“So, what do you do?”

Thanks to the recession, one in 10 people doesn’t have a good answer to that question.

In employment centers, “we are flooded with people who’ve lost their jobs,” says Jane Goodman, PhD, a professor emerita of counseling at Oakland University in Rochester, Mich., where she runs a career center. “We’re seeing lots more mental health issues associated with career issues.”

Millions of Americans are facing the possible depression, anxiety, domestic violence and substance abuse associated with unemployment, says David Blustein, PhD, a professor of counseling and psychology at Boston College. Job loss, he says, entails “anywhere from a huge life challenge to psychological devastation.” According to a 2009 survey by Mental Health America, the National Alliance on Mental Illness and the Depression is Real Coalition, jobless Americans are four times as likely to have severe mental illness as their employed counterparts.

Although the U.S. Bureau of Labor Statistics reports that unemployment is approximately 10 percent, that’s an understatement. The bureau does not count people who have given up looking for work. It also leaves out the unhappily employed — people who’ve been forced to “trade down” to a job that doesn’t use their talents, for example, or people who are working but constantly in fear they’ll lose their jobs.

As psychologists’ research shows, in addition to the obvious financial ramifications, job loss has huge psychological consequences (Journal of Vocational Behavior, Vol. 74, No. 3). “Employment is a powerful part of your self-image,” says Peter Kinderman, PhD, a professor of clinical psychology at the University of Liverpool in England. “That loss of identity is overwhelming.”

As unemployment goes up, the number of unemployed people seeking psychological counseling also rises, Blustein says, although exact numbers are not available. As a result, psychologists find themselves performing a dual role of psychotherapist and career counselor — a function that may be novel for them.

“All clinicians need to be prepared to talk about work issues,” says Nadya Fouad, PhD, chair of the department of educational psychology at the University of Wisconsin in Milwaukee. But too often, she says, psychotherapists aren’t well versed in these issues (see www.div17.org/vocpsych/Guidelines).

To help address that gap, Fouad and the Society for Vocational Psychology (a section of APA Div. 17, Society of Counseling Psychology) have drafted and proposed APA practice guidelines that encourage psychotherapists to get up-to-date on work issues and incorporate vocational considerations into the broader context of lifespan development.

But that’s just a start. Since most psychology training programs still focus on clinical issues — not unemployment and its emotional baggage — psychologists should look for continuing education on working with unemployed people. It’s training worth considering, points out San Francisco State University counseling professor Robert Chope, PhD, since the unemployment problem is probably here to stay.

What we know

Research by psychologists and others is offering insights into how unemployed people feel and what might help them. Research has found, for example, that unemployment and poor health feed off each other. Recent job loss is detrimental to emotional and physical health, according to a 2002 survey of 756 job seekers (Journal of Occupational Health Psychology, Vol. 7, No. 4). Conversely, even mild or moderate depression or anxiety can prevent people from working, Kinderman says.

In addition, many studies have linked unemployment to increased blood pressure and heart disease symptoms. The body’s defenses suffer, too; the authors of a 2007 study found reduced numbers of immune cells in the blood of unemployed people (Psychosomatic Medicine, Vol. 69, No. 3). Although past studies have focused on men, the same happens in women. Researchers at the November meeting of the American Heart Association reported that women who worried about losing their jobs suffered increased blood pressure, cholesterol and weight.

Unemployment is particularly harsh for those who strongly identify with a specific organization or career path, and people who lose blue-collar jobs suffer more than the white-collar unemployed, according to a 2009 meta-analysis of unemployment and mental health (Journal of Vocational Behavior, Vol. 74, No. 3).

In addition to stripping away a crucial facet of one’s identity, unemployment breaks down social structure and leaves people with nowhere to go every day, Chope says. Further, he notes, people are left feeling they have no control.

Responses to job loss vary. In a 2009 paper, researchers from Australia reported that people who scored high for self-esteem and perceived control over their lives, and low for neuroticism, were best equipped to deal with unemployment. People who held a strong commitment to working suffered (Personality and Individual Differences, Vol. 47, No. 4). Recent studies show that people who are especially conscientious also struggle with unemployment (Journal of Research in Personality, Vol. 44, No. 4), while those who score high on resilience tests are less susceptible to depression (Journal of Employment Counseling, Vol. 44, No. 3).

Traditional gender roles also affect one’s perception of unemployment. In a 2010 study of parents, men were more likely to see job loss as defeat, while women saw opportunity (Journal of Organizational Behavior, Vol. 31, No. 5).

Psychotherapists can help, but only for those who can afford their services. “The problem is finding clinicians who can see people for lower fees,” Blustein says. “That’s a huge crisis that complicates the situation.”

A person’s response to unemployment can parallel the five classic Kubler-Ross stages of grief, although people may not necessarily hit each one or follow them in order, says Michael Lazarchick, a retired employment counselor in Weymouth, N.J. Lazarchick is acting president of the National Employment Counseling Association, a division of the American Counseling Association. Depression and anger are common responses to joblessness, he says. Denial also happens — for example, Lazarchick says, some unemployed men continue to put on a suit, grab a briefcase and leave the house each morning, although they have nowhere to go. Others try to bargain with former employers, offering their services for less pay.

The psychotherapists’ goal, Lazarchick says, is to help people reach the acceptance stage. Psychologists can reduce feelings of guilt, particularly in times such as these when the economy, not the individual, is often to blame. Therapy can help people banish negative thoughts and deal with their situation by maintaining a routine and accepting support from friends and family. Lazarchick also suggests people join a job search support group.

As they confront the emotional fallout from unemployment, psychotherapists also have to help people get back to work — helping them identify key skills, access job-search resources, and network with professionals in their fields. “Working with unemployed clients is not the same as career counseling as most people know it,” Blustein says. Traditional career counseling is about helping people who have options choose the ideal path.

But for unemployed people, the problem is hardly an overabundance of options. Blustein says the focus should be on transferrable skills — abilities the person already has, but could apply in a new field. For example, five years ago there was no job title “iPhone app developer,” but now it’s a booming market, notes Paul Englert, PhD, an industrial/organizational psychologist based in Sydney, Australia, and expert on maintaining mental health during unemployment.

In another example, Chope cites two of his clients, Silicon Valley engineers who turned their skills to the food industry. One started a high-tech street food service and the other developed an online order system; many San Francisco restaurants have copied their methods.

Psychotherapists can help by pointing their clients to important resources, such as the U.S. Department of Labor’s o*net website (www.onetcenter.org). With o*net, which is free, users can browse a large database of job descriptions. The online o*net Academy offers instruction on topics such as job-seeking tools and emerging occupations. There are also Web-based seminars on tools counselors can use.

Older clients, in particular, may need help adapting to modern strategies. Many have never filled out an online employment application or logged in to the online networking site LinkedIn.

Job seekers must learn to project confidence in job interviews — or as Chope says, to “fake it ’til you make it.” Most important, Lazarchick says, people need to network. He recommends job hunters spend half their time meeting new people — through social clubs, chamber of commerce meetings or volunteer work, for example.

And people must accept that the employment environment is changing. These days, it’s unlikely that a person will spend a lifetime with one company. In between regular jobs, many people find themselves assembling an income from several projects or contracts — Goodman calls it a “patchwork career.”

Finding a sense of peace

Painful as job loss is, a new study offers a glimmer of hope. Within a year, most people bounce back, according to researchers at the New York University School of Medicine and Columbia University in New York City. They analyzed life-satisfaction ratings from the German Socioeconomic Panel Data, a longitudinal study that ran between 1984 and 2003. During the study, 774 of the participants lost their jobs. The researchers found that 69 percent of those people reported a dip in life satisfaction at the time of job loss, but were back to their normal feel-good attitude a year later (Journal of Neuroscience, Psychology and Economics, Vol. 3, No. 32).

Still, says Englert, society as a whole must accept unemployment. “A lot of people have held their concept of who they are with their job, and that’s very dangerous,” he says. “There simply aren’t enough useful jobs, in any economy.” Englert is founder of the Occupational Psychologists and Research Associates Consulting Group in Auckland, New Zealand.

To make people perceive unemployment as less of a black hole — even as an opportunity — Englert looks to the power of marketing. Mass media campaigns can be very effective, according to a recent review in Lancet; such efforts have reduced smoking, increased condom use and persuaded people to wear seat belts (Lancet, Vol. 376, No. 7948). In Englert’s case, he’s selling the idea that unemployment offers opportunities to go with the challenges. “The dilemma with work is that you are often financially rich and time poor, whereas now you’re financially poor and time rich,” he says. “This is the greatest opportunity that you have had because it’s going to make you look at your life in a new way, as a life to be lived.”

Unemployment offers the chance to spend time with family, read books and learn new skills. To get people thinking that way requires more than public service announcements. “The most powerful marketing is face-to-face,” Englert says. Case managers, public welfare officers, and others who work with job seekers should take care to use positive language, he recommends.

Although unemployment certainly can be an opportunity, Goodman says, it’s important not to blithely encourage suffering clients to turn lemons into lemonade. “Sometimes, it’s still lemons,” she says.

And settling into unemployment can impede the job search, points out Peter Warr, PhD, a professor emeritus at the Institute of Work Psychology at the University of Sheffield in England. “It’s a terrible dilemma,” he says. “If you don’t feel bad, you don’t want to get back to work.” Warr is the author of “Work, Happiness, and Unhappiness” (Erlbaum/Routledge, 2007).

During the 1980s, Warr studied Sheffield steelworkers who lost their jobs as the industry nosedived. Some became resigned to their fate, and simply waited for the job market to turn around. Others tackled the problem constructively, finding volunteer work or hobbies to occupy their time. The latter group was certainly happier — but they were not rushing to rejoin the work force (Journal of Social Issues, Vol. 44). The authors of a more recent 2007 review also argue that active unemployed people are happier than their inactive counterparts (Work: Journal of Prevention, Assessment & Rehabilitation, Vol. 28, No. 4).

Thus, psychologists must enact a delicate balance: helping people develop the skills to survive without work, even as they continue to seek work.

Psychotherapists can also contribute by helping policymakers understand the devastation of job loss, Blustein says: “We can provide a voice for the unemployed who see us.” For example, in 2010 APA asked Congress to increase funding to train psychologists who deal with underserved populations, such as the unemployed (APA Monitor, Vol. 41, No. 6).

“The financial impact doesn’t have to come with the psychological impact,” Englert says. “If we don’t start dealing with the psychological issues … we’ll be dealing with all the social and health issues.”

Amber Dance is a writer in Los Angeles.