A UK publication, ‘Psychology, personal injury and rehabilitation', looks at the “often underestimated and misunderstood” psychological aspects of rehabilitation. When a worker is physically injured, it isn't just the body that suffers. Addressing psychological impacts can have as big role to play as any in that person's successful rehabilitation.

The publication, which aims to “create a fully co-ordinated, effective, timely and appropriately funded response to any case of personal injury,” outlines the two essential elements of addressing the psychological impacts of injury as early intervention and co-ordination with employers.

“As with other aspects of rehabilitation, psychological and social factors benefit from, but frequently do not receive, early intervention. Early psychological and social intervention can and does prevent deterioration,” states the publication.  

It also says that co-ordination with employers can have a critical effect on return to work. It is essential to good, successful outcomes. Coordination means working together (see RTW Matters article 'Positive steps towards a culture of collaboration in the UK' for more on this) – something that seems obvious when everyone ultimately seeks the same goal: to return the injured worker to their normal, working life. However, collaboration is too often a distant ideal in return to work scenarios, to the detriment of the patient or injured worker.

The publication also reiterates what several RTW Matters articles have highlighted: the importance of maintaining the level and quality of social contact with the workplace during absence. 

When there is this workplace contact, coordination and early intervention, the personal effects of a physical injury are easier to identify and address, and less likely to develop in the first place.

The publication speaks towards improving the current workers' compensation system in the UK, which has “unhelpful” constraints working against the successful rehabilitation of the patient, such as “medico-legal experts not usually being asked to identify appropriate rehabilitative care and to give their expectations of its effectiveness; compensation systems requiring inactivity as a qualification criterion; and delays in medico-legal resolution which delay effective treatment.”

To overcome these constraints it recommends strategies that have currency across the board. The system could be improved, it argues, at three levels:
 

• "At a local level through education, training, minor changes to case management systems and the use of appropriate, field tested, assessments."
• "At a system level through increased adoption of patient/client centred systems and co-ordination with other service providers and employers."
• "At a policy level through representation of psychological and social issues during the ongoing reviews of rehabilitation and liability insurances." 

"Ensure that rehabilitation objectives have real meaning and benefit to the injured person and that rehabilitative interventions are consistent with agreed objectives,” it says, and “train all those involved in case handling (medical, legal and insurance) to understand psychosocial issues, recognise cases at risk and take steps to improve prognosis.”  

Ideally, argues the publication, systems like that of medical care, public and private compensation, employment, education and training, should be self-consistent and mutually reinforcing, and they should be based on high-quality research. They should be based on collaboration, and should be aware of issues that run deeper than simply those that are immediately visible.