Many thanks to iCare, GIO and EML for embracing the Purpose for People program. A comprehensive whole-person program designed to prepare people experiencing injury and disability take back control of their life.
The program is based on the following principles:
Since the program was first offered in June 2019, we have had 8 people referred to the program.
Of these referrals, we have offered 7 people the opportunity to participant in the program, with 1 person clearly demonstrating at the time of our initial consultation that they were not interested in making change (yet).
The program is conducted in 3 stages, with the total program being provided over a 9 month period (for those who will benefit from all 3 stages of the program).
By the 1st of Oct 2019, we have had 2 participants complete stage 1 of the program.
A 57-year-old gentleman who resides in regional NSW whose date of injury was in 2002. He is classified as a High Support Needs client and has achieved a 21% WPI. Along with a significant injury work related injury including reactive depression there are a range of other co-morbidities.
This gentleman did not wish to engage with computer technology, therefore Consultant Rehabilitation Counsellor Kylie Warry creatively delivered the program to the participant (and his wife) over the phone. Initially frightened by the idea of a “program’ that contained homework this participant was an active and fully engaged participant throughout the program who embraced the homework set for him. Again, Consultant Rehabilitation Counsellor Kylie Warry demonstrated her skills in being able to create homework activities that reinforced the new learning in ways that are meaningful to the participant.
The gentleman has shown significant improvement in his Depression, Anxiety and Stress (as identified through the completion of the DASS) and has been noted to become more active socially throughout the program.
We ask all clients to set goals for 6 weeks and then 12 weeks. Of the 6 goals identified 2 have been FULLY achieved, 2 have been PARTIALLY achieved, and 2 have NOT been achieved and are a result of medical needs.
We also achieved a reduction in the AQOL-8D scores in a very short period of time which was unexpected given the level of bio psychosocial disability being demonstrated.
Of considerable note for this client (and his wife) was prior to stage 1 of this program, they were both at significant risk of social isolation with both leaving the home to attend medical appointments of which there were few (not weekly). We all know from research, that with social isolation comes increased morbidity and decreased life expectancy. Both live with significant medical diagnosis and chronic disability, and due to decreasing mental health resilience, they found it easier to disengage from social interactions. We are proud to report that they have embraced the use of their individual strengths to build their resilience and now have a set coffee date with another couple on their community every week and have reconnected with their faith-based community.
This gentleman has re engaged with a wood working hobby that creates connection with his grandchildren, nieces and nephews and provides him with a topic for discussion in social interactions.
We have recommended that this gentleman participate in the second stage of the program, where among other things, he will be empowered to use the functional capacity that he does have and try new ways of performing activity. However, we have requested an ADL Assessment with an appropriately qualified and experienced OT to ensure that we deliver Stage 2 in a way that is the best fit for this gentleman.
We don’t expect this gentleman will return to paid employment. But we can slow down the rate of disability and the need for increased medical care, medication, treatment intervention, aids and equipment.
A 54-year-old gentleman who resides in a rural NSW community whose date of injury was March 2018. However, this is not the participant’s first work-related injury. The result of his current claim is affecting the previous injury (which is ongoing) and he was advised that he is unable to maintain his employment, which has subsequently been terminated. The significance of this situation is that the participant’s pre disability employment included the home he is currently residing in. He advised he was uncertain about his living arrangements and about his ability to finically provide for his partner and granddaughter whom they have custody of.
We were advised upon referral that this gentleman could be at time aggressive and difficult. He reported unhelpful conversations with key players in his injury management to date and was sceptical that we could offer him anything useful. It took 4 different conversations with the participant before he would agree to engage with the program.
This gentleman does have medically certified capacity for employment, however the medical limitations for work preclude any return to employment currently without further upskilling. This client is determined to return to paid employment, however, has expressed in strong terms that he will not consider previously prescribed job options that do make use of his ability, knowledge, skills and social circumstances.
Our initial meeting with this gentleman was conducted in his current residence where it was identified that there is no public transport and that telecommunication infrastructure is poor. Driving too and from the home to access the local community was problematic for this participant on account of his pain and medical symptoms.
We have determined that this participant’s emotional responses significantly impact his experience of a pain flare, which interrupts his functional capacity thus adding to the downward cycle of incapacity.
Due to poor telecommunication infrastructure we were again required to be creative and have purchased a land line phone with a hands-free speaker so that the sessions could be delivered via telephone without creating increased pain. This solution has been effective for this client.
The initial AQOL-8D inventory demonstrated very high levels of biopsychosocial impairment at the commencement of this program.
This participant has reported the following subjective improvements:
What do you know about Strengths and how they affect resilience?
- Knowing your limits, using strengths to help him cope, Talking to people, asking for help, getting out of the house
What have you learned about your strengths?
- When I use my strengths, I feel more positive as long as I stay within my limits; acceptance of where I am at
How are you currently using your strengths?
- Catching up with mates, talking shop, seeing family that are supportive (avoiding those who are not), taking the pressure of myself
What have you learned about your thinking?
- That I can change my thoughts and think more positively, manage my expectations of situations, self and others and stop black and white thinking
What is an example of a Pessimistic thought you have changed into a more helpful Optimistic thought?
- If I can’t do it all, it is not worth doing – to I can do 15 minutes and see how if feel, that is better than nothing
What have you learned about Empathy and making healthy connections?
- Thinking of others is important it is not all about me. It is a two way street, being in pain and stressed makes this harder but being aware of it I can support myself more so that I have room for others.
These statements demonstrate s shift in mindset from reactive to responsive, and from passive victim to active participant.
We have recommended that this gentleman participate in the second stage of the program, where among other things, he will be empowered to use the functional capacity that he does have and try new ways of performing activity. It will also address with him cost of living resources and ensure that he has the knowledge and skills to be able to care for himself and his family into the future independently.
We do expect this gentleman to return to paid employment. However, we expect that he will achieve this by learning how to manage his emotional responses and therefore his pain, by developing the relationships he has with his local community, and by learning what tasks he can and cannot perform and how we can modify a task to make it safe for him.
What we have learned as a service provider
This program was requested by iCare to meet the needs of a cohort of people who are experiencing lack of engagement in both independent living, quality of life and vocational services. We were asked to develop a program based on our extensive knowledge and experience, that could support these workers to take back control of their life.
What we hadn’t expected:
- Being a Sydney founded service we were surprised by the lack of available telecommunications services available in rural NSW.
- The number of conversations and communications that have been required to help potential participants understand the program and the potential benefits that it can offer.
- The number of participants who have commenced the program who have thanked us for making the program available, realising that we do genuinely want to assist them to take back control of their own lives.
What we are committed to next:
- We remain committed to serving those workers who would benefit from this program.
- We are in the process of developing video resources that will be available on the com.au website for everyone to access and for potential participants to be able to use in addition to the print material that is already available.
If you are interested in learning more about the Purpose for People program and how it may assist you or someone you know, please reach out to firstname.lastname@example.org