Adult Treatment Planner
43: Vocational Stress
SNOMED Terms
- Adjustment disorder with depressed mood
- Adjustment disorder with mixed anxiety and depressed mood
- Antisocial personality disorder
- Narcissistic personality disorder
- Paranoid personality disorder
Goals
- Improve satisfaction and comfort surrounding coworker relationships.
- Increase sense of confidence and competence in dealing with work responsibilities.
- Be cooperative with and accepting of supervision of direction in the work setting.
- Increase sense of self-esteem and elevation of mood in spite of unemployment.
- Increase job security as a result of more positive evaluation of performance by a supervisor.
- Pursue employment consistency with a reasonably hopeful and positive attitude.
- Increase job satisfaction and performance due to implementation of assertiveness and stress management
strategies.
Behavioral Definitions
- Feelings of anxiety and depression secondary to interpersonal conflict (perceived feelings of
inadequacy,
fear, and failure) secondary to severe business losses.
- Fear of failure secondary to success or promotion that increases perceived expectations for greater
success.
- Rebellion against and/or conflicts with authority figures in the employment situation.
- Feelings of anxiety and depression secondary to being fired or laid off, resulting in unemployment.
- Anxiety related to perceived or actual job jeopardy.
- Feelings of depression and anxiety related to complaints of job dissatisfaction or the stress of
employment
responsibilities.
Diagnoses
- Adjustment Disorder With Depressed Mood
- Dysthymic Disorder
- Major Depressive Disorder
- Occupational Problem
- Adjustment Disorder With Anxiety
- Alcohol Dependence
- Cocaine Dependence
- Polysubstance Dependence
- Paranoid Personality Disorder
- Narcissistic Personality Disorder
- Antisocial Personality Disorder
- Personality Disorder NOS
Objectives and Interventions
- Identify own role in the conflict with coworkers or supervisor.
- Clarify the nature of the client's conflicts in the work setting.
- Help the client identify his/her own role in the conflict, attempting to represent the other
party's
point of view.
- Identify any personal problems that may be causing conflict in the employment setting.
- Explore possible role of substance abuse in the client's vocational conflicts.
- Explore the client's transfer of personal problems to the employment situation.
- Review family of origin history to determine roots for interpersonal conflict that are being reenacted
in
the work atmosphere.
- Probe the client's family of origin history for causes of current interpersonal conflict
patterns.
- Identify patterns of similar conflict with people outside the work environment.
- Explore the client's patterns of interpersonal conflict that occur beyond the work setting but
are
repeated in the work setting.
- Replace projection or responsibility for conflict, feelings, or behavior with acceptance of
responsibility
for own behavior, feelings, and role in conflict.
- Confront the client's projection of responsibility for his/her behavior and feelings onto
others.
- Reinforce the client's acceptance of responsibility for personal feelings and behavior.
- Identify and implement behavioral changes that could be made in workplace interactions to help resolve
conflicts with coworkers or supervisors.
- Assign the client to write a plan for constructive action (e.g., polite compliance with
directedness, initiate a smiling greeting, compliment other's work, avoid critical judgments)
that
contains various alternatives to coworker or supervisor conflict.
- Use role-playing, behavioral rehearsal, and role rehearsal to increase the client's probability
of
positive encounters and to reduce anxiety with others in employment situation or job search.
- Implement assertiveness skills that allow for effective communication of needs and feelings without
aggression or defensiveness.
- Train the client in assertiveness skills or refer to assertiveness training class.
- Verbalize more healthy, realistic cognitive messages that promote harmony with others, self-acceptance,
and
self-confidence.
- Train the client in the development of more realistic, healthy cognitive messages that relieve
anxiety and depression.
- Require the client to keep a daily record of self-defeating thoughts (e.g., thoughts of
hopelessness, worthlessness, rejection, catastrophizing, negatively predicting the future);
challenge each thought for accuracy, then replace each dysfunctional thought with one that is
positive and self-enhancing.
- Identify and replace distorted cognitive messages associated with feelings of job stress.
- Probe and clarify the client's emotions surrounding his/her vocational stress.
- Assess the client's distorted cognitive messages and schema that foster his/her vocational
stress;
replace these messages with positive cognitions.
- Confront the client's pattern of catastrophizing situations leading to immobilizing anxiety;
replace
these messages with realistic thoughts.
- Identify the effect that vocational stress has on feelings toward self and relationships with
significant
others.
- Explore the effect of the client's vocational stress on his/her intra- and interpersonal
dynamics
with friends and family.
- Facilitate a family therapy session in which feelings of family members can be aired and
clarified
regarding the client's vocational situation.
- Develop and verbalize a plan for constructive action to reduce vocational stress.
- Assist the client in developing a plan to react positively to his/her vocational situation;
process
the proactive plan and assist in its implementation.
- Verbalize an understanding of circumstances that led up to being terminated from employment.
- Explore the causes for client's termination of employment that may have been beyond his/her
control.
- Cease self-disparaging comments that are based on perceived failure at workplace.
- Probe childhood history for roots of feelings of inadequacy, fear of failure, or fear of
success.
- Reinforce realistic self-appraisal of the client's successes and failures at workplace.
- Assign the client to separately list his/her positive traits, talents, and successful
accomplishments, and then the people who care for, respect, and value him/her. Process these
lists
as a basis for genuine gratitude and self-worth.
- Teach the client that the ultimate worth of an individual is not measured in material or
vocational
success but in service to a higher power and others.
- Outline plan for job search.
- Help the client develop a written job plan that contains specific attainable objectives for job
search.
- Assign the client to choose jobs for follow up in the want ads and to ask friends and family
about
job opportunities.
- Assign the client to attend a job search class or resume-writing seminar.
- Report on job search experiences and feelings surrounding these experiences.
- Monitor, encourage, and process the client's search for employment.
Index