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Actevate’s Pathways Program is guided by the biopsychosocial model of rehabilitation and is the basis of the World Health Organisation’s International Classification of Functioning, Disability and Health (WHO, 2011). The biopsychosocial (BPS) model comprises the following:

• Biological – the physical or mental condition
• Psychological – personal factors that influence an individual’s functioning, such as attitudes
• Social – the role of society, its expectations or limitations and how this impacts on an individual’s functioning.

An individual’s ability to return to health, daily functioning, and particularly to work, is dependent on personal/psychological factors and social/occupational factors (HWCA, 2005). The BPS model considers the individual as a whole rather than traditional medical management which focuses solely on the injury.

The Leading Authorities of Workers Compensation Australia (HWCA, 2005) has illustrated that the BPS model can be adopted in a worker’s rehabilitation and return to work plan. It recognises that a person’s fears and beliefs about their injury can impact on their return to work and health, and should therefore be incorporated into their injury-management planning. Likewise, an individual’s personality, as well as social pressures, will impact on how one recovers from injury. At Actevate, we are focussed on using evidence-based practice; we ensure these factors are integrated into our assessments and are integral in the development of rehabilitation plans.

We spoke with Actevate Rehabilitation Consultant (RC), Brittany Turnbull, and gained an insight into the psychosocial barriers present in her return to work coordination. She gave us her view on how these can be managed.

What are the barriers you’re faced with as a rehabilitation consultant on a day to day basis?

Primarily the key challenge in managing recovery and return to health for severe, complex and psychological injuries is the impact of biopsychosocial factors. Commonly, people within this population experience prolonged recovery with the following biopsychosocial factors impacting their rehabilitation:

• Fear avoidance and pain-focused behaviours – including fear of re-injury or re-aggravation
• Continuation of passive, symptom-focused treatment in the absence of improved functional outcomes
• Reported worsening of symptoms through minor activity
• Perception that injury is catastrophic and creates fear
• Belief that pain is harmful and engagement in activity results in further damage
• Reported stress in the workplace with lack of support
• Failed attempts to return to work

All these factors reinforce long-term disability with the individual and reduces the opportunity to achieve a recovery to health.

How do you manage these barriers?
I have achieved positive outcomes in managing these barriers through:

• Obtaining comprehensive information about the individual in relation to their injury history, recovery to date and their support systems. It is important to ascertain why the worker believes they are not recovering and establishing what is required to help them.
• Goal-setting with the worker to determine what they want to achieve in the return to work process, how they will achieve this, and the time frames.
• Providing feedback to stakeholders and developing a program that reflects the goals to be achieved and biopsychosocial factors to be addressed. The program is developed in consultation with stakeholders with a focus on how this will assist the worker in addressing the biopsychosocial factors impeding their recovery to health.
• Directly providing feedback to the worker as to their engagement in the program ensuring that they are responsible for their goals.

In following a person-centred approach of goal setting and engaging all stakeholders we effectively address the core biopsychosocial factors impacting the workers recovery. Frequently, workers report that they are in a better state of health following rehabilitation due to a greater sense of wellbeing and self-regulation.

To get in touch with Brittany Turnbull and talk about how she manages her rehabilitation clients, please call her on 1300 669 552 or email us at info@actevate.com.au