As mentioned in Part 1 of Mental Health and Vocational Disability, it behooves career counselors to understand the DSM's classification of mental disorders, their symptomology and likely course, and treatment modalities. This quick guide is the result of the author's 25 years as a career counselor and 13 years as a vocational consultant for about 2500 disability hearings.
Nearly 25% of the population has experienced an Anxiety Disorder at sometime in life and 12-13% have experienced one in any given year. Stress related to anxiety is a significant factor in more than 30% of those who consult physicians with concerns about physical ailments. While career counselors are probably not trained in clinical mental health counseling techniques, they will likely interact with anxious clients, and need to know how these disorders affect the client's work life and what interventions could be helpful.
Generalized Anxiety Disorder
Panic attacks can be expected (such as those triggered by an event/situation), or somewhat expected (when situational factors predispose a person to have one) or unexpected (untriggered). They vary most in their frequency and duration (anywhere from 5-30 minutes), but the intensity is generally at a high level. Usually a recovery period of varying duration is needed. Most individuals with severe panic disorder are receiving at least one anti-anxiety and/or anti-depressant medication. Symptoms often include:
Agoraphobia is an associated condition where people rigidly avoid physically closed situations in which they could not obtain help from others, e.g., in a public place. For this reason, they prefer to be accompanied by friends and family members every time they leave their residence. Since this is not feasible for employment, it creates problems with lateness and absenteeism.
Obsessive Compulsive Disorderis defined as having recurrent obsessions (thoughts) or compulsions (actions) that are severe enough to be time consuming (more than one hour a day) or cause significant distress to the person (or more typically others) as well as impaired functioning. Ability to maintain long conversations and interactions may be impaired by distractions from obsessions. Symptoms may include:
To aid career counselors working with people experiencing mood and anxiety disorders, the following interventions are suggested.
When I feel a panic attack coming on I feel___ I start thinking _____I begin to do ___...
If I find myself thinking terrible or strange thoughts in the middle of a meeting or conversation, I start thinking ___ believing ___telling myself___...
If I am feeling down , and someone tells me I am being unreasonable or critical, I think ___ feel____ say ___ to others, and do____...
Dean Pappas, a graduate student in the Mental Health Counseling Program at Walden University, with prior experience as an art therapist, offers the following for managing anxiety:
Maintain a Positive Focus
The focus in career counseling should just not be on mitigating negative symptoms, but on using positive psychology approaches. Can clients see some stress as challenges, an opportunity for mastery, or as a way to build support among peers? What can they do to cope? How did they change diet and exercise to sleep better? Self generated, salubrious activities are always in vogue, as they promote positive emotions and thoughts, which over time can become habitual and even enthralling to people with mood and anxiety disorders.
Seligman, L. (1998). Selecting effective treatments: A comprehensive, systematic guide to treating mental disorders. San Francisco: Jossey Bass Publishers.
Peter Manzi, Ed. D, NCC, NCCC, MCC, CDFI is a part-time faculty member in counseling and education and a full-time vocational consultant and counselor, who resides in Rochester NY. His interests include technology in counseling and career development and education, working with diverse populations, people with disabilities, and the relationship between mental health and career development. He can be contacted at firstname.lastname@example.org