Chapter Fourteen Career Counseling in Mental Health and Private Practice Settings

Career Counseling: Foundations, Perspectives, and Applications edited by David Capuzzi and Mark Stauffer Chapter Fourteen Career Counseling in Mental Health and Private Practice Settings Mary H. Guindon Francesca G. Giordano

Mental Health Settings Common career/mental health overlap Those suffering mental health disorders due to job loss, career problems Those who seek help with occupationally related stress reactions

Clients with Severe Mental Disorders (SMD) Stigmatization Apathy Impairment of abilities becomes barriers

Clients with Severe Mental Disorders (SMD) (cont.) Endorse the value of work Focusing on careers rather than just obtaining jobs Stressing client strengths rather than deficits

Clients with Severe Mental Disorders (SMD) (cont.) Use individual job placement Provide support or transitional placement during rehabilitation in anticipation of higher level employment. Not impose assumptions about the role of meaningful work with SMD Help clients overcome communication barriers

Clients with Severe Mental Disorders (SMD) (cont.) Counselors typically offer Assessing the client’s level of vocational maturity, self-concept, and developmental life stage; Referring clients for formal vocational assessment through rehabilitation services; Facilitating the setting of realistic career plans and implementing them; Addressing the impact of unrealistic/inappropriate career plans on the client’s self-concept and level of success.

Clients with Severe Mental Disorders (SMD) (cont.) Form and maintain suitable relationships Experience success Improve vocational identity

Persons with Personality Disorders Personality is a pattern of cognitive, affective, and behavioral traits that endures over extended periods of time and manifests in a learned and predictable structure of overt and covert behaviors. Those with personality disorders attempt to cope with everyday activities and relationships with inflexibility and maladaptive behavior.

Persons with Personality Disorders (cont.) Personality disorders vary in level of dysfunctional behaviors. The more severe disorders are less amenable to treatment and thus career counseling.

Persons with Personality Disorders (cont.) Kjos (1995)—effective career counseling with persons with personality disorders includes the ability to Recognize the traits that make up specific personality disorders that may inhibit (or enhance) career development; Develop treatment plans that capitalize on the positive aspect of individual client personality styles; Work with such clients to maximize their strengths.

Depression Variance of Depression Symptoms of Depressive Episodes

Depression (cont.) Career indecision Dysfunctional career thought Vocational identity Role ambiguity Work engagement Self-esteem

Mood Disorders and Depression In conjunction with personal Counseling and Medical Treatment Career strategies help with decision making problems. Realistically evaluate the various constituent elements of the self to address issues of self-esteem.

Anxiety Disorders Panic Disorder Agoraphobia Specific phobia (to an object or situation) Social phobia Obsessive-compulsive disorder Posttraumatic stress disorder Acute stress disorder Generalized anxiety disorder

Anxiety Disorders (cont.) Apprehension and fearfulness may be severe enough to limit everyday workplace behaviors.

Anxiety Disorders (cont.) Social phobia affects approximately 13% of the population Underemployed common Can significantly interfere with occupational functioning

Anxiety Disorders (cont.) Posttraumatic Stress Disorder Rape Military combat Internment Genocide

Anxiety Disorders (cont.) Posttraumatic Stress Disorder Affects understanding and memory, concentration, persistence, social interaction, and adaptation; and can significantly reduce tolerance of stress

Substance-Related Disorders Must provide elements of career or employment counseling Career and life planning for these clients includes setting and implementing career goals while committing to recovery Helps with immediate financial and survival needs

Substance-Related Disorders (cont.) Development on many levels may be stunted, including career development and development of vocational identity May even be more true with co-occurring disorders

Job Loss and Mental Health Feelings of isolation, rejection, and shame Stress reactions, depression, and anxiety Models of grief are applicable Gender is an important consideration

Occupational Stress Feelings of hopelessness and powerlessness, anger related to oppression, disparity in earnings, and rapid change can be stressors. Role overload, role ambiguity, interpersonal conflict, underemployment, and job loss are major causes of psychological and physiological strain.

Occupational Stress (cont.) Help clients to recognize symptoms of stress and then manage stress by employing stress management techniques.

Intake and Assessment Use of assessment instruments Mental status exam Personal and vocational identity

Treatment Planning and Interventions Levels of treatment Primary Secondary Tertiary

Treatment Planning and Interventions (cont.) Competency model of mental disturbance Importance of diversity issues

Interventions for Mental Health Concerns Standard programs Hands-on experiential programs Group work Job retention groups

Collaboration and Referral It’s ethical to make appropriate referrals. Cultivate professional relationships for the betterment of clients.

References Kjos, D. (1995). Linking career counseling to personality disorders. Journal of Counseling & Development, 73, 592-597.

Chapter Fourteen Career Counseling in Mental Health and Private Practice Settings