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Ilene A. Serlin Ph.D.

Depression

Depression and Learning Disabilities: Putting the Pieces Together

Learning disabilities, depression and the workplace

Ilene Serlin asks:

Have you ever had a client or a friend who thought they were stupid or cannot understand why he or she cannot catch their grammatical or mathematical mistakes, or a client or a friend, who is a supervisor, complaining that co-worker is being lazy or not careful with their work, and the stress this causes an adult with a learning disability is rarely understood. This disability often appears hidden from view. Depression is another factor that can affect a client or person's ability to manage his or her learning disability. It has been estimated that 50% of adults with learning disabilities suffer from depression. If we do not review the relationship between of depression and a person's learning disability, the client and treatment provider will be missing an important factor which can significantly affect the outcome of the assessment, treatment plan and the success of treatment. I would like to share some insights that I discovered by talking with Michael Watson, MFT, CEAP, an Employee Assistance Professional, and his experience dealing with types of cases. Michael believes that this information will help clients and treatment providers to be more successful in treating this problem.

Michael Watson, MFT, CEAP, replies:

Let's review the case of Henry. Henry has set up an appointment because his supervisor has placed him on a performance improvement plan. Henry tells you he was promoted to a management position last year. His current supervisor and others employees asked him to apply for the position. He had worked with the program previously and everyone liked his worked. During the year, the relationship between him and his supervisor had deteriorated. The supervisor described his writing and the way he facilitated committee conference calls as poor. During the assessment, the client appeared depressed. The client mentioned he always had difficult time writing. He also said that he thought he had a writing disability, but he had never been assessed.

Henry said he had been working long hours. He had conflicts with his supervisor because they did not agree on how the program should be run and the communication between them deteriorated. Their conflict was over the "Big picture". Henry focused on detail facts and this frustrated his supervisor. Henry worked hard to prepare for the conference calls, but he had a hard time communicating with the participants, and understanding their questions. Participants believed he wandered from the topic to topic and these topics were not part of the agenda. Henry also admitted he had a hard time remembering his assignments from meeting to meeting. Henry described his concentration as poor. He feels guilty, disappointed and humiliated. He believes the situation is hopeless. Henry also told me he has lost interest in all his outside activities. It appears Henry is depressed, but does he have a learning disability? If he does can it be playing a role in his depression?

 

Where Henry should be referred? The best resource for Henry would be a psychologist or mental health practitioner who has experience with assessing, and treating both disorders, and learning specialist or educational psychologist. In this type of situation, Henry may need to be off of work, because of his depression. The provider needs to be able to consult with Henry’s Primary Doctor about how depression and learning disability symptoms can exacerbate each other, and this will enhance Henry’s recovery. 

 

What would treatment look like? Treatment should consist of Henry receiving psychotherapy and may include anti-depressant medication. The treatment for a learning disability may consist of focusing exercises that consist of helping Henry improve his motor skills, audio processing, identifying grammars, and organization skills. Henry may also need special equipment to help him at work, and he should  feel comfortable using the equipment before returning to work. The treatment needs to focus on improving Henry's ability to pay attention and his ability to focus.  

When will Henry be ready to return to work? The questions that need to be answered when determining Henry's readiness to return to work are:

 

  • How affectively is Henry’s depression being managed?

 

  • Have Henry’s concentration, focus and organizational skills to have improved enough for him to be successful at work? And how has he been able to demonstrate his improvement?

 

  • Has Henry successfully demonstrated that he has mastered the equipment or tools that will assist him at work?

 

  • What is the willingness of Henry’s supervisory or workplace to work with him? How will they accommodate him because of his disability?

 

These questions are based on behavioral observations and workplace climate. Due to the fact that,  Henry was on an improvement plan, we need to evaluate if Henry can be successful at work, and looking at demonstrated behavior is the best way to evaluate his abilities. Workplace climate and client and supervisor relationship is one of the key issues of successfully returning  to work. If the support is poor, this will affect his ability to be successful. This is especially true when you're dealing with a disability which is not well known or understood.

 

EAP assessment will be enhanced by asking questions about learning disabilities. Our job is putting all the pieces together to help our clients to be successful at work.  Will Henry be successful? Hopefully, yes but it will depend on his preparation to return to work, and Henry’s supervisor and the workplace ability to work with him.

 

 

Michael Watson is a licensed Employee Assistance Professional with extensive experience working in Internal Employee Assistance programs and helping employees with return to work problems. He can be reached at michaelwatsoneap@yahoo.com.

 

Copyright 2010 by Michael Watson, MFT, CEAP

 

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About the Author

Ilene Serlin, Ph.D., is a clinical psychologist and the founder and director of Union Street Health Associates and the Arts Medicine Program at California Pacific Medical Center.