How to address psychosocial barriers to returning to work

As a GP, it's important to identify and address psychosocial issues that may present a barrier to returning to work.

While many patients recover quickly and return to work, others may face a range of social or psychological issues that delay recovery. It's important to address psychosocial issues as they come up. Below are a number of intervention tactics to consider if your patient is facing psychosocial barriers to returning to work. 

During GP consultations

  • Educate and reassure your patients about the normal course of injury and address the unhelpful beliefs below (for example, pain catastrophising)
  • Communicate expectations for recovery and work e.g. “I expect that in four weeks you will have returned to your previous work capacity.”
  • Talk about the health benefits of good work
  • Contact the employer / case manager to understand the employer's ability to accommodate a gradual recovery at work
  • Request a case conference with the case manager and other key stakeholders to discuss any support or intervention required to assist with recovery and return to work

Other professional intervention

Specialist intervention        

  • Referral for assessment with an occupational physician
  • Referral for assessment with a psychiatrist or pain management specialist1

Both of these referrals can be made in the certificate of capacity. You can highlight bio-psychosocial factors in the certificate of capacity under the ‘Factors Delaying Recovery’ section of the ‘Capacity for Employment’.

This will assist the case manager in identifying where and when additional supports can be provided to the worker.

Learn more about completing the certificate of capacity

If you have concerns about your patient’s recovery, you're encouraged to contact the case manager to discuss other possible strategies that may assist in managing their injury.

How to escalate concerns

 1Adapted from Using the Flags Model a Practical Guide for GPs, Workcover WA

Addressing unhelpful beliefs

Everyone has their own beliefs and expectations about their own health and work. These don’t always align to the evidence and might be detrimental for your patient’s health and recovery.

As a GP, your role is crucial in helping dispel these unhelpful beliefs and guiding your patient to the best outcome for their long-term health and recovery.

Below are some of the common misconceptions about the health benefits of good work, and some evidence-based responses you can use to dispel these misconceptions:

 Worker misconceptions Evidence based response
 My injury or illness will be made worse by work.
  • Safe work is good for you - physically, psychologically, socially and financially.
  • Pain or discomfort does not always mean your injury or illness is getting worse.
  • Recovering at work, as with any increase in activity, may be uncomfortable or difficult for a time but does not usually cause any lasting negative effect.
  • Incremental, time-based increases in function (despite symptoms) are likely to achieve better long term outcomes.
 My injury or illness is the result of underlying damage or disease.
  • There is often little or no underlying disease or permanent damage, and even if there is, incapacity is not inevitable.
  • Clinical symptoms do not reliably correlate with findings on investigative imaging.
 My injury or illness will be cured by medical intervention and treatment alone.
  • Treatment is beneficial when it is tailored to your work tasks.
  • Clinical management is often about managing symptoms to allow you to continue or resume your usual activities at home and at work.    
 My injury or illness will improve or be cured with rest, that is I cannot return to work until I am completely better.
  • Staying active (including safe work) promotes recovery.
  • For most people with a workplace injury, time off work is not medically necessary.
  • Common health problems can often be accommodated at work with the necessary adjustments and support.
  • The longer a worker is off work, the less likely they are to ever return*.
 I will lose my job if I have a work related injury / claim.
  •  Employers must not dismiss a worker because of a work related injury within six months** from when they first become unfit as a result of the injury.
  • However, the worker must make reasonable efforts to return to suitable employment*** with their pre-injury employer and, if this is not possible, with a different employer
                                                                       

*Johnson D, Fry T. Factors Affecting Return to Work after Injury: A study for the Victorian SIRA Authority. Melbourne: Melbourne Institute of Applied Economic and Social Research; 2002.

** Section 248 of the Workers Compensation Act 1987

*** Section 48(1) of the Workplace Injury Management and Workers Compensation Act 1998