04/01/2013

Career Retention for Vulnerable Populations: A Relapse Perspective

By Shan Johnson

Over the last fifteen years Darnell Clemons had been homeless because of his crack cocaine and alcohol addiction. If he worked, it was through temporary agencies and his lowest point came when he was assigned to clean out the elephant stall at the circus. After five jail terms, he said, "I was tired of the [jail] doors slamming in my face and I knew I had put myself there."

Today, Darnell is happily married; blessed by the birth of a healthy baby girl in January. He has been in stable housing for over a year and will celebrate his first anniversary as a full-time employee on May 1^st. It hasn't been easy for him to maintain change but he was fed up with his old life and determined to get it right this time. His first step was to enter treatment and graduate from an addiction recovery program; there he learned tactics to avoid returning to old behaviors.

While I visited with Darnell a few weeks ago, I thought about relapse prevention and wondered how it might relate to career counseling and vulnerable populations. As career professionals, many of us have encountered these clients. They are the individuals who get decent jobs in their vocational field and within ninety days are let go for attendance issues. Or perhaps they quit after a month because they cannot get along with co-workers. Their resumes read like an impoverished list of short-term jobs with longer-term gaps. Behaviorally, I wondered, could there be career "relapsers" whose conduct result in a continual cycle of temporary employment? And, if so, what could be done to help them remain in "employment recovery"?

In 1985, addiction relapse experts G. Alan Marlatt, Ph.D. and Judith R. Gordon, Ph.D., revealed tactics to help individuals in addiction learn to maintain sobriety. In particular, the Relapse Prevention (RP) Model identified three high-risk situations that were associated with almost 75% of reported relapses: negative emotional states, interpersonal conflict and social pressure. Negative emotional states: anger, anxiety, depression, frustration and boredom that, if uncontrolled, result in a return to previous detrimental actions; some people call this behavior insanity. Albert Einstein (1879-1955), defined insanity as "doing the same thing over and over while expecting different results" (Quotation #29032 at Quotationspage.com). It is a person's response to a situation that determines whether a lapse will occur. If we look at this from a career standpoint, there is a direct correlation between an employee's reaction to pressures on the job and their retention of that job. Vulnerable populations fall through the cracks because they have not learned necessary emotional coping strategies aimed at job preservation.    

In Marlatt's (1996) study, he found that negative emotional response and interpersonal conflict caused half of all relapse episodes. I don't know what your workplace is like, but ours contains human beings, situations, and decisions that can get on anyone's nerves. Hopefully, when we respond to workplace stress there are no verbal or physical displays of anger, walking-out, stealing or destruction of company property. Why are our responses different? Because we possess some effective coping mechanisms: we know how to take a break, inhale deeply, talk it out, or laugh it off. We have mastered avoiding potentially high-risk employment behavior and possess the self-efficacy to retain our jobs. Can we say the same of our clients . . . especially those who struggle with mental or physical health problems, addictions, illiteracy, homelessness, criminal background, impoverishment or the burden of disability?

An old Latin proverb contained in the Random House Dictionary of Popular Proverbs and Sayings (1996) says, "Forewarned is forearmed" (p. 116). When working with individuals from vulnerable populations we must anticipate and identify previous failures to handle employment activities during initial career assessment interviews. Self-reported behaviors help to classify emotions, situations, or interpersonal factors associated with past job loss. Once identified, there are two intervention strategies that can be used to lessen the risks: "teaching the client to recognize the warning signals associated with imminent danger... and then helping the client learn more effective coping skills" (Larimer, et al, 1999) which will enhance self-efficacy and promote employment retention.

Darnell Clemons has begun to believe in success: in his career, in his married life, in his recovery . . . one day at a time. But everything doesn't go perfectly. Not long ago he got a traffic ticket for driving without a license when his usual car pool driver was unavailable. "In the old days, bad luck like that would make me head right back to addiction," Darnell said, "but today, I just work it out. It's not really that big a deal." Learning to handle problems successfully, what a difference that has made for his future.

References

Larimer, E.L., Palmer, R.S., & Marlatt, G.A. (1999). Relapse prevention: An overview of Marlatt's cognitive-behavioral model, Alcohol Research & Health 23: 151-160.

Marlatt, G.A. (1996). Taxonomy of high-risk situations for alcohol relapse: Evolution and developments of a cognitive-behavioral model. Addiction 91 (suppl): 37-49.

Marlatt, G.A.; & Gordon, J.R., eds, (1985) Relapse Prevention: Maintenance strategies in the Treatment of Addictive Behaviors, New York: Guilford Press.

Quotationspage (2009) Quotation #26032 from Michael Moneur's (Cynical) Quotations obtained on April 1, 2009 at http://www.quotationspage.com/quote/26032.html.

Titelman, G. Y. (1996): Random House Dictionary of Popular Proverbs and Sayings, 2^nd Ed., New York: Random House Reference.

Shan Johnson, BS, MA, GCDF, CIWA, is a Case Manager and the Job Development Coordinator for the Carpenter's Place, a day outreach center for the homeless in Rockford, IL. She serves on a professional committee called EXCHANGE which provides educational events and community assistance to individuals with criminal background. She has background in addiction recover and chairs weekly 12-Step recovery meetings. To contact Shan: shanj@carpentersplace.org.