For many years I worked as an RTW Co-ordinator. Many of the claims I used to manage had nothing to do with the actual injury and everything to do with relationships in the workplace. You may agree that in a lot of these cases, by the time the RTW Co-ordinator is involved it’s like closing the gate after the horse has bolted. There can be unresolved feelings of resentment, bitterness and victimisation, and sustainable return to work is often only achieved by segregation.

The medical model traditionally rules the day when it comes to RTW and it works well when there is a highly-predictable injury such as a fracture. However, when there are less predictable injuries the likely time-frame of recovery can be unknown, and more importantly, the worker’s feelings greatly influence whether they come back to work or not.
 

Emotional intelligence and returning to work

These days there is a lot of talk around emotions in the workplace and the concept of Emotional Intelligence (EI). What is that really, and what does it mean in the context of Return to Work?

Daniel Goleman popularised EI in 1995 after publication of his book Emotional Intelligence: Why It Can Matter More Than IQ. In actual fact, Peter Salovey and John D. Mayer have been the leading researchers on EI and were the first to coin the phrase ‘Emotional Intelligence’. In their influential article “Emotional Intelligence,” (1990) they defined EI as:

“... the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions”.

In the years since they established Emotional Intelligence as a verified science, extensive and substantive research has demonstrated the effectiveness of EI skills in helping people connect and communicate effectively, make decisions, and manage stress, pressure and conflict.

In one study (Pesuric & Byhan, 1996) supervisors in a manufacturing plant received training in EI competencies to help raise their EI skills in areas such as:

• How to listen better
• How to help workers resolve problems on their own
• How to empower and inspire others
• How to become more effective personal leaders

After training:

• LTI’s were reduced by 50%
• Formal grievances were reduced from an average of 15 per year to 3 per year
• The plant exceeded productivity goals by $250,000

So how does that fit into the day-to-day role of a case manager or RTW Co-ordinator?

Communicating with Emotional Intelligence

Clear communication, with sensitivity to the emotional needs of workers / claimants is essential in the return to work. Without it, case managers can feel workers are being uncooperative, and vice versa.

The good news is that Emotional Intelligence gives us a framework for resolving conflict as well as getting benefits that you might not first expect such as building trust and rapport with others.

Whether injured or not the expression of feelings and emotions at work follows a structured continuum, called the Emotions Communication Continuum. From least to most effective, the five types typically used are:

1. Avoidant– typically demonstrated through turning away or withdrawal from the person or situation
    
2. Passive-Aggressive– typically demonstrated through procrastination or inefficiency in the individual’s work. This is typically related to dissatisfaction with current circumstances coupled with poor self-belief that the situation can be influenced by the individual
    
3. Aggressive– typically based in defensiveness or uncertainty regarding the individual’s feelings and emotions. Typically focussed on attaining their own emotional needs at the expense of all others
    
4. Assertive– an honest and clear expression of how the individual is feeling about situations and events without any undue negative emotion, in a way that doesn’t infringe or discount others’ feelings and emotions
    
5. Collaborative– centred on actively communicating feelings to others and subsequently providing the opportunity for others to challenge, clarify or reframe.

Understanding where your worker / claimant sits within the Emotions Communication Continuum can help formulate the most effective communication strategies.

When communicating with your worker:

• Make sure that good relationships are the priority: Treat others with respect, this will help build rapport and trust in you
• RTW programs work best when everyone involved has a say in its design. Then everyone knows what their rights and obligations are. This can reduce conflict.
• Keep people and problems separate. Recognise that in many cases the worker is not just ‘being difficult’ – real and valid differences can lie behind interpersonal conflict claims. By separating the problem from the person, real issues can be discussed without causing further damage to working relationships
• Listen first, talk second. By listening carefully you’ll most likely understand why the worker is adopting his or her position.

These may sound obvious steps yet often different underlying needs, interests and goals can cause people to perceive problems very differently. You’ll need to agree the problems that you are trying to solve before you’ll find a mutually agreeable solution.

Case conferencing can be an effective way of bringing key stakeholders together to discuss return to work strategies. Don’t be afraid to ensure you are the person facilitating this conversation. Sometimes, key parties can have their own agendas and can get passionate about taking over the conference, losing the worker in the process.

It is also useful to build a framework for the case conference. For example:

Step One: Set the Scene

When opening a conference, setting some guidelines can be appropriate. Let everyone know that you would like to hear from all of them regarding a possible way forward, and ensure the discussion remains focused on what you are hoping to achieve. Use active listening skills to ensure you hear and understand the others’ positions and perceptions:

• Restate
• Paraphrase
• Summarise

Step Two: Gather Information

This is also an opportunity to get to the underlying issue, needs and concerns. Ask for the viewpoint of the worker, along with other participants, and confirm that you respect their opinions and co-operation to come to a mutually agreeable solution. Be sure to focus on work issues and leave personalities out of the discussion.

Step Three: Agree on the Problem

Sometimes different people will see different or interlocking problems – if you can't reach a common perception of the problem, then at the very least, you need to understand what the other person sees as the problem.

Step Four: Brainstorm Possible Solutions

If everyone is going to feel satisfied with the resolution, it will help if everyone has had fair input into generating solutions. Be open to all ideas, including ones you may not have considered before.

Step Five: Develop the Plan

If possible, develop the RTW program at the Case Conference, and if possible have all parties sign it. It may include a graduated return or alternative short-term arrangements.

Here are some useful suggestions for leveraging your own emotional intelligence:

• Ask your worker / claimant how they feel. Acknowledging their feelings helps them feel validated.
• When people are feeling threatened, trying to influence them will not work. Helping them shift their perspective can solve the problem. Questions to ask can include:
  • What is the outcome you want?
  • What is it about this outcome that appeals to you? Get it all out on the table, often the issue is not the injury, it is the fear of change caused by family, possible retirement or job change.
  • What’s going to be evidence of progress as you pursue this goal? This can also help set the benchmark in the RTW program / plan. If the worker has set these milestones themselves then they are more likely to reach them.
  • Ask them to tell you the steps they will take to facilitate their rehabilitation. Put these steps in the RTW Plan. This is a big deal, because it means they have to consciously accept responsibility for getting themselves in a better state. Summarise what they have told you.

The most important step is taking action. When you take action it helps break any patterns of feeling helpless. Check in with your worker to make sure they have completed the action steps they were supposed to. If they haven’t, ask them what they were prioritising their time on. What is not focussing on their rehab costing them? And it’s not just financial: it’s the social and family cost as well.