Clients in mental health and private practice settings have unique issues and the services they receive are only as good as the counselor’s skills. It is suggested that career counseling for individuals with mental health issues requires a counselor who is skilled in both mental health and career counseling. Herr, 1992 (as cited in Capuzzi & Stauffer, 2006) suggested that unless one is willing to look at the interaction of career counseling and behavior health or mental health problems, there is little likelihood that one can be effective in assisting persons with job adjustment problems, dislocated workers, spouses of those experiencing job dislocations, or recovering alcoholics (p. 283). The client who enters career counseling sometimes discovers that unresolved or current issues may surface as a result of confronting perceived stressors, such as severe mental disorders, depression, anxiety and phobias.
These clients have several needs, as do most, however, the concerns are certainly magnified by the additional diagnosis. Aside from mental health, and factors related to career planning, this counselor may benefit from a solid knowledge of the effects, side effects, adverse reactions and contraindicated substances in relation to the medications and treatments that must be addressed. Therefore the mental health professional who would counsel this population will probably need to blend or balance mental health counseling with career counseling just for starters. However, according to Capuzzi and Stauffer (2006) efficacy increases for this population as a result of counseling.
People with Severe Mental Disorders (SMD) have additional emotional hurdles to overcome or defuse like low self esteem, depression and apathy. Possibly this is due to years of repeated exposure to negative attitudes from others including his or her immediate support group. We have learned of the power of this in our coursework here at Walden and Sue & Sue (2008) have expressed that the experiences and expectations of others may determine how SMD clients view themselves.
Saunders, Peterson. Sampson, & Reardon (as cited by Capuzzi & Stauffer, 2006) have found research which indicates significant positive relationships between Major Depressive Disorder and career indecision, and between depression and dysfunctional career thought, and a significant negative relationship between depression and vocational identity (p.290). Another concern for these clients is that they can be apathetic or disengaged and unable to commit to a course of action, which sets up further stress because work is not being done, and depression, hopelessness increase. This client may benefit from the techniques of cognitive behavior therapy, and group work. The counselor will assist the client in creating and understanding his or her own realistic and authentic values, likes and dislikes. The counselor will challenge and teach the client how to stop irrational thoughts, as well as job search skills.
Symptoms of PTSD can affect understanding and memory, concentration, persistence, social interaction, and adaptation and can significantly reduce stress tolerance. Each of these issues will have a significant impact on the life experience of the client including those related to career. These clients have difficulty with stress, deadlines, change and independent goal setting (Capuzzi et al., 2006). Counselors seek to educate the client about the disorder and its effects mentally, emotionally and physically. Treatments may include congruence, self-exploration, cognitive-behavioral techniques such as journaling, and/or guided meditation. Primary support is also very influential and therefore group therapy could be empowering.