Video

The Light Bulb Moment: How A Career Journey Began

George shares his story of recovery and the important role that work has played in his life. He discusses his struggles to complete college and the feelings of envy as he compared his accomplishments to those around him. As George continued his career journey, these feelings of envy gave way to those of pride and success as he continued to achieve the goals he set for himself. George recalls a time when he was receiving services and a peer came to speak about his own recovery and the valued roles he held in his life. This moving story provided George with the informative nudge needed to return to school and embark on a life of career success. He refers to this moment as the “light bulb going off.” This is a good reminder of the influence we can have on one another.

A Personal Story

As we work to improve opportunities for people with the lived experience of mental illness, we inevitably find ourselves battling misinformation and prejudice. Whether you’re a peer, a consultant, a provider, a family member, or an educator, you have probably found yourself up against people who have very low expectations for people with mental illness. As vigorously as we challenge those beliefs, nothing is more powerful than a personal story. This link is to an article recently in the New York Times written by a law professor who has a diagnosis of schizophrenia. It is well worth the read.

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!

New Year’s Resolution- Conveying Economic Hope to Persons Served!

As I prepare and plan for our new year, like many of you, I’ve reflected about my own personal and professional needs. In 2013 I will improve my emotional, physical, and spiritual health. Professionally I will increase attentiveness to detail, develop time management and computer skills, scholarly publishing, listen to classical, jazz, nature sounds, and instrumental music to lessen stress while driving to work so I have the energy to better serve others.
During the first week of January I was making a “Work, Education, and Recovery,” presentation to both peers and staff. Insightfully, a person served expressed wanting to be supported holistically; that the staff, clinical team and family view them as a “whole person” in order to be successful at pursuing educational and employment goals. For example, having emotional and medication (side-effects) needs timely addressed and flexible medical appointment hours that support pursuing education and work goals. Furthermore, another person mentioned balancing intake of sugar, caffeine tobacco products, watching TV, and sitting too much. Plus, gaining access to quality foods and making informed food and life choices. I noted, we also need to thoughtfully challenge one another through “peer support” and self-help. The lack of physical health is a challenge and barrier to maximizing one’s skills and talents of gainful employment. In addition, regardless of the economic climate we need to dispell the notion that there are “no jobs” when developing skills and “job searching is not a priority.” Our health and social standing depends on it!

Join the Pledge!
• Work is not a Choice!
• Work is an Expectation!
• Avoid Life Long Poverty!
• When paid work is available I will not volunteer instead!
• If I am going to be unsuccessful let it be during relentless employment/school attempts!
• Employment is healthy risk taking!
• Accept (as needed) supports for work/school!
• I know work/career improves my health!

I welcome your New Year employment thoughts to support individuals living with mental health and addiction concerns.

George Brice

FREE!!! NewTraining: Narrative Approach to Career Development

Don’t miss our new training: Narrative Approach to Career Development! It’s part of the Career Development Training Series in the advanced track. The training will be held on 1/23/13 from 9:45am-4pm at UMDNJ’s Stratford campus. For more information or to sign up for this new training please go to our website.

 From the Trainer:

People in recovery pursuing their career goals confront many challenges, however, confronting challenges while pursuing career goals is not unique to people with psychiatric illness. How did you get to where you are today? Chances are it was a process, or as more recent career development theorists Drs. Cochran and Savickas contend, it is the story of your career!

This interactive training will teach providers how to help individuals they work with reframe their thinking about themselves in regard to their careers. Attendees will develop their own career narrative during this training, and be provided with tools to help people in recovery develop a career narrative that will be empowering and assist with choosing a career path.

How Can Residential Services Promote Employment Goals?

I recently provided training on employment services to staff members of mental health agencies in New Jersey and Pennsylvania.  Some staff members worked in residential programs including supervised apartments and group homes.  Many of them stated that they provide little if any employment services because they do not believe residential programs are conducive to provide employment services.  They reported that the program is designed to teach community living skills so that the consumers can move to an independent living environment in the future.  They provide services to assist consumers with medical appointments, picking up prescriptions, doing grocery shopping, and recreational outings.  I asked how many consumers have “graduated” and moved on.  They admitted very few consumers have achieved the goal.  I think this phenomenon will remain for a very long time because very few people in our society can live independently without a job, regardless if they have mental illness or not.   Therefore, employment goal should be a core service for independent living.

Here are some suggestions that residential staff can try to promote employment goal.

  1. Have conversations about consumers’ employment interest, preference and history.  For those who have little work history, ask them to talk about jobs of their family members.  The idea is help them to see employment can provide the necessary and most reliable resources for independent living including having own apartment, enjoying leisure activities, making friends, having family/children.
  2. Observe and discuss various jobs while visiting a business.  For example, while grocery shopping, watch how many different types of jobs are there such as bakery, meat and seafood departments, flower shop, etc.  There are a lot more jobs other than cashier in a grocery store.   Have conversations with employees in various department about what they do everyday, where and how they learned to do the job, what they like or dislike about the job or store.
  3. Talk about you own career path.  How did you find the first job?  How did you get to where you are today?  What obstacles did you overcome?  What support did you have when you had problems?
  4. Inviting working consumers to the residence to talk about their experience can be very inspiring for those who are not working.  Help them to develop buddy or mentoring relationships.
  5. Connecting consumers with self-help centers and attend peer run activities including employment support groups.

You can see this list can go on and on.  As a matter of fact, I am inviting anyone esp. those who are working in residential services to add to this list so that more ideas can be generated and shared.

Why Share Our Personal Recovery Narratives? A Tool for Respect!

I am grateful of a gentleman who shared his recovery story at a partial care program that I was attending in December of 1989. He traveled out of county working for Collaborative Support Programs of New Jersey, (CSPNJ) Inc. The guest speaker spoke of his challenges and the inspirational moments that gave him hope. He valued natural supports, acceptance of living with mental illness, achieving goals despite clinical diagnostic labeling, working full-time and more. Furthermore, I admired his courage to thoughtfully and intimately self-disclose his story with both peers and staff. His hopeful, genuine, and balanced narrative was exceedingly important to me.

I was submerged in lifeless depressive feelings, such as anxiety, stress, listlessness, apathy, isolation, invisibility, helplessness, hopelessness, worthlessness, anger, guilt, societal stigma, labeling, suicidal ideation, and more. I was a month shy of my 28th birthday when listening to my first personal recovery narrative/ lived experience presentation. I began to develop internal motivation based on peer support. The “peer role modeling,” unearthed my buried and dormant insight of lost self-awareness and lost citizenship.

I now had the energy and interest to disrupt the systematic and personal dependency of routinely attending partial care. I took steps to re-pursue occupational goals of work and college. Here I will outline some benefits for encouraging and respecting the sharing of personal recovery (mental illness and/or addiction concerns) narratives.

Personal Recovery Narrative:
1. Creative written/verbal task planning and learning experience
2. Help building self-esteem, self-worth and confidence
3. Transforming an Illness narrative to a Recovery narrative develop  positive self-talk, lessening perceived and real external (public) and internal (self) stigma
4. Opportunity to publicly “role model” hope- giving back, increasing citizenship feelings
5. Why self-disclose? Weighing benefits and addressing challenges

What has your experience been in utilizing people to share their personal narratives at your agency, school; corporate business, place of worship, home, community organization or other settings? What points would you like to make about sharing your own personal story? I am active in sharing my lived experience in varied settings. I will be building on my current comments and I look forward to your posts!

Do More With LinkedIn

In case you haven’t heard, LinkedIn, “the largest professional networking site in the world,” helps people to connect with colleagues and classmates past and present. It’s  a great way to increase your professional network and get in touch with people who can help you advance in your career. The other day I came across an article by Amy Levin-Epstein, LinkedIn: 3 ways to use it much more efficiently, in which LinkedIn’s Senior Manager of Corporate Communications and the company’s Connection Director shared new strategies for getting the most out of the site. They recommend: 1)using the site more regularly to stay up to date on the latest trends in your field including promotions, mergers, and best practices, 2) following some of the 2 million companies using LinkedIn which will provide you with automatic updates, like job opening, on your homepage, and 3) taking advantage of LinkedIn Answers.

LinkedIn Answers was new to me and the tip I was most excited to try out. This feature allows you to get targeted information from the LinkedIn community as well as show off your own skills and expertise by answering other people’s (did someone say “smartest kid in the class”) inquiries all while building your professional network.

If you’re not already signed up with LinkedIn, do it!!! and let us know if you have a LinkedIn tip.

Dismissing the Diagnoses of Unemployment: Our Health & Recovery Depends On It!!!

I often hear that work is a “choice” for people living with mental illness. This view needs to be actively challenged by stakeholders such as clinicians, families/caregivers, organizations, and even by recipients of psychiatric services. Living in poverty is not limited to finances but can negatively impact overall health, self-worth, and feelings of citizenship in valued social roles. As a person living with bipolar disorder I am angered about my own history on social security for 14 years that began at the age of 26. I am currently 50 years old and have been competitively working mostly full-time the past 10 years and living my life “system dependent free” by planning healthy risk taking. Viewing work as an expectation promotes lives of community inclusion (integration).  Employment is our most recognized cultural health tool of “hope and promise” toward wellness and recovery. Here are some common themes I hear:

  1. Lacking access to public transportation
  2. I had to get rid of my car since I’m now at a boarding home
  3. There are no jobs
  4. I need to work part-time to not interrupt “my” social security benefits
  5. Professionals/family/caregivers/peers tell me that work will increase my symptoms
  6. I am volunteering
  7. I’m pressured not to miss day treatment program to look for a job
  8. I need the benefits to pay for medication
  9. I’m satisfied on social security
  10. I don’t have the energy or physical stamina to work

We need to actively challenge these beliefs, values, and the people created system barriers of misinformation, and underused resources perpetuating this fear to support work. Creating social security exit plans and tailored social security benefits to meet specific needs of individuals. For example, living with my parents I did not need emotional stigmatizing social security check. Those monies could have been utilized elsewhere. I will explore these issues further in future posts. Your comments are welcomed!

 

Damaging Labels

On more than one occasion while doing trainings on assisting people in recovery with returning to work, I’ve heard participants refer to the people they work with as “low functioning.” I always ask what that means, as we all “function” at different levels at different activities. Some people are better at math than others, so does that mean poor math students are “low functioning?” After processing with the group on what they meant by “low functioning,” the reply is that it is a way to refer to program participants whose impairment from their psychiatric symptoms tend to be more severe than other participants. However, I point out that mental illness tends to cyclical, and often there is great variation in level of symptoms and impairment. Also, the recovery process has been defined as a dynamic, non-linear process.  So ultimately, the term “low functioning” is a meaningless, damaging label.  

Aside from being meaningless, there are other problems with the term. First of all, it is highly disrespectful to label someone as “low functioning.” Also, it denotes low expectations that recovery is possible, thus negatively impacting the quality of services the person is likely to receive. At the typical training, after addressing these concerns with the group, I suggest they bring these concerns back to their programs to change the use of this language. Inevitably, I hear, “then what do we call the low functioning group?” After some reflective listening and responding, the participants are confronted with the fact that they don’t need to label anyone, and their job is to facilitate the recovery process.

Another way to look at their concern is that different individuals may have different support needs among their program participants. However, if someone has more support needs at a certain stage of their recovery, there is no reason to suspect that they will always have higher support needs, because as mentioned above, the recovery process is a dynamic process. Therefore, the consensus is that using language such as low functioning doesn’t ease the recovery process. USPRA has language guidelines which could be a useful resource to bring back to programs https://uspra.ipower.com/Certification/2003_Language_Guidelines.pdf,

The point is to always be respectful and assume that recovery is both possible, and the expectation of all service delivery in the mental health field. I am interested in hearing from the blogosphere on the prevalence of the use of the term “low functioning”, and to hear some ideas on how people address the use of this term in order to help the mental health field become more recovery-oriented.