Career counselling can assist youth with mental illness to challenge cultural scripts and become successful in their careers

By Christa Boychuk 

Individuals are more vulnerable to the onset of mental illness during late adolescence and emerging adulthood (ages 14 to 29). Mental illnesses vary from anxiety to schizophrenia and are often associated with formal medical diagnoses, and can result in social and vocational deficits that limit opportunities for young individuals to develop their career.[1][2][3][4]

Magnifying the challenges encountered by young individuals with mental illnesses are cultural scripts, or “the range of possibilities for an individual in a given cultural milieu to perceive, think, feel, and act in ways that are experienced and seen by others as being normal.”[5] Though mental illnesses are influenced by complex factors, many non-mentally ill individuals believe that those with mental illnesses can recover through their own efforts, without medical or psychosocial interventions by “pulling themselves up by their bootstraps.” Such cultural scripts can marginalize individuals with mental illnesses and constrict their educational, employment and financial opportunities.

Cultural scripts and the career development of Canadian young adults

Young adults may start to work part-time jobs or volunteer after school to develop their work experience and abilities, to prepare for adult work roles. In their educational paths, they may try out different options that prepare them for various types of work. This exploration allows a young individual to connect their experiences with their interests and competencies to develop their career identity.[6][7][8]

Career development is associated with participation in post-secondary education, as a growing number of young adults seek advanced education.[9][10][11][12] In addition, young adults tend to live with their parents after completing their education, in order to repay debt and obtain employment.[13]

Overall, the cultural script of the career development of Canadian young adults is marked by a prolonged and indirect transition from adolescence to adulthood, characterized by career planning, career exploration, post-secondary education and the search for independence.[14][15][16]

Career development script applied to Canadian young adults with mental illnesses

The cultural script of the career development of Canadian young adults poses challenges to the career development of individuals with mental health problems. According to Caparoso & Kiselica (2004), most young adults with mental illnesses do not complete post-secondary education nor develop a career identity after illness onset due to barriers such as:

  • Early dependence on government disability assistance;
  • Limited availability and quality of vocational services for those with mental illness;
  • Belief by some health practitioners and family that post-secondary education and competitive employment may create stress and prevent full symptom recovery; and
  • Social stigma.

 
Limited employment and social experiences encountered by young individuals with mental health problems constrains vocational decision making due to having few successful decision-making experiences and lack of decision-making competence.[17]

Young adults with mental illnesses often perceive few career options, engage in few decision-making tasks and are frequently limited to few career and educational options that lead to residential and financial dependence.[18][19]

Implications

The cultural script of the career development of Canadian young adults presents challenges to individuals with mental illnesses. This script is based on limiting assumptions that reinforce negative stereotypes that individuals with mental illnesses are incapable of obtaining and maintaining careers and experience a lifetime of limited career prospects.

Career counselling can provide a suitable context for young individuals with mental illnesses to challenge career-related scripts and facilitate career decision-making competence by providing an environment that instills hope, facilitates self-awareness, challenges negative thinking and facilitates goal planning.

Challenging cultural scripts in the career counselling context    

Often clients with mental illnesses enter into career counselling lacking self-awareness and having limited career decision-making skills, as they are often disengaged from education and employment. As a result, career clients with mental illnesses often lack hope and engage in negative patterns of thinking. Career counsellors can assist clients in challenging career-related scripts and promoting their career decision-making competence using the following suggestions.

  • Cultivate collaborative and supportive therapeutic relationships with clients through the use of open-ended questions during sessions, be prepared to discuss clients’ mental health concerns and open and willing to discuss and challenge mental healt-related biases;
  • Facilitate clients’ self-awareness through written narratives that encourage clients to explore their values, skills, interests and how these have influenced their career development;
  • Assist clients in identifying and addressing their career development challenges through Socratic Questioning, a psychotherapeutic approach used to challenge the accuracy and completeness of a clients’ thinking and helps them move towards their goal (Medical University of South Carolina, 2016). This approach can help clients challenge their maladaptive thinking and develop critical thinking skills pertaining to their career development issues; and,
  • Stimulate clients’ career exploration and planning through vision boards, career literature, completion of online career inventories (e.g. Career Fitter and Career Cruising), career assessments (e.g. Strong Interest Inventory, Career Values and Motivated Skills) and identification of potential supports, education and training opportunities.

 
Conclusion

The cultural script of the career development of Canadian youth presents challenges to young people with mental illnesses, as this script is based on limiting assumptions that reinforce negative stereotypes limiting their career development. Despite these challenges, career counselling can provide a suitable environment for mentally ill youth to challenge career-related cultural scripts, build their career decision-making competence and encourage career exploration and planning.

Christa Boychuk is a PhD candidate in Rehabilitation Science at Queen’s University in Kingston, ON. Her research and clinical practice interests include the employment experiences of individuals with mental illnesses. You can contact Boychuk by email at christa.boychuk@queensu.ca.

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[3] Mental Health Commission (2013). Making the case for investing in mental health in Canada. Mental Health Commission for Canada.
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[14] Andres, L., & Adamuti-Trache, M. (2008). Life-course transitions, social class, and gender: A 15-year perspective of the lived lives of Canadian young adults. Journal of Youth Studies, 11(2), 115-145.
[15] Beaujot, R., & Kerr, D. (2007). Emerging youth transition patterns in Canada: Opportunities and risks. PSC Discussion Papers Series, 21(5), Article 1, 1-40.
[16] Borgen, W., & Hiebert, B. (2006). Career guidance and counselling for youth: What adolescents and young adults are telling us. International Journal for the Advancement of Counselling, 28, 389-400.
[17] Caparoso, R. A., & Kiselica, M. S. (2004). Career counseling with clients who have a severe mental illness. The Career Development Quarterly, 52, 235-245.
[18] Caparoso, R. A., & Kiselica, M. S. (2004). Career counseling with clients who have a severe mental illness. The Career Development Quarterly, 52, 235-245.
[19] Rinaldi, M., Perkins, R., McNeil, K., Hickman, N., & Singh, S. P. (2010). The individual placement and support approach to vocational rehabilitation for young people with first episode psychosis in the UK. Journal of Mental Health, 19(6), 483-491.