This guide provides information about supporting people with personality disorders. It is a starting point for understanding some of the important issues involved when providing employment assistance to job seekers with a personality disorder.
What are personality disorders?
Personality disorder is a broad term covering a cluster of conditions, with the most common personality disorders being the antisocial, borderline, narcissistic, and dependent types. Personality traits are diagnosed as a personality disorder only when they are inflexible, maladaptive, persisting and cause significant functional impairment or subjective distress.
Generally personality disorders are marked by long standing difficulties with relationships in both social and personal situations. A person may experience difficulties in how they think, feel and relate to others, partially as a result of problems with their own sense of identity. They may also experience difficulties with controlling their emotions and behaviour. The severity of impairment will vary from person to person.
It is important that employment consultants have an appreciation of the impact of 'co-occuring' depression and anxiety on the job seeker, in addition to being aware of individual treatment arrangements. The most appropriate way to achieve this is to work in partnership with treating health professionals wherever possible. This will greatly assist in delivering coordinated and individualised employment related support that can respond to the person’s needs should they change over time.
The Workplace Adjustment Tool contains further information on depression and anxiety. The Workplace Adjustment Tool is a searchable database that allows you to search for ideas for workplace adjustments and solutions based on a particular disability and the type of job being undertaken.
How personality disorders impact on employment
Personality disorders are likely to affect all aspects of obtaining and retaining employment. Most forms of employment involve social contexts in which self discipline and regular social interaction with supervisors, co-workers, and customers is required. There are strong unwritten expectations that people behave nicely in the workplace. This means that any overt displays of negative emotions are unlikely to be tolerated by employers. People with personality disorders can have difficulty with social boundaries and self control and can find it challenging to sustain consistent work behaviour and positive work attitudes.
The characteristics of people with personality disorders can also appear inconsistent from day to day. This can be difficult to understand because we usually expect people to be consistent in their behaviour and attitudes. You may need to work hard to identify the person's strengths as well as trying to understand their unique difficulties and how these relate to each specific work duty.
Examples of the impact on employment of particular features of personality disorder:
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A grandiose view of self-importance—the person is happy to talk endlessly about their life and problems and may have difficulty forming a helping alliance with you because of an inability to balance their personal needs with the needs of the employment service. Job search and workrelated assistance needs include:
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assistance to learn new social skills and learn to have brief conversations, which are focused on the self
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help to identify and consider the needs of others.
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An exaggerated sense of entitlement—the person may not accept the right of the service to decline assistance if he or she does not cooperate and they may be reluctant to accept reductions in income support payments, or may refuse work in entry level jobs. Job search and work related assistance needs include:
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Can be interpersonally inconsistent or exploitative—the person may form closer relationships with some people than others in the workplace which can contribute to social disharmony in the workplace by the person not attempting to relate equally to all staff.
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May lack empathy or be unable to identify with the feelings and needs of others—the person may ask for a high level of assistance, yet may be unwilling to recognise that other employees may also need similar assistance. Job search and work related assistance needs include:
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Can be envious of others or believe others are envious of them—the person may be envious of couples who show affection because he or she craves an ideal love relationship which he or she may have never experienced. Job search and work related assistance needs include:
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Other symptoms may be present such as recurrent anxiety and depression, self harm risk and prior substance abuse—the person may regularly report feeling anxious, depressed or report excessive use of substances; high anxiety may hinder attending work, taking on new tasks, or trying a new way of doing things; self-harm risk will increase with levels of distress. Job search and work related assistance needs include:
Pre-employment strategies
You can assist job seekers with personality disorder to find suitable and durable employment by developing an individualised pre-employment plan that incorporates a discussion and clear agreement on roles and responsibilities between you and the job seeker. The plan should set clear boundaries for the type of help to be provided, its intensity, and the conditions under which assistance can and cannot be provided
Other pre-employment stategies include:
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commencing career planning by eliminating jobs the person does not want to perform and considering educational attainment and work history in order to identify longer term career goals and clarify reasons for wanting employment
- liaising with treating health professionals (with job seeker consent) to identify the need for additional interventions for substance abuse, anxiety and depression, problem solving skills and work-related social skills
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working closely with treating health professionals wherever possible to develop a coordinated approach to monitoring the person's wellbeing or distress
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take seriously any perceived risk of self harm and signs of mental health deterioration, referring these immediately to the treating health professional
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work in partnership to develop strategies to manage sudden deteriorations in mental health
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avoiding administrative delays to commencing job searching and pre-vocational activity—encourage the person to learn the skills to conduct independent job searching.
Job Search
Provide suitably intensive assistance to research, locate, secure and commence suitable employment. If the person can manage job searching without assistance, or they decline assistance, allow them to do this independently. You may also need to provide:
- supportive counselling to help the person manage any employer rejections
- help to solve any non-work related problems that could interfere with job searching and starting work.
Disclosure issues
There is no one answer to the question of disability disclosure for people with personality disorder. Work in partnership with the job seeker to develop a disclosure strategy that accounts for any gaps in employment history. Prepare a statement to explain this to employers in non-medical terms and ensure the job seeker is satisfied with its content. Also seek to describe the possible impact of the condition in an employment setting, rather than describing symptoms. 'Personality disorder' is a particularly stigmatising label and should be avoided whenever possible.
Post placement strategies
Starting a job can be a testing time for any new employee but people with personality disorder need specific assistance to ensure satisfactory integration into the workplace. Ongoing support requirements and the way this support is delivered should be discussed, and again formally agreed, with the worker.
Ongoing support may include:
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working in partnership with treating health professionals to monitor the person's risk of substance use, self harm and signs of mental health deterioration
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regular liaison with the person's treatment professionals
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providing continuing assistance to maintain employment (both on and off site) as long as is needed
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further training in work-related social skills to facilitate appropriate social relationships in the workplace—this could help with job retention and will only be possible if the person is willing to learn new social skills
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providing help to solve any non-work-related problems (for example, personal relationships outside the workplace) that could interfere with continuing employment
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managing work performance and work behaviour by helping the person understand and experience the direct consequences of their actions and choices in the workplace
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providing appropriate support to the employer to design training strategies and to facilitate the formation of appropriate work relationships—ensure that such strategies do not place the person at risk of becoming overly dependent on one or two people in the workplace.
Employers may require assistance to treat the person no differently from other workers and to discourage the person from bringing personal issues and problems to work. Work performance can be monitored regularly so that challenging behaviours can be identified early and addressed before they become an issue in the workplace.
More information
For information and step by step instructions on the financial help available to employers of people with disability, including the application process, visit:
The following fact sheets, developed for service providers, are also a useful resource:
References
Becker D.R and Drake R.E 2003, ‘A working life for people with severe mental illness’ Oxford Press, New York.