A Novel Application of Social Cognitive Career Theory to Adult-Onset Disability: Examining Work-Related Learning Experiences in Parkinson's Disease

Background and Purpose: Employment is an understudied social determinant of health, and can significantly influence quality of life in the context of chronic disease and/or disability. Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the United States, yet there is limited research on the employment experiences of individuals with PD (Koerts et al., 2016). The present study addresses significant gaps in existing understanding of employment after the onset of PD by using a vocational theory, social cognitive career theory (SCCT), as a framework for examining work-related learning experiences and outcome expectations. SCCT posits that occupational outcomes are influenced by the impact of direct and indirect learning experiences on occupational outcome expectations (Lent, 2013). Study findings represent a novel contribution to the extant literature on SCCT in the context of disability, by demonstrating how employment-specific learning experiences that occur 1) in adulthood and 2) in the context of a progressive disease affect work outcome expectations. The author utilized findings to develop a conceptual model applying SCCT to the working lives of adults with progressive diseases.

Methods: A purposive sampling strategy was employed. Recruitment occurred at the movement disorders clinic of an urban teaching hospital and the state chapter of a national PD organization. The author conducted individual 45-90 minute qualitative interviews, with working, unemployed or retired individuals with PD under the ages of 65 (N=23). Interviews were audiorecorded, transcribed, and data were analyzed utilizing a thematic analysis approach (Braun & Clarke, 2006).

Results: Findings suggested that access to workplace accommodations may act as a learning experience that influences occupational outcome expectations. Analysis identified three individual resources (workplace control, value and support) that may safeguard participants from disability-related discrimination, as participants used these resources to access workplace accommodations and thus continue working. In turn, gaining access to accommodations acts as a learning experience that shapes work outcome expectations by demonstrating that work is feasible after PD-onset. Participants without control, value and/or support were not buffered against disability-related discrimination (evidenced by denied accommodations), and this acts as a learning experience that work is not feasible. Findings indicated that as a learning experience, access to accommodations also affects work outcome expectations by influencing participants’ perceptions of the effects of work on health.

Conclusion and Implications: Existing studies utilizing SCCT to examine career development in people with disabilities are limited and focus primarily on serious mental illness or youth. To the best of this author’s knowledge, this study represents the first application of SCCT to an adult-onset progressive medical condition. This study also makes a unique contribution by focusing on an under-examined concept within SCCT: learning experiences, utilizing SCCT to demonstrate how employment-specific learning experiences that occur in adulthood may affect work outcome expectations. Findings have implications for social work practice and policy that supports economic justice for chronic disease and/or disability populations.