Challenges and Choices: Three Barriers Families Face When Supporting Vocational Rehabilitation
June 01, 2017
The Vocational Rehabilitation process can be one of the most challenging aspects of supporting a loved one through their treatment. In our work with various clients and their families and friends, we have seen three primary areas these challenges tend to present themselves in these relationships: stages, goals, and stories. While differences in each of these areas can be painful, support offered in each of these areas can have a stark impact on outcomes. Below are several choices available to those supporting their loved ones, each matched with a challenge that we see families experiencing.
First, very often a person experiencing challenges with their vocational engagement may be in a different stage of change than those supporting them would wish. Conflict in this area is often expressed in a spouse or parent’s exasperated question: “Why won’t they do anything?”
Very often, this conflict arises not because of an individual’s unwillingness to “do something,” but because what they are doing is different from what their loved ones would prefer. One of the most effective things a loved one can do in this scenario is look for ways to understand and accept where their loved one is. Prochaska and DiClemente’s Stages of Change model is helpful in this process.
Their Stages of Change are:
- Precontemplation: In this stage, a person is not thinking about making a change
- Contemplation: Here, a person is considering making a change. However, this consideration is very preliminary and noncommittal.
- Preparation: A person in this stage is getting ready to make a change, and is “counting the cost” to determine what it will take.
- Action: In this stage, a person practices the change over time.
- Maintenance: A person in the Maintenance Stage is measuring their adherence to a new way of being in terms of years rather than weeks or months.
- Relapse: A person here has regressed to a previous way of being, and has at least temporarily stepped away from the change.
Very often, when a person in Vocational Rehabilitation experiences conflict with their family, it is due to their being in one stage, and their family being in another. For instance, a person may be in the Preparation Stage, and their family may be frustrated that they are not moving directly to action. When this is happening, one of the most effective things a family member or loved one can do is to acknowledge where their loved one is in the change process, and accept this. While this can be very difficult to do, this acceptance leaves the onus for progress on the loved one, which is ultimately where it belongs. Movement through the stages arising out of external pressures tends to be a quick road to relapse. When a person moves through the stages somewhat independently, they more clearly “own” the gains of each stage. It can be challenging to allow them to move at their own pace, but if we choose to understand and accept, we can more readily move into an effective supporting role.
Sometimes the conflict arises not out of a person’s action or lack thereof; rather, it arises from their progress towards a goal that is not shared by their family. For instance, a woman may value theological studies, when her parents had imagined that she would pursue a law degree.
When this occurs, family members may experience distress, worry, and outright fear for their loved one’s future. They may perceive the goal being pursued as being without value, being unrealistic, or even being dangerous. However, there is an amazing opportunity lurking underneath these challenging emotions. When we choose to engage with our loved ones in support of a responsible pursuit of their goals, we create space and opportunity for our loved ones to find out for themselves what will work and what will not.
In our work with clients, we regularly encounter individuals with fairly lofty goals for their careers. It is not uncommon for someone to admit to Vocational Services with a goal of being “a famous musician/actor/dancer” with three houses on three continents. If we were to explain the numerous ways in which this might be unrealistic, we would likely experience our clients “digging in their heels” and insisting on pursuing their dream without our help. However, if we begin setting out a course of action for success in the entertainment industry, very often clients will realize the combination of incredible hard work, obscure labor, and “lightning strike” luck required to become famous. At this, many clients may self-select out of these goals.
When this occurs, it creates an opportunity for us to assist the client in expressing their talents and values in more grounded ways, and also does something even more important: it moves our role in the mind of the client from that of an “expert” to that of an “empathizer.” Clients, seeing our willingness to support them in their endeavors, and to mourn with them the loss of one dream, are more likely to trust us with another dream.
For family members, choosing this strategy may involve an uncomfortable suspension of authority, but the yields in connection and openness are often a source of comfort to both the client and their loved ones.
Sometimes, the story that your loved one tells is simply not the same one that you live. They may remember their childhood, courtship, or other past experiences with you differently than you do. They may blame you for things which you do not feel are your responsibility. When there are mental health concerns involved, they may express their cognitive distortions, dysregulated emotions, or perhaps even delusions as immutable facts.
This is often a source of significant pain for family members, and pain often leads to intense reactivity. It may begin to feel extraordinarily important to argue back with your loved one that it didn’t happen that way, their feelings are out of scope with what happened, or their delusion is utterly insane.
Most family members who have been supporting their loved one for some time will recognize that the urge to do this is as natural as it is unproductive. However, many family members are tired of these unproductive strategies, and also unaware of what else to do.
Unfortunately, often there is not much that can be “done” to change this tension between your loved one’s experience and yours. What can be effective in maintaining relationship, however, is actually as simple in theory as it is difficult in practice: listening.
Reflective Listening prizes understanding over agreement, and acknowledges that while agreement may be impossible, understanding is a choice. We may not find ourselves on the same page as our loved one, but we can communicate our love for them by choosing to understand their page as well as we can. In some cases, there may even be an opportunity for us to share our “page” with them, and to experience mutual understanding.
To do this, one need only do the following:
- Listen to what is being said. Seek to stay fully present, not preparing a response or rebuttal.
- Reflect back to your loved one what they have said to you. Be as close to word-for-word as you can, and above all, seek to accurately reflect what they said, without your own take on it.
- Confirm with your loved one that you are understanding them. A simple question such as “Did I get that right?” can get at this. In addition to clarifying for you as the listener, this creates an opportunity for the speaker to be accountable for the words they are saying, insofar as the listener is mirroring it back accurately. Many times, when someone hears their words repeated back to them, they may realize where they are being harsh, irresponsible, or ineffective in their communication.
- Wonder: Ask your loved one if there is anything else they’d like to say. If there is, repeat the steps.
This process is effective for several reasons. First, it communicates love and respect to the person being listened to. Many people carry the belief that they are not valuable, not seen, and not heard. Being listened to in this way can cut through that fear, and give your loved one a sense of being valued and loved, simply because they have been heard.
Additionally, it can help the listener pause whatever reactivity they are feeling towards the speaker. Reactivity can shut down listening, but similarly, listening can shut down reactivity. It can remind the listener experientially that they are not responsible to get their loved one on the same page as them. Rather, they can pursue relationship with their loved one in the midst of believing, thinking, and feeling different things. It can also remind the listener that hearing their loved on out does not require agreement on their part. It is possible to understand a different point of view without sharing any of it. Once this has been acknowledged, the door is open to seek understanding, since achieving agreement, with all the stress that goes along with that, is no longer the primary goal of the conversation.
Finally, in understanding the most challenging things our loved one is saying, we gain an opportunity to question ourselves. Perhaps the thing we thought of as black and white has some grey mixed in. Perhaps there is information we were not privy to, or a point of view we had not yet considered. Often, on the other side of listening, we are able to be more effective in expressing love and support for our loved ones.
While supporting a loved on through their vocational engagement can be an exhausting process, it can also be a very rewarding one. The choices offered above can enable a close engagement that is effective in supporting someone through the stages of change, their own goals, and their differing experiences of the world. Better still, they can be a roadmap for maintaining a close connection with your loved one, even if you experience them as “distressingly different” from you.