Breaking the web of needless disability

Abstract

Background: In 2012 I presented a program to the London IFDM entitled “Breaking the Web of Needless Disability”. The model drew heavily from the latest neuroscientific theory, and was quite well received. This program represents further development of the ideas presented in London to encompass “resilience”.Hypothesis: 1. “Resilience” is a behaviour that is learned and unlearned like any other skill; 2. Understanding how humans think and react in compensation systems will yield valuable insight into the building of resilience to unnecessary disability.Methods: Extension of existing literature and pilot studies examining the differences between those people who suffer injury and recover as expected and those who suffer the same sort of injury and spiral down into despair and dependency. Principal findings: “Resilience” is a specific behaviour beneficially affecting the sense of loss of control that attends injury. There are four specific “styles” of resilience. Each person uses one or more of these styles to a greater or lesser degree. By use of modified psychological inventory tools, the predominant resilience style of an individual can be ascertained, and approaches that enhance their resilience style can be utilised for either prevention or treatment.Discussion: “Habits of thought” are established by repetition. For habits of thinking of one's self as able or disabled, the most significant form of repetition is internal dialog. In resilient people, there are four discrete kinds of dialog that are used to overcome a sense of loss of control. By identifying and bolstering those styles of resilience an injured person can become less susceptible to a sense of loss of control that gives rise to unnecessary disability.Conclusion: The approach is useful in understanding failure to recover as expected, and shows promise for effective individualised treatment for injury management.

Insurance workers’ and physiotherapists’ perceptions of their roles in the management of workers with injuries in the Western Australian workers’ compensation system

“…Many stakeholders are involved in the management of individuals with work-related musculoskeletal pain, which in itself can be a barrier to the efficient management of 5 injured workers (13)(14)(15)(16). Effective communication amongst these stakeholders can be a factor associated with improved work rehabilitation outcomes (16)(17)(18)(19)(20), particularly in complex cases and/or where there is delayed recovery.…”

Do claimants over-report behavioral health dysfunction when filing for work disability benefits?

“…Many aspects of mental and behavioral health are typically assessed by self-report as compared to using more objective, external measures of mental health [7]. Complicating this issue further, previous literature introduces reasons for potential reporting bias of self-reported disability – typically assumed to be in the direction of individuals over reporting their disability level [8,9]. …”

Problematizing ‘productive citizenship’ within rehabilitation services: insights from three studies

“…Furthermore, our discourse analysis of vocational rehabilitation in New Zealand identified that there is a significant danger of 'failure' in mainstream vocational rehabilitation for people whose work (re)entry is not fast and straightforward, which can occur for a variety of reasons including complicated interpersonal relationships at work and other what is termed 'psychosocial' reasons. In a sense then, perpetuating a system of vocational rehabilitation that defines successful resumption of work-ability in such a narrow way can be argued to actually produce ongoing work-disabilityclassifying people who do not achieve that definition of success as 'off track', 'complex', or 'difficult' which in turn affects their understandings of (and responses to) their own situation [19,39].…”