Vocational Implications of Psychiatric Disabilities

1
Vocational Implications of Psychiatric
Disabilities

• Introduction to Anxiety Disorders
• David Strauser, Ph.D., CRC

2
Changing Nature of Work

• Quick Review
• Macro level- how work is performed
• Increased cognitive and interpersonal demands
• Impact on Individuals with Psychiatric
  Disabilities

3
Problems with Work Behavior

• Conflicts with authority
• Problems with co-workers
• Poor work quality
• Inability to modify behavior to meet standards
  and productivity requirements
• Inability to create effective boundaries between
  work and non-work issues

4
Conceptualizing Work Problems

• Occupational Adjustment
• Performance Adjustment
• Personal and Social Adjustment
• Work Adjustment

5
Occupational Adjustments

• Following work rules
• Relating to others
• Dealing with public
• Using judgment
• Interacting with supervisor
• Dealing with work stress
• Functioning independently
• Maintaining attention and concentration

6
Performance Adjustments

• Complex Instructions
• Detailed Job Instructions
• Simple Job Instructions

7
Personal and Social Adjustment

• Maintaining personal appearance
• Emotional stability
• Predictable in social situations
• Demonstrate reliability

8
Work Adjustment

• Work 8 hours per day
• Work 5 hours per day
• Work without excessive breaks
• Maintain regular attendance

9
Posttraumatic Stress Disorder

• What is it?
• Anxiety Disorder that can affect any age and can
  occur with no predisposing mental health
  condition
• Three key components
• Traumatic event
• Sufficient intensity
• Symptom clusters

10
Traumatic Events

• Physical pain or injury
• Sudden Onset
• Out of the individuals control

11
Sufficient Intensity

• Personal and psychological resources
• Duration of the event
• Past experiences

12
Sufficient Magnitude

• Three symptom clusters
• Avoidance and numbing
• Arousal
• Re-experiencing

13
Dimensional Model

• Emphasis
• Symptom presentation
• Implications for treatment
• Do not need to meet criteria
• Focus on symptom presentation

14
PTSD and Disability

• Incidence rate 1 to 14
• 3 to 58 in population at risk (vets)
• Only 25 who experience traumatic events usually
  experience PTSD
• Often times negative reactions go untreated

15
Individuals with Disabilities

• Co-occurrence with disabilities
• Heart, Burns, amputation, spinal cord injury
• Individuals with disabilities more likely to be
  at risk of abuse
• Violence, sexual assault
• Sexual assault for women with disabilities
  between 40 to 70
• Men and children with disabilities also at risk

16
What is PTSD Like

• Exposure to trauma
• Re-experiencing the trauma
• Avoidance of stimuli
• Persistent symptom problems

17
PTSD Effect on Work

• Inconsistent pattern of work performance
• Reduced stress tolerance
• Low energy, poor endurance
• High error rate

18
Making Occupational Adjustments
19
Making Performance Adjustments
20
Work Adjustment
21
Making Personal and Social Adjustments
22
Vocational Strategies

• Identify skills and abilities that will meet
  workplace requirements (due to vague sense of
  future and poor planning
• Predictable and stable work environment
• Work independently
• Flexible scheduling
• Flexible work pace
• Social support
• Individual knowledge of condition

23
Intervention Approach

• Rapport/Relationship
• Analysis
• Support
• Develop