Odyssey Health Services combines Medical Science and Behavioural Science to effectively and efficiently treat mental health and chronic physical conditions. When not treated appropriately, the result can be that individuals suffer from significantly restricted or impaired lives. In the workplace, this can mean reduced productivity, protracted work accommodation or modification, higher than normal levels of absenteeism or prolonged time off work on either sick leave or disability benefits.
It has been established that non-medical (behavioural and psychological) factors are the primary determinants of reduced function including significant absence from work. It is common with these syndromes that psychosocial stressors play a role in the degree to which the patient becomes dysfunctional (see ACOEM document). Factors such as: issues in the workplace (that may include a mismatch between the patient and their job, undesired or unpleasant changes in the workplace, or general job dissatisfaction); family or marital difficulties; financial or other stressors, may play a role in impairing the patient’s ability to cope with what might otherwise be far less troublesome symptoms.
Research tells us that being at meaningful work contributes to a person’s recovery from illness and injury; that employment is a significant social determinant of physical and mental health; and that prolonged time off work decreases chances of a successful return to work.
There have been many approaches developed to help people struggling with physical, emotional and psychological difficulties. How does someone find the best fit for his/her needs and concerns? While there are no guarantees that a specific approach will work for someone, we do know that certain approaches work for many people experiencing a specific type of concern (e.g. chronic pain, depressed mood, anxiety, substance abuse, post-traumatic stress disorder, etc.).
These types of approaches are termed “evidence-based”. An evidence-based approach is one that has been scientifically investigated and been shown to effectively address a particular concern or problem. Evidence-based treatment can increase the chance that a problem is identified accurately and handled effectively. This can prevent the problem from being drawn out unnecessarily and decrease the chances of it coming back (i.e. relapsing).
Individuals who suffer with chronic health problems frequently become deconditioned due to disuse and inactivity. At Odyssey Health Services our clinicians use exercise in the management of chronic disease and injury and focus on the improvement of function and well-being for both physical and mental health conditions.
With input from our physicians and the client’s health care providers regarding any medical contraindications, our clinicians develop both an individualized exercise routine as well as a gradually progressed plan for increasing family, social, recreational and vocational activities. In addition, we use goal oriented activity plans for increasing physical conditioning and overall functional activation.
It is important that planned activities be realistic and not tied to the client’s level of symptomology. It is also important to recognize that often symptoms, or flare-ups of symptoms, do not represent signals of harm. The scientific literature clearly establishes that such careful planning and quota-based activities assist in improving function in spite of ongoing symptomology and also appears to contribute to the symptoms gradually receding into the background.
Our clients learn not to overdo activities when they are feeling well or feeling like they have extra energy and not to avoid planned activities when they are feeling unwell. Ultimately, this places the individual in control of what they plan to do, when they are going to do it and how much they are going to do. It prevents symptoms from acquiring control by determining how much or how little a person does.
In situations of chronic physical or mental health conditions, it is often the secondary suffering that makes matters worse. Both can lead to some common problems over time such as fatigue, sleeplessness, withdrawal from physical activity, work disability and reduced social, recreational and family activities.
And, although the symptoms of chronic physical and mental health conditions may not be readily palliated, the issues of secondary suffering can be dealt with effectively. Individuals can lead a valued and fulfilling life in spite of their chronic condition.
The benefits or meaningful are well known and accepted. Working provides an individual with a way of structuring and occupying their time, social contacts and support, physical and mental activity, an opportunity to develop and use skills, social status, a sense of identity and personal achievement, money and other resources needed for material well-being.
In order to be able to afford to engage in valued and meaningful activities in one’s life, MOST people have to work. As well, work is generally good for physical and mental health, and promotes well-being (AFOEM, 2011; ACOEM, 2006; Waddell and Burton, 2006). It is also a key factor in a person’s self-worth and identity (Black, 2008). Thus, it represents an appropriate treatment goal.
Research has shown that return to work is critical to the recovery process and should be used as rehabilitation to enhance recovery, increase activity and function, and optimize successful and sustained employment (ACOEM, 2006). Our clinicians provide return to work coordination in order to facilitate and support the successful transition to gainful employment.
It is very common for individuals who are returning to work, after a prolonged absence, to experience both fear and anxiety. We find that many of our clients experience an increase in symptoms, of all types, as we begin the planning and implementation phase of a return to work. We understand that this is a difficult time for our clients and that the increased symptoms do not represent harm or signal increased pathology, but rather a very understandable increase in anxiety and fear about returning to the workplace. For some individuals, this leads them to either delay or abort the return to work process in order to avoid the discomfort. Sustaining avoidance often requires effort and energy and limits one’s focus at the expense of fully experiencing what is going on in the present. Avoidance may get in the way of other important, valued aspects of life.
Unfortunately, delaying or aborting the return to work is a solution that has the short-term benefit of reducing the discomfort. However, in the long term this strategy actually results in increasing fear and anxiety resulting in unnecessary avoidance and a shrinking of the individual’s meaningful life.
The role of our clinicians is to develop a plan for a graduated return to work in conjunction with our patient, the insurer and the employer. Typically, the graduated return to work extends over the course of 4 to 8 weeks, depending on the situation. Our involvement does not end with the beginning of the return to work. We continue to meet with our client until he/she is working full time in order to provide ongoing support, problem solving and reminders about how to best utilize the strategies and skills learned during their involvement with us. We have had considerable experience at managing a successful return to employment for our clients.
 See: Grillon, C. (2008). Models and mechanisms of anxiety: Evidence from startle studies. Psychopharmacology, 199(3): 421-437 and Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.