Work, Choice, and Recovery

Some years back, as a provider of supported employment services, it always appeared that work was indeed a choice for the jobseekers I worked with. On many occasions individuals changed their mind about wanting to go back to work for whatever reason. And I was aware that in probably all cases the person was receiving disability benefits from Social Security. In addition, in most cases the person appeared to be in a reasonable state of wellness or “psychiatrically stable” from a clinical perspective. My position was always that work was a critical component of the recovery process, and I’ve seen people transform themselves from the experience of returning to work. Thus, I felt they may have made an ill-advised choice by not pursuing employment as a recovery goal. However, I was also aware that “choice” is one of the principles of Psychiatric Rehabilitation, and at that point I didn’t think much further about this issue.

One thing is clear, I had never thought about this issue of work being a choice in the terms that my colleague George Brice Jr. stated. George is really clear that if one is healthy, able-bodied and in a state of wellness, that one is expected to work as an adult in our society. In addition, he states work should not be a choice! Further, George makes the point that Social Security benefits should be there for people who need them, and if one becomes well enough, one is obligated to get off benefits. Clearly, George is making a powerful point here, and one that is usually not addressed in the community mental health field.

Consequently, after reading George’s recent blog, I was speaking with another colleague who made the observation that she knows many people in recovery who volunteer at self-help centers, and participate in unpaid committees, all of which take up as much time as a full time job. Again, the point was made that these individuals are clearly healthy, able-bodied and in a good state of wellness. This conversation bought to mind some of the literature on self-help centers and their focus on empowerment. However, in my colleagues and my own experiences with self-help centers, there is often little emphasis placed on career development. And I think this point may bring up the issue that, how can the choice not to work, especially if one is not financially well-off, be empowering?

Clearly, the impact on getting on Social Security benefits help to foster an “illness identity.” In addition, the lack of expectation of work from too many community mental health providers also reinforces an illness identity. In addition, there are numerous barriers to employment for persons with disabilities. Nevertheless, I think my colleagues make a cogent point that perhaps even the self-center movement, for which I have great respect, may need to rethink what empowerment is really about? Can one be healthy, able-bodied and in a good state of wellness and not pursuing some career or employment oriented goal, while collecting Social Security benefits and thus living in poverty, and truly be empowered?

As a provider who is strongly influenced by the person-centered philosophy of Carl Rogers, I am surprised I progressed to the point to even write a blog that perhaps can be perceived as highly challenging to persons in recovery. However, from listening to my colleague’s perspectives, I am forced to rethink the meaning of two important concepts in the field, choice and empowerment. And I am reminded by another principle of Psychiatric Rehabilitation that I adhere too as well, that everyone has the capacity to learn and grow, and that includes me!

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