International Health Day 2024
06/03/2024
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14/07/2024
Explaining Choice to an Injured Worker on RTWSA
Navigating pain recovery choices is essential for regaining control over your well-being after a workplace injury.
In my practice, a significant portion of my focus revolves around helping people who have sustained physical workplace injuries. With over three decades of experience in pain science, I am deeply passionate about this field. My work in this area involves various facets, but I've always put emphasis on two essential areas:
- Understanding Pain Mechanisms: Delving into the intricacies of pain perception and explaining how the brain plays a pivotal role in shaping our experiences (I often liken the body to a 'chop – meat, tendon and nerves that do not think' to underscore this point). Read our blogs on pain Pain Facts 1 Blog , Pain Facts 2 Blog , Pain Facts 3 Blog .
- Empowerment through Informed Decision-Making: I am committed to empowering individuals to make informed decisions that align with their needs and preferences. It's about equipping them with the knowledge to navigate their journey towards recovery independently.
I'm passionate about weaving metaphor into my therapy sessions – it's a universal language that bridges cultural divides. Everyone gets it.
I recently saw one of my old clients (I hadn’t seen him for 10 months). He was still on RTWSA, but since seeing me, he had 3 more surgeries (making his pain and function worse). In addition, he had developed a frozen shoulder and had a procedure done when he thought he was having something else (again increasing his pain). His medication usage had also increased. He had not returned to work and didn’t think he would ever work again. His lawyer was going for “seriously injured” – he had basically given up and was quite depressed.
10 months ago, I had explained injury, RTWSA, and choice of treatment to him using the following metaphor. It made 100% sense to him at the time.
Me: “Just pretend that you have insured your house for $750,000 and it burns down. What do you do? Do you build a house for $500,000 and give the rest back to the Insurer or do you build a house for $1M and demand more money?”
Client: “Of course I build for $750,000, unless I have a spare $250,000 that I want to put in myself.”
Me: “Do you design the house? Or do you let google design it, your neighbour, your mate, the insurer, the local tradie, etc?”
Client: “I design it but get advice from the architect or a builder friend as I don’t want it to go over the price. But I need it to fit my needs.”
Me: “So, how many bedrooms and bathrooms would you have?”
Client: “There is only my son and me, so 3 bedrooms but 2 bathrooms.”
Me: “What if the architect and the tradies suggested 4 bathrooms and 2 bedrooms because they love designing and building bathrooms? What if they showed you a house with stunning bathrooms they had built.”
Client: “Nope, sticking to the 3 bedrooms and 2 bathrooms as that’s what I need.”
Me: “What if they insisted on building the 4 bathrooms?”
Client: “I would change architects and tradies to ones that listened to me.”
Me: “Lets imagine the building has started and some extra problems have been identified.”
Client: “Like what?”
Me: “The cladding they were going to use is no longer available, or it’s now going to take 2 years to become available. The architect kind of knew this but didn’t let you know it was a possibility when they were designing the house.”
Client: “I would sit down and find another solution. And probably change architects.”
Me: “So, the house is yours (body), the insurance has been paid for years (RTWSA) and the architects and tradies are on standby (Health Professionals), but ultimately the choice is yours. If you decide to go with the 4 bathrooms and 2 bedrooms, you will be the one living with this.”
Client: “Makes sense…. I have to be careful what decisions I make, and I have to understand the decisions.”
Fast forward 10 months later.
My client had allowed the 4 bathrooms and now he was very unhappy.
At the end of the session, he turned to me and said “I remember the house story…. I have to ask more questions and not just allow things to happen…”.
He left armed with a list of questions to ask his doctor/surgeon. He left with ideas regarding the things he could do himself to improve his function - mirror therapy, purposeful movement of the affected limb, retraining the brain, asking the insurer to send him for a driving assessment, and arranging a spinner knob on his automatic car so he didn’t have to use taxis, and finally, having some fun!
He reported that his hand therapist had discussed similar interventions with him, so he felt these suggestions were on the right path of getting the 3-bedroom, 2-bathroom house he originally wanted.
He came in dejected and left with hope and purpose. For me, it reinforced my role in “explaining and empowering”.
As a healthcare provider, our responsibility is to advise rather than decide. Explain, explain, and explain some more till your client understands the decisions they're making. Use whiteboard illustrations, models of bodies, pictures, perhaps even interpretive dance, or even a house metaphor, but make sure that they leave your room fully informed.
Empower your recovery with expert insights into pain recovery choices. With over three decades of experience, I help individuals understand pain mechanisms and make informed decisions about their treatment. By focusing on education and empowerment, we work together to improve function and well-being after workplace injuries. Learn how to take control of your recovery journey and achieve lasting results. Check out our Pain Programs.
