Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

The Importance of Choice

Why is choice important for my family member?

Finding a person’s old hopes and dreams begins the rebuilding a life of meaning and purpose. Often, having the person begin to help others, no matter how disabled he or she is currently, helps to reclaim hope, resilience, and a life. Let recipients amaze and astonish you!
– Courtenay Harding, Foundation for Excellence in Mental Health Care

Many individuals who have suffered from mental health conditions lose the opportunity to make choices, and in essence they lose their freedom. As a result, they may have less confidence in their ability and their own skills to choose. Often by the time the idea of employment presents itself, the person has to relearn the notion that there are choices and there are ways to explore new horizons. Supportive people, vocational resources and the many resources on the internet can open doors that were once closed. (Chamberlin)

One of the great contributions of the disability rights movement and the mental health peer movement is the focus on informed choice and self determination in life and in recovery. For some, the loss of choice and the inability to make decisions have been so long term, that the person has to learn all over again what it means to decide for oneself. (Cook; Farkas; Schauer)

Also, choices we once thought were not feasible are finding new places in the spectrum of vocational choice. Self-employment, careers and professional positions are among the possibilities. (Ellison)

Self Employment and Entrepreneurship

The Office of Disability Employment Policy has compiled these resources, which are available to people with disabilities who want to start their own businesses.

The 6 Reasons You’ll Get the Job

Elisabeth (Harney) Sanders-Park’s book discusses the job-search and hiring processes from the employer’s perspective, namely four ways to prove a candidate has what an employer wants, six tools to avoid being screened-out, and strategies for people with barriers to employment.

Self Employment for People with Mental Health Problems

View these 7 stories of persons with mental health conditions who are self employed. You may watch this 30-minute film as a whole or view each story individually.

How does self-determination fit into my family member’s employment decisions?

Whether your family member’s employment decisions follow a “Self-Directed” approach or one of getting professional employment services, they are the person in charge of the process (Deegan). When your family member is an active participant in decisions, the decisions will have great personal meaning, greater satisfaction leading to better quality of life.


This is Temple University’s explanation of self determination. Understanding self-determination may help a person consider and prepare for a self determined employment option

How can my family member relearn how to make choices?

When someone has to relearn choice-making, it helps to start with small, relatively unimportant choices. You might ask (more frequently) what your family member wants to do that day, what food for dinner, what flavor ice cream to get, what color to paint the bedroom, or what movie to watch. Provide many opportunities for the family member to choose increasingly important choices.This can be done even if the individual does not live with you. Follow the same principle of identifying opportunities for the family member to make choices. (Morris)

What do we do if our family member seems to make vocational choices we do not think are good ones?

Along with the freedom to make choices comes the responsibility to make good choices; however, we all have the freedom to make mistakes or choices that are not in our best interests. Families can find it very difficult to see their loved ones in recovery making choices that are deemed not good for them. Keep in mind that people are much more receptive to ideas when they feel their own interests – (even “unrealistic” dreams) are part of the plan. (Woolis)

In the world of employment, it is really helpful for the potential job seeker to get the best information about vocational choices and possible resources. Having very complete and accurate information helps your family member to make better choices. However, the vocational direction is their choice to make.The ability to make a choice may even be more important than the choice itself because it often takes many starts and stops to get through a vocational recovery process. Also, it is by our mistakes that we learn, and “next time” it will hopefully be a choice closer to the “right” one.

If you are worrying about the vocational choice your family member is making, keep in mind that “helping an individual take back a meaningful life requires supporting self-determination and, if necessary, actively creating opportunities and providing assistance to develop more experience in making informed choices. If a person cannot choose a specific type of role because they have not, for example, worked in many decades, a recovery oriented service would organize a variety of work experiences to help the individual figure out what their preferences might be.” (Farkas)

Return to the main page on helping your family member Find a Path to Employment.

What am I looking to help my family member do?