Career and Mental Health Disorders

Goals

• To identify the intersections of career issues and mental health
• To explore four primary categories of mental health issues likely to emerge in

career-focused counseling (CFC)

• To appreciate the reciprocal impact of career and mental health
• To apply a developmental, wellness-based philosophy to career and mental health

Career & Mental Health

1. Career is personal and it is a component of both mental health and career counseling
2. Clients who seek help for issues that are primarily career related are similar (psychological distress) to clients who seek help for other issues.
3. Counseling sessions for clients who seek counseling for primarily career related issues also contain noncareer content and vice versa.
4. Counseling primarily focused on career issues is more effective if salient noncareer issues also are addressed
5. Counselor and client in-session behaviors are fundamentally similar
6. The nature and course of therapeutic change is similar
7. The process of supervision is similar

Bottomline: Every career issue is a developmental issue, and every developmental issue is an opportunity to benefit form counseling.

Neuro-Informed CFC

Interpersonal neurobiology: is a theoretical orientational and treatment modality based on how neurobiology inform our understanding of early relationships and their impact on later functioning ( Siegel,2012)

Translation model: seeks to explain what is happening in the brain when psychosocial interventions are implemented and where they occur in the brain (Felstein Ewing’s & Chung, 2013)

Metaphorical approach: takes information from the current understanding of the brain and central nervous system and offers numerous metaphors for human behavior (Luke & Michael, 2016)

Four main diagnostic categories of mental health:

1. Anxiety
2. Depression
3. Stress and trauma
4. Addiction

Anxiety

Anxiety: is the brain and body’s response to a perceived threat.

• It’s an affective experience, cognitively it is a confused state of uncertainty and behaviorally, it is a set of fight/flight/ freeze ( experiential avoidance)

Dimensions of career-related anxiety: (Saka adapted from Gati et., 2011)

1. Career process generally
2. Uncertainty of choosing a career
3. Actually choosing a career
4. The outcome

The parts of the brain impacted by anxiety includes the limbic system, cerebral cortex, amygdala, and hippocampus.

Anxiety

Work performance: Hypervigilance leading to fatigue and irritability

Career Decision-making: avoidance, leading to premature commitment or delayed choice

Job Satisfaction: anxiety diminishes satisfaction in numerous life domains; career is a prime example

Protective factors: Work provides a creative outlet to relieve stress, increase sense of purpose and meaning, focus attention, inoculate against external, personal stressors, provides opportunities for structure, productivity, short and long-term rewards

Depressive Disorders

Depression: a set of criteria that, when combined, result in a socially constructed phenomenon called depression

Cognitive and behavioral components- concentration, fatigue physically and mentally, inhibition, and withdrawal.

CFC:

Career counseling may help with depression because clients may experience hope that comes with concrete plans for tangible goals.

Career counselors, by taking one symptom at a time, have opportunities to move back and forth between presenting issues in order to balance strengths and needs.

Mood related disorders { Depression}

Work performance: decreased concentration, leading to limited attention to detail

Career Decision-making: passivity, past orientation, impacting future planning

Job Satisfaction: depression limits perspective for deriving satisfaction from work

Protective factors: Work provides a creative outlet to relieve stress, increase sense of purpose and meaning, focus attention, inoculate against external, personal stressors, provides opportunities for structure, productivity, short and long-term rewards

Stress and Trauma

• Stress and trauma are two sides of the same coin both stress and trauma can be acute, chronic, or both. Also both change the functioning of the brain which makes, concentration, problem solving, goal-setting more difficult.

Stress: brain’s way of communicating to body that a threat has been detected

Trauma: massive trauma or a deprivation of nurturance that impacts an individual's psychosocial structure and functioning. [Shengold’s (1989)]

CFC

• Trauma and dysfunctional career thoughts are strongly positively correlated.
• CFC assist by untangling the cyclical nature of stress and its effects

Neuro- Perspective

• Stress causes cortisol to be released but during prolonged stress states, cortisol affects the central nervous system by degrading short-term memory, impairs concentration, disrupts digestion, and increases blood pressure

Stress and Trauma related Disorders

Work performance: reactivity and distractedness leading to mistakes, errors

Career Decision-making: chronic and acute stress similarly impact critical thinking and problem solving capacities

Job satisfaction: as performance and engagement decrease, so does satisfaction

Protective factors: Work provides a creative outlet to relieve stress, increase sense of purpose and meaning, focus attention, inoculate against external, personal stressors, provides opportunities for structure, productivity, short and long-term rewards

Addictions

• Addiction is addiction because of the behavioral expression.

Table 10.4. DSM-5 Criteria by Eight-Factor Model

1. Uses more or for longer than intended
2. Wants to qut and tries to unsuccessfully
3. Spends a lot of time and energy pursuing, using, recovering
4. Wants to use very badly
5. Fails to meet expectations in major areas of life, like work, family, socially
6. Keeps using even after negative experiences
7. Ignores major life role and expectations
8. Uses when dangerous or precarious to use
9. Ignores consequences of use and persists in using
1. Has to use more to continuing getting “high”
2. Ceases getting as “high as before on same amount

11.a Withdrawal Symptoms

11.b. Uses to cope with withdrawal

Top-down: the role of cognitive control circuitry in modulating the processing of sensory information

Bottom- Up: the primacy of sensory information processing and salience of drug cues

CFC:

DSM-5 categorizes addiction by a 8-factor model. By this definition, addiction directly negatively impacts work-related activities, see criteria 5 & 7, and indirectly (3, 4 and 9).

Career issues that are unaddressed or unresolved lead to negatively coping behaviors such as substance abuse.

Brain - Based Features of Addiction:

Addictions

Work performance: besides on-site inebriation, lethargy, and paranoia, hang-overs, and lateness

Career Decision-making: long term planning often gives way to short term behaviors and making up for past behaviors

Job satisfaction: work becomes a means to an end, and often as a last resort

Protective factors: Work provides a creative outlet to relieve stress, increase sense of purpose and meaning, focus attention, inoculate against external, personal stressors, provides opportunities for structure, productivity, short and long-term rewards

References

Luke, C. (2018) Essentials of career-focused counseling: Integrating theory, practice, and Neuroscience. San Diego, CA: Cognella Academic Publishing.