Return to Work ForumReturn to Work Forum –– 2929thth--3030thth July 2014July 2014
Anya Stephens
Registered Psychologist
Co...
 Anya Stephens
Registered Psychologist/ Director
 Psychologist for 20 years
 Worked in the Injury Management industry f...
 Outcomes for injury have not significantly improved – plateaued
 In 2012–13, premiums rose by an average of 25 per cent...
 Disability support pension is paid to 824 k Australians at an
annual cost of $15 billion
 Psychological problems becomi...
What is Complex Rehabilitation?What is Complex Rehabilitation?
Case Study 1Case Study 1
Predictable Complexity
 A 46 year old male in a physical role
 Above knee amputation
 Mother d...
Case StudyCase Study 22
Unpredictable Complexity
 35 year old female customer service role
 Lower back pain – occurred a...
Outcome
 Employee identified that she experienced
resistance from her manager in relation to
her Return to Work Program
...
Outcome
 Insurer took nine months for decision – during this
time, client became financially unstable and was
evicted fro...
 Pre-existing vulnerability
 Low morale
 Disengaged – passive and avoidant
 Decision point Decision point
 Effective...
 Low morale – can quickly turn into something more
 Stress and conflict heightens pain arousal
 Clients can receive ‘ad...
Barriers
Injured worker General Practitioner Insurer
Treating specialists
(including
Employer
 Ignorance
 Attitudes
 Co...
 Communication, Communication
 The best rehabilitation work is conducted face to face
with as many of the interested par...
Education, Education, Education
 GP’s and treating practitioners must view the
workplace as part of their patients recove...
Early Intervention
 Efficient success rates depend on the perceived
support from the organisation
 Average psychological...
Use Work-Oriented Therapy
 Complex rehabilitation requires
specialised structured programs e.g.
schema focussed CBT
 Use...
Case Conference with all parties – regularly
 Including the General Practitioner in decision making
is crucial
 Includin...
Use rehabilitation providers who have multi-
disciplinary teams and good supervision structures
 There is huge variation ...
Remember the person in the process
 Use a solution focussed, person-centred approach
rather than a ‘policy’ approach
 Us...
 If you treat people with a lack of regard, or ignore
their concerns, they will resist attempts to
rehabilitate
 Do not ...
Questions?
Experts in Workplace and Vocational Rehabilitation and
Employee Assistance Programs
(08) 9388 9000
reception@pe...
Anya Stephens - PeopleSense (Finalist, ComCare Work Health and Safety Awards 2013 - Rehabilitation and RTW individual cont...
Anya Stephens - PeopleSense (Finalist, ComCare Work Health and Safety Awards 2013 - Rehabilitation and RTW individual cont...
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Anya Stephens - PeopleSense (Finalist, ComCare Work Health and Safety Awards 2013 - Rehabilitation and RTW individual contribution) - Complex rehabilitation

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Anya Stephens delivered the presentation at the 2014 Return to Work Forum.

The 2014 Return to Work Forum brought together speakers from multiple sectors to share best practice in return to work, injury management and rehabilitation.

For more information about the event, please visit: http://bit.ly/returntowork14

Published in: Recruiting & HR
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Anya Stephens - PeopleSense (Finalist, ComCare Work Health and Safety Awards 2013 - Rehabilitation and RTW individual contribution) - Complex rehabilitation

  1. 1. Return to Work ForumReturn to Work Forum –– 2929thth--3030thth July 2014July 2014 Anya Stephens Registered Psychologist Co-Director PeopleSense
  2. 2.  Anya Stephens Registered Psychologist/ Director  Psychologist for 20 years  Worked in the Injury Management industry for 10 Years Background in working with the hardest to reach, including Background in working with the hardest to reach, including offenders/prisons, school excludees, drug related issues  Established PeopleSense (WA) in 2005  Focus in EAP (Nationally) and Work Place Rehabilitation (WA)  Grew from 5 in 2005, to 70 employees to in 2014, by focusing quality and successful outcomes
  3. 3.  Outcomes for injury have not significantly improved – plateaued  In 2012–13, premiums rose by an average of 25 per cent (2011– 12: 18 per cent) to reflect the increasing cost and complexity of claimsclaims  Premium increases will continue until the underlying issues of workplace harm and return to work are addressed. Comcare Annual Report 2012-2013
  4. 4.  Disability support pension is paid to 824 k Australians at an annual cost of $15 billion  Psychological problems becoming the main reason for grant.  By 2035 the number of over-65s is expected to almost double. By 2035 the number of over-65s is expected to almost double.  56% of people aged 50-65 plan to work beyond state pension age
  5. 5. What is Complex Rehabilitation?What is Complex Rehabilitation?
  6. 6. Case Study 1Case Study 1 Predictable Complexity  A 46 year old male in a physical role  Above knee amputation  Mother died the month prior  Long term girlfriend has just left him (found his injury too difficult to deal with)  Employer is reluctant to explore support internally while redeployment options are explored
  7. 7. Case StudyCase Study 22 Unpredictable Complexity  35 year old female customer service role  Lower back pain – occurred after lifting 10 kilo boxes in the workplacein the workplace  MRI scan indicate no further damage – diagnosis back ligament strain  Should have been a straight forward case…….
  8. 8. Outcome  Employee identified that she experienced resistance from her manager in relation to her Return to Work Program  Employee accused manager of using the term Employee accused manager of using the term ‘malingerer’  Employee developed significant anxiety, disturbed sleep, panic attacks and agoraphobia  Employee submitted a further claim for anxiety disorder
  9. 9. Outcome  Insurer took nine months for decision – during this time, client became financially unstable and was evicted from her homeevicted from her home  Second claim declined  2.5 years later – she finally returned to full-time, pre- injury duties (new work environment/new more sympathetic manager)
  10. 10.  Pre-existing vulnerability  Low morale  Disengaged – passive and avoidant  Decision point Decision point  Effective treatment = builds resilience  Ineffective or no treatment = increased medicalisation and increased resistance
  11. 11.  Low morale – can quickly turn into something more  Stress and conflict heightens pain arousal  Clients can receive ‘adjustment disorder’ label, or ‘secondary depression’  All parties embark on a process of trying to work out which parts are compensable and which parts are non-compensable
  12. 12. Barriers Injured worker General Practitioner Insurer Treating specialists (including Employer  Ignorance  Attitudes  Complacency and apathy (including
  13. 13.  Communication, Communication  The best rehabilitation work is conducted face to face with as many of the interested parties as possible  All parties need to sign up to and engage in positive communicationcommunication  Human Resources personnel must be involved if there are morale/conflict issues
  14. 14. Education, Education, Education  GP’s and treating practitioners must view the workplace as part of their patients recovery  Managers need to understand the compensation system and put personal opinions to one side. Goodsystem and put personal opinions to one side. Good line management is key to good workplace health  All parties need to try and understand and treat the whole person  Educating all parties about the strengths, limitations and boundaries of the compensation system
  15. 15. Early Intervention  Efficient success rates depend on the perceived support from the organisation  Average psychological injury has at least 6 mth gestation periodgestation period  Intervention appropriate to the injury – if its worth doing, its worth doing properly  Careful management, early on, can prevent a claim  Internal support for managers to assist them to understand the minefield of workers compensation.
  16. 16. Use Work-Oriented Therapy  Complex rehabilitation requires specialised structured programs e.g. schema focussed CBT  Use external practitioners who view Use external practitioners who view work as part of the treatment and not the only cause  Use work related interventions – empower internal staff as much as possible Dr. Peter Cotton, clinical and organisation psychologist, 2014
  17. 17. Case Conference with all parties – regularly  Including the General Practitioner in decision making is crucial  Including work representatives is useful, if they are supportive of the injured workersupportive of the injured worker  Rehabilitation providers need to be confident enough to challenge the GP if required
  18. 18. Use rehabilitation providers who have multi- disciplinary teams and good supervision structures  There is huge variation in the experience, quality and focus of rehabilitation providers  Some cases need a range of professional Some cases need a range of professional involvement  Rehabilitation is a highly skilled area of work. Good consultants tend to: ◦ have an allied health background ◦ have been trained in rehabilitation ◦ Have access to ongoing supervision and support
  19. 19. Remember the person in the process  Use a solution focussed, person-centred approach rather than a ‘policy’ approach  Use reasonable adjustment in ways that are focussed on outcomeson outcomes  Try saying ‘yes’, instead of ‘no’  Do not ignore the difficult  Adjustment, conflict, self-esteem, anxiety, depression are all important factors and need to be respected and overcome
  20. 20.  If you treat people with a lack of regard, or ignore their concerns, they will resist attempts to rehabilitate  Do not lose the injured person in the process Do not lose the injured person in the process  Try and feel the world from the injured person's perceptive
  21. 21. Questions? Experts in Workplace and Vocational Rehabilitation and Employee Assistance Programs (08) 9388 9000 reception@peoplesense.com.au www.peoplesense.com.au

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