Workers' Comp: Is It in You?

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June 2003

By Christopher A. Park, OTR, FABDA

Rsehabilitation professionals can work in a variety of settings including inpatient, outpatient, and acute care rehabilitation, and in schools. This variety of patient population can be both a drawing point for the profession, as well as a limiting factor impacting advancement and career change for seasoned professionals. Each particular area involves unique skills, experiences, and comfort levels in order to succeed and work effectively. Industrial rehabilitation is one specific area that challenges work injury rehabilitation professionals. But what does it take to be successful in this area? How can rehabilitation managers find the right person for their team?

PERSONALITY TYPES

Researchers have studied personality traits of health care workers, including rehabilitation professionals, since the 1960s. The information has proven useful for students, educators, and others expressing an interest in the health care professions. Lyons wrote that occupational therapy and associated health care professionals, particularly those in which women predominate, are often loosely described as “caring” professions. He found that objectivity is an attainable and desirable attribute of health care professionals.¹ Kalyanpur and Rao have suggested that professional helping relationships are too often characterized by a lack of respect for service users’ opinions.² Persons using services may not be regarded as legitimate sources of opinion in making decisions about actions designed to benefit them.³

Fidler found that strong skills in professional behavior were critical for success. In addition, specific professional behaviors identified as important in this study were positive self-regard, self-awareness, interpersonal competence, and commitment to learning.⁴ Balboa and Peloquin identified additional skills needed including respect for others, responsibility, problem solving, flexibility, confidence, cooperation, constructive handling of frustration, modification of behavior in response to feedback, giving constructive feedback, and balancing obligations.⁵

Of particular interest to rehabilitation professionals resulting from research by Lysack was the discovery of personality type differences between physical therapists and occupational therapists.⁶ The researchers used the Keirsey-Bates Personality Inventory to measure personality type and temperament. This inventory is a 70-item forced choice questionnaire of the widely used Myers-Briggs Type Indicator.

Although not an intended focus of their study, the most significant finding was the difference between the personalities of physical therapists and occupational therapists. The study results found occupational therapists to be people-oriented, social, flexible, and creative and physical therapists to be task-focused, direct, structured, and efficient. All of these are traits that would be useful in any rehabilitation setting. But what particular skills are necessary if the majority of your caseload is in workers’ compensation?

SUCCESSFUL QUALITIES

Diane Aja, MS, OTR, is the operations manager for Fletcher Allen Health Care, Colchester, Vt. She has 20 years of experience, primarily in the industrial rehabilitation arena. During this period of time, she has been responsible for the recruitment, hiring, and retention of rehabilitation staff. She has not found a particular personality style that is ideal, but instead looks for qualities that are important for success in this area. These include a clear understanding of roles and responsibilities and an open and adaptive communication style. Aja has found that it is very helpful for therapists to clearly understand their role and how it relates to the other members on the interdisciplinary team.

“Communication in the workers’ compensation arena involves conversing in multiple formats to a variety of people,” she says. “The therapist needs to be able to converse in multiple styles and situations. At times, you are communicating with the patient, rehabilitation nurse, or another therapist that treated the patient previously or may treat in the future. Your communication method and style will differ when you speak with the employer, the insurer, and perhaps an attorney. Therapists in workers’ compensation need to be comfortable with this.”

Aja has found that a team approach and a willingness to share information are essential. “Sometimes it is uncomfortable for therapists to handle the chronic pain field,” she says, adding that there is a tendency to want to find and fix all things that could be wrong with a patient, an approach that may backfire with an unmotivated patient with chronic pain. Says Aja, “A successful therapist in this field must have the willingness to handle the ambiguity of chronic pain.”

Pat Conn, PT, is the rehabilitation services manager at McKenzie-Willamette Hospital, Springfield, Ore. During her more than 25 years of experience, she has noticed “a different mindset in therapists working in an industrial rehabilitation-focused program and traditional outpatient treatment.” Both settings may see work-related injuries. Says Conn, “It seems the focus for the outpatient manually trained therapist is to look for what is causing these symptoms. These therapists enjoy unraveling the great mystery. That is what makes them so thorough and so focused. But in workers’ compensation, the focus is more return to work. You cannot always delve into the past and examine all the injuries and potentially contributing symptoms.”

EXPERIENCE COUNTS

Both Aja and Conn point out that the past work experiences of rehabilitation professionals in jobs such as manufacturing, labor, and service are useful. Past work experiences can be utilized in the development and structure of work simulation activities and problem-solving ergonomic issues. This can give some credibility to the therapists and help them in relating to patients. Conversely, therapists who have never held a physical labor position may have difficulty relating to patients in this type of setting. Patients can pick up on that during the course of rehabilitation.

According to Aja, perhaps the most important skill necessary in the field of workers’ compensation is task analysis and, specifically to industrial rehabilitation, job analysis. Therapists working in this field need to get out to the work site, analyze the job, identify risks and hazards, and then work to reduce exposure to those risks. If the therapist is not comfortable in attending the work site—whether it is manufacturing, a mill, or a warehouse—they will not be as successful as possible in their endeavors.

Christopher A. Park, OTR, FABDA, is in private practice and can be reached at ctpark@aol.com

REFERENCES

Lyons M. Understanding professional behavior: experiences of occupational therapy students in mental health settings. Am J Occup Ther. 1997;51:686-692.
Kalyanpur M, Rao S. Empowering low income black families of handicapped children. Am J Orthopsych. 1991;61:523-532.
French S. On Equal Terms: Working with Disabled People. Oxford, England: Butterworth-Heinemann; 1994.
Fidler GS. Brief or new: developing a repertoire of professional behaviors. Am J Occup Ther. 1996;50:583-587.
Balboa KA, Peloquin SM. Interpersonal skills for practice. Am J Occup Ther. 1999;47:260-264.
Lysack C, McNevin N, Dunleavy K. Job choice and personality: a profile of Michigan occupational and physical therapists. J Allied Health. 2001;20:75-82.

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June 2003