Mr X had been a 'journeyman 'worker for many years.

He had grown up in rather impoverished socio-economic circumstances and was unable to complete his secondary school education.

Moving from one itinerant and casual menial job to the next, Mr X finally found a vocation in his mid thirties, as a storeman and packer, a position that provided him with some belated vocational peace of mind, if not satisfaction.

However, having left school at the age of fifteen (15), life had taken its toll and there were occasions when he would resort to appropriate self-medicating (such as the responsible usage of Voltaren Emulgel creams).

His employer sold the business to another corporate entity and a sophisticated, mechanised system was implemented in a bid to increase the volume of goods being unloaded from semi-trailers, which were then swiftly reloaded onto pallets for storage into racks in the enormous state of the art warehouse.

Mr X was now finding that his intermittent lower back symptoms were increasing in frequency and severity. Unusually, he was beginning to experience palpitations.

His general practitioner reassured him that his palpitations were a manifestation of anxiety and that he was borderline hypertensive.

He was prescribed alprozalam (Xanax) and he took his medication responsibly.

However, he was subsequently formally disciplined and counseled for his forklift unloading and loading rate.

He noted that many of his colleagues were strapping young men in their twenties with seeming unstoppable vigour. To Mr X, these young work colleagues appeared to be reaching their targets effortlessly.

Mr X was now approaching the age of forty, for all intents and purposes a young age, but for Mr X, attaining the threshold age of forty was not a cause of celebration.

His anxiety and sense of insecurity grew. Instead of two daily tablets of 0.25mg of Xanax, he was now taking up to 4.5mg per day in order to cope.

A paradoxically insecure yet proud man, Mr X refused his general practitioner's pleas to seek cognitive-behavioural therapy in a bid manage his anxiety condition.

Mr X did not listen.

The caring general practitioner was left in a quandary. Dr Z had many patients who were taking Xanax responsibly, often and successfully, .Teachers, policemen, barristers, even other doctors – were functionally well in their professional and social lives through a responsible medication regime.

Dr Z also had a number of workers' compensation patients who were totally disabled. Some of these patients, with the full blessing of their psychiatrists, were taking between four (4) to six (6) milligrams of Xanax. Both Dr Z and the consultant psychiatrists were prescribing responsibly and in accordance with the MIMS guidelines.

Back at the warehouse, Mr X was now taking up to four and half milligrams of Xanax per day while driving his forklift.

Mr X crashed the forklift. An ambulance was called, a representative from the occupational health and safety inspectorate was also called in. Fortunately, Mr X suffered only superficial minor cuts and bruises.

He was called into his manager' office after the ambulance and inspector had left the premises. His manager advised him that his employment was being summarily terminated on the grounds of misconduct.

Uncharacteristically, and in the heat of the moment, Mr X threw a punch at his manager. The punch connected ; the manager's jaw was broken.

Assault charges were laid and Mr X was subsequently convicted and imprisoned for eleven months.

While in prison, Mr X was assigned to a construction gang whose project was to build a new toilet block for the many prisoners. A remorseful Mr X worked diligently until, some months later he noted that he was unable to get out of bed due to excruciating lower back pain.

He was examined by the prison doctor and subsequently underwent spinal fusion surgery after successfully lodging a WorkCover claim against the prison for access to reasonable medical and like expenses (as is allowed under the Victorian workers' compensation legislation).

The surgery went well; while back stiffness remained, the frightening pain that extended all the way from his groin to his legs (and into his toes) had dissipated.

Finally, he was released from prison. Mr X was at loose ends. Manual labour was now out of the question. He idled his days away, drinking coffee at his favourite cafe which was located next to a travel agent. Sometimes, in a fitful and restless mood, he would walk into the travel agent to pick up a brochure or two.

The days and aimless weeks passed away.

One day, he was surprised to receive a phone call from a rehabilitation provider who had been assigned to his case by the insurer.

Mr X was bemused; he was not receiving weekly compensation benefits (as legislative amendments in 1994 meant that Victorian prisoners were barred from receiving weekly benefits under the WorkCover system).

A meeting took place between Mr X and the rehabilitation provider. Mr X was unexpectedly impressed by the kindly rehabilitation consultant (who had asked Mr X if there was a new field of employment endeavour that he would like to contemplate).

Mr X pulled out the brochures from the travel agent that he routinely kept, as some kind of talisman, in his leather jacket. Could the rehabilitation consultant assist him in becoming a travel agent, asked Mr X.

The rehabilitation provider made inquiries and obtained a quote for a twelve month course, the successful completion of which would guarantee him a job with the travel agency that ran the course.

The rehabilitation provider wrote to the authorised agent seeking authorisation for the cost of the twelve month accreditation certificate.

Mr X and the rehabilitation provider promptly received correspondence from the insurer rejecting liability for the costs of the course.

Mr X was devastated, but the rehabilitation provider noted that the denial of liability letter contained an addendum explaining various appeal rights. The decision could be appealed, at no cost to the worker. Even better, the letter contained the contact details of groups who could assist Mr X, for no fee at all, at the Accident Compensation Conciliation Service (ACCS).

Mr X lodged his appeal although his expectations were low.

One bright, late afternoon at the ACCS, an understanding representative from the insurer advised Mr X, his advocate and the Conciliation Officer that the full cost of the certificate would be met.

Mr X completed the course three years ago and today is happily and constructively employed as a successful travel agent.

Key learnings

Motivation is a key driver of behaviour. It can be easy to assume that people off work for long periods, or those with 'disadvantaged' backgrounds, will remain off work or 'play the system.'

Assessing a person's motivation is not difficult in circumstances such as these. Questions like the following will give you a sense of the person's motives:

• On a scale of zero to ten, how much do you want to do this course?
• What is it that increases your score? (i.e.. the things that motivate them)
• What is it that decreases your score? (i.e.. the things they perceive as barriers)

Knowing these things can help you work with the person to identify barriers that may need to be overcome to complete the course successfully.