Psychiatric Rehabilitation & Young Adults with Serious Mental Health Conditions

Research Paper Title

Factors that hinder or facilitate the continuous pursuit of education, training, and employment among young adults with serious mental health conditions.

Background

This study can inform psychiatric rehabilitation practice by describing the patterns of education, training, and employment activities among young adults with serious mental health conditions and identify potentially malleable factors that hinder or facilitate their ability to continuously pursue these activities.

Methods

One-time, in-person interviews were conducted with 55 young adults, ages 25-30, with serious mental health conditions in Massachusetts. The life story interview script asked participants about key life and mental health experiences and details about their education, training, and employment experiences.

Results

Young adult paths’ through post-secondary school, training, and work were often non-linear and included multiple starts and stops. Many young adults reported unsteady and inconsistent patterns of school and work engagement and only half were meaningfully engaged in education, employment, or training at the time of the interview. Employment often included service industry jobs with short tenures and most who had attempted post-secondary college had not obtained a degree. Barriers to continuous pursuit of school, training, or work included stress-induced anxiety or panic, increased symptomatology related to their mental health condition, and interpersonal conflicts. Flexible school, training, and work environments with supportive supervisors helped facilitate the continuous pursuit of these activities.

Conclusions

Psychiatric rehabilitation professionals need to help young adults with serious mental health conditions manage stress and anxiety and periods of increased symptomatology, navigate interpersonal challenges, and advocate for flexible and supportive accommodations. Early and blended education and employment supports would also be beneficial.

Reference

Sabella, K. (2021) Factors that hinder or facilitate the continuous pursuit of education, training, and employment among young adults with serious mental health conditions. Psychiatric Rehabilitation Journal. doi: 10.1037/prj0000470. Online ahead of print.

On This Day … 27 February

People (Births)

People (Deaths)

  • 2012 – Tina Strobos, Dutch physician and psychiatrist (b. 1920).

Roberto Assagioli

Roberto Assagioli (27 February 1888 to 23 August 1974) was an Italian psychiatrist and pioneer in the fields of humanistic and transpersonal psychology. Assagioli founded the psychological movement known as psychosynthesis, which is still being developed today by therapists and psychologists, who practice the psychological methods and techniques he developed. His work, expounded in two books and many monographs published as pamphlets, emphasized the possibility of progressive integration, or synthesis, of the personality.

Assagioli received his first degree in neurology and psychiatry at Istituto di Studii Superiori Pratici e di Perfezionamento, in Florence in 1910. It was during this time he began writing articles that criticised psychoanalysis in which Assagioli argued a more holistic approach.

Once he finished his studies in Italy, Assagioli went to Switzerland, where he was trained in psychiatry at the psychiatric hospital Burghölzli in Zürich. This led to him opening the first psychoanalytic practice in Italy, known as Istituto di Psicosintesi. However, his work in psychoanalysis left him unsatisfied with the field of psychiatry; as a whole, as he felt that psychoanalysis was incomplete.

Tina Strobos

Tina Strobos, née Tineke Buchter (19 May 1920 to 27 February 2012), was a Dutch physician and psychiatrist from Amsterdam, known for her resistance work during World War II. While a young medical student, she worked with her mother and grandmother to rescue more than 100 Jewish refugees as part of the Dutch resistance during the Nazi occupation of the Netherlands. Strobos provided her house as a hiding place for Jews on the run, using a secret attic compartment and warning bell system to keep them safe from sudden police raids. In addition, Strobos smuggled guns and radios for the resistance and forged passports to help refugees escape the country. Despite being arrested and interrogated nine times by the Gestapo, she never betrayed the whereabouts of a Jew.

After the war, Strobos completed her medical degree and became a psychiatrist. She studied under Anna Freud in England. Strobos later emigrated to the United States to study psychiatry under a Fulbright scholarship, and she subsequently settled in New York. She married twice and had three children. Strobos built a career as a family psychiatrist, receiving the Elizabeth Blackwell Medal in 1998 for her medical work, and finally retired from active practice in 2009.

In 1989, Strobos was honoured as Righteous Among the Nations by Yad Vashem for her rescue work. In 2009, she was recognised for her efforts by the Holocaust and Human Rights Education Centre of New York City.

On This Day … 26 February

People (Births)

People (Deaths)

  • 1930 – Mary Whiton Calkins, American philosopher and psychologist (b. 1863).
  • 1969 – Karl Jaspers, German-Swiss psychiatrist and philosopher (b. 1883).

Emile Coue

Émile Coué de la Châtaigneraie (26 February 1857 to 02 July 1926) was a French psychologist and pharmacist who introduced a popular method of psychotherapy and self-improvement based on optimistic autosuggestion.

Considered by Charles Baudouin to represent a second Nancy School, Coué treated many patients in groups and free of charge.

Sandie Shaw

Sandie Shaw, MBE (born Sandra Ann Goodrich; 26 February 1947) is an English singer. One of the most successful British female singers of the 1960s, she had three UK number one singles with “(There’s) Always Something There to Remind Me” (1964), “Long Live Love” (1965) and “Puppet on a String” (1967). With “Puppet on a String”, she became the first British entry to win the Eurovision Song Contest. She returned to the UK top 40, for the first time in 15 years, with her 1984 cover of the Smiths song “Hand in Glove”. Shaw announced her retirement from the music industry in 2013.

Mary Whiton Calkins

Mary Whiton Calkins (30 March 1863 to 26 February 1930) was an American philosopher and psychologist. As a psychologist, she taught at Wellesley College for many years and conducted research on dreams and memory. Calkins was the first woman to become president of the American Psychological Association and the American Philosophical Association.

Karl Jaspers

Karl Theodor Jaspers 23 February 1883 to 26 February 1969) was a German-Swiss psychiatrist and philosopher who had a strong influence on modern theology, psychiatry, and philosophy. After being trained in and practicing psychiatry, Jaspers turned to philosophical inquiry and attempted to discover an innovative philosophical system. He was often viewed as a major exponent of existentialism in Germany, though he did not accept the label.

On This Day … 24 February

People (Births)

  • 1900 – Irmgard Bartenieff, German-American dancer and physical therapist, leading pioneer of dance therapy (d. 1981).

Irmgard Bartenieff

Irmgard Bartenieff (1900 to 1981) was a dance theorist, dancer, choreographer, physical therapist, and a leading pioneer of dance therapy. A student of Rudolf Laban, she pursued cross-cultural dance analysis, and generated a new vision of possibilities for human movement and movement training. From her experiences applying Laban’s concepts of dynamism, three-dimensional movement and mobilization to the rehabilitation of people affected by polio in the 1940s, she went on to develop her own set of movement methods and exercises, known as Bartenieff Fundamentals.

Bartenieff incorporated Laban’s spatial concepts into the mechanical anatomical activity of physical therapy, in order to enhance maximal functioning. In physical therapy, that meant thinking in terms of movement in space, rather than by strengthening muscle groups alone. The introduction of spatial concepts required an awareness of intent on the part of the patient as well, that activated the patient’s will and thus connected the patient’s independent participation to his or her own recovery. “There is no such thing as pure “physical therapy” or pure “mental” therapy. They are continuously interrelated.”

Bartenieff’s presentation of herself was quiet and, according to herself, she did not feel comfortable marketing her skills and knowledge. Not until June 1981, a few months before she died, did her name appear in the institute’s title: Laban/Bartenieff Institute of Movement Studies (LIMS), a change initiated by the Board of Directors in her honour.

Dance Therapy

She held a position of dance therapy research assistant (1957-1967) to Dr. Israel Zwerling at the Day Hospital Unit of Albert Einstein College of Medicine. Zwerling, a psychiatrist […] was very receptive to further exploration of dance as a therapeutic tool for defusing aggression and anxiety. What particularly reinforced his interest in her was that she had a vocabulary and a notation for recording observations of movement. This became a vital factor in daily observations through the one-way screen, especially of family and therapeutic groups.

Dance therapy was then an emerging field of adjunctive therapy. Bartenieff’s special contribution was in bringing Laban’s work to a field very much in need of movement documentation: [It] provided a method of movement analysis and a system of notation which placed dance therapists on their own professional ground, giving them a language for describing patients’ movements, and eliminating the need to rely on less accurate jargon borrowed from other disciplines.

On This Day … 23 February

People (Births)

  • 1883 – Karl Jaspers, German-Swiss psychiatrist and philosopher (d. 1969).

Karl Jaspers

Karl Theodor Jaspers (23 February 1883 to 26 February 1969) was a German-Swiss psychiatrist and philosopher who had a strong influence on modern theology, psychiatry, and philosophy. After being trained in and practicing psychiatry, Jaspers turned to philosophical inquiry and attempted to discover an innovative philosophical system. He was often viewed as a major exponent of existentialism in Germany, though he did not accept the label.

Jaspers earned his medical doctorate from the University of Heidelberg medical school in 1908 and began work at a psychiatric hospital in Heidelberg under Franz Nissl, successor of Emil Kraepelin and Karl Bonhoeffer, and Karl Wilmans. Jaspers became dissatisfied with the way the medical community of the time approached the study of mental illness and gave himself the task of improving the psychiatric approach. In 1913 Jaspers habilitated at the philosophical faculty of the Heidelberg University and gained there in 1914 a post as a psychology teacher. The post later became a permanent philosophical one, and Jaspers never returned to clinical practice. During this time Jaspers was a close friend of the Weber family (Max Weber also having held a professorship at Heidelberg).

In 1921, at the age of 38, Jaspers turned from psychology to philosophy, expanding on themes he had developed in his psychiatric works. He became a philosopher, in Germany and Europe.

After the Nazi seizure of power in 1933, Jaspers was considered to have a “Jewish taint” (jüdische Versippung, in the jargon of the time) due to his Jewish wife, and was forced to retire from teaching in 1937. In 1938 he fell under a publication ban as well. Many of his long-time friends stood by him, however, and he was able to continue his studies and research without being totally isolated. But he and his wife were under constant threat of removal to a concentration camp until 30 March 1945, when Heidelberg was liberated by American troops.

In 1948 Jaspers moved to the University of Basel in Switzerland. In 1963 he was awarded the honorary citizenship of the city of Oldenburg in recognition of his outstanding scientific achievements and services to occidental culture. He remained prominent in the philosophical community and became a naturalized citizen of Switzerland living in Basel until his death on his wife’s 90th birthday in 1969.

Book: Psychotherapy in Later Life

Book Title:

Psychotherapy in Later Life.

Author(s): Rajesh R. Tampi, Brandon Yarns, Kristina F. Zdanys, and Deena J. Tampi (Editors).

Year: 2020.

Edition: First (1st).

Publisher: Cambridge University Press.

Type(s): Paperback and Kindle.

Synopsis:

Psychotherapy in Later Life is a practical how-to-guide for psychiatrists, psychologists and mental health workers on choosing and delivering evidence-based psychological therapies to older adults.

It covers all the main evidence-based psychological therapies such as cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT), as well as specialist topics such as combining psychotherapy with pharmacological treatments, working with diverse populations and individual versus group therapy.

The World Health Organisation estimates that over the next four decades, the proportion of the world’s older adults will nearly double, from 12% to 22%, and that one in five older adults has a diagnosable mental health disorder.

Given the increasing number of older adults requiring mental health treatment, incorporating talking therapies into treatment plans is key to tackling issues related to polypharmacy, medication interactions and side effects. Written by experts in geriatric mental health, this book provides the most authoritative information on the use of psychotherapy in older adults.

On This Day … 21 February

People (Births)

  • 1892 – Harry Stack Sullivan, American psychiatrist and psychoanalyst (d. 1949).
  • 1914 – Jean Tatlock, American psychiatrist and physician (d. 1944).
  • 1961 – Elliot Hirshman, American psychologist and academic.

Harry Stack Sullivan

Herbert “Harry” Stack Sullivan (21 February 1892 to 14 January 1949) was an American Neo-Freudian psychiatrist and psychoanalyst who held that “personality can never be isolated from the complex interpersonal relationships in which [a] person lives” and that “[t]he field of psychiatry is the field of interpersonal relations under any and all circumstances in which [such] relations exist”. Having studied therapists Sigmund Freud, Adolf Meyer, and William Alanson White, he devoted years of clinical and research work to helping people with psychotic illness.

Jean Tatlock

Jean Frances Tatlock (21 February 1914 to 04 January 1944) was an American psychiatrist and physician. She was a member of the Communist Party of the United States of America and was a reporter and writer for the party’s publication Western Worker. She is most widely known for her romantic relationship with Robert Oppenheimer, the director of the Manhattan Project’s Los Alamos Laboratory during World War II.

The daughter of John Strong Perry Tatlock, a prominent Old English philologist and an expert on Geoffrey Chaucer, Tatlock was a graduate of Vassar College and the Stanford Medical School, where she studied to become a psychiatrist. Tatlock began seeing Oppenheimer in 1936, when she was a graduate student at Stanford and Oppenheimer was a professor of physics at the University of California, Berkeley. As a result of their relationship and her membership of the Communist Party, she was placed under surveillance by the FBI and her phone was tapped.

She suffered from clinical depression and committed suicide on 04 January 1944.

Elliot Hirshman

Elliot Lee Hirshman (21 February 1961) is an American psychologist and academic who is the president of Stevenson University in Owings Mills, Maryland since 03 July 2017. Prior to Stevenson University he served as president at San Diego State University and served as the provost and senior vice president of the University of Maryland, Baltimore County.

On This Day … 15 February

People (Births)

  • 1856 – Emil Kraepelin, German psychiatrist and academic (d. 1926).
  • 1940 – Vaino Vahing, Estonian psychiatrist, author, and playwright (d. 2008).

Emil Kraepelin

Emil Wilhelm Georg Magnus Kraepelin (15 February 1856 to 7 October 1926) was a German psychiatrist. H. J. Eysenck’s Encyclopaedia of Psychology identifies him as the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics.

Kraepelin believed the chief origin of psychiatric disease to be biological and genetic malfunction. His theories dominated psychiatry at the start of the 20th century and, despite the later psychodynamic influence of Sigmund Freud and his disciples, enjoyed a revival at century’s end. While he proclaimed his own high clinical standards of gathering information “by means of expert analysis of individual cases”, he also drew on reported observations of officials not trained in psychiatry.

His textbooks do not contain detailed case histories of individuals but mosaic-like compilations of typical statements and behaviours from patients with a specific diagnosis. He has been described as “a scientific manager” and “a political operator”, who developed “a large-scale, clinically oriented, epidemiological research programme”.

Vaino Bahing

Vaino Vahing (15 February 1940 to 23 March 2008), was an Estonian writer, prosaist, psychiatrist and playwright. Starting from 1973, he was a member of Estonian Writers Union.

Vaino Vahing has written many articles about psychiatry, but also literature – novels, books and plays with psychiatric and autobiographical influence. He has played in several Estonian films.

On This Day … 13 February

People (Deaths)

  • 1964 – Werner Heyde, German psychiatrist and academic (b. 1902).

Werner Heyde

Werner Heyde (aka Fritz Sawade) (25 April 1902 to 13 February 1964) was a German psychiatrist. He was one of the main organisers of Nazi Germany’s T-4 Euthanasia Programme.

Early Life

Heyde was born in Forst (Lausitz), on 22 May 1902, and completed his Abitur in 1920. From 1922-1925, he studied medicine in Berlin, Freiburg, Marburg, Rostock and Würzburg and after short placements at the General Hospital in Cottbus and the sanatorium Berlin-Wittenau became assistant doctor at the Universitätsnervenklinik (university psychiatric hospital) in Würzburg. He obtained his licence to practice medicine in 1926, having completed all courses throughout his studies with top marks.

Career until 1945

In 1933, Heyde made the acquaintance of Theodor Eicke, and became a member of the NSDAP. One year later, he was appointed director of the polyclinic in Würzburg. In 1935, he entered the SS as medical officer with the rank of SS-Hauptsturmführer, and became commander of the medical unit in the SS-Totenkopfverbände. There he was responsible for establishing a system of psychiatric and eugenic examinations and research in concentration camps, and for the organisation of the T-4 Euthanasia Program. Additionally, he also worked as a psychiatric consultant for the Gestapo. He also was leader of the Rassenpolitisches Amt in Würzburg, Seelbergstraße 8, 97080 Würzburg. Later he was accompanied by his Rassenpolitisches Amt assistant, Mr. Johannes Riedmiller aka Kurt Riethmüller aka Hans Riedmüller/Hans Riedmiller.

In 1938, he was appointed chief of staff of the medical department in the SS-Hauptamt (headquarters); in 1939, he became professor for psychiatry and neurology at the University of Würzburg, and from 1940 on he also was director of the psychiatric hospital.

He was replaced as head of the T4 programme by Paul Nitsche in 1941, but continued his involvement as member of the “department Brack” (after the end of World War II, it was never found out what his role there was).

He worked at Buchenwald, Dachau concentration camp and Sachsenhausen concentration camps.

In 1944, he was awarded the SS-Totenkopfring, and before the end of the war and reached the rank of SS-Standartenführer (Colonel).

Life after 1945

After World War II, Heyde was interned and imprisoned, but escaped in 1947. He went underground using the alias Fritz Sawade and continued practicing as a sports physician and psychiatrist in Flensburg. Many friends and associates knew about his real identity, but remained silent even as he was an expert witness in court cases.

His true identity was revealed in the course of a private quarrel, and on 11 November 1959 Heyde surrendered to police in Frankfurt after 13 years as a fugitive. On 13 February 1964, five days before his trial was to start, Heyde hanged himself at the prison in Butzbach.

Literature

  • Klee, Ernst, Das Personenlexikon zum Dritten Reich. S. Fischer Verlag 2003. ISBN 3-10-039309-0.
  • Godau-Schüttke, Klaus-Detlev, Die Heyde/Sawade-Affäre. Nomos Verlagsgesellschaft 1998. ISBN 3-7890-5717-7.

Films

  • 1963 (GDR): The Heyde-Sawade Affair (Category: biography/drama) (Produced in the DEFA-studios for movies, Potsdam, Babelsberg/Eastern Germany. Produced by Bernhard Gelbe; script by Wolfgang Luderer, Walter Jupé and Friedrich Karl Kaul and directed by Wolfgang Luderer. Available via the Foundation German TV and Broadcast Arkhive Babelsberg. Arkhive-No. IDNR 03581. Length: 101 minutes, First run: 03 June 1963 in the television programme No.1 of the German Democratic Republic).

Paintings

In 1965, German artist Gerhard Richter painted Herr Heyde, based on a photo of Heyde’s 1959 arrest.

Book: Psychoanalysis and the Cinema- The Imaginary Signifier

Book Title:

Psychoanalysis and the Cinema- The Imaginary Signifier.

Author(s): Christian Metz.

Year: 1984.

Edition: First (1st).

Publisher: Palgrave Macmillan.

Type(s): Hardcover and Paperback.

Synopsis:

In the first half of the book Metz explores a number of aspects of the psychological anchoring of cinema as a social institution.

In the second half, he shifts his approach…to look at the operations of meaning in the film text, at the figures of image and sound concatenation. Thus he is led to consideration of metaphor and metonymy in film, this involving a detailed account of these two figures as they appear in psychoanalysis and linguistics.