RETURN TO WORK

Occupational Therapy Support for Return to Work Services

Occupational Therapist (OTs) are experts in the assessment and treatment of function in everyday life, helping individuals to return to occupations that are meaningful to them in the areas of self-care, work, and leisure. OTs address the whole person (physical, cognitive, and psychological), as well as the person’s environment, in helping to break down barriers to optimize function.
Occupational Therapists provide return to work programming, regularly working with individuals dealing with mental health difficulties, including post-traumatic stress disorder (PTSD). Occupational therapy involvement in the return to work process for mental health injuries involves the following: 

The OT meets with the worker to:

  • Assess barriers to fully meeting their job demands
  • Assess current function in daily life to inform program planning
  • The OT works as a team with the treating psychologist (if involved) to develop an individualized rehabilitation and return to work plan that is suitable for the worker’s psychological and functional tolerances.
  • Initially, programming typically focuses on ensuring adequate functioning in the realm of self-care and daily life tasks. This aspect of programming is individualized, with programming beginning at the level that is appropriate for the person. This part of programming often involves the OT setting up a behavioural activation program with the worker, setting weekly goals around return to basic activities of daily living such as regular bathing, grooming, and sleep routine. This program progresses to optimize functioning in other aspects of daily life including shopping, homemaking, socializing, and exercise. This stage of programming also involves implementation of anxiety management strategies, including programming such as mindfulness meditation, grounding techniques, and breathing awareness/practice. 
  • The OT works with the individual on community integration – collaboratively setting goals with the worker on returning to community-based activity and socialization. Similar to all aspects of the OT programming, the speed of this progression and the specific goals are highly individualized to the person. This stage of programming often involves exposure therapy programming – using specific protocols to gradually expose individuals to environments and situations that are anxiety-provoking for them in relation to the PTSD while coaching them on using their anxiety management strategies. These first two stages of programming also involves the identification of avoidance behaviours, education around this, and collaborative goal setting to address these.
  • Once the OT and other treating medical and rehabilitation team members have determined that the individual is ready to initiate a gradual return to work, the OT collaborates with the employer, worker, and other team members to take a lead role in creating a return-to-work plan. This plan involves a gradual increase in both work hours and duties, beginning with activities that are anticipated to be best tolerated by the worker, and ideally gradually resuming full duties. The OT monitors the return-to-work progression closely, liaising with both the worker and the employer on at least a weekly basis, and adjusting the plan if needed to ensure a successful return.

Group Education Session

A 1-hour education session with the clients includes the following information:

  • Education regarding the role of occupational therapists within a return-to-work program (as described above)
  • Education around the effect of PTSD on the nervous system, how this affects functioning, and how OTs can help as part of a multidisciplinary team to address these issues
  • Education on exposure therapy – the principles, as well as how this programming is carried out
  • Education on the importance of gradual return to activity (behavioural activation), and the OTs role in this
  • Education around how a return-to-work plan is developed, the factors that are considered, and examples of what this looks like when carried out
  • Time for questions regarding any of the aboveA 1-hour education session with the clients includes the following information:
    • Education regarding the role of occupational therapists within a return-to-work program (as described above)
    • Education around the effect of PTSD on the nervous system, how this affects functioning, and how OTs can help as part of a multidisciplinary team to address these issues
    • Education on exposure therapy – the principles, as well as how this programming is carried out
    • Education on the importance of gradual return to activity (behavioural activation), and the OTs role in this
    • Education around how a return-to-work plan is developed, the factors that are considered, and examples of what this looks like when carried out
    • Time for questions regarding any of the above