A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
People with mental health challenges have conditions like depression, anxiety, bipolar disorder, or schizophrenia. Adults with mental health challenges face a variety of barriers, and are less likely to find and keep jobs, or complete college degrees, when compared to adults without disabilities. Young adults in their 20s who have mental health challenges may have difficulty meeting important milestones on the path to adulthood such as identifying their career goals or enrolling in college classes. In a recent NIDILRR-funded study, researchers tested Career Visions, a program aimed to help young adults with mental health challenges develop and implement career plans. The researchers wanted to find out if the program could increase young adults’ sense of self-determination, or being in charge of their own lives and choices, which can be key to successful transition to employment and independence. The researchers also wanted to find out if the program could increase the young adults’ involvement in career development activities.
Researchers at the Rehabilitation Research and Training Center for Pathways to Positive Futures enrolled 67 young adults in a study to test Career Visions. The participants were between the ages of 20 and 30, and had been receiving mental health services for at least two years. They had a variety of mental health diagnoses including depression, anxiety, bipolar disorder, schizophrenia, or attention deficit disorders. Most of the participants had more than one diagnosis.
The researchers enrolled about half of the participants into the experimental group and half in the comparison group. The participants in the experimental group were enrolled in the Career Visions program where they participated in career planning with a career advisor in 30 meetings over 12 months. The first 12 meetings occurred about once a week for 3 months. During these meetings, the participant completed a series of workbook modules with guidance from the career advisor. In these modules, the participants identified personal strengths and interests, developed career goals, and then developed detailed written action plans for achieving their goals and overcoming potential barriers. After this first phase of the program, the participants moved on to the second phase, where they had 18 meetings with the career advisor about twice per month for 9 months. During these later meetings, the participants checked in with the career advisor as they worked on implementing their action plans, and received support and encouragement. The participants in the comparison group had one meeting with the career advisor and were given some job resources, but they did not receive any other materials.
To find out how well the program was working, the researchers gave questionnaires to the participants in both the experimental and comparison groups. Each participant filled out the questionnaires four times: at the beginning of the study; after the first phase of the program (3 months into the study); after the second phase of the program (12 months into the study); and, finally, 6 months after the program ended (18 months into the study). On each questionnaire, the participants completed a self-determination scale, where they indicated the degree to which they felt to be in control of their life decisions, goals they had for their lives in the next five years, and how confident they felt about their ability to solve problems. The participants also indicated which of 60 career-related activities they had done in the past 3 months. Those activities were grouped under four categories: career planning (e.g. identifying interests), career exploration (e.g. doing an informational interview), education (e.g. taking a college class), and work activities (e.g. applying for a job).
The researchers found that the participants in the experimental group reported higher levels of self-determination after the first program phase than they did before beginning the program, with scores rising by about 10% for the group. Their self-determination continued to increase by another 10% after the second phase of the program. Though the scores dipped slightly six months after the program ended, the participants in the experimental group still reported stronger feelings of self-determination than they did at the beginning of the program. In contrast, self-determination scores for the participants in the comparison group showed little change over the 18-month study period. By the six-month follow-up, the participants in the experimental group had self-determination scores about 10% higher than the participants in the comparison group.
When they looked at participation in career-related activities, the researchers found that the participants in the experimental group engaged in more career-related activities during and after the program than before, from about 5 career-related activities to nearly 20 on average. The comparison group participants also engaged in more career planning activities at the end of the study period than at the beginning, but this increase was not as large as it was for the experimental group participants. The experimental group engaged in more than double the number of activities on average than the comparison group during the program. The researchers also found a link between increases in self-determination and greater participation in career planning activities: They found that the participants in the experimental group who reported higher levels of self-determination also engaged in more career planning activities during and after the program.
The researchers took a closer look at participation in two important activities: attending college classes and being employed. They found that the experimental group’s rates of attending classes increased from 11% before starting the program to 63% at the end of the program. In contrast, comparison group’s rates of attending classes increased from 9% before starting the program to 19%. When the researchers looked at employment rates, they found that the participants in both groups increased their employment during the study period, from 26% to 54% for the experimental group and from 21% to 38% for the comparison group. However, these gains lasted longer for the experimental group participants. By the end of the study period, the participants in the experimental group had double the employment rate of the participants in the comparison group (50% vs. 25%).
When asked for their feedback, the participants rated the experimental program as highly useful. They liked the consistent focus on strengths, exploring new career options, learning how to develop written career plans with steps and problem-solving tools, and learning about the Americans with Disabilities Act and how to request accommodations in school and at work.
The authors noted that a number of participants in both groups dropped out of the study, with just 20 participants in the experimental group and 16 participants in the comparison group completing the fourth questionnaire. Some of the participants dropped out because they moved out of state or had other life changes that made follow-up difficult. Future studies with larger samples will be useful in verifying the consistency of the results.
In this study, the participating young adults with multiple mental health challenges had high rates of college enrollment and employment after completing the Career Visions program. The program may have helped these young adults to identify their strengths and talents, set clear goals, and develop clear plans for achieving their goals. The career advisor provided guidance to help these young adults solve problems and overcome barriers along the way. As a result, the young adults who completed the program had a stronger sense of self-determination that continued to increase after the program was over. This, in turn, may have led them to participate more actively in career development activities such as taking college classes during the program. After the program ended, they were more likely to find and keep jobs than the participants in a comparison group. According to the authors, this may indicate that the program participants found jobs that better matched their interests, and were better able to solve problems that came up. Mental health clinicians, vocational counselors, and college staff serving young adults with mental health challenges may wish to consider implementing similar programs that help these young adults build their self-determination and take charge of their own lives.
To Learn More:
Career Visions was developed during the 2009-2014 Pathways RTC. The project website includes peer-reviewed articles, factsheets, and videos including:
- What Do You Want to Be When You Grow Up? Guidance on career research, available in English and Spanish.
- If, When, and How to Disclose to an Employer that You Have a Mental Health Disability.
- Supporting Self-Determination and Enhancing Career Development for Young Adults with Mental Health Diagnoses webinar.
Research on supporting youth and young adults with mental health conditions continues under the current Pathways RTC as well as the Rehabilitation Research and Training Center on Learning and Working During the Transition to Adulthood (Transitions RTC).
- Check out more publications, factsheets, and training opportunities from the Pathways RTC.
- Visit the Learning and Working Center and Voices 4 Hope peer-run website from the Transitions RTC.
Both projects are also supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).
To Learn More About This Study:
Sowers, J., & Swank, P. (2017) Enhancing the career planning self-determination of young adults with mental health challenges. Journal of Social Work in Disability and Rehabilitation. This article is available from the NARIC Collection upon request.