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OT & Vocational Rehabilitation

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Many employees dealing with chronic pain are not ready to return to work following a long absence from injury or illness. Disability Managers and Rehabilitation Professionals have the task of determining barriers to occupational engagement and providing accommodations where needed, to assist employees back to meaningful work.  Occupational Therapists understand that one way we achieve meaning in our lives is through the intrinsic and extrinsic purpose that work can provide us.  Intrinsic purpose or motivation could be to master a task, feel good about the work we do, feel that we are contributing, with no ulterior motive. The extrinsic purpose or motivation may be to earn money, please a boss, or get a promotion.

 

Through Motivational Interviewing (MI), a counselling approach developed by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D. (Miller and Rollnick, 1991), Rehab Professionals can work with an employee to address the intrinsic values that work provides, and assist them to challenge their fears, and self-imposed barriers to returning to work.  Common fears are that their symptoms will increase, co-workers’ and supervisor’s attitudes about accommodation, there will be new learning requirements, their replacement is doing a better job, etc.

 

Using MI to align the employee's values and goals with returning to work, Rehab professionals can help take employees who are at "Pre-contemplation" to the “Contemplation Phase” and right through to “Action Phase” of the Motivational Interviewing: Stages of Change, to reduce fears, and replace with an acceptance that returning to work will bring purpose, meaning, and promote engagement in activities that will lead to improved productivity in preparation for returning to work.

 

Returning to work can be a challenging endeavour for employees and their advocates for other reasons as well, such as having an employer who is not willing to make reasonable accommodations, the wait for physicians to send medical documentation, employee feeling pushed back to work before being ready, and many more. Using MI might just smooth the ride while navigating around these obstacles.

 

An Australian article review of MI outcomes in Return to Work suggests, “Whilst evidence for the efficacy of MI in clinical settings to motivate health behaviour change is strong, more research is needed to determine whether MI can be usefully applied to improve RTW and other work-related outcomes.”1

 

1. Kathryn M. Page and Irina Tchernitskaia (2014). Use of Motivational Interviewing to Improve Return-to-work and Work-related Outcomes: A Review . The Australian Journal of Rehabilitation Counselling, 20, pp 38-49. doi:10.1017/jrc.2014.5.

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