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

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

Starting the Conversation


How might I start talking to my family member about work?

The conversations about work should be ongoing from young adulthood and up. Young people need consistency in infusing strong expectations. All influential people in an individuals life should stress the importance of work. (ODEP) It is a good idea to start the conversations around the individual’s strengths, especially those that are good for a job. (Rapp) You might share compliments such as “You are well organized, a good listener… well groomed… persistent etc”. It is important to build the individual’s confidence by discussing their strengths. It is also important to avoid criticism unless it is a something important, such as a safety concern. The moral, practical, and motivational support is the best way families can aid in recovery. (Aldersey)

If the individual is in a program that provides vocational supports – you might talk about those services and how they work. Who else does your family member know who has used those services? It could help to describe some situations when your family member has demonstrated a skill. This would include things like decorating the house for a holiday, organizing items for a yard sale, or teaching someone a computer skill.

Conversations about strengths and skills can be very motivational. It is also important that family members spend time listening. It is very helpful to know the needs and wishes of the individual about their preference. This includes how and when family is involved in their employment process. A recent study showed that job seekers were 600% more likely to join a supported employment program when accompanied by their family members to a motivational interviewing training session. This shows that family members’ knowledge and support makes a huge difference.

How can we offer “nag-free” and ongoing support for work goals?

Non-judgemental support for work goals by both family members and team staff is very beneficial for the job seeker. This is perhaps the most important thing the family can do to help with a successful job experience. Families can provide hope even when the family member may feel hopeless. The presence of support can be a reminder to the individual that they come before their diagnosis. Families can also help individuals learn skills that will make their work environment less stressful. This includes starting conversations, organizational strategies, and more. Families must be aware that they can act as a barrier by reinforcing stigma and adding stress when not being supportive. (Aldersey)

Family education programs, such as National Alliance on Mental Illness’ Family to Family program, or the evidence-based Family Psychoeducation, available through many mental health providers around the U.S., can help to reduce family stress through better understanding of the impact of mental illness on the individual and on the family.

How would our family member begin the process of identifying resources for making a vocational choice?

The family member can contact the local state or county Department of Mental Health or the local office of Vocational Rehabilitation. If the family member has recently been in high school, vocational training or college, guidance personnel can be helpful. The school should be able to provide the names and phone numbers of those who offer these services. If the family member is part of a treatment team such as ACT or a psychosocial program such as a Clubhouse, these are programs where help is available to think about and ultimately participate in work. Your family member would express their interest to staff about needing helping in choosing employment.

Some regions have Supported Employment Programs which are a great resource – a person just needs to find out if they qualify for the program. It is most likely that the Dept. of Mental Health would be able to identify those services which might be available. There are also America’s Job Centers (also called “one stops” or “career centers”) that can be helpful with training and/or job placement ideas or may provide testing and counseling to explore ideas.

One practice that can help in exploration is to identify, if possible, individuals who work in a job that the family member considers their “dream job”. After identifying the “dream job” people, set up an interview or a chance to visit their worksite to see them “in action”. The internet is another excellent tool for exploration. Most employment or employment-related programs could help the individual to explore different types of work. If they are not yet connected to a program, the local librarian might be of assistance. Exploration materials are being developed by the Boston University Center for Psychiatric Rehabilitation particularly for considering careers.

How might we think about our family culture in relation to work?

“Culture is central not peripheral to recovery” as cited by the Psychiatric Rehabilitation Association (PRA) in their principles of Multicultural Services. Culture is really central to the understanding of mental illnesses and to the overall treatment. (NCBI)

If your family member is a part of a racial, ethnic, religious or other minority, it is important that any cultural concerns related to work are expressed to the Employment Specialist and at times to the employer. For example, if the individual is part of an extended family which supports elders, their responsibilities to the elders in terms of time commitments and wages should be communicated to the employer. When there is strong focus on extended family or community, these values influence decisions about employment. In some families the culture may be more focused on the individual and self-determination so those values would come into play.

If the family has certain religious holidays or customs that are important to them, the family member would need to communicate with the employer about how they might participate in those customs. Some work environments would be unacceptable to a family because of cultural or religious values and these should be communicated as well.

In a family-owned business there may be expectations that the person be part of that business and the family would carve out the job for their family member. Other cultural considerations (or think of them as “layers” of culture) include the culture of unemployment in which persons with psychiatric disabilities live. Employment rates, already low, are getting worse for people with mental health conditions (23% in 2003 down to 17.8% in 2012) (SAMHSA). The other layer/s of culture are in the local business community. (Sanders-Park) The challenge then becomes matching job seekers with their culture to the employment setting and its culture.

Return to the main section on helping your family member Think About Work.

What am I looking to help my family member do?

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