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

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

Supports for Work

How can we consider what supports are needed and available?

At this stage the supports are for exploring the idea of working, and possibly exploring some personal interests. Initially it is not so much about specific jobs or careers. Informal supports for thinking about work may be: friends, neighbors, or relatives who can keep the employment idea open and alive. They can do this without judging whether any particular job category is right or wrong for your family member.

In this considering work stage the issue of worker identity is very important. For someone with a poor work record or no work experience, this thinking about work may be more difficult. (Yanos) For those who do not have a strong work identity and have more anxiety about the idea of work, some interim steps might be helpful such as internship or volunteering. If the job seeker is in a program that offers direct job attainment with lots of support, the worker identity issue can often be overcome in this way.

Too often persons with serious mental health conditions view themselves as disabled and stigmatized which is difficult to reconcile with the self-story as a worker and valued member of the community. Support for a family member to create a new story is especially important when considering a new role such as that of worker. (Roe)

Why would my family member need supports for work when they aren’t employed?

The kind of support needed during unemployment might be those that help with motivation to return to work. In early stages of recovery it might be stressful just to think about work. However, at the “ripe” moment information about resources might help the person to clarify interests or learn about employment trends. The practice of Motivational Interviewing, a well researched approach, can help to decrease the uncertainty your family member experiences (Larson). Your family member might not realize that having an Employment Specialist or Rehabilitation Counselor could open the door with employers or help get started on a career.

What supports might we need to know about in the early stages of the employment journey?

Typically the supports for work would include professionals who can:

  • Help the family member assess their strengths, interests, and limitations.
  • Help them determine what type of work or work environment would be a match.
  • Help decide if education or training is needed to reach the intended goal. (Leonard)
  • Help the family member maintain wellness, stay healthy while working. (Dixon)
  • Match the individual to suitable jobs in the community.
  • Help the person to acquire any specific job-related resources such as uniforms, bus passes, or car repairs.
  • Teach the person skills and help find resources to maintain employment and manage money.
  • Help in overcoming specific barriers to employment either in the individual or in the community. (Boston University)
  • Help in determining what resources are available and accessible to pursue your family member’s goal. (Mental Health America)

The supports for work might also include a professional peer (another person in recovery trained to help). This person can help with inspiration, motivation or information. (Temple University)

Who can help us find the right services to provide the employment related supports?

Professionals who interact with the family member such as case managers, therapists, residential counselors, psychiatrists and others may be very helpful in encouraging the idea of work. They may identify others such as Employment Specialists or Rehabilitation Counselors that can open the door further. More likely they can open the doors to employment programs or employment services that can help your family member learn what is available. The Employment Specialists or Rehabilitation Counselors might locate or provide services that would support the exploration. If a referral is made to a program, it is likely that your family member will be invited to an orientation session or a tour of the program to help determine if it is a good match. Volunteer work for the ambivalent person can also be a type of support, that increases confidence and gives the volunteer useful feedback.

If your family member is already involved with an Assertive Community Treatment Program, a Clubhouse Program or other Psychiatric Rehabilitation Program providing training in community living and working (PRA), you can suggest that your family member talk to the program about getting involved with employment services. If you have permission from your family member to talk with staff, (HHS) you could discuss whether it is feasible to get started on employment. These programs typically have employment as part of the overall program but members might need encouragement to use them.

It is best to avoid spending too much time and effort in the thinking about work and, whenever possible, find a path that leads quickly to employment. The IPS model (Individual Placement and Support) repeatedly shows that rapid job search is important. Sometimes, due to mental health conditions, and/or struggles with substance use, the window of time for action is not very large, so time is of the essence. Mueser found that persons with both mental health and substance use conditions have a 36% better job acquisition rates using IPS and rapid placement.

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

What am I looking to help my family member do?