The question ‘who am I?’ is at the fundamental core of humanity (Broderick, & Blewitt, 2010). One’s self concept is how seeks to answer that question by formulating a description and mental representation of that individual (Niepel, Brunne, & Preckel, 2014). William James discussed the differences of “I” and “Me” when discussing the self-system. He made the distinction that “me” centers on defining an individual’s self-concept and who they project to others (Broderick, & Blewitt, 2010).
Charles Cooley’s looking-glass-self metaphor is derived from the idea that we gain a sense of self, and therefore self-concept by observing the appraisals or criticisms from others, particular attachment figures. The influence of such interactions impact outward behaviors and social awareness (Broderick, & Blewitt, 2010). Within a culture there are varying themes including gender roles, social connections, academic, and career expectations that shift and impact an individual’s self-concept (Broderick, & Blewitt, 2010. & Wagner, Gerstorf, Hoppmann, & Luszcz, 2013).
Self-concept internally as an external description of features, characteristics and attributes through interactions with others (Broderick, & Blewitt, 2010). The role of early care givers is important in establishing self-concept in that secure attachments allow a child to develop positive self-worth and self-concept (Broderick, & Blewitt, 2010). Studies show that there is a strong correlation between self- concept and achievement. Individuals with a positive self-concept show tendencies toward continued self-enhancement and motivation in several domains throughout life (Niepel, Brunne, & Preckel, 2014). On the contrary, individuals with poor self-concept show trajectories toward maladaptive behaviors, delinquency, and substance abuse (Steiger, Allemand, Robins, & Fend, 2014).
Self-concept possess elements of stability and change throughout an individual’s lifespan and eventually begins to differentiate form others with maturity (Broderick, & Blewitt, 2010). Adolescence is marked by a period of rapid changes throughout multiple domains. Transitions such as those in adolescence are marked by shifts in domain competencies and the development of new skills that shape social interactions and identity (Wagner, Gerstorf, Hoppmann, & Luszcz, 2013).
Self-concept cannot completely be isolated from the self-system. Self-concept helps to shape and formulate self-esteem and self-regulation. The interaction of biopsychosocal and spiritual domains continues to impact fluctuations in the self-system (Broderick, & Blewitt, 2010). Individuals with a positive self-concepts show tendencies toward an overall higher self-esteem and self-regulation through transitional life phases (Steiger, Allemand, Robins, & Fend, 2014).
References:
Broderick, P. C., & Blewitt, P. (2010). The lifespan: Human development for helping professionals (3rd. ed.). Boston, MA: Allyn & Bacon.
Niepel, C., Brunner, M., & Preckel, F. (2014). The longitudinal interplay of students’ academic self-concepts and achievements within and across domains: Replicating and extending the reciprocal internal/external frame of reference model. Journal Of Educational Psychology, doi:10.1037/a0036307
Steiger, A. E., Allemand, M., Robins, R. W., & Fend, H. A. (2014). Low and decreasing self-esteem during adolescence predict adult depression two decades later. Journal Of Personality And Social Psychology, 106(2), 325-338. doi:10.1037/a0035133
Wagner, J., Gerstorf, D., Hoppmann, C., & Luszcz, M. A. (2013). The nature and correlates of self-esteem trajectories in late life. Journal Of Personality And Social Psychology, 105(1), 139-153. doi:10.1037/a0032279
Trends in employment reflect the market demands and growth rate in correlated and respective industries. Service industries have experienced an increased demand for employees over during the later part of the past decade. Data in 2009 showcased a 13% increase in service sector jobs while only a 10% increase was observed in financial and managerial sectors. Understanding and recognizing labor market trends is important to the field of vocational and career counseling as the trends reflect potential opportunity and the theoretical strategies used (VanVoorhis, et. al., 2012).
Global events such as the COVID-19 pandemic have greatly shifted the employment space. Many Americans have experienced job loss due to the health and safety quarantine while others have experienced radical changes to the work environment and workflow. Additionally, the reopening of the country leaves a divide between the need to return to work and the apprehension of recurring outbreaks. Many industries have begun to address such shifts, but the uncertainty still remains.
Several contemporary economists have released predictions that showcase significant changes to corporate hiring strategy. Cheremond (2020) predicts that at least “32% of organizations are replacing full time employees with contingent workers as a cost-saving measure”. This suggests that employees retuning to work may experience reduced vocational security in a post-COVID environment.
Some companies have begun to acknowledge the volatile nature of a contingent based workforce. HR departments have increased the provision of benefit packages to increase sick leave, financial assistance, and adjust working schedules to accommodate childcare provisions. Such companies respond to the potential needs of employees as a tool to recruit top tier employees (Cheremond, 2020) to an unstable market.
Other trends include the increase of remote work as organizations alter workflow processes. Company hiring practices will include the expectation of new hires to have a degree of comfort with technology and remote work strategies. Additionally, many companies will require their workforce to utilized key skills within multiple roles (Cheremond, 2020). This shifts the emphasis away from hiring specific roles and focuses on hiring employees who can utilize critical skills in multiple roles.
The idea that automation will become an increasing presence in the workplace has been a topic of discussion for some time. Democratic presidential nominee Andrew Yang extensively discussed the growing concern of industry replacing people with automation. Concerns surrounding wages, trade negotiations, spur a discussion surrounding the concept of a universal basic income wile workers adapt to increased education and skills needed.
Many potential employees will consider the way in which an organization responded to the pandemic crisis. Top tier recruits will have a degree of negotiating power as they may have other potential opportunities. On the contrary, individual on the lower socioeconomic scale may have less options and negotiating power. Many will find themselves experience economic hardship and become relocated to accept a position within a company that dehumanizes employees by devaluing safety and employee wellbeing.
As the post-COVID work environment continues to take shape, it is important for vocational and career counselors to remain up to date on various trends within their relevant community or area of service. Theory driven interventions that acknowledges the ‘wholeness’ of the individual, potential environmental factors, life transitions, and motivations will become increasingly important when working with clients (Yates, et. al., 2017).
Existential philosophy reflects the desire to understand a deeper human condition through the emphasis of purpose and meaning. It is often reflected in the form of angst experienced by individuals in their daily lives and in the post agricultural societies. The industrialization and increased automation of work increases individual isolation and decreases a purposeful connection to work (Sterner, 2012). Thus, existential philosophy is applicable when seeking to identify patterns within contemporary work relations.
The philosophical emphasis on freedom, meaning, and death suggests that existential psychology is somewhat amorphous and can be applied to many aspects of a client’s wellbeing. Working to align with client’s values related to meaning and purpose presents a well-suited approach to working thought periods of adjustment. If an individual’s career trajectory is viewed as a series of adjustments related to work, existential philosophy becomes applicable when navigating adjustments within a complex system of employment related concerns (Sterner, 2012).
Sterner (2012) argues that in a postmodern workforce, less emphasis is placed on the alignment of traits when seeking career opportunities. Workers often seek career opportunities that reflect the fundamental existential pillars of purpose and meaning. There is a common duality that exists between the individuals and their environment in which the individual and the environment engage in reciprocal interactivity and influence. This creates a sense of tension as the point in which the individual stops and the social sphere begins is often ambiguous, creating a sense of fluidity and motion. Physics would ultimately describe the phenomenon as interacting field systems (Martin, 2003, & Wagmans, et. al., 2012) and the concept would extend into other domains of philosophy, psychology, social science, and economics.
Gestalt concepts in psychology and philosophy recognize that the individual is more then the sum of its parts by being both part of and different then its parts. In essence, the reciprocity between the individual internal and external filed of influence create a ‘whole’ in which perception switches between the internal and external by means of temporal states and sensory input (Wagmans, et. al., 2012, Kohler, 1947, & Ellis, 1930). It is this perception of pressure from the internal self and the external world that drive motivation, and the construction of meaning and purpose.
Contemporary Career Conceptualization
The contemporary concept of work has evolved as societal changes occur forcing the reevaluation of the ‘career’ to reflect such change. Prior to the 21st century, careers were akin to a linear trajectory or the movement up a defined career ladder (Swanson, & Fouad, 2015). Social and economic changes within a more digital, multicultural, and global economy shift the average career trajectory. Jobs have become less permanent and reflect the proliferation of temporary assignments (Brown, & Lent, 21013).
Today one’s career path often consists of several protein careers in which the individual constructs their own unique narrative (Swanson, & Fouad, 2015, & Brown, & Lent, 2013). Contemporary careers are no longer conceptualized as a ladder. Instead individual career progression often resembles a trellis in which a series of lateral, parallel, and perpendicular steps lead to a larger career goal.
Career Construction Theory and the Life Design Paradigm
Mark L. Savikas is one of many contemporary career theorists who expanded on the work of Super’s life-span, life-space theory. He proposed his Career Construction Theory and the Life Design Paradigm as a way to understand the broader connection of the ‘self’ to career and vocational paths. The origins of Career Construction Theory have roots in Super’s work, yet diverge to so some degree (Swanson, & Fouad, 2015) to emphasize the active role of the individual in vocational evolution.
Career Construction Theory and the Life Design Paradigm focus on the process through which individuals construct their sense of self, engage is self-determinism by deliberate vocational behavior, and construct personal meaning form their careers. The primary concept emphasized and active self-construction which begins during childhood. (Savickas, 2013, & Swanson, & Fouad, 2015).
The construction of the self is a multilayered process consisting of complex phases of reflecting and experiencing. Language represents a way to shape identity by providing a means to project subjective aspects of the self and who the individuals intends to be. During childhood, children serve as actors playing a social role (Brown, & Lent, 2013) within the context of their environment. Here beliefs surrounding personal abilities, values, and actions are incorporated into the self-schema which is then reflected back into their environment for appraisal (Lo & Abbott, 2019, & Tafarodi, 1998). This can also be illustrated and supported through Charles Colley’s looking glass theory.
As individuals mature, the sense of self becomes subjective. Savikas (2013) suggests that the individual embarks on a journey of self-discovery and become an agent. Self-discovery and subjectivity reflect the individual’s journey toward self-determination. The individual can progress through a hierarchy of goals and achievements that resemble a bureaucratic social structure. This self-discovery process mirrors Maslow’s hierarchical development toward self-actualization. The self as agent reflects a sense of career adaptability that has its evolutionary origins in Super’s concept of career maturity (Brown, & Lent. 2013, & Swanson, & Fouad, 2015).
Individuals move through their career path transitioning from actors to agents, and finally authors. Reflection of patterns throughout the individual life enables the construction of experiences and influences into a constellation of purposeful goals. The narration of experiences enables individuals to construct resumes and occupational plotlines that represent the sequence of career transitions and adjustments. This helps to crystalize meaning and purpose in the individual’s relationship to work (Savikas, 2013, & Brown, & Lent. 2013).
Savikas’ concept of career adaptability evolved out of Super’s concept of career maturity in which the individual moves through four dimensions related to concern, control, curiosity, and confidence. The concept of career concern and career indifference introduces the use of Holland’s RIASEC code during career and vocational education trajectories thar reflect the optimism of the individual as actor. The concept of career control and career indifference reflects the choice or apathy one might experience as a self-discovery agent. Career curiosity and career indifference further reflect the curiosity of career construction and adaptation. Career confidence and career inhibition reflects the self-efficacy of success or failure along a career progression illustrated by the individual as author (Swanson, & Fouad, 2015).
Happenstance Learning Theory
In a similar manner, contemporary career theorist John D. Krumboltz considered the everchanging influences and interests that shape career progression. He introduced the Happenstance Learning Theory which acknowledged career progression as a free flow of exploration that need not be planned. His theory focused on achieving satisfaction in the individuals personal and professional life by participating in various beneficial activities such as lifelong learning and remaining open and alert to alternative opportunities (Krumboltz, 2008).
The happenstance of unpredictable events leads to outcomes that no one could predict or foresee. This echoes the idea of an unknow destiny permeates Krumboltz work. Krumboltz believed that human behavior is the product of both planned and unplanned experiences from which the individual learns and develops skills, beliefs. Preferences, sensitivities, and emotions. The idea of destiny enters by way of the life experiences and influences which the individual cannot control. Individuals are able to alter their destiny by choosing to focus on a particular aspect of their situation and employ a particular belief or behavior. Individuals who are open to various options and outcomes are able to capitalize on the unknown and engage in self-initiated actions related to personal strengths learned over the lifetime (Krumboltz, 2008).
The idea of destiny is rooted in the existential postmodern concept of purpose and meaning. The notion of freedom and choice reflect the dimensions of adaptability to circumstance and hazard. Destiny in essence is designed to question the freedom and choice related to the deterministic notion of external forces (Dion, 2009).
Krumboltz was highly interested in understanding the various influences on human behavior. He cites the work of several noteworthy theorists including Ellis, Bandura, Watts, Zimbardo, and Schroeder to illustrate the various influences. Genetic influence illustrates aspects of heritability that connect brain function to social behavior. Twin studies connect psychological variables of interests, aptitudes, and career interests to genetic predisposition (Krumboltz, 2008). Genetics also acknowledges that predispositions make up some of the internal influence that is beyond the control of the individual.
Learning experiences are constant throughout the lifetime and stem from observations about the larger world. Learning shapes generalizations and enables individuals to self-identify with a particular way of being and cement beliefs based on social feedback. Associative forms of learning enable children to observe the environmental behaviors of others as well as the corresponding consequence. Judgments are made that relate to preferred behavior by means of emulation. Here the family environment and socioeconomic status, and media influence the types of learning experiences available (Krumboltz, 2008, Thelamour, et. al., 2019).
The environment in which an individual finds themselves has a powerful influence on beliefs and behaviors. The concept of individual attachment illustrated through Bowlby’s attachment theory connects patterns of behavior to environmental conditions and self-concept. Bonds with key individuals throughout the lifetime influence the level of lifelong anxiety and confidence (Krumboltz, 2008, Broderick, & Blewitt, 2010, & Gibson & Schwartz, 2008). The experiences within one’s community and social environment further solidify identity, values, and belonging.
These influences and many more combines with dimensions of social inequality that provide or limit opportunities for individuals as they follow areas of developed interest. Individuals align themselves with education, mentors or leaders, and environments that reflect their particular life space at any given moment. This alignment or happenstance of circumstances enable people to find themselves in roles unrelated to their initial career ambitions or intended career fields. Personal fulfillment is found through the expansion of knowledge and interdisciplinary learning across many spheres of environmental influence. This enables the individual to develop a rich arsenal of experiences that enable fluid movement throughout the career trajectory. (Krumboltz, 2008).
Comparison and Application
In many ways, both Career Construction Theory and the Life Design Paradigm and Happenstance Learning Theory view career progression as a personal journey. Both theories recognize the influence of life experience, situations, and circumstance on career and vocational outcome. Over the course of the lifetime various fields of influences shape the individual and create a ‘whole’ or ‘self’. The individual is both consisting of sum of their influences and experiences yet separate from their influences and experiences as outlined in gestalt philosophy. Reactions or adaptations to the internal and external drive the progression of a career journey.
Key differences in the theories lie in the active or passive role of the individual. Career Construction Theory and the Life Design Paradigm views the individual as an active participant in building and shaping their career potential. This is keenly noted in Savikas’ (2013) self-deterministic framework as the individual fulfills the role of actor, agent, and author of their career progression. Three key types of interventions occur throughout the vocational lifespan. Vocational guidance reflects the matching of traits and aptitudes developed during early roles of individual as actor. Career education refers to the various stages of career readiness and vocational development as the individual assumes agency. Career counseling focuses on stories and themes throughout the individual life narrative and personal design paradigm through a narrative interview that guides further career progression (Swanson, & Fouad, 2015).
Happenstance Learning Theory views the individual as a passive participant who employees various personal strengths to capitalize on unpredictable circumstances and situations. This enables individuals to adapt and move through transitions of life in general. The flexibility of happenstance enables career transformation during difficult times such as economic decline and periods of unemployment (Krumboltz, 2008).
Our Present Predicament
As we enter another period of economic uncertainty and instability, career and vocational counseling will impact the wellbeing of many individuals. The use of both Career Construction Theory and the Life Design Paradigm and Happenstance Learning Theory provide insight to fulfillment and transition. Both theories are strongly rooted in the existential and gestalt philosophy that acknowledges the influence of external spheres and the conflict between freedom and determinism. Using the narrative interview derived form a stage like progression of constructed and deliberate choices allows counselors to better understand the needs and goals of the individual. The fluidity of happenstance and circumstance enables individuals to reduce anxiety related to the unknown and situations that are outside of their control, while finding meaning and purpose in their relationship to work.
References
Broderick, P. C., & Blewitt, P. (2010). The lifespan: Human development for helping Professionals (3rd. ed.). Boston, MA: Allyn & Bacon.
Brown, S. D., & Lent, R. W. (Eds.). (2013). Career development and counseling : Putting theory and research to work. Retrieved from https://ebookcentral-proquest-com.library.capella.edu
Dion, M. (2009). Human Destiny at the Edge of Existential Categories of Life: Musil and Kundera in Dialogue. Existence, Historical Fabulation, Destiny, 345–357. doi: 10.1007/978-1-4020-9802-4_22
Gibson-Beverly, G., & Schwartz, J. R. (2008). Attachment, Entitlement, and the Impostor Phenomenon in Female Graduate Students. Journal of College Counseling, 11(2), 119–132. https://doi.org/10.1002/j.2161-1882.2008.tb00029.x
Kohler, W. (1947). Gestalt Psychology. New York. NY: Liverlight
Lo, A., & Abbott, M. J. (2019). Affective, cognitive, and behavioural responses to repeatedly demanding performance expectations across adaptive and maladaptive dimensions of perfectionism. Canadian Journal of Behavioural Science / Revue Canadienne Des Sciences Du Comportement, 51(4), 278–289. https://doi-org.library.capella.edu/10.1037/cbs0000144
Thelamour, B., George Mwangi, C., & Ezeofor, I. (2019). “We need to stick together for survival”: Black college students’ racial identity, same-ethnic friendships, and campus connectedness. Journal of diversity in Higher Education, 12(3), 266–279. https://doi-org.library.capella.edu/10.1037/dhe0000104
Wagemans, J., Elder, J. H., Kubovy, M., Palmer, S. E., Peterson, M. A., Singh, M., & von der
Heydt, R. (2012). A century of Gestalt psychology in visual perception: I Perceptual grouping and figure–ground organization. Psychological Bulletin, 138(6), 1172–1217. https://doi-org.library.capella.edu/10.1037/a0029333
Vocational and career counseling has always had direct ties to historical events and cultural trends. The notion that people dedicate large swaths of time to work is a testament to the socio-cultural importance of work. Parsons recognized this in during the second industrial revolution in the early 1900s; a period known for extreme economic inequality and intense labor disputes. His ideas emphasized an occupational fit during a time of increased urbanization, need for factory labor (Stebnicki, 2015), and a culture consisting of extremes.
During the mid-1900s, the rise of fascism and Nazi occupation in Europe saw many noteworthy psychiatrists and psychologists seek refuge from persecution in America. Concepts such as behaviorism, Gestalt philosophy, cognitive, and personality theory mixed with existing emphasis on scientific measurement and correlative outcome (Hunt, 2007). Interests in gender roles, social values, and childhood upbringing paved the way for career theorists to recognize the evolution of occupational interest over the course on one life. The 1950s saw an integration of work and leisure into the construct of the self and the cold war era saw the increased demand science and technology industries (Stebnicki, 2015, & Sperdakos, 2002).
Economic factors influence career and vocational trajectories. The Socio-cognitive model highlights levels of commitment and anxiety related to career decision making. Contextual societal supports provide means to self-efficacy and comfortability in career exploration while barriers inhibit exploration, goal setting, and potential outcome (Lent, Wang, Morris, Ireland, & Penn, 2019). This is true on a more intimate familial level as well as a larger social level. In economic recessions or depressions, barriers to employment are high leaving those with limited means in a more vulnerable position to secure career fulfillment. Emphasis is placed on survival and securing monetary income. During times of economic expansion, there is often a reduction in societal barriers that afford more people the latitude to engage in career exploration.
We are presently living through an event which will certainly leave its mark and shape our future. The COVID-19 crisis has fundamentally altered the concept of economy and work. Quarantine and social distancing measures have limited commerce in most industries deemed non-essential. This has resulted in a rapid increase of unemployment as companies and freelancers are unable to maintain operation.
Viruses and pandemics are nothing new. Humans have existed alongside of deadly viruses and bacteria since the beginning of time. Each rise of deadly illness has had effects on the civilizations and economies effected. Anxiety surrounding the illness itself is compounded by the economic response of the governments of the time. The preparedness or unpreparedness of a society has a lasting effect on the greater social psyche. Such notions have effects that echo through the public and private sectors of work (Wolf, 2020).
While we may not yet understand the extent of COVID-19’s impact on work, we do understand that there will likely be fundamental shifts in its aftermath. Many companies have set up opportunities for employees to continue to sustain employment via remote work (Wolf, 2020) through various digital platforms. This shift is likely to highlight the value of remote work for many industries. Career and vocational counselors will be part of the adaptation assisting both employers and employees navigate the challenges and benefits of a more remote workforce.
The greater psychological community has widely accepted the idea that isolation has negative consequences. At present we are seeing polarized responses to social distancing and quarantine measures which is both health and financially oriented. This becomes rather apparent if one follows activity on any social media platform. The commonality between polarized responses appears to be the complex combination of fear and anxiety caused by unknown health outcomes, financial means, and the break down in daily schedules or structure.
Children are impacted as education remains halted. Parents struggle to balance work, continued remote education, and daily childrearing obligations in households with a moderate income. Children of low-income household loose access to the benefits provided by public schools such as student food programs and afterschool care (Wilkinson, & Pickett, 2007). Many low-income households may be unable to provide optimum alternatives for continued education.
Income inequality and extreme class striations impact overall health and psychological outcomes. Those existing in neglected or impoverished communities face hardships that those in higher income and socio-economic classes do not. As income disparity and stratification increases, trust, corporation, and reciprocity decrease between class divisions (Wilkinson, & Pickett, 2007). This breakdown increases the potential for criminality and exploitation as a form of to make ends meet (Wolf, 2020). We have begun to witness reports of larger employers engaging in exploitive practices of both customers and employees as well as reports of increased petty crimes in COVID-19 affected communities.
As career and Vocational counselors, we will need to consider these effects on the concept of work and society as we engage in recovery efforts. Counselors can use their advocacy platforms to aid in increased pay and benefits for low wage essential workers and consult with companies surrounding recruitment strategies for hard to fill positions. This may include shifts in compensation benefits, in the notion of work life balance, and the flexibility to increase remote work options.
Work offers social connection, inclusion, and friendships for many people (Brown & Lent, 2013). In the absence of work, many communities are coming together to offer support. Digital groups are forming to increase social activity, and many are finding meaning in volunteer activities to help aid those most effected. It may be safe to suggest that we are beginning to see a shift in the relationship between purpose and social contract within vocational spheres that reflect a more corporative society.
In the upcoming months and throughout the duration of the pandemic crisis, career and vocational counselors will play a significant role in helping many who are employer and unemployed. Counselors can help emphasize, create, and develop a new sense of route and structure to combat social isolation, loneliness, and loss of purpose due to the lack of work. Counselors will also help people connect to and learn new digital networking platforms in order to access work. Most important, career and vocational counselors can help society shift the emphasis away from being ‘the best’ and our obsession with hyper productivity to one in which we embrace radical acceptance and become comfortable in our personal limitations.
Hunt, M. (2007). The story of psychology. New York, NY: Anchor Books. ISBN 9780307278074
Lent, R. W., Wang, R. J., Morris, T. R., Ireland, G. W., & Penn, L. T. (2019). Viewing the Career Indecision Profile within a theoretical context: Application of the social cognitive career self-management model. Journal of Counseling Psychology, 66(6), 690–700. https://doi-org.library.capella.edu/10.1037/cou0000367
Wilkinson, R.G., & Pickett, K.E. (2007). The enemy between us: The psychological and social costs of inequality. European Journal of Social Psychology. https://doi.org/10.1002/ejsp.2275
Wolf. R.D. (2020, April 13). Economic Update: The Psychological Aspects of Today’s Crises featuring Tess Fraad Wolf. Democracy at Work. Retrieved from https://youtu.be/ZA02qZndDSA
Advocacy is an important component of the role of counselors. By definition, advocacy is the act of working toward improving the welfare of their clients by bringing awareness to issues within the mental health filed. Over the years the American Counseling Association had advocated for the advancement and strengthening of the counseling profession. Often times counselors advocate for their role within a particular context or for the overall profession (Erford, 2018). Other times counselors advocate for a specific cause related to their counseling domain.
The concept of healthcare reform has been around for several years and has become a focal topic in many recent political campaigns. Healthcare reform impacts the mental health community as changes to healthcare policy have the potential to shift who can access what types of mental healthcare. Serious mental illness including chronic psychosis, depression, anxiety, and substance use disorders presently account for the majority of disability claims worldwide. The cost of serious mental health care has risen exponentially and when left untreated leads to premature morality rates (Kilbourne, Keyser, & Pincus, 2010).
Under our present system, the cost of treating individuals without adequate healthcare is shifted to the general population by means of fees, service costs, and point of service charges. In 1991, it was estimated that the burden of healthcare for underinsured populations was more than $21 billion (Daschle, Cohen, & Rice, 1993). Multi-payer insurance providers form a patchwork system consisting of in network and out of network services which may shift depending on a client’s coverage package.
As a result, there is an increase in administrative costs allocated to managing the paperwork required to navigate the current healthcare system. Misallocation of funds has led to research in tertiary healthcare procedures while less glamorous areas of healthcare have been deemphasized. Additional aspects of a fee-for-services system has complicated immediate access to care and benefitted some organizations with internal referral systems where unnecessary services are provided (Daschle, Cohen, & Rice, 1993).
This has created what Kilbourne, Keyser, & Pincus (2010) call a cook-book method of treatment where organizations operate within silos rather than integrative treatment through collaborative efforts. Fee-for-service is often evaluated on 3 major domains; structure, process, and outcome with the rationale that mental healthcare resources and policies inform process used by clinicians. In practice, evaluation of fee-for-service systems have emphasized the characteristics of the treatment setting including infrastructure and staffing over quality of care.
The art of counseling relies heavily on the therapeutic relationship through the emphasis of person-centered approach. The core of person-centered counseling emphasizes unconditional positive regard, congruence, and accurate empathy that empowers a client to examine patterns of behavior and reflect on opportunities for personal growth and well-being (Cormeier, & Hackney, 2012). The quality of care provided becomes difficult to measure under a fee-for-service medical model where a client-therapist fit should take precidence.
Under a single payer system, a single publicly financed insurance fund would cover all Americans evenly while ensuring access to comprehensive mental healthcare despite income, employment, or that ability to cover out of pocket expenses (Hsiao, Kinght, Kappel, & Done, 2011). Several single-payer proposals exist that illustrate more subtle nuances such as funding at the federal or state level (Daschle, Cohen, & Rice, 1993) and implementation strategy. Programs similar to Medicaid/Medicare offer flexibility in coverage to include medical, psychological, and homeopathic treatments. This would allow flexibility in treatment approach for counselor to tailor their therapeutic methodology to fit each client on an individual level; emphasizing a client-centered, counselor-client fit.
Presently, there are several barriers preventing the implementation of a single-payer system. Advocacy against healthcare reform comes heavily from the for-profit insurance industry. Accessing information surrounding policy on healthcare reform is limited and often difficult to understand. I personally struggled to find free resources that outlined policy in an easy to digest manner and much of my understanding has come from previously reading Senate Bill 1129 introduced to the 116th Congress this past May. I feel it is safe to assume that many counselors and mental health practitioners may not fully understand the implementation of healthcare reform on their personal practices and livelihoods. Advocacy serves as an avenue to break down complex congressional legislature into digestible articles that can be read and understood easily.
References
Cormier, S., & Hackney, H. (2012). Counseling Strategies and Interventions (8th ed.). Pearson. ISBN 10: 0-13-707018-7
Erford, B. T. (2018). Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations (3rd ed.). New York, NY: Pearson.
Hsiao, W.C., Kinght, A.G., Kappel, S., & Done, N., (2011). What Other States Can Learn From Vermont’s Bold Experiment: Embracing A Single-Payer Health Care Financing System. Health Affairs. Retrieved from https://doi.org/10.1377/hlthaff.2011.0515
Kilbourne, A. M., Keyser, D., & Pincus, H. A. (2010). Challenges and Opportunities in Measuring the Quality of Mental Health Care. The Canadian Journal of Psychiatry, 55(9), 549–557. https://doi.org/10.1177/070674371005500903
Sanders, Baldwin, Blumenthal, Booker, Gillebrand, Harris, Leahy, Markey, Merkley, Schats, Udall, Warren, Whitehouse, Hirono, & Heinrich. (2019) Senate Bill 1129. 116th Congress. 1st Session. Medicare for All Act of 2019. Retrieved from https://www.congress.gov/bill/116th-congress/senate-bill/1129/text
Socioeconomic status includes aspects of ownership, wealth, and class identity. Gradients between rich and poor highlight the variation of outcome linked to mental and physical health outcomes, access to resources, opportunity, and education. Socioeconomic status provides a pathway to power through access and acceptance in a status-driven western economy. As socioeconomic differences increase, so does the subjective emphasis on the importance of status and income (Wilkinson, & Pickett, 2017).
Dominance hierarchies form a social organizational structure through which individuals are stratified into a class system. Stratifications encompass more than financial status, further dividing individuals based on cultural drivers and social values. Stratified societies maintain a ranking system used to evaluate and maximize perceived value within the hierarchy. Social ranking is based on access to valuable or scarce resources and the accumulation of resources provides a pathway to power (Wilkinson, & Pickett, 2017).
Egalitarian framework counterbalances resource-based social ranking systems to a small degree through the value of generosity and selflessness. Cultural aspects associated with selflessness and community provide an avenue through egalitarian endeavors provide recognition and prestige. However societal inequality increases internal status-driven anxiety as socioeconomic based access becomes a valuable attribute (Wilkinson, & Pickett, 2017).
According to an intrapersonal perspective, global self-esteem is based on an individual’s perception of performance in domains deemed important. American societal constructs emphasize a high degree of value and prestige associated with socioeconomic status and occupations. High education, income, and status-based occupations are valued in American society and serve as a basis of assessing an individual’s worthiness (von Soest, Wagner, Hansen, & Gerstorf, 2018). This in turn serves as a validation for self-esteem in adults.
Interpersonal framework emphasizes the role of social interaction and social symbolism on self-esteem. Individuals who maintain healthy social interactions experience higher self-esteem outcomes. On the contrary, individuals with poor social connections experience low self-esteem outcomes. The internalization of the perceptions of others establishes a framework for self-evaluation. Individuals with low socioeconomic status are often marginalized and alienated in professional roles. Threats of social exclusion negatively influence self-perception (von Soest, Wagner, Hansen, & Gerstorf, 2018) leading many individuals to increase socioeconomic standing as a form of social inclusion.
Social mobility becomes restricted by socioeconomic class origins as cultural worldviews are influenced by economics and access to resources. The expectations and demands that culture places on the individual limits the ability to transcend socioeconomic stratifications. Awareness of the degree in which socioeconomic stratification impacts self-esteem drives many high achieving individuals to pursue avenues to socioeconomic advancement (Sánchez, Liu, Leathers, Goins, & Vilain, 2011).
Individuals experience class mobility in three directions, their class or origin, their current class, and their class as others ascribe them. Throughout life, individuals move between classes shifting their sense of self and belonging. Individuals of lower or working classes find themselves straddling class divisions and developing the need to operate between two distinct class identities. Lower income classes are often faced with the choice to be loyal to their class of origin, while striving to achieve career goals. In order to achieve career goals, individuals are often forced to assimilate into cultural norms and expectations of a higher socioeconomic class. This frequently results in the individual feeling alienated from both class environments (Ardoin, 2018).
Imposter Phenomenon relates to one’s desire to appear in a particular manner within a peer group (Langford, & Clance, 1993). Individuals shift between social classes throughout educational and career progression. Transitioning socioeconomic class is a source of anxiety for many individuals. Individuals in working classes find themselves to be out of place when working toward financial and occupational advancement. There is a lack of comfortability and belonging to both the aspirational social class and the social class of origin (Ardoin, 2018). Straddling socioeconomic classes results in behavioral adaptations of separate personas when interacting in each class.
American mythology maintains the belief that higher education is a pathway to upward mobility despite the socioeconomic stratifications of one’s origin (Sánchez, Liu, Leathers, Goins, & Vilain, 2011). Socioeconomic position encompasses aspects of education and the prestige associated with institutions of higher education. Higher education continues to be an avenue for socio-economic mobility by serving as a training ground for the labor market. Human capital theory connects educational qualifications to employee productivity and thus increased earning potential. Employers often select employees based on educational credentials (Delaney, & Farren, 2016).
Institutions of higher education have a longstanding history of inequality and exclusionary practices based on socioeconomic status. The increasing cost of education, ranked and selective admissions, and tuition assistance contribute to contribute to illusion of education as a privilege. Students are often expected to conform and assimilate in order to “catch up” to more well-off peers (Ardoin, 2018).
Many individuals from lower socioeconomic classes choose avenues of distance learning or pursue lower level higher educational qualifications in order to balance financial and academic responsibilities (Delaney, & Farren, 2016). Those who do gain entrance to prestigious institutions or purse high level educations experience a marginalization and find difficulty connecting to peers in higher socioeconomic positioning (Ardoin, 2018). As higher education is a prerequisite for many forms of employment, individuals from lower socioeconomic standing are forced to assimilate with a new socioeconomic culture while mitigating the dissonance of class identity.
Aspects of social expression through dress, dialect, and manners contribute to the perception of a particular social standing sending a message that is then affirmed by society (Ardoin, 2018, & Wilkinson, & Pickett, 2017). Individuals with low self-esteem rely on the validation of others and are often compelled to adopt the behavioral patterns and appearance of the aspirational social class. Straddling socioeconomic class divisions contribute to additional dissonance surrounding one’s identity. The feeling of fraudulence may be increased due to conforming with social class expectations of two groups in varying environments. The desire to be validated within the aspirational in-group is compounded by intense fear and anxiety that that group will recognize an individual’s fraudulence (Gibson & Schwartz, 2008) which ultimately increase the occurrence of Imposter Phenomenon at the socioeconomic level.
Gibson-Beverly, G., & Schwartz, J. R. (2008). Attachment, Entitlement, and the Impostor Phenomenon in Female Graduate Students. Journal of College Counseling, 11(2), 119–132. https://doi.org/10.1002/j.2161-1882.2008.tb00029.x
Langford, J., & Clance, P. R. (1993). The imposter phenomenon: Recent research findings regarding dynamics, personality and family patterns and their implications for treatment. Psychotherapy: Theory, Research, Practice, Training, 30(3), 495–501. https://doi-org.library.capella.edu/10.1037/0033-3204.30.3.495
Sánchez, F. J., Liu, W. M., Leathers, L., Goins, J., & Vilain, E. (2011). The subjective experience of social class and upward mobility among African American men in graduate school. Psychology of Men & Masculinity, 12(4), 368–382. https://doi-org.library.capella.edu/10.1037/a0024057
von Soest, T., Wagner, J., Hansen, T., & Gerstorf, D. (2018). Self-esteem across the second half of life: The role of socioeconomic status, physical health, social relationships, and personality factors. Journal of Personality and Social Psychology, 114(6), 945–958. https://doi-org.library.capella.edu/10.1037/pspp0000123
Wilkinson, R. G., & Pickett, K. E. (2017). The enemy between us: The psychological and social costs of inequality. European Journal of Social Psychology, 47(1), 11–24. https://doi-org.library.capella.edu/10.1002/ejsp.2275
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