N o Employees come to work every day completely free of personal problems and struggles. However, people with mental illness face additional adversity in the workplace. Just showing up and completing tasks can be an uphill battle for employees bombarded with intrusive, obsessive, or critical thoughts. traumatic flashbacks; depressive episodes; Anxiety triggers; and other challenges.
To make matters worse, there can be friction at a workplace if a mental illness – disclosed or not – leads to an employee having difficulty keeping up with his workload or often taking time off to attend counseling appointments go or seek advice on their mental health. Colleagues and supervisors cannot support a relapsing teammate, sometimes regardless of whether they are aware of the mental illness underlying their colleague's work performance, which makes the situation worse.
Professional advisors can be important allies for clients whose mental health problems affect their working life or even derail. Being an ally includes support on an individual level, for example by providing clients with coping mechanisms and discussing career decisions, and on a systemic level, for example by helping clients find accommodation with an employer or otherwise standing up for themselves.
In these situations, a supportive counselor can normalize the client's experience, help with perspective, and act as a sounding board while the client talks about work and career decisions and emotions, says Meredith Montgomery, a supervising professional clinical counselor in Ohio and Assistant Professor of Consultant Education at the University of Dayton. “It is also the job of a consultant to know what different diagnoses can occur in a work environment. When a clinician is working with a client who meets the criteria for Obsessive Compulsive Disorder (OCD), you really need to do research to know what this could potentially mean in the workplace. But at the same time don't buy into clichéd old ideas; Look for the latest, updated information and laws that may aid them in their work environment, ”said Montgomery, a member of the American Counseling Association. “Ultimately, the task of a consultant is one of support and enlightenment: [a client’s] to illuminate the way, not to create the way or to determine the way or to push or pull on the way or to push away from it, but to equip it with everything Information that you can to help them make their own decisions. ”
A daily fight
Behaviors that can suggest that a client's mental health is causing problems in the workplace include frequent absences, being late, difficulty motivating themselves to do their job, or problems with job performance like the problem , Meeting deadlines or other work expectations, says Amanda Hembree, a licensed professional consultant (LPC) and certified employee assistant with a private practice in New Orleans.
Perfectionism can also be a factor, she adds. For example, a client with OCD may miss deadlines or have difficulty getting involved in team projects because they need extra time to prepare and perform compulsive rituals or steps until a job is just right. This can be especially the case for security-related jobs, Hembree points out. Employees with Obsessive Compulsive Disorder may feel like they need to repeatedly check and recheck their equipment, tools, and other safety protocols, resulting in being late or having difficulty completing other tasks.
At the same time, Hembree admits that many people with mental health problems find “workarounds” to get through the working day and not be noticed by employees or superiors.
A client's workplace challenges can also go under the radar in counseling sessions unless the clinician fully studies how the person's mental illness manifests itself over the course of their life, Hembree points out. Clients may seek counseling about another problem, such as parenting problems or communication problems within a marriage, and may or may not recognize that work problems can be a factor in difficulties in their private lives.
“Don't lose work,” Hembree urges her fellow advisors. “Clients spend more than 40 hours there every week and that will affect what they bring to the counseling center. Work is a huge part of our lives and you need to find out why they are in your office and what is going on at work and what can be helped in both areas. None of us live in a vacuum. Mental illnesses affect every part of the well-being of a whole person – and especially work. "
Seth Hayden, Associate Professor of Counseling at Wake Forest University and President of the National Career Development Association, a division of the ACA, also emphasizes the importance of listening to clients and asking them about work-related challenges, regardless of whether their presentations involve worrying about work. A comprehensive assessment of the client should include questions about how their current concern is manifested over the course of their life, including their physical health, relationships, ability to pursue hobbies of interest, and views about work.
If a client identifies work as a source of stress or discomfort, a counselor should investigate in the session, says Hayden, an ACA member who specializes in career transitions with military and veteran clients. This involves uncovering the thoughts and feelings the client associates with his or her work, and how these things are related to the person's self-concept and are consistent with their core beliefs.
"If work keeps popping up in your conversation, let's stop here and dive deeper and talk more about the work you're doing and how you feel about it," says Hayden, a licensed mental health advisor in North Carolina and LPC in Virginia. “Have your feelings [about work] changed over time? Make a comprehensive study of aspects of occupation and work and how [they’re] relates to other areas of life. … If you try to artificially separate them [mental health and career] this could possibly be to the disadvantage of the customer … because they are interconnected. "
Asking the right questions
Avoidance behaviors and other signs of stress and dissatisfaction at work can result from any number or combination of sources, says Montgomery, who teaches the Enhance Counseling Services by Integrating Clinical and Career Counseling Strategies session at ACA's Virtual Conference Experience moderated with in April. It emphasizes the need for clinicians to fully express the feelings and emotions of clients regarding their work situation during the counseling sessions.
Montgomery encourages clinicians to rely on two basic counseling skills: asking questions and empathic reflection.
“We [counselors] have to make sure that we are asking the right questions. We don't necessarily want to jump on the "you hate your job, let's get out of there" bandwagon. If you take it apart, it could be a toxic environment, or … a bad fit, or they could make changes to make it fit better, but often customers see the only option is to leave, ”says Montgomery. "We have to research, research, research, research [the client’s situation] before we jump to any kind of solution formulation."
When clients talk about how hard the work is for them, counselors should reflect empathically and repeat what clients say so they can think those thoughts through, says Montgomery. It can be a knee-jerk reaction to agree or sympathize with statements from clients such as "I hate my job" or "The work has been horrible since the COVID-19 pandemic," but counselors need to be careful not to accidentally make a client's statement with . she advises to substantiate her reactions.
Instead, clinicians can search for details and ask clients to describe their feelings under the statements they make. Montgomery finds that an emotion wheel can be helpful in stimulating these conversations.
Often times individuals do not fully express their experiences because they do not have the language to do it, says Montgomery. Using tools like an emotion wheel is one way to improve a person's ability to better understand and communicate their experiences. For example, a customer may initially say, "I'm angry at work". But after looking at the emotions listed on the bike, you may be able to articulate your feelings better by saying, "I feel underestimated, exhausted, and disrespectful at work". This deeper and clearer understanding is much more beneficial to both the client and the clinician because the solutions to feeling underestimated are different than the solutions to feeling anger, says Montgomery.
This exploratory phase of counseling should also include a focus on identifying clients' needs and which needs are not met by work or are marginalized or restricted in the workplace, adds Montgomery. For example, a customer who is social and who benefits from discussing challenges with others may feel isolated and have difficulty processing things or getting tasks done when in an environment where they work alone or through the Office structure is physically separated from colleagues. The identification of these needs often creates clarity and helps customers either to make changes in their current work situation – such as
Montgomery initially worked in the corporate and non-profit sector before moving to consulting. She recalls her own process of adapting to a new role as a consultant-trainer. After some self-reflection, she realized that she longed for structure to cope with the varied demands of being a university professor, and there were some ways in which she could ask her employer for help and support in this area.
Montgomery was looking for tools to create structure, such as a whiteboard to make lists and take notes in their work area. She also suggested her department streamline processes by creating a master calendar with due dates for reviews and other key benchmarks. Not only did this modification prevent Montgomery from feeling like he was always behind, but several colleagues mentioned that they found it helpful, she says.
Coping mechanisms
The intertwining of career and mental health can lead to work-related complaints that affect clients when they don't have the time. This can manifest itself in many ways, including sabotaging their ability to get to work on time in the morning or transmitting feelings of frustration or dissatisfaction to family members after a frustrating day at work.
Amanda Barnett, an LPC that specializes in mental health and work issues with clients from her private practice in Gainesville, Georgia, helps clients struggling to separate work stressors from their personal lives in order to incorporate intentionality into their routines . She suggests that clients imagine changing “hats” as they transition to and from work. For example, when a customer leaves the office, he or she can take off his accountant's hat and put on his father's hat. For some professions, this transition is literally because employees don work uniforms or wear a tool belt or other work equipment, notes Barnett, an ACA member. Regardless, she encourages clients to take the time to center themselves, to give themselves a lift, and to take care of preparing for the work day or returning home.
Hembree notes that providing psychoeducation about how anxiety manifests itself in the body and providing tools to reduce stress and anxiety at the moment can be particularly helpful for this group of patients. Breathing techniques can be a useful tool in the workplace, especially because some of these techniques can be used without others noticing, she says. Hembree, who has extensive experience working with customers through employee assistance programs, often teaches her customers "box breathing," which involves inhaling four counts, holding four counts, and exhaling four counts. This technique can be performed discreetly, even when an employee is sitting in a work session or preparing for a presentation, she emphasizes.
Another powerful, yet simple tool, helps clients see that they can take a break – if only for a moment – when things escalate at work. Many clients get so lost in the emotions they feel when they are stressed that their instinct is to delve further into the situation instead of withdrawing for a moment.
"If you're not on a heart transplant team, you can take five minutes to have a snack, take a break, meditate, or perform a grounding technique," advises Hembree. “Even if your boss is on your neck and says, 'I need this yesterday,' you'll do a lot better if you take a few minutes to ground yourself … and center yourself – and it will make your work easier better. ”
Hembree also finds techniques that counteract negative self-talk helpful in this population. Customers who have difficulties in the workplace can easily fall into the "comparison trap", she says. But, as is the case when people compare themselves to others just based on what they see on social media, workers only see part of others' lives at work. When a client is bombarded with negative self-talk, a coworker's success can plunge them further into this spiral. It is easy to compare yourself and to catastrophe when you think they will never be as good as their colleague, that they are a failure, or they will be fired, notes Hembree.
“Maybe a colleague will get praise from the boss. But what [the client] didn't see is that [the co-worker] stayed up until 2am to finish [the work assignment]missed her kids' soccer game, argued with her partner, and sore himself over this little one Getting praise from the boss, ”she says. "A counselor can offer psycho-education that others have good and bad days and you will have a day when you are the superstar."
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Disclosure
The decision to disclose your mental illness in a work environment can lead to good, bad or ugly. In the best case scenario, an employer will respond to the disclosure in a supportive and understanding manner. Employees whose mental health problems are affecting their working lives can be supported by an understanding ally – be it a supervisor or a trusted employee – who knows the reasons for their labor disputes. In the worst case, however, disclosure could result in an employee directly or indirectly exposed to hostility, misunderstanding, awkwardness, retaliation or discrimination by an employer.
“There should be an element of dignity in work and the ability to say things without fear. But [counselors should] acknowledge that there are precarious elements of work that do not make it easy for people to do so, "says Hayden, who presented" Career Development and Mental Health in the Context of COVID "at the ACA's Virtual Conference Experience . Hayden and the other consultants interviewed agree that disclosure of mental illness at work is a complex issue that needs to be carefully considered depending on several factors, including support for the general climate in the client's workplace.
Marina Williams, a Lexington, Virginia LPC that specializes in helping clients with work problems, emphasizes that clients should think carefully about what they can gain from disclosing a mental illness in the workplace. This issue is even more complicated for customers, whose work environment can have direct or indirect effects if an employee is deemed unfit. People in law enforcement, in the military or in professions with security clearance often feel particularly vulnerable when it comes to disclosing mental health problems of all kinds.
"Mental health discrimination is very common," said Williams, who lectured on workplace bullying at the 2018 ACA conference. “I recommend customers not to tell anyone about it [at work] but the exception is when they are having such difficulties that they have to ask for accommodation at work. But even then I would restrict [disclosure] to human resources. "
Hembree has also worked with clients who were treated differently in the workplace after they became aware of their mental illness. She has heard customers talk about being treated like "fragile glass", being denied career advancement, or being targeted by bullying behavior such as being referred to as a "snowflake".
"It would be amazing if we lived in a post-stigma mental health world, but we're not there yet," says Hembree. "I generally do not suggest that people disclose unless they are in a very supportive or progressive workplace."
When the issue of disclosure comes up in counseling sessions, Barnett encourages clients to carefully consider their situation. She warns customers not to share too much and assume that coworkers are friends. And she reminds her customers that HR works for their employer, not the employees. “Anything you tell HR could be put on your permanent record,” she tells her clients. "Be aware that you have an obligation to the company, not to you."
Barnett once worked with a client who had mixed results after his boss found out about his mental health problems. The client had frequent panic attacks at work. Since the workplace was a closed, safe environment, the client could not just go outside or bring personal items to help them cope.
The client's boss became aware of the situation after an incident at the workplace triggered a panic attack and the client was visibly upset in front of him during the working day. After that, the customer received what they called "reluctant" support from his boss. The boss wasn't cruel, but he wasn't overly understanding either, recalls Barnett. The client's stress also increased when the supervisor announced his departure and warned the employee that the next boss might not be as sympathetic to their situation as he is.
What helped, however, were the coping mechanisms that the client learned and refined in counseling with Barnett, as well as the concentration on suppressing negative self-talk. Barnett and the client also found small ways in which the client could remain mindful and calm during the working day, for example by chewing gum.
Clients who work on-site at a workplace may need to obtain permission to go to therapy appointments. You may also be faced with questions or comments from colleagues about their frequent absences. If a client feels they need to explain their mental health issues at work, a counselor can help them figure out a way to apply for vacation without disclosing it in full. For example, Williams says, the person could tell their boss, “I'm going through something and these appointments are helping me.” It is also okay to just say “I have an appointment” and leave it at that, she claims.
Hembree agrees that the disclosure may contain a variety of information and does not necessarily have to contain details about diagnosing a customer. She once counseled a client with attention deficit / hyperactivity disorder who had difficulty maintaining focus when sitting still for long periods of time, such as in training sessions or meetings. His solution was to get up and move around regularly or to ask for breaks with the simple explanation that he felt “fidgety”.
Counselors can ask clients what they think of disclosing information and how receptive their workplace is to their mental health problems and the provision of possible accommodation. Most importantly, customers should disclose on a level that feels safe and comfortable to them, says Hembree.
“Everyone has to stand up for himself, individually. It will be different for everyone, ”she says. “For some, they are desperate to remove the stigma of mental health problems and wave that flag for everyone in their office and create a better environment for [all employees]. But that's not for everyone. You don't have to take up this fight. You don't have to be the spokesman for depression [or another diagnosis]. You just have to do the best you can on a given day, and that may be revealing and maybe not, or [it may be] disclose in different ways. ”
Accommodation
Employees may need to report mental illness at work when looking for accommodation that will help their situation. Possible work arrangements include the ability to regularly leave work for therapy appointments, reduce an employee's hours or responsibilities, or move from a cubicle to an enclosed office for more privacy and less distraction, Williams notes.
Although the Americans with Disabilities Act (ADA) provides protection for workers, the wording of the law guarantees "reasonable accommodation," Williams points out. Advisors and clients should be aware that employers may make a counter-offer or decline an employee's request, depending on how sensible they deem it appropriate.
Hembree urges consultants who are unfamiliar with ADA or the safeguards it provides to study, research, or consult with colleagues (including professionals in related areas such as human resources) to better support their customers. The ADA also has an information line (ada.gov/infoline.htm) that advisors or clients can call to ask questions, she adds.
Hayden and Montgomery both suggest that counselors whose clients discover mental illness or seek shelter in the workplace should role-play in sessions to help clients gather their thoughts and prepare for the interview. Hayden advises that advisors and clients alike may find it helpful to investigate the following questions:
What does the client hope for from the conversation?
How could the conversation go? What do you expect?
What reaction could you get? How will you react to that?
Montgomery encourages clinicians not to make assumptions about a patient's level of comfort when asking about things they need. Just because a client works in management or in a position of authority doesn't mean they can easily stand up for themselves, she says. Counselors should also never make assumptions based on the educational level, socialization, cultural background, or other factors of the client, she adds.
"Suppose everyone is scared of asking for what they need and goes from there," advises Montgomery. “If we assume that no one is comfortable, then we don't have to worry about offending someone or leaving them unprepared for feeling uncomfortable asking you [their counselor] for help in learning how to ask . "
Hembree believes that lodging can be helpful for clients whose mental health problems at work are more than a "nuisance" and really affect their daily ability to do their jobs. As with disclosure, workplace arrangements – and the process for finding them – fall on a spectrum and vary from customer to customer. Hembree says the documentation she wrote for property inquiries ranged from detailed reports for clients in government positions to a brief letter confirming that a client left work to see them on a specific date and time specific time. Regardless of the circumstances, she always lets clients review the document to make sure they're okay with it before showing it to their employer. She tries to focus her documentation on the customer's needs rather than the customer's problems, says Hembree.
Counselors can also work with clients to explore coping strategies that they can apply themselves without having to seek permission from the employer. In Hembree's experience, customers found it helpful to have fidget devices, noise-canceling headphones, or quiet strips (textured stickers that a person can touch to calm or ground themselves) at their desk. Das Anpassen eines Arbeitsplatzes durch Hinzufügen von Pflanzen oder die Verwendung einer Lampe anstelle von Leuchtstofflampen über dem Kopf kann ebenfalls beruhigend sein, bemerkt sie.
In anderen Fällen können Mitarbeiter um Maßnahmen bitten, die ihrer Situation helfen würden, ohne sie als Unterkunft für psychische Gesundheit zu bezeichnen, sagt Hembree. Beispielsweise kann ein Kunde feststellen, dass in seinem Büro ein anderer Arbeitsplatz zur Verfügung steht, und ohne Angabe von Gründen um einen Umzug bitten.
Arbeit arbeiten lassen
Was ist der Wendepunkt zwischen einem Jobschwierigkeiten aufgrund einer zugrunde liegenden psychischen Herausforderung und dem Scheitern in einer Position, die einfach nicht gut zu jemandem mit der Diagnose eines Klienten passt? Auf diese Frage gibt es keine einfache Antwort, sagt Williams, aber „soldat weitermachen“ ist keine Lösung.
Die für diesen Artikel befragten Berater stimmen darin überein, dass die Suche nach Antworten auf diese Frage die Erforschung der Identität eines Klienten beinhalten sollte und wie der Klient glaubt, dass seine Arbeit mit seiner Identität und seinen persönlichen Werten übereinstimmt. Es kann auch hilfreich sein, die Zeitleiste zu besprechen, wann ein Klient begann, bei der Arbeit zu kämpfen und ob dies mit anderen Ereignissen in seinem Leben zusammenfiel, bemerkt Williams.
Barnett schlägt vor, dass Berater Klienten dazu anregen, darüber nachzudenken, wie lange sie sich selbst in ihrer aktuellen Rolle vorgestellt haben. Sie könnten zum Beispiel fragen: „Wollten Sie schon immer in diesem Beruf sein? Ist es die Leidenschaft Ihres Lebens? Oder ist es einfach eine Möglichkeit, Dollar auf Ihr Bankkonto zu bekommen?“
„Man muss herausfinden, ob [the job] zum Kern ihrer Identität passt“, sagt Barnett. Fragen Sie den Kunden: „Wollen Sie das wirklich? Ist es Ihre Leidenschaft? Erfüllt es Ihre Bedürfnisse? Wenn nicht, gib dir diese Freiheit, eine Wahl zu treffen.“
Berater können auch die Perspektive bieten, dass Klienten nicht in einer Karriere bleiben müssen, nur weil sie es in der Schule gelernt haben oder seit Jahren tun, bemerkt Barnett. Klienten können andere Berufe ausprobieren, indem sie einen Nebenjob oder eine Teilzeitbeschäftigung annehmen und langsam in eine andere Position wechseln, wenn sie zu ihnen passt.
Vor allem sollte der Klient das Gespräch leiten, fügt Montgomery hinzu. „Arbeit kann wie Beziehungen eine großartige Quelle von Sinn und Bedeutung sein und ein Ort sein, an dem wir wachsen und wirklich aufregende Dinge tun und den Wunsch unseres Gehirns nach Stimulation erfüllen können. Es kann auch ein Ort sein, an dem wir einen Gehaltsscheck bekommen, und wir gehen nach Hause und bekommen all diese Dinge an anderen Orten [outside of work]“, sagt Montgomery. „Wenn es Ihnen wirklich wichtig ist, einen Sinn aus der Arbeit zu ziehen, und Sie dies tun möchten, dann treffen Sie die Entscheidung, die dieses Ergebnis unterstützt. Aber es ist auch in Ordnung, einfach bezahlt zu werden und dieses Geld zu verwenden, um an anderen Orten fantastische Dinge zu tun. … Wir erhalten alle Arten von Botschaften, dass Sie durch Ihre Arbeit die Welt retten sollten. Aber die Realität ist, dass es nicht für alle gilt. Jeder hat andere Bedürfnisse, und wir müssen nur herausfinden, wie wir diese erfüllen können.“
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Bethany Bray ist leitende Autorin und Social-Media-Koordinatorin für Counseling Today. Kontaktieren Sie sie unter [email protected].
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