No one plans on getting sick or injured; it happens unexpectedly. For some clients, an injury or illness is a mere bump in the road and for others it is life-changing. A life-changing injury or illness can have a devastating effect on a client’s career and working with this client group brings unique challenges.
Returning to work after an injury or illness can be very difficult. In addition to managing their recovery, many clients also have to navigate the challenges of dealing with third-party stakeholders such as insurance agencies, long-term disability carriers or workers’ compensation systems. This can often lead to clients feeling a loss of control, struggling with a sense of perceived injustice and feeling completely overwhelmed.
It is not uncommon for clients with an injury or serious illness to lose their job. Even in cases where there is no job loss, a period of adjustment is needed – to grieve the loss of normalcy, the way it was before the injury or illness. For many, adjusting to their new reality can lead to anxiety, depression and reduced self-esteem. It may also affect the individual’s sense of purpose, their motivation and daily routine, and may cause a decline in their ability to cope with stressors of everyday life.
When planning and managing a client’s return to work, a vocational rehabilitation counsellor has to consider the limitations of the physical and/or psychological injury or illness, as well as these secondary factors related to the client’s sense of loss. Understanding the degree to which a client’s life has been altered by an injury or illness will help a vocational rehabilitation counsellor to effectively support their client.
Using theory to support clients
Schlossberg’s Transition Theory explains how adults adjust to and cope with transitions they experience throughout their adult lives. The model describes three types of transitions:
- Anticipated transitions: typical life events such as graduating high school or university, starting a first job, getting married, changing careers or retiring
- Unanticipated transitions: unexpected and disruptive events such as illness, injury or termination of employment
- Non-event transitions: when expected events fail to occur, such as not graduating high school, not getting married or not receiving an expected promotion
Applying the Transition Model can help a vocational rehabilitation counsellor understand the degree to which a client’s life has been affected by an injury or illness, where in the transition process the client is and what resources are available to the client.
Schlossberg identified four factors that impact a client’s ability to cope, known as the 4S’s: situation, self, supports and strategies.
- Situation includes the trigger for change, the timing of the change, how much control the client has over the change, previous experience with similar change, duration of change, whether a change of role is involved, and other stressors the client is currently experiencing.
- Self refers to personal and demographic characteristics that impact how a client may view life and include age, gender, stage of life, ethnicity, socio-economic status, as well as psychological resources such as emotional and coping capacity.
- Supports can come from a variety of sources including friends, family, community resources and relationships at work. It is important to note when the client is lacking supports to ensure the necessary referrals for such supports are in place.
- Strategies are the coping responses that a client can use to manage the transition, whether it is to change the situation, control the meaning of the problem or to manage the stress associated with the transition.
Tips for managing return to work for this client group
No two clients are the same and each case requires a vocational rehabilitation counsellor to consider the client’s unique circumstances. The following strategies, however, are helpful in facilitating return to work for this client group:
- Give back control to the client. The more engaged the client is, the more in control he/she will feel. Encourage the client to be an active participant and support him/her to make decisions along the way.
- Focus on ability. Following an injury or diagnosis, it is easy for the client to get caught up in the world of disability. Acknowledge the injury or illness, while helping the client to focus on their remaining abilities and how these can be used to be successful in their return to work.
- Collaboration is key. Working together as a team with the client, their employer and all treatment providers is one of the best resources available for successful return to work.
- Be patient and flexible. Return to work is a process that often feels like one step forward and three steps back. Celebrate the steps forward, anticipate the steps back and have a back-up plan.
The strategies I’ve shared here are just a handful that I have found to work very well with this client group. I share more advice about supporting clients with illness or injury in a chapter I co-authored in the book Career Development for Diverse Clients: Beyond the Basics.
When I first started working as a vocational rehabilitation counsellor, I had no idea the extent to which an injury or serious illness could impact a client’s life. Now, almost two decades later, I have seen first hand the devastation it can cause. I’ve had the privilege of walking alongside clients as they’ve put the pieces of their lives back together and I’ve witnessed the utter despair of clients who were not able to move forward. What I have learned is that it takes tremendous courage, a lot of patience, and an army of support for a client to return to work after an injury or serious illness. And while it may seem like an insurmountable obstacle, every motivated client will celebrate a successful return to work.
