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In Part 1 of this two-part series, I explored six common interferences that can potentially get in the way of a client having a successful stress leave.
Identifying problems is the first step – but I wasn’t going to leave you with a list of issues without providing you with potential approaches and solutions!
In this article, I outline approaches and tools to navigate these six interferences, so that you can best support your client toward a successful stress leave (as defined in Part 1). How and if you use them will depend on your professional scope and the unique situation of your client.
Interference #1: No goals or action plan for the client’s stress leave
A stress leave can be an ambiguous and uncertain period for your client. Without goals, your client may feel even more lost and stressed.
- Identify goals by helping the client brainstorm what is important to them to work on during their leave. From there, you can identify goals. These goals do not have to be huge changes. They can include healthier eating, scheduling in rest, taking care of health complications, addressing grief or learning stress management techniques, for instance. A tool I use is the Wheel of Well-Being (interactive online version).
- Create goals: Ensure the goals are structured using models like SMART or GROW. For example, let’s take “reduce stress” as a goal. What does this mean to the client? How is it measured? What action steps will be taken? Is it realistic?
- Support your client in reaching these goals: With ongoing coaching and counselling throughout their leave, you can help support the client with accountability, encouragement and re-assessment of goals.
Interference #2: Not addressing the stress/stressors
A stress leave can allow time not only to heal and recover but to create plans to address and manage stress.
- Identify the source/sources of stress. A client may be on a stress leave for multiple reasons, work-related or otherwise. Demands and expectations – including ones coming from your client’s own thought processes – can create stress. A stress scale, such as the Holmes-Rahe Life Stress Inventory or this informal online questionnaire from the Canadian Mental Health Association, can be helpful.
- Categorize: Simultaneously thinking of all the stressors someone is experiencing can be overwhelming. I often get clients to use Steve Covey’s Circle of Concern to determine to what degree they feel their stress is in their control, what they can influence and what is not in their control.
- Assessing options and taking action: The 4 A’s of stress management categorizes four options to respond to stress-inducing situations: alter, avoid, adapt or accept. You can work with your client to create a stress-management plan, working on what a client can control or finding ways to manage what is not in their control. Helpful tools include the Wheel of Coping Strategies in Difficult Times and Start, Stop, Continue Decision Making.
Interference #3: Cognitive distortions, self-limiting beliefs and guilt
Since internal thought mechanisms, beliefs and accompanying emotions can have a huge influence on how a situation is perceived and experienced, such as the negative stigma and guilt around taking a stress leave, it is essential to address these.
You can support your client by:
- Holding a safe space for your client to be able to identify and express their emotions and thoughts. An Emotions Wheel can be a helpful tool.
- Validating and acknowledging their experience.
- Bringing awareness to and helping the client identify thought patterns, distortions and self-limiting beliefs that may be negatively affecting them.
- Processing emotions and thoughts so your client does not make decisions solely based on their emotions (such as fear of being fired).
- Creating new, supporting thoughts and beliefs by challenging negative thoughts, fears, anxieties, self-limiting beliefs and the burden of guilt. CBT techniques like the ABCDE method can help.
Interference #4: Not accessing appropriate healthcare resources and support
Stress leave is an opportunity for your client to focus on areas outside their work. Your client may need additional support in areas that may fall outside the scope of your profession. You can help by:
- Asking the client what other areas they need to attend to right now, which can include grief and loss, medical issues, relationship, legal, financial, psychological, etc.
- Following up for accountability, encouragement, structure and continued support.
- Sharing additional resources, which may include referrals to programs or other professionals.
Interference #5: Weak boundaries (during the leave)
Your client may need to set some boundaries, which may or may not be work related. You can support a client by helping them to:
- Recognize that boundaries need to be implemented, which can include explaining what boundaries are and how they might support the client. Here is a worksheet on Setting Boundaries. Boundaries may include emotional (reducing guilt about not working), physical (not checking work emails) or mental (not thinking about work when not working).
- Identify potential boundaries, bringing awareness to any that the client has not brought up that you think might warrant their attention.
- Implement boundaries, including how these will be communicated and establishing consequences of not adhering to the boundaries.
- Follow up to ensure boundaries are effective and identify any changes that may need to be made.
Interference #6: Poor return-to-work (RTW) planning
Your client may or may not decide to go back to their workplace or back to the same job they took a leave from. They may also not be able to work in the same way they did before. Regardless of the length of leave, I encourage a RTW plan; otherwise, your client may be returning to the same situation.
*Note: If a client decided to not return to their place of employment, this would require a separate approach that is not included in this article.
A RTW plan may include:
- Identifying accommodations, for instance: Gradual RTW, ergonomic equipment, changes in job duties or the way the job is performed, different approaches to their work, further training or exploring other positions within the company/organization.
- Obtaining and addressing necessary paperwork, documentation to support a client’s accommodation and RTW plan. Clients may need to obtain documents from you, their occupational therapist, psychiatrist or EFAP (Employee and Family Assistance Program).
- Ongoing career coaching and counselling. Whether working toward a different career or position or returning to their job, your client may need continued support. A reminder that RTW planning is not just what your client will do/not do at work, but what they will do differently outside of work!
A stress leave can be difficult to navigate. Although each client and their circumstance will differ, I hope this article leaves you with basic approaches and effective measures to incorporate into your work with a client who may be considering, entering or taking a stress leave.
