Strategies for Enhancing Career Maintenance Self-Efficacy of People with Multiple Sclerosis

Abstract

Strategies for Enhancing Career Maintenance Self-Efficacy of People with Multiple Sclerosis(1) The purpose of this article is to apply a psychosocial theory for human behavior (self-efficacy theory) to career maintenance problems encountered by people with evere disabilities such as multiple sclerosis (MS). Specifically, their employment retention rates following diagnosis are lower than those reported by people with disabilities in general and, according to experts, lower than would be expected based solely on severity of symptoms associated with MS (LaRocca, Kalb, Scheinberg, & Kendall, 1985). Two explanations are offered for high unemployment rate of people with MS. The severe and pervasive impact of multiple sclerosis is, of course, one reason for low rate of post-diagnosis employment. However, factors other than disability-related symptoms result in poor career maintenance outcomes. A self-efficacy theoretical position is used to explain exceptional problems that people with multiple sclerosis face in attempting to continue working. We propose that lack of predictability of MS symptoms (Falvo, 1991) and resulting uncertainty about one's life and future (LaRocca et al., 1985) have a negative impact on one's sense of self-efficacy. Decreased feelings of efficacy result in less frequent proactive behaviors that are required to maintain one's career. A psychosocial training intervention is, therefore, needed to enhance feelings of self-efficacy among people with MS and, thereby, increase likelihood that they will initiate such career maintenance actions as requesting that their employers review their needs for reasonable accommodations on job. Career Maintenance and Multiple Sclerosis Recent statistics document assertion that most people with disabilities find it difficult to maintain employment. According to figures cited by Ficke (1992) and Yelin (1991), only 36% of males and 28% of females with work disabilities are in labor force, compared to 89% and 69% of males and females who do not have work disabilities. Retention of employment among people with MS is lower than previously cited figures for people with disabilities in general and lower than would be expected even given presence of a severe physical disability. LaRocca and Hall (1990) reported that more than 90% of people with MS have employment histories, and most (60%) were working at onset of MS. Unfortunately, only one in four people with MS (25%) is typically able to retain employment (Jackson & Quaal, 1991), and some research suggests that employment outlook for women with MS is even worse. LaRocca et al. (1985) found that only 14% of women with MS were employed. The employment rates of 25% and 14% respectively for all people with MS and women with MS are clearly lower than for a comparison group of people with work disabilities. But surprising fact is that some experts believe that poor rates of career maintenance reported by people with MS exceed what one might expect even considering severity of disability. Consistent with common sense, research indicates that physiomedical impairments of MS reduce likelihood that a person who acquires illness will return to or retain employment (Jackson & Quaal, 1991; Komblith, LaRocca, & Baum, 1986). In concluding their research on topic, however, LaRocca and Hall (1990, p. 53) noted that the physical aspects of MS do not come close to fully explaining high rate of unemployment. They stressed that both symptoms associated with MS and unpredictability of those symptoms, that is, exacerbations followed by remissions, have a debilitating psychological effect on people with MS which decreases their capacity to cope with on-the-job barriers to career maintenance. Symptom Unpredictability and its Impact on Self-Efficacy In unraveling complicated relationship between MS and high unemployment rates associated with it, LaRocca and Hall (1990) proposed that unpredictable medical symptomatology of MS causes diminished feelings of self-efficacy and self-control. …

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