center for Pathways to Positive Futures, Portland State University

7. PROJECT PURPOSE To evaluate how effective the Career Visions program is for helping young adults (20 to 30 years of age) with mental health challenges to: • Re-engage in pursuing career and job goals. • Have confidence that they can work in a career or job which fits their strengths and desires. • Gain knowledge and skills they can use to take the lead in choosing, planning for, and taking steps to achieve their career or job goal—self-determination. To help young adults with significant mental health challenges to not get caught in long-term unemployment, Social Security and the mental health system. Research & Training Center for Pathways to Positive Futures, Portland State University

8. NEED FOR INTERVENTIONS AND RESEARCH • Some focus on youth transitioning from school to work and postsecondary education. • Growing focus on supported employment for older adults with long histories of unemployment. • Few attempts to address the unique developmental stage of young adults in their 20s. Research & Training Center for Pathways to Positive Futures, Portland State University

9. Who Are the Young Adults? • Some have never worked, others have had lots of entry level jobs. • Some have completed high school or GED, a few attempted college, and a few are currently in college. • Most have received at least three mental health diagnoses over the years of involvement in the mental health system and many have more. These diagnoses may include anxiety, depression, bipolar, schizophrenia, ADHD, PTSD, etc. • On the Brief Symptom Inventory (BSI) a high percentage reported struggling with several symptoms, including feelings of hopelessness for the future. • About 25% are on Social Security. • Some are clients of community mental health systems and others are engaged in private care. • Participants may cycle in and out of crises and psychiatric hospitalizations. • Many have found that their substance use has become problematic and are attempting to reduce or cease use. • Some have histories of involvement in the criminal justice system, both as juveniles and as adults, which present significant barriers. • Some still live with families, some on own, some in agency-run housing. • A few of the young women have children who live with them. Research & Training Center for Pathways to Positive Futures, Portland State University

10. MY CAREER VISIONS PROJECT • The Career Vision Project intervention is an adaptation of a model and guide developed by Dr. Michael Wehmeyer called the Self-Determination Career Development Model (SDCDM). • We have adapted the SDCDM to focus on the unique issues experienced by young adults, between the ages of 20 and 30 years and who have mental health diagnoses. Research & Training Center for Pathways to Positive Futures, Portland State University

11. THE HOPE Our hope is that: • Career Visions serves as a platform from which the young adult participants gain or regain hope that they can achieve the same types of career goals as other young adults, • The young adults achieve the knowledge, skills, and momentum to be able to continue to move toward their goals. Research & Training Center for Pathways to Positive Futures, Portland State University

12. Research & Training Center for Pathways to Positive Futures, Portland State University

13. Research & Training Center for Pathways to Positive Futures, Portland State University

14. Research & Training Center for Pathways to Positive Futures, Portland State University

15. CAREER VISIONS BASICS • The young adults meets about once a week with a Career Guide for 12 sessions (about 3 months) and for about 2 hours. By the end of this time they will have completed the guidebook and have developed a goal and plan. • They then meet with their Career Guide about twice a month for 9 more months to continue to work on their plan. Research & Training Center for Pathways to Positive Futures, Portland State University

16. PHASES

17. Research & Training Center for Pathways to Positive Futures, Portland State University

18. YOUNG ADULTS LEARN & USE Knowledge (Knowledge = Power). • They learn the steps (answer the questions) in the self-determination career development process. • They learn practical information that will help them to self-direct the career planning process and to move forward in getting the resources and supports they need to achieve their goals. Skills (Learn By Doing) • They apply the knowledge they learn about the process and the practical information to themselves. • Practice the skills in order to feel more confident in using them. Overarching Action Orientation • Learn and apply a set of key self-determined and self-directed actions. Research & Training Center for Pathways to Positive Futures, Portland State University

19. OVERARCHING ACTIONS • Be persistent—Don’t give up. • Remind yourself everyday of things that you have achieved. • Believe in yourself and your goal—even when others doubt you. • Take risks. • Get the help that you need. Research & Training Center for Pathways to Positive Futures, Portland State University

20. RESEARCH DESIGN The young adults are randomly assigned to one of two conditions: • 50 young adults in Career Visions 1—full model intervention; 12 meetings over 2 to 3 months, then 1 to 2 meetings per month for remainder of the year to provide additional coaching and support. • 50 young adult in CV 2 in comparison group--1 meeting to review career planning and resource guide. Check-in meetings once every 3 months. Research & Training Center for Pathways to Positive Futures, Portland State University

21. MEASURES SELF-DETERMINATION • ARC Self-Determination Scale- Adult Version CAREER DEVELOPMENT ENGAGEMENT • Career Development Engagement Checklist (examples: career goal, plan, applied for jobs, worked, explore postsecondary education, took classes, started a business) SELF-EFFICACY • Career Decision Self-Efficacy Scale-Short Form • Disability-Related Self-Efficacy Scale • Quality of Life Questionnaire • Mental Health Recovery Measure • Empowerment Scale MENTAL HEALTH • Brief Symptom Inventory SOCIAL SUPPORT • Multidimensional Scale of Perceived Social Support Research & Training Center for Pathways to Positive Futures, Portland State University

22. HYPOTHESES & RESEARCH QUESTIONS Following participation in Career Visions, the young adults will make significant gains and will make significantly greater gains than those in the comparison group on: • Indicators of self-determination & career development engagement. • To what extent do the young adults demonstrate significant gains on measures of self-efficacy, quality of life, recovery, and social support compared to those in the comparison group? • What is the reported satisfaction and benefit of the participants? Research & Training Center for Pathways to Positive Futures, Portland State University

23. PRELIMINARY FINDINGS • The young adults in the full Career Visions program have made significant gains on self-determination, engagement and self-efficacy measures from T1 to T2. The other young adult have not. • Most of the young adults have indicated that the program is useful. Research & Training Center for Pathways to Positive Futures, Portland State University

24. FEEDBACK-- MOST USEFUL ASPECTS • Clarifying their job goals that are good fits for their strengths and interests and Consistent and regular meetings to talk about what she or he has done, and develop new steps that she or he wishes to take. • develop a plan with specific steps. • Learning how to research careers on the web and informational interviews to learn about jobs. • Learning about and obtaining support to access resources needed to achieve career goals. • Learning how to write a resume to deemphasize work history gaps. • Learning about issues of disclosure and their rights under the ADA, including accommodations that she or he may wish to consider asking for. Research & Training Center for Pathways to Positive Futures, Portland State University

25. PARTICIPANT FEEDBACK • More confident that they can get and keep the type of job that they would like to have. • A more self-determined career planner and in general. • Increased hope for the future. • Length and number of meetings was appropriate. • Information in the Guide was very helpful, but a few would like it to be on-line. Research & Training Center for Pathways to Positive Futures, Portland State University