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How to Help Your Psychologist Help You
Jason Vella
Psychological Services Manager
Injury Treatment Pty Ltd
28 February 2016
A guide for Agents, Providers, Employers & Employees
A medical certificate is returned with a month long interval but no additional
treatment plan
Psych Treatment Plans use only broad terms such as ‘CBT’
It is simple to discuss progress in the gym, but confidentiality prevents detailed
discussion about progress in the counselling room
Suitable duties boil down to: You either can or you can’t
Job Dictionaries are precise for physical demands and general for psychological
ones
It is unclear where (or if) the psychologist draws the line between functional
treatment goals and whole of person treatment
Questionable diagnoses and questionable impact on progress
Practical workplace applications of therapeutic suggestions are absent
Familiar Scenarios?
Edwin Smith Papyrus
Anonymous 1600BCE(ish)
fMRI
History of Psychology
The Golgi Method
(1890s)
A scientific endeavour without direct observation
MBTI
Keirsey Temperament Sorter
MMPI
16PF
Jung’s Cognitive Functions
History of Psychology
16 Personalities
Personality Theory: Introspection + Statistics?
A. The development of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviours are clinically significant, as evidenced by one or both of the following:
1. Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.
2. Significant impairment in social, occupational, or other important areas of functioning.
C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a pre-existing mental disorder.
D. The symptoms do not represent normal bereavement.
E. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.
Specify whether:
With depressed mood Low mood, tearfulness, or feelings of hopelessness are predominant.
With anxiety Nervousness, worry, jitteriness, or separation anxiety is predominant.
With mixed anxiety and depressed mood A combination of depression and anxiety is predominant.
With disturbance of conduct Disturbance of conduct is predominant.
With mixed disturbance of emotions and conduct Both emotional symptoms (e.g., depression, anxiety)
and a disturbance of conduct are predominant.
Unspecified For maladaptive reactions that are not classifiable as one of the specific subtypes of adjustment disorder.
Diagnostic Criteria: Adjustment Disorder
A. The development of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviours are clinically significant, as evidenced by one or both of the following:
1. Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.
2. Significant impairment in social, occupational, or other important areas of functioning.
C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a pre-existing mental disorder.
D. The symptoms do not represent normal bereavement.
E. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.
Specify whether:
With depressed mood Low mood, tearfulness, or feelings of hopelessness are predominant.
With anxiety Nervousness, worry, jitteriness, or separation anxiety is predominant.
With mixed anxiety and depressed mood A combination of depression and anxiety is predominant.
With disturbance of conduct Disturbance of conduct is predominant.
With mixed disturbance of emotions and conduct Both emotional symptoms (e.g., depression, anxiety) and a disturbance of conduct are predominant.
Unspecified: For maladaptive reactions that are not classifiable as one of the specific subtypes of adjustment disorder.
Diagnostic Criteria: Adj. Disorder
Psychological Function
Psychological Functional Analysis
Cognitive
Accuracy
Attention to Detail
Judgement
Memory
Speed
Variability
Knowledge
Interpersonal
Team Size
Power Differences
Communication Style
Audience
Media
Age Range
Intent
Emotional Regulation
Conflict Management
Freedom of Expression
Access to Support
Access to protective
factors
Dealing with distress
Degree of Risk
Psychological Functional Analysis
Environment
Familiarity
Ownership/Control
Visibility
Required Travel
Dress Standard
Shift timing
Exposure
Culture
Management Style
Independence
Autonomy
KPIs
Organisational Alignment
Workplace Based Treatment Plans
Workplace Based Treatment Plans
Key Features:
Combination of treatment plan and a suitable duties plan goals
Articulates the specific functional demands associated with duties
Specific interventions are associated with those demands
Gradations are articulated as increases in functional demands
Treatment goals are functional/activity based
Time frames based on treatment or workplace needs
Workplace Based Treatment Plans
Psychological Treatment Formulation:
Early family history of conflict
Current financial concerns within family unit
Relationship conflict with spouse
Passive communication style
Avoidant coping mechanisms
Low self-esteem/tendency towards self criticism
Cardio-vascular symptoms leaning towards panic
Excessive rumination
Poor sleep hygiene
Social withdrawal and decline in usual activities
Low mood
An Example
An Example
Likely Capacity for Work:
Avoid contact with Manager
Travel/location restrictions
Avoid new customer meetings
Restricted meeting numbers/day
3 days per week
4-6 hrs per day
Likely Suitable Duties Considerations:
New/temp line manager
Provide new temp area
Stick to familiar areas
Temp suspension of performance
discussion
Hours
An Example
Functional Psychological Job Task Analyses
Functional Treatment Goal: Adapt to new geographical region
Cognitive: Develop understanding of new clients, develop new travel routine
Interpersonal: Build new sales relationships in person + remote media
Emotional: Dealing with frustration/rejection
Environment: Plan for unfamiliar routines & client locations, regular travel
Culture: Work to specific targets
Psychological Treatment Formulation:
Early family history of conflict
Current financial concerns within family unit
Passive communication style
Avoidant coping mechanisms
Low self-esteem/tendency towards self criticism
Cardio-vascular symptoms leaning towards panic
Excessive rumination
Poor sleep hygiene
Social withdrawal and decline in usual activities
Low mood
Relationship conflict with spouse
An Example
An Example
Graded Recovery at Work Towards Functional Goal
Potential Gradations:
Time to plan new routes
Time to develop strategies for new clients
Opportunity for regular review, with a meeting agenda
Structure client visit expectations in a way that supports time for practising arousal
reduction, note taking, debriefing
Attend clients with support
An Example
Graded Recovery at Work Towards Functional Goal
Potential Psychological Interventions:
Arousal Reduction
Education/Normalisation
Cognitive Restructuring
Exposure
Goal Setting/Planning
Time Management
Assertiveness
Where To From Here
Development of a best practise taxonomy for psychological functional demands
Earlier and more thorough integration of psychologists in RTW planning
Development of best practise models of functional treatment goals
Better understanding of confidentiality in treatment
Research into resilience in the workplace
Contact Details
Jason Vella
Psychological Services Manager
Injury Treatment Pty Ltd
Phone: 02 8746 1354
Mobile: 0455 086 141
Email: Jason.Vella@injurytreatment.com.au
Renee Thornton
General Manager of Customers
Injury Treatment Pty Ltd
Phone: 02 8746 3307
Mobile: 0415 620 298
Email: Renee.Thornton@injurytreatment.com.au
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