ARS combines elements of intensive interdisciplinary treatment and the lower costs associated with office based rehabilitation counselling to provide an innovative solution for an under-served population. These individuals do not meet the criteria for the most prevalent treatment services in our communities.
For many years it was believed that if an individual had been off work for more than 2 years, it was unlikely that they would return. The study most quoted is: Waddell, G. (1987) A New Clinical Model for the Treatment of Back Pain. Spine, 12 (7), 632-644. While the paper discusses a broad biopsychosocial approach to pain, it presented data from a limited study of workers compensation patients in British Columbia and by extrapolating the limited data, suggested that return to work after 2 years was next to impossible.
Other studies however have demonstrated that this is far from true. See, for example:
Gatchel, R.J., Adams, L., Polatin P.B. and Kishino, N.D. (2002) Secondary Loss and Pain Associated Disability: Theoretical Overview and Treatment Implications, Journal of Occupational Rehabilitation, 12, 2, 99 – 110;
Main, Sullivan and Watson (2008) Pain Management: Practical Applications of the Biopsychosocial Perspective in Clinical and Occupational Settings. Elsevier: Flor and Turk. (2011) Chronic Pain: A Biobehavioral Approach. International Association for The Study of Pain Press;
Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain 1992;49:221–230;
Turk DC, Okifuji A. Treatment of chronic pain patients: clinical outcomes, cost-effectiveness, and cost-benefits of multidisciplinary pain centers.
There is evidence that intensive interdisciplinary treatment can successfully result in employees being able to increase their level of function to pre-disability levels, including a return to gainful employment. However, programs that can accomplish these outcomes are time and labour intensive, resulting in high costs and inaccessibility for all but a few individuals.
We also know that individuals who have been off work for a year or less can be successfully treated utilizing short term, rehabilitation counselling at a much reduced cost.
But what happens to those employees who are caught in the middle? Those who have been off work for 1-3 years? Their situations are often deemed too complex for short term counselling. Yet, they do not meet the stringent criteria for access to the most intensive and costly interdisciplinary services.
ARS has been designed specifically to meet the needs of this group. We begin with a comprehensive psychological assessment to evaluate the likelihood of being able to provide the patient with further treatment that would permit him/her to increase his/her overall level of function including being able to return to some form of meaningful, gainful employment consistent with his/her background.
Treatment includes evidence based functional activation and physical conditioning that for the first several weeks is delivered in an intensive manner under the guidance of a psychologist and psychotherapist to get treatment goals identified and a treatment plan developed. Treatment continues for an additional 20-30 weeks with a psychotherapist.
Both assessment and treatment are conducted via our health compliant video conferencing platform.