Daniel D. Dieringer, Janet G. Lenz, Seth C. W. Hayden, and Gary W. Peterson
Although some research literature focuses on the integration of mental health and career counseling, there has been little that examines both areas in relation to depression and hopelessness. This study investigated the relationship among dysfunctional career thinking, depression, and hopelessness in a sample of 139 undergraduate and graduate students seeking drop-in or individual career counseling services at a university career center. The authors found that two aspects of dysfunctional career thinking, decision-making confusion and commitment anxiety, accounted for a significant amount of variance in depression. Decision-making confusion also accounted for a significant amount of variance in hopelessness. Implications for counseling practice include the need for more careful screening of career clients who present with high levels of anxiety and negative thinking. Future research could involve more diverse client populations, such as unemployed adults, and explore the use of additional screening measures to assess the intersection of career and mental health issues.
Keywords: career counseling, depression, dysfunctional career thinking, hopelessness
Distinctions are often made between career counseling and personal
counseling or counseling that is more focused on mental health issues.
The existence of separate entities such as a career center and a counseling
center on a college campus is one tangible exhibition of this dichotomous
perspective. Although understandable from an organizational standpoint,
these distinctions ignore the reality that career and mental health issues
are often strongly connected. Career decision making involves complex
psychological processes that affect all aspects of life (Yost & Corbishley,
1997). Over time, counselors in a variety of settings have embraced more
holistic career counseling approaches that include consideration of mental
health issues (Blustein, 2008; Lenz, Peterson, Reardon, & Saunders, 2010;
Zunker, 2008). Hinkelman and Luzzo (2007) noted that there was little
research that considered the potential reciprocal effects of mental health
and career development issues on students. These authors pointed out that
career practitioners, as well as college counseling center staff members,
affirmed that students often present with both types of issues.
There have been indications of the relationship between career and
mental health concerns both in clients’ identified issues and in their desire to engage in self-exploration, receive emotional support, and
discuss general issues in the context of career counseling (Anderson &
Niles, 1995, 2000). Fouad et al., 2006; Zunker (2008) suggested that
although personal and career counseling have traditionally been viewed
as separate entities, they should be viewed through an integrative approach
that takes into account career, affective, cognitive-behavioral, and
cultural needs. Lenz et al. (2010) presented a career services delivery
model that was based on cognitive information processing (CIP) theory,
which integrates career and mental health counseling in a university
setting. College students often experience career decision difficulties
and psychological distress when making career decisions (Fouad et
al., 2006). Others have noted that mental health issues have emerged
as a source of difficulty in the career decision-making process (Lucas,
Skokowski, & Ancis, 2000).
Practitioners, in a variety of settings, are challenged to effectively
assess and treat both career concerns and a range of personal concerns
(Zunker, 2008). Practitioners who desire to be more holistic by treating
mental health and career issues concurrently may consider methods to
make better use of the assessment resources to which they have access.
Learning more about clients’ emotional functioning from career assessment
data may be invaluable for practitioners seeking to improve
the integration of career and mental health services (Dozier, Lenz, &
Freeman, 2016). Using measures that are commonly administered in
career-services settings to screen for potential depression and hopelessness
and career readiness factors (Sampson, McClain, Musch, & Reardon,
2013) can enable practitioners to more readily identify and treat at-risk
individuals, as well as refer them for additional psychological support as
needed. Despite suggestions regarding the connection between career
and mental health factors, more empirical evidence is needed on how
this connection can be explored using assessment tools in career services.
This study was designed to examine whether a measure used to
identify negative career thinking could also serve as a screening device for
identifying clients who may be experiencing depression and hopelessness.
Connection Between Career and Mental Health Concerns
Examining the connection between career decision making and mental
health, including the cognitive effects of depression, can provide insight
into the relationship between the two domains. Previous research has indicated
that depression may lead to higher levels of dysfunctional attitudes,
negative automatic thoughts, and cognitive distortions such as loneliness,
feeling trapped, and hopelessness about the future (Eaves & Rush, 1984;
Murgai & Sathyavathi, 1987). Research also indicates a link between
depression and the ability to effectively engage in career decision making
(Rottinghaus, Jenkins, & Jantzer, 2009; Saunders, Peterson, Sampson, &
Reardon, 2000; Walker & Peterson, 2012). Walker and Peterson (2012)
suggested that “venturing into the realm of mental health issues has the
potential to reveal severe or chronic pathological states or even suicide
ideation. . . for which career counselors should be adequately prepared
to manage” (p. 503). Several studies have shown that psychological distress
is associated with career decision-making difficulties, and depression
and general emotional distress are associated with career concerns and hopelessness (Constantine & Flores, 2006; Fouad et al., 2006; Gati et al.,
2011; Lease, 2004). Depression has also been found to have a significant
relationship with dysfunctional career thinking (Dagenhart, 2004; Saunders
et al., 2000; Walker & Peterson, 2012).
DBHDD was center stage at the Georgia Mutual Aid Task Force meeting on June 16, 2017. The MATF is a quarterly meeting held at the Georgia Public Safety Training Center in Forsyth, GA, and attendees representing healthcare organizations from all over the state meet to share ideas and best practices in emergency preparedness.
DBHDD’s Catherine Ivy, Director of Community Services for the Division of Developmental Disabilities, gave a presentation highlighting the shift from an institutional-based model of health care delivery to a community-based system of care for individuals with intellectual and developmental disabilities. Ms. Ivy emphasized the importance for disaster planners to have an understanding of the needs of this populations so they can collaborate with service providers to meet those needs during times of disaster.
Steve Herndon, Project Director for the Georgia Recovery Project, works out of DBHDD’s Office of Adult Mental Health in Division of Behavioral Health. Mr. Herndon gave a presentation on the Georgia Recovery Project, which is a FEMA funded crisis counseling program for the survivors of the January 2017 tornadoes in South Georgia. The GRP operates out of Aspire Behavioral Health Services serving Dougherty and Worth counties and Behavioral Health Services of South Georgia and serving Berrien, Cook and Turner counties. The GRP is a program that provides outreach to the tornado survivors and services include: individual and group counseling, psychoeducation, assessment, referral and linkage to resources.
There were representatives from two CSBs at the MATF meeting as well. Sabrina Tuten from Unison Behavioral Health was there with her local disaster planning partners from the Region M healthcare coalition in southeast Georgia. Region M’s leadership comes from Memorial Satilla Health and GA Department of Public Health District 9-2 in Waycross. Babs Hall, from Aspire Behavioral Health out of Albany, GA, also attended the meeting. Ms. Hall is the Team Leader for Aspire’s GRP and oversees all aspects of the crisis counseling program for Dougherty and Worth counties. In addition to supervising 13 staff members, Babs has done an excellent job networking with other agencies involved in the tornado recovery and she’s had much success marketing the program through local media outlets.
Behavioral health and intellectual and developmental disabilities have always been underrepresented at MATF and other disaster planning meetings but it doesn’t have to be that way. Providers are encouraged to attend future meetings and get involved with their local healthcare coalition. The next meeting of the MATF is on Friday, September 15, 2017 at the Georgia Public Safety Training Center, 1000 Indian Springs Road in Forsyth, GA from 9:00 AM to 2:30 PM and lunch is provided. Attending one of these meetings is a great way to meet your local disaster planning and response partners and learn about trends and best practices in the field of disaster preparedness and response. If you’d like more information about MATF and disaster planning contact DBHDD’s Disaster Mental Health Coordinator, Jeannette David, at Jeannette.firstname.lastname@example.org.
Happy Summer to all! The transition to a new season on the calendar offers an opportunity to reflect upon the previous months and also peek forward into the weeks ahead.
Summer represents different things to each of us. For some it is the relief from school schedules, for others, the promise of a planned vacation, and still others, the joy of ballgames or concerns about sweltering heat. One element of summer that brings us all together is the celebration of July Fourth. There is something about the waving of the Red, White and Blue of our nation’s flag that brings us together and compels us to think about the gifts of freedom and independence. Hot dogs in hand, with family and friends we honor both the idea of independence, and also the reality of the liberties that we enjoy. It is a great way to unify in celebration.
Of course, independence has additional meaning for DBHDD team members, and our partner providers and advocates. We strive to promote independence and integration into the community for individuals with Intellectual and Developmental Disabilities (I/DD) each and every day. Creating opportunities that allow for individual advancement is our mission, and I thank all of you for your collective commitment to demonstrating that Georgia can be a leader in this movement toward recovery and independence. Like every civil rights movement before it, the drive for people with disabilities to achieve more has been bolstered by very capable individuals that inspire and challenge us to push forward. Sometimes that requires assistance from DBHDD, and other times, that requires us to step out of the way. We are working hard to do both, so that our administrative necessities do not stand in the way of independence, but instead, facilitate it.
In June, I had the privilege to share in a celebration of Georgia’s leadership for people with disabilities. Governor and Mrs. Deal hosted a press conference at the Capitol to celebrate the launch of Georgia’s STABLE program. STABLE is the fulfillment of federal legislation designed to enhance the ability for people with disabilities to save and invest without losing benefits. It is tax-free savings plan that allows for qualified disability-related expenditures through the use of a STABLE card. You can learn more about this progressive program through the link on the DBHDD website or directly at Georgiastable.com. The press conference featured DCH Commissioner Frank Berry, Chair of the Georgia’s ABLE Board, Rep. Lee Hawkins, sponsor of Georgia’s ABLE legislation, and Tena Blakely, representing advocates and providers in Georgia. Governor Deal’s personal pride and commitment to people with disabilities was on full display. The wind beneath the wings of this effort is most certainly individuals that motivate us through individual courage and achievement. It is a proud step forward toward individual independence for people with disabilities.
This reflection upon freedom offers an additional opportunity for gratitude. This expression of thanks is to our veterans that bravely answered the call to serve our country and many of whom answered a similar call to serve Georgia’s most vulnerable individuals. DBHDD and our provider network employ numerous veterans, and we want to thank each of you for your commitment to serve. We honor your courage, dedication, and the selfless work you do each day. At our state office at 2 Peachtree, we are inspired every day by Dr. Emile Risby, DBHDD’s Medical Director. Dr. Risby is a Colonel in the United States Army Reserve and embraces this duty with the same enthusiasm that he leads our hospitals. This is further evidence that the goals and values we strive to achieve are often embodied by those right in front of us.
Happy Independence Day to us all!
Judy Fitzgerald, Commissioner
Department of Behavioral Health & Developmental Disabilities
In 2015, under the leadership of Monica Johnson, Director of the Division of Behavioral Health, and Dawne Morgan, Director of Federal Grant Programs and Special Initiatives, DBHDD began developing the Listening, Inspiring, and Guiding Healthy Transitions Early Treatment Program (LIGHT-ETP), to bring Coordinated Specialty Care services to Georgia’s young adults ages 16-30.
Coordinated Specialty Care (CSC) is an evidence-based approach to providing team-based, integrated treatment to young people in the early stages of severe mental illness, with the goal of reducing disability and promoting long-term recovery.
Recognizing that many individuals with conditions such as schizophrenia and bipolar disorder experience the first symptoms of illness during adolescence and young adulthood; and that many encounter long delays before receiving effective, evidence-based treatment, LIGHT-ETP is an ambitious effort to address the needs of young people and their families at a critical point in their lives.
The goals of LIGHT-ETP include early detection of psychosis; rapid access to coordinated, team-based, specialty care; recovery-focused interventions; and youth- and young-adult-friendly services that emphasize engagement, person-centered planning, shared decision making, assertive outreach, and family involvement.
The services offered by these multi-disciplinary teams include psychotherapy, case management, supported education and employment, peer support, family support and education, medication management, and primary care coordination. The intended outcomes: a reduction in the duration of untreated symptoms and illness; reduction in unnecessary hospitalizations; and improved clinical, social, and academic/occupational functioning.
Research conducted worldwide over the past two decades supports the value of early intervention following an initial episode of psychosis. In the U.S., findings from the National Institute of Mental Health’s RAISE (Recovery after Initial Schizophrenia Episode) Study (https://www.nimh.nih.gov/health/topics/schizophrenia/raise/state-health-administrators-and-clinics.shtml) which was launched in 2009 spurred the implementation of CSC services in community settings throughout the country.
Over 150 young people have been served in DBHDD’s Coordinated Specialty Care programs, which are currently offered by four Community Service Boards and are funded through the Substance Abuse and Mental Health Service Administration’s Community Mental Health Block Grant. Advantage Behavioral Health Systems in Athens, Aspire in Albany, and River Edge in Macon now have Coordinated Specialty Care programs. View Point Health in Metro Atlanta has two CSC teams, one serving DeKalb and Fulton counties, the other serving Gwinnett County. McIntosh Trail, in Region 6, will have a CSC program operating within the next few months.
Hospitalization rates and legal system involvement have substantially decreased for young people in DBHDD’s CSC programs, and the focus on education and employment has resulted in many program participants remaining in or returning to school, and finding and keeping meaningful work.
For further information on the LIGHT-ETP initiative, or to make a referral to a Coordinated Specialty Care program, please contact Project Coordinator Ellen Dean at email@example.com.
Press Release -Washington, DC (May 25, 2017) – The tenth Annual Ramstad/Kennedy Award for outstanding leadership recognizes Cassandra Price, Director of Addictive Services in the Georgia Department of Behavioral Health and Developmental Disabilities, who is being honored for her leadership in recovery support programs across her state and nationally. The award was established in honor of Congressmen Jim Ramstad and Patrick Kennedy. The two Congressmen have been vocal advocates of recovery support services in all forms, and championed localized efforts to support prevention, treatment and recovery.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes that long-term recovery is not only possible, but is the goal of addiction and mental illness treatment and support programs. The 2017 honoree has worked to spread this positive message and the message that prevention can be effective in helping to break the cycle of addiction in families.
Cassandra designed the program to support families dealing with addiction and those whose loved ones are in recovery. She is recognized for her leadership and untiring spirit for the field, the state and most importantly for those whose lives have been touched by substance use disorders. “She has worked to engage state agencies and create change, statewide, that will provide enduring resources for residents and encourage recovery for the future benefit of Georgia families and communities,” said Sis Wenger, National Association of Children of Alcoholics (NACoA), a Recovery Month partner.
“Together in partnership with the dedicated organizations who comprise the Recovery Month Planning Partners, recovery success stories have become commonplace in Georgia, in part because of Cassandra’s on-going and exceptional commitment,” Wenger continued.
“The recipient of the Ramstad/Kennedy award embodies the innovation of a leader dedicated to support prevention, treatment and recovery in their community. On behalf of over 200 collaborating organizations in the Recovery Month Planning Partners, we congratulate Cassandra on her vision and commitment” said Recovery Month partner Marie Gallo Dyak, President of the Entertainment Industries Council, Inc.
Georgia was one of 3 States featured in the SAMHSA sponsored webinar, “Peer-Run Respites: Effective Alternatives to Hospitals”. Jayme Lynch, CPS, Director of the first PSWRC (2008), and Roslind Hayes, CPS, Statewide Coordinator of the PSWRCs presented to over 700 webinar participants about Georgia’s five Peer Support Wellness and Respite Centers (PSWRCs), which are operated by the Georgia Mental Health Consumer Network through a contract with the Georgia Department of Behavioral Health & Developmental Disabilities. Georgia’s PSWRCs offer 24/7 peer support over the phone; Wellness Activities 7 days a week; and up to 7 consecutive nights of respite, an alternative to psychiatric hospitalization, that uses a strengths-based approach to focus on realizing opportunities for recovery.
The PSWRCs are managed and staffed by Certified Peer Specialists who participate in on-going extensive training to insure that the center environments are welcoming, comfortable, trauma-informed, safe, inclusive, nurturing, respectful, and supportive of intentionally mutual relationships between staff and guests that allow individuals to learn new ways of seeing and relating to themselves, others and the world. Participation in center activities is free and strictly voluntary; no professional referrals are accepted. Proactive Conversation establishes peer relationships before a respite stay is needed.
To learn more about Georgia’s PSWRCs go to www.gmhcn.org. The archived webinar can be downloaded at http://nasmhpd.org/content/peer-run-respites-effective-alternatives-hospitals-0.
Highland Rivers Health and its supporters celebrated Thursday another tool aimed at keeping local children out of the foster care system.
The brainchild of CEO Melanie Dallas, the Home Again program offers customized help for Floyd County kids, ages 8 to 18, and their families with mental health problems.
“In Georgia, as a whole, we don’t do enough to support families in crisis,” she said. “And Floyd is one of the top in the state for the number of foster kids placed outside their home county.”
She came up with a short-term, intensive, program that teaches children and their parents hw to handle the problems — such as depression, drugs, aggression, self-harm and truancy — that threaten to tear them apart.
“We try to get families so they can live in the home together, Home Again,” Dallas said.
There’s one in Gordon County, and the Floyd County office at 1838 Redmond Circle, Suite E, held a ribbon-cutting Thursday. A third is planned for space in Pickens County.
Dallas said the program is funded by the Georgia Department of Behavioral Health and Developmental Disabilities and will soon be a Medicaid-reimbursable service.
Rep. Katie Dempsey, R-Rome, championed the program by working to ensure start-up funding in the 2016 state budget.
Highland Rivers Health board chair Chief Magistrate Allen Wigington (with scissors, from left), state Rep. Katie Dempsey (R-Rome), Highland Rivers CEO Melanie Dallas and Tawanda Scales with the Georgia Department of Behavioral Health and Developmental Disabilities, celebrate the opening of Highland Rivers’ Home Again office at 1838 Redmond Circle Thursday.
She said many children who end up in foster care come from families with mental or behavioral problems, including addiction. Home Again targets those issues.
“It could be for the parents. It could be for the child. But it’s to try to get ahead of the situation,” Dempsey said. “We try to keep the family together because, almost always, the child wants to stay with a parent.”
Ricardo Bermudez the program therapist, is currently working with eight families. He said they could be referred through the Georgia Department of Juvenile Justice — or by anyone, including teachers, doctors, pastors, neighbors and the parents themselves.
“These are kids who potentially would be moved out of their homes,” he said. “The goal is to re-establish the unity within the families, to stabilize them.”
The Floyd office can serve up to 10 families, Dallas said, but she’s advertising for another licensed therapist and will then be able to double the number.
For information about the program, visit the HighlandRiversHealth.com website, email firstname.lastname@example.org or call 706-784-4175, extension 4702.
Diane Wagner May 19, 2017
view on NorthWestGeorgiaNews.com
In December, 2016, Tony Sanchez, Director of Recovery Transformation Services at the Georgia Department of Behavioral Health and Developmental Disabilities participated in a RESPECT Institute of Georgia training that was hosted at the Sparrow’s Nest in Athens. Below, Tony shares his thoughts about his experience.
For several years, I have heard from many Peers that the RI training was a trans-formative experience. In December, 2016, I had the opportunity to participate in a RI and I can affirm that it is trans-formative – and healing.
I confess that I felt vulnerable when I started sharing my story with the other participants. I wasn’t planning on it, but I found myself sharing
experiences and feelings that I had never shared with anyone before. I actually think everyone felt vulnerable, but there was so much encouragement and compassion, that everyone took a chance. Everyone took a chance to be open and authentic and though it felt raw emotionally, it was also very liberating and healing.
Having been a veteran of the 12-step program, I assumed that the RI training would come easy to me. But I realized that the expectations of the RI require a different approach. For example, the exercise of having to write out my story and condense 40 years of my life into a 10-minute presentation demanded that I prioritize my lived experiences and at the same time deliver an educational and poignant message. This was not an easy task, but as I continued to edit my presentation, I realized how far I had come in my recovery. I realized that my resilience and recovery eclipse all of the pains and struggles of my life.
What I will treasure the most from my RI experience is the feedback sessions. After a participant shares their story, everyone is so encouraging and empathetic and compassionate that these sessions felt sacred. And when you consider that these stories have been held inside for so long due to shame and stigma, these sessions truly are sacred.
In my position at [DBHDD], I have had many opportunities to hear RI Graduates begin an important meeting by sharing their stories. Now that I have participated in a RI, I want to impress upon everyone that behind every 10-minute inspirational presentation, there is an enormous amount of effort. The RI is designed with great precision, but to get the optimal benefits, a participant goes through three days of intense, emotional and sometimes exhausting processes as they make peace with their past and learn to tell their story. And telling their stories is precisely what the RESPECT Institute Graduates do – every day. To date, RESPECT Institute Graduates have presented their recovery stories to over 100,000 Georgia stakeholders.
From The RESPECT Institute of Georgia Team
We encourage all Graduates to go into their community and tell their story!
RESPECT Institute of Georgia Organizational Development Coordinator
RESPECT Institute of Georgia Training Coordinator
RESPECT Institute of Georgia
RESPECT Institute of Georgia
Tony Sanchez’s RESPECT Institute Experience
In the past, people living with mental health challenges were often encouraged not to work. But on the road to recovery, finding purpose through meaningful activities, such as employment, can be helpful.
At East Central Regional Hospital in Augusta, the work therapy program aims to empower people with skills learned on the job. The program is guided by several principles and practices, including supported employment that helps people with severe mental illness work at regular jobs of their choosing.
“Through the work therapy program, consumers can become contributors, and people who are isolated can become engaged,” said Work Therapy Coordinator Tiffany Snow.
The scope of work ranges from individual experiences to group experiences that includes hobbies and career exploration to campus job sites. At both the Augusta and Gracewood campuses, individuals have the opportunity to work at the treatment mall, in the central kitchen, with the yard crew, in the library, and in the apparel shop, among other job sites. More than 50 individuals have paid employment, more than 20 individuals are in training and groups, and three individuals are in transitional employment.
Recovery-oriented cognitive therapy (CT-R) also is an important component of the work therapy program. DBHDD staff were trained by the Beck Initiative in 2014 through a series of workshops and weekly consultations. The work therapy program now utilizes CT-R to help people who may continue to experience symptoms or challenges.
The program continues to expand by strengthening connections with vocational rehabilitation and supported employment providers, and by developing off-campus work and volunteer opportunities.
In 2014, Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD), Department of Corrections (GDC), and the Georgia Mental Health Consumer Network (GMHCN) embarked on a partnership to offer innovative peer support to Georgia’s returning citizens through the Forensic Peer Mentor Program. In 2015, the partnership expanded to include the newly formed Department of Community Supervision (DCS). Plans are underway for the program to expand into additional facilities in January 2017.
On November 28, 2016, the third cohort of 15 certified peer specialists (CPS) and certified addiction recovery empowerment specialists (CARES) began the weeklong training designed to help them use their own experience in the criminal justice system and their recovery from a behavioral health disorder to help the people that they will support. As forensic peer mentors, they will help individuals leaving correctional facilities with transition/release planning; obtaining stable housing; employment; disability benefits; transportation coordination; linkage to community behavioral health services and recovery supports; and learning new skills.
The training was facilitated by Jonathan “DJ” Rees, a subject matter expert on the forensic peer movement, as well as the Sequential Intercept Model, an emerging best practice that assists communities in identifying points of interception along the criminal justice system continuum where stakeholders can intervene to prevent individuals with mental illness from going to jail/prison due to offenses that may be related to their symptoms.
According to Rees, “when returning citizens are released from jail, they face challenges like discrimination in being hired for a job and finding housing in the community. Despite these challenges, peer support can reduce the recidivism rate of people returning to jail.”
Upcoming program expansion will include placement of forensic peer mentors at four GDC state prison sites, two DCS day reporting centers, one mental health court, and one DBHDD regional hospital. This expansion brings the total number of the forensically trained CPS and CARES workforce across the state to 37, and increases the number of worksites from 11 to 17.
“Since enrolling our first returning citizen in April of 2015 into the Forensic Peer Mentor program, the program has really taken off,” said Jill Mays, assistant director of DBHDD’s Office of Adult Mental Health and coordinator of the Forensic Peer Mentor Program. “Data shows that we have been able to greatly increase successful re-entry and reduce the recidivism rate for individuals with mental illness and/or co-occurring substance use disorders who are being released from prison or on probation/parole. Our belief is that with support from the forensic peer mentors and other appropriate community resources, all returning citizens have the capacity to live and thrive in the community.”