When someone is recovering from a herniated disc, shoulder surgery, or a broken leg, judging their work capacity is predominantly based on what they can and can’t do, at a physical level.
It’s a matter of whether the client can achieve task ‘X’, given their capacity ‘Y’. Their role requires them to stand, walk, lift, carry, hold a weighted item overhead… And in their session we see them standing, walking, lifting, carrying, and moving weights. Do X and Y add up?
But what about in the case of mental health clients? When their limitations are psychological, subjective, and not able to be quantified on a numeric level?
We aren’t psychologists… So where does Exercise Physiology fit in?
Exercise Physiology for Mental Health
Exercise has huge benefits for mental health, by increasing feelings of self-efficacy and self-esteem, providing a distraction from negative thought processes, improving energy levels and sleep quality. Changes occur even at a biochemical level – exercise releases mood-enhancing endorphins such as dopamine and serotonin, and reduces the circulating cortisol (stress hormone) levels! If you’re keen to learn more about Exercise Physiology for Mental Health, check out our article: Unconvinced That EPs Can Help With Psych Claims?
We often deal with clients who have conditions such as major depressive disorder, anxiety, panic disorder and PTSD. For these individuals, their ability to lift a power drill over their head, or pick up a 10kg box is irrelevant.
Instead, we are asking questions such as…
“Can this client get themselves out of bed at a reasonable hour?”
“How well does this client handle stress and/or responsibility?”
“Is this client able to interact with other people?”
And in some cases, “Is this client confident enough to leave their home?”
When we assess an individual’s ability to tolerate a return to work, it’s a matter of their ability to tolerate the cognitive, emotional, psychological implications of their work.
We have to put on our detective hats! Look wider, think broader, and be on the lookout for subtle clues. Changes in personal demeanour, behaviours, and the clients’ language (both verbal and body language!) throughout the program are all important to help us ‘solve the case’…
Can this client return to work?
Detective hats on
Some of the clues that we are looking for may include…
- Time management:
- Does the client show up on time to their planned sessions?
- Do they need reminders?
- Motivation and engagement during sessions:
- Is the client keen to participate?
- Are they able to remember their exercise program without constant prompts?
- Commitment to sessions:
- Has the client canceled any sessions?
- Are they making excuses to avoid doing certain tasks?
- Are they completing their independent exercise sessions?
- Daily schedule:
- What does the client spend their day doing?
- What time do they get out of bed?
- Are they able to get done all of their housework each week?
- Do they nap during the day?
- Do they try again when they fail at something, or give up?
- Are they emotionally up and down, or stable (even despite setbacks)?
- Social engagement:
- Are they part of any community or social groups?
- Do they make eye contact during the sessions?
- Are they comfortable engaging with people in the community?
This is by no means a comprehensive list, but it shows the level of qualitative data that we can use to build our case!
Working with us, to get clients back to work
Believe it or not, work has great benefits for mental health! So we are quick to let you know of any detective findings that might support the case to get that client back in the workplace. We send through comprehensive fortnightly email updates, which can then be taken along to the GP allowing a more informed conversation between all parties.
Of course, as with any file that we are working on, collaboration is key! We are also happy to reinforce and reaffirm any key messages that need to be conveyed to the client (perhaps we are also part-time cops?!).
We know how challenging mental health claims can be, and we’ve learned firsthand that a lateral approach can make a huge difference. If you need someone to help you look at things differently, don’t forget to look toward an EP!
Author: Yolanda van Vugt
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Have you got a Psych claim that needs the detective eye of one of the Specialised Health EP’s?
Refer to the team!