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
(a) Assessing the client’s level of vocational
maturity, self-concept, and developmental life
stage;
(b) Referring clients for formal vocational
assessment through rehabilitation services;
(c) Facilitating the setting of realistic career plans
and implementing them;
(d) 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
1)
2)
3)
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.)



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

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 selfesteem.
Anxiety Disorders

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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 cooccurring 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.