Identify obstacles to staying active and working, so that you can plan to overcome these. There are two types of obstacles, those that are modifiable and those that are not. Avoid falling into the trap of assuming that immovable obstacles cannot be navigated around.

 

What Obstacles to Look For

 

The three places to look for obstacles to staying active and working are the Person, their Workplace, and the Context in which they function.

 

TIP: Remember Identify, Plan, Action - identify any obstacles, plan how to overcome them, and put this into action.

 

PERSON

 

Thoughts

• Catastrophising (focus on worst possible outcome, or interpretation that uncomfortable experiences are unbearable)

• Unhelpful beliefs and expectations about pain, work and healthcare

• Negative expectation of recovery

• Preoccupation with health

 

Feelings

• Worry, distress, low mood (may or may not be diagnosable anxiety or depression)

• Fear of movement

• Uncertainty (about what’s happened, what’s to be done, and what future holds)

 

Behaviours

• Extreme symptom report

• Passive coping strategies

• Seeking serial ineffective therapy

 

WORKPLACE

 

Worker

• Fear of re-injury

• High physical job demand (perceived or actual)

• Low expectation of resuming work

• Low job satisfaction

• Low social support or social dysfunction in workplace

• Perception of high job demand or feeling stressed by work

 

Line Manager

• Lack of job accommodations or modified work

• Lack of employer communication with employees

 

CONTEXT

 

• Misunderstandings and disagreements between key players (e.g. employee and employer, or with healthcare)

• Financial and compensation problems

• Process delays (e.g. due to mistakes, waiting lists, or claim acceptance)

• Overreactions to sensationalist media reports

• Spouse or family member with negative expectations, fears or beliefs

• Social isolation, social dysfunction

• Unhelpful policies/procedures used by company

 

 

How to Look for Obstacles

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Ask these Useful Questions

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1. What do you think has caused your problem?

2. What do you expect is going to happen?

3. How are you coping with things?

4. Is it getting you down?

5. When do you think you’ll get back to work?

6. What can be done at work to help?

 

 

The Obstacles Question

 

“What three things about your health problem and your work are affecting your work ability – in other words, what’s making it difficult to stay at work (or get back to work?”

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You can use this question to help point you to the obstacles that your colleague is struggling with. You should ask this after the work ability question. It will flag up the most important and immediate things that you’ll need to deal with.

 

If your colleague has scored 8 to 10 on the work ability question (see above, in Action 3), you may not need to look any deeper for obstacles, but remember new obstacles can crop up, so keep an eye on their work ability. If they scored 3 to 7 you will need to check the wider range of obstacles. If they scored 0 to 2, you should consider getting professional help in identifying the obstacles and developing the plan.