The Therapeutic Value of Work

By Jennifer C. Jones

(Editors note: Everyone who has studied in a therapeutic or human development discipline understands that there are adolescent "Stages of Development". What I have noticed over the last twenty-five years of working with families is that there are also "Stages of Development" when it comes to career and work. Many of the students who are plagued by emotional concerns miss out on this developmental process. Developing a career path and the necessary skills and competencies is an important aspect of human development. I hope you find this piece by Jennifer Jones engaging and informative. Thank you for visiting, Stephen C. Schultz)


Jared Schultz did not want to be a mortician when he grew up. No matter what the interest survey suggested, as a sophomore in high school he was sure formaldehyde was not the way to a girl’s heart; which, after all, was his primary concern at the time. 



Nor did he want to be an apartment maintenance worker or a day laborer. He learned that because he worked those jobs as a teenager.

But what do teens in therapy learn about what they like or don’t like in the world of work? How do they experience critical vocational learning in a residential treatment center?

Work is a very important part of that rehabilitation process because it’s an entry way into society,” Schultz says. “It’s how people become integrated into their communities.”

Schultz, who holds a PhD in Rehabilitation Counseling and is a Licensed Vocational Rehabilitation Counselor, says there’s an important void in the lives of most adolescents receiving therapy.

“In many cases these teens have very limited work experience, primarily because of their age,” Schultz says. “In some cases it’s because they’ve been in and out of treatment programs and in and out of trouble. Work hasn’t been at the top of their priority list.”

But Dr. Schultz believes therapy programs are missing a great opportunity to contribute to the teen’s over-all well-being.

He cites Viktor Frankl’s belief that the two best ways to find meaning in life are to develop meaningful relationships and meaningful work.[1]

“It’s not just about making money and being self-supporting,” Dr. Schultz says. “There is an aspect of work that speaks to us as human beings. It’s a very important part of who we are.”



According to Schultz, people don’t work simply to make money. In fact, he says, Fredrick Herzberg’s research shows that salary ranks sixth among what motivates people to work. “Achievement, recognition, engaging in the work itself all came in above salary,” Schultz says.[2]

He adds, “It’s an interesting construct when you look at residential treatment centers.”  That’s because students have what Schultz calls “an existential vacuum.” While most facilities work on the relationship piece of a teen’s well-being they overlook the importance of a vocational relationship.



He began brainstorming with his brother in the adolescent residential therapy industry. What if a student’s therapy could include both relationship and vocational therapy? In fact, what if vocational therapy could be used as an accelerator in relationship therapy?

Schultz decided to put his experience as the Director of Rehabilitation Counseling at Utah State University to work in a different setting. He had spent years researching and applying best practices to help people with disabilities find jobs matched to their unique skill sets. Why not apply some of those same theories to troubled teens?[3]

“In the average teenager’s life parents will talk with them, work with them, maybe even insist they get a job for the summer,” Schultz says. “When these kids are in treatment programs that pull them out of those regular ‘normal’ experiences, they don’t have that experience the rest of us naturally go through. What we try to do is make up some ground.”

He’s quick to explain the process is not about helping a teen identify a career. It’s about giving him a chance to learn from having a job. “My first job was making wood frames. My second job was doing manual labor for a property management company. And even though I didn’t go into those things, they taught me quite a bit about the behaviors that are required for maintaining a job. There are a lot of skill sets that are picked up through those early work experiences.”

“This is not just an interest inventory,” Dr. Schultz points out. “It’s not about doing an on-line interest piece.  This is not personality testing. Myers-Briggs is great for what it is and it can be used but it doesn’t lead you where you need to go. If you’re going to claim that you have a vocational program, it’s got to be more involved than just doing an interest assessment and throwing that in the student’s file.”

“This is not a means of figuring out what to tell the kid to do. It’s a tool to be utilized in the counseling process. This is really just a beginning. It’s a tool to facilitate the exploration process.”


Getting Started
Dr. Schultz says a specialized, individual assessment is the foundation of an effective vocational therapy approach. He uses six different tests to measure a student’s abilities, interests, and values. They include:

Work history
Exactly what kind of work has the student done in the past? This can include things as simple as taking out the garbage at home to working at the local burger joint. Equally important, this assessment helps Schultz get a feel for the student’s family. “We get an idea what the norms within the family are regarding work and professions.”

Vocational social skills assessment
“People usually don’t lose their jobs because their work is inferior,” Dr. Schultz says. “They lose their jobs because of interpersonal challenges they have on the job with co-workers and supervisors.”

The vocational social skills assessment helps measure where the student is at in terms of abilities to interact appropriately on the job. Schultz says, “This is a critical piece that is often overlooked in traditional assessment.” He adds, “The more we can do up front to help students learn how to interact the more successful they’re going to be.”

Interest assessment  

In this part of the test, Dr. Schultz is looking to identify what types of activities interest a student.  The student is asked to score 168 items on a four point scale ranging from strongly liking an activity to strongly disliking it. Students who are depressed or angry at being in therapy often dislike most of the choices. Schultz says that’s still good information to have.  “Because it’s not diagnostic, that gives the therapist something to talk about. If three items make the student break the pattern, that’s relevant information.”

Task analysis
What do plumbers or engineers actually do on the job? How much education does it take to be an architect? Once the student has identified a job that interests him, he discusses the nuts of bolts of performing that job. Understanding the requirements of a certain job may make a big difference in whether or not the student is really interested. A student that loves to be outdoors may not care to be outdoors working construction.

Values assessment
“The values assessment helps to identify the three or four values that are the most important to the student and will have the largest impact on his or her vocational goal selection,” Schultz says.

He explains, “Does the student value independence, aesthetics? All of us have things that we value. If those values are supported in the workplace, the potential for success goes up significantly.”            

Abilities assessment
This assessment measures a student’s mechanical reasoning, mathematical, and visual/spatial abilities.  Schultz says this information is helpful because specific groups of careers and jobs require different combinations of these basic abilities.

Job Match Index
The final assessment tool is the job match index Dr. Schultz designed. The job match index provides a feel for how closely a student’s interests match the actual conditions or environment of the job.

An occupational information handbook provides Schultz with detailed information on jobs, including educational requirements, environmental conditions, and employee temperament.

He matches the data he’s gathered from the other assessment pieces with those job listings. “We’re actually able to calculate a match index which shows us if this is the job the student picks here’s how closely that matches with his preferences in these other areas.”

Schultz says he’ll often come up with a list of seven to ten sample occupations he recommends the student explore.

“The whole idea is the closer you are in the match there’s a significant increase in the possibility of success in the job and that’s what we’re trying to establish.”

When all of the assessment pieces have been finished, the student and his family end up with a 10-12 page report that summarizes the information and contains recommendations for career exploration.

“The challenge is writing these reports so that the people who receive them don’t think, ‘This is what the report says so you’re going to do this.’ It’s intended to be a tool to facilitate the exploration process.”

Schultz says there is also guidance for the therapist as well. “If a student scores low on the vocational social behavior assessment for working with a supervisor, there may need to be some role playing and some instructions on how to appropriately approach a supervisor or a co-worker or appropriately resolve conflict at work or those kinds of things,” he explains.


An Individual Approach
Dr. Schultz emphasizes, “Really, the key piece on this is each of these assessments are individualized.” 

But it’s not just the assessment that is tailor-made. Schultz says internship opportunities are critical to vocational therapy and each of them must be custom created.

“The natural tendency is going to be for people to set up a couple of internship sites and put everybody in to it,” he says and then warns, “In my opinion, that’s absolutely wrong. You put them into places they’re not interested in and it teaches them that work stinks. If you’re ramming it down their throat it’s not going to be effective.”

“Other therapists may disagree but the thing that’s important about the vocational therapy piece and how it can be effective is that it should focus on strengths,” Schultz says.

He notes students who have always been on the receiving end of treatment and mandates need a vocational therapy approach that emphasizes the positives. “Even if they’re not the best in the world, they can accomplish something and you can build on that. You start giving them opportunities to succeed and you build.”

Having a chance to actually practice job skills is essential. “There’s something about a real life work situation that changes a client’s perspective.”

           
Internships

“You can do the paper assessment piece but until the student gets into that environment and really tries those things out you’re not really quite sure.”

Schultz says it may not necessarily mean the student has to go off-campus for vocational experience. Some types of jobs can often be brought to the student. But the chance of actually “going” to work can be a therapeutic gold mine.

“As you get students out into the community doing situational assessments, or work samples, you’re doing two things,” Schultz says, “First, you’re gaining more information about their interests and abilities in a real world setting. Second, you’re doing ‘work hardening.’ That’s a piece a lot of the kids aren’t used to – getting up, organizing tasks, getting used to the physical, psychological and emotional aspects of getting up and going to work. Many students don’t have the stamina right off the bat to do what it takes to work an eight hour day.”

Coming up with work experiences that fit the student, the program and potential job managers takes creativity and commitment. Discovery Connections, where Schultz currently consults, has a part-time staffer that is responsible for arranging internship opportunities with local businesses.

“The key on this is the relationship that the person representing the program has with the employer,” Schultz says. Programs should be willing to give back when they can to employers who provide internship opportunities for students.

Recognizing that one work experience does not fit all, Discovery Connections has expanded its business network to match a variety of needs.

One student was fascinated with the military or police work. But his values assessment didn’t match up with that career cluster.

Schultz explains, “What did show up were activities around museums and  history.” His interest assessment and values didn’t seem to fit – at least on the surface.

Connections staff took the information and found the student a volunteer position at a local museum where he also assisted with some security duties.

Dr. Schultz recalls, “What was exciting about it was when he got his foot in the door and started talking with people at the museum, in the morning he would do security and then he would lead tour groups of students and tell them about what’s going on in the museum.”

Even a successful internship experience like that doesn’t mean a teen will always want to do that kind of work. “Most of us don’t stay in the same job forever,” Schultz notes. He says this kind of vocational therapy can teach the process of problem solving and career development. It can also build a supportive process for parents that they may not be used to.

Family Buy-in

“It helps them to see there is hope,” Schultz says. “As we get into the counseling and assessment process, we’re actively engaging the student in the process of figuring out what they’re going to do – setting up a plan.”

Dr. Schultz notes that for students in treatment, the child’s history may have left parents emotionally exhausted. “Sometimes the trust has been worn down a little bit between the child and the parents,” he says, “and people in that situation sometimes don’t know fully how to move forward.”

Vocational therapy may also ease parents’ concerns about what their child will do after treatment.

“If the student has done the assessment, had the internship experience, and developed good employer relationships, there’s evidence he has the capability to succeed. Parents have been on the failure side of things for so long they forget that.”

Yes, Schultz admits, there are times when families have been disappointed by their child’s vocational interests and/or abilities. It might be tough to let go of the dream your daughter will go to Harvard law just like everyone one else in the family.

Dr. Schultz has some advice, “Pushing a certain agenda or pushing a certain idea very frequently just creates a power struggle. If parents can just look at this as it’s not ‘ruining’ everything. What it’s actually doing is informing the process.”

Schultz says the fact that the assessment is done by a “neutral” third party gives it credibility. “It’s somebody from the outside saying this student has the ability to work and to pursue jobs and careers and here’s what they need to do in order to accomplish that.” Perhaps equally important, Schultz says the therapy process tells parents, “Here are some ways you can help support this process and help your student to be successful.”

Parents can learn how to talk with their troubled teen about job choices, recognizing that the first job the student shows interest in is probably not going to be the one he works for the rest of his life.

“When your son is five and says he wants to join the Army, that’s cute,” Schultz says. “At 15 it can be terrifying, depending on the parents’ expectations and beliefs about the potential and future direction their student should take. Parents often have pre-conceived notions of what a child can and can’t do. Family dynamics and expectations play a significant role on our vocational decisions.”

He says family boundaries may need to change a little to allow the student flexibility to explore vocational interests and that can create stress in the family system. Done in therapeutic sessions, the student’s counselor can guide the family through this new and unfamiliar territory.  

Counseling

Vocational therapy works best when it works hand in hand with the treatment plan developed by the student’s therapist.

“You’re looking at a family system that is in transition and so the rules of the family and the roles of each member of that family need to be re-negotiated,” Schultz says.

He says therapeutic opportunities multiply once a student is engaged in work scenarios. “You’re not relying on the ability to create a therapy moment in the office,” he says. “Things come up that are grounded in everyday life.”

Consider, for instance, what he calls “The Rock Star Dilemma.” “It’s common for students to claim that career choice,” Schultz explains. “The appeal of money and fame is obvious but the student actually has no idea what it takes to realize that career goal. Looking at the probabilities, mom and dad might be tempted to cut short the discovery process.”

But Schultz points out the student’s mis-perceptions can be fuel for the counseling process.

“If he wants to be a rapper, you start exploring it. That’s very empowering to the student. It helps you understand what’s driving him.”

Rather than telling the student his job choice is impractical or unrealistic, counselors can help students explore what it really takes and how that may or may not fit with the student’s individual needs.

“At no point do we say, ‘No. This can’t happen.’ It’s not an absolute,” he explains. Exploration invites understanding – not just of the job but of the student himself.

“That’s what counseling is,” Schultz says. “It’s helping this student deal with the educational, psychological and sometimes the physiological things he’ll need to be successful.”

Can a vocational mis-step be detrimental to the therapeutic process? “It’s possible,” Dr. Schultz says, “but I’ve never seen it happen.”

“I’m a very strong believer in the process that if a student gets put in a situation and it doesn’t work out, we can make something positive of it. That takes it right back to the skill and role of the therapist. You process that and use it to build.”

He points out that the therapy program itself can serve as a sort of safety net for students as they practice job skills.

Dr. Schultz is not aware of any studies that have been done yet on the effectiveness of vocational therapy among a juvenile therapeutic population.

So far, he says all he has to go on is his own anecdotal experience. “When you have kids not required to do these kinds of things, that’s where a lot of this ‘Peter Pan’ syndrome comes from,” Schultz says. “They don’t understand that work can be a satisfying and fulfilling activity.”



[1] Frankl, V. (1945) Man’s search for meaning: an introduction to logotherapy
[2] Herzberg, F.I. 1987, 'One more time: How do you motivate employees?', Harvard Business Review, Sep/Oct87, Vol. 65 Issue 5, p109-120
[3] Lent, R.W. & Brown, S.D. (2002) Social cognitive career theory and adult career development, Adult career development; concepts, issues and practices, 76-97.

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