Newsflash: You're a Rehab Counsellor, Not a Wizard

Hey Able-Minded people. 

I have been in a season of busyness lately (you too?). The good news is that I'm feeling mighty fresh after a week of holidays in the gorgeous hunter valley... and I got to channel my inner amateur photographer for a few days:

 

Australia's latest and most worrisome organised crime syndicate. #followtheleader #huntervalley

A photo posted by Natalie Taylor (@ablemindedrc) on

 

Back on topic... preparing for holidays was one of the most stressful things I've had to do this year (a first-world problem if there ever was one, but stay with me here).

It was probably the first time I've been important enough to worry about what will happen while I'm gone, and much to my team's amusement/frustration I was definitely not on my A-Game as I tried to get things in order before my leave.

But here's what happened:

  • I had a meeting with my boss where she gave me the time I needed to talk through what I was working on, what I could delegate and what could wait until I got back.
  • She gave me permission to be a bit stressed out, helped me make sense of why I was feeling the way I did and reassured me that everything would be fine while I was gone as long as I prioritised the important things before I left.
  • My teammate called me to ask, "What can I help you with so that you can leave on time today?" (and I immediately collapsed into a puddle of gratitude).
  • My entire team wished me a safe and happy week off. I know I will be missed but I also know that my team will look after things while I'm gone. 

This past week, I felt so connected to my team. I had permission to be human (while still being held accountable to the stuff that matters), I felt important and I felt like a valued part of a community of people who really care about me.

So what I'm really trying to say is... 

I feel safe at work.

Many of our clients aren't as fortunate. 

Often, they're unwell as a result of the stress they've dealt with at work, and for those who aren't, many are reluctant to return to workplace where they don't feel valued, supported, understood.... and safe.

Layer on top of that a heaping of suspicion towards third-parties (including us) and fear around loss of benefits... and you've got a client who is suddenly feeling very threatened and very unsafe. 

So what does this mean for us? 

We need to take Rehabilitation out of the vacuum. We simply cannot do this alone.

Talking about capacity and medical certificates just isn't going to cut it. 

People are not inspired to return to work because a piece of paper tells them that it's okay to start working again.

People go back to work because they feel safe, that they belong and that they matter.

From Simon Sinek: 

This is what I mean by feeling safe: "I love the people I work with, I love where I work, I enjoy going there". [The imbalance happens when]: "I feel safe at home, but I don't feel safe at work". 

It's time for us to have bigger conversations about going back to work. 

Workplaces, employers, insurers and treating health professionals all have a crucial role to play in recovery and return to work.

The most troubling thing about our current processes is that they often exacerbate the uncertainty and lack of control that a person experiences after they become unwell or injured. 

And even if we're doing everything in our power to help our clients feel empowered to make choices and decisions, to regain some sense of safety in their lives, rehab is still bigger than us. 

It's not just our actions that matter. 

I've been in so many situations where I've been too scared to speak up and say that pushing a "return to work" with a certain employer just isn't going to work because my client and their employer have a poor relationship and a lack of trust.

Then there are other times where a client is so suspicious of their insurer's motives (and mine, too) that they become paralysed and completely stuck. 

I was afraid that this would signal my failure as a rehabilitation consultant - because I couldn't make things work out. 

Rehab is bigger than just our clients. 

If we want our clients to take personal responsibility, then we need to do the same. And we need to ask that everyone else involved take responsibility for their role in this process as well. 

Please just keep in mind... 

Rehab Counsellors Aren't Wizards!

Newsflash: You're a Rehab Counsellor, Not a Wizard!

Newsflash: You're a Rehab Counsellor, Not a Wizard!

If you're in a situation like the one I've described - feeling like you're stuck between a rock and hard place, and feeling like you're failing because you just can't seem to make things stick - I want to let you know that you can't do this alone. And you're not a failure because it didn't work out. 

Even the world's best Rehabilitation Counsellor, with master-level persuasion and negotiation skills, can't make a "return to work" happen if everyone else doesn't want to come to the party.

With that said, please don't go hide under a rock and assume that you're powerless. 

Because we need you.

We need you to speak up and help us change the conversation about what recovery and return to work look like and the role that everyone can play in this process. 

We need you to speak about what we can offer as Rehabilitation Counsellors, as well as what we can't fix on our own. 

We need you to clarify expectations with everyone up front and be clear on who is responsible for what, as well as the type of outcome that is realistic given the timeframe and resources you've been given. 

Sometimes, I think that people mistake us for wizards dressed up as normal people. 

(It's because most people don't really know what a Rehab Counsellor does in the first place.)

You can be the quiet voice of disruption that helps people understand that they, too, have a role to play in recovery and return to work. 

You don't have to do this alone, but you can be part of the conversation that makes things better. 

Take this idea out for a spin...

Try out this diagnostic next time you feel like you're stalling - does your client feel safe?

We all seek out safety... so what is your client currently doing to create a feeling of safety for themselves? 

Start there. 

Have you had a similar experience to the one I've described above? Connect with me in the comments below - I'd love to hear from you. 

 

Feature image by Steve Rotman is licensed under CC by 2.0.

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You're Too Young To Be a Rehab Counsellor

I’ve often felt like I’m too young for this job.

What could a person in their twenties have to offer someone who’s two, three decades older?
Don’t you need life experience to be a decent Rehab Counsellor?
And seriously, what could a twenty-something possibly know that all the other experts haven’t already tried?

There’s that word… expert. 

Rehab and return to work management is like an expert’s playground.

You’ve got doctors, specialists, psychologists and stumpologists (OK - I made that one up), every other –ologist you could think of…. plus anybody else with an opinion. That means friends, families, benevolent co-workers, bosses, managers and that guy two doors down who slipped at work and got a massive payout. How’d he do that?

We put a lot of faith in experts. Our clients trust and hope that one day, some expert will finally find the missing piece of the puzzle that puts them back together again.

By the time they come to us, our clients are no strangers to the “expert opinion”.

And yet, none of those expert opinions have helped them get unstuck.

If expertise was all it took, your client wouldn’t be sitting in front of you, saying (or thinking) something along the lines of:

“Let’s see what you’ve got that I haven’t already tried yet.”

And I know the feeling of terror that comes with those clients who just make you want to throw your hands in the air and say, "yep – I seriously have no idea what to do now."

Aren’t you supposed to have a plan? Well…

Whose Expertise Is It Anyway?

I’ve worked myself into the ground trying to come up with The Answer  to my clients’ problems. I’d agonise over transferable skills, analyse possible job options and bang my head against a wall trying to discuss the benefits of work with my clients and their doctors.

Nothing moved forward. Nobody cared.

To my clients, I became just another person with an opinion who let them down because I couldn’t fix them, right the wrongs of the system and give them their old life back.

The last thing your client needs in their life is another expert. They have plenty. 

It’s all too easy to fall into the trap of feeling like you need to have all of the answers for your clients, and this feeling is especially pronounced when you’re a new graduate and you feel like you have none of the answers.

Experience is important, expertise is needed, but you already have the most important expert right there in the room.

It’s your client.

And you don’t need 28 years of experience plus a doctorate to start asking them some better questions.

Seriously, It’s Not About You

I often still catch myself feeling like an idiot because I don’t know what to do yet, what to recommend or what the plan should be. I get caught up in a trope I know all too well:

“You’re too inexperienced, you don’t know anything, you’re a big fraud and everybody knows it.”

It’s times like this when I thank my brain for that story (broken record that it is) and remind myself that seriously. it. is. not. about. you.

The experience that is crucial, and the experience that is mostly ignored, belongs to our clients.

Only they can answer questions like:

  • What’s missing here?
  • What’s working and what isn’t?
  • Where do you feel stuck?
  • What do you wish people knew about you?
  • What matters to you and how can we do more of that?

And those are just a couple.  You need exactly zero years of experience to be curious.  It doesn’t cost anything to listen, hear and seek understanding.

And you’ll be one of the few people who do.  Our clients are sick of being told what to do by experts who don’t get it and don’t listen.

Our real expertise lies in being able to help our clients draw on their own experience, their own expertise, to start making choices about where they want to go next.

I’ve been playing with this idea of shared expertise for a little while now.  And what’s an idea worth if you can’t turn it into a venn diagram?

Shared Expertise and The Sweet Spot

Shared Expertise in Rehabilitation Counselling. There's beauty in not having all the answers. Ⓒ Able-Minded 2016.

Shared Expertise in Rehabilitation Counselling. There's beauty in not having all the answers. Ⓒ Able-Minded 2016.

Thinking about sharing expertise has been a revelation for me. Our expertise as health professionals only becomes relevant and useful through the lens of our clients’ experience, their values and their unique insight into their own lives.

Asking big and powerful questions helps us find the sweet spot, where we can exchange expertise with our clients, back and forth, to move towards an outcome that is meaningful and valuable to them.

If we’re lucky, we might even stumble across a big, hairy audacious goal that catapults us and our clients forward.

Every meeting you have with your client in which you are the expert is a missed opportunity. 

Being the expert is boring.

The question-askers get to have some fun.  First of all, a question-asker doesn’t run themself ragged trying to solve someone else’s problems. They don’t have to shoulder the burden of having all the answers and engineering a plan for someone else’s recovery.

Question-askers get to be curious. They get to be humble. They aren’t plagued by the insecurity of not knowing it all because that means they get to work with their client to figure it out. Question-askers build partnerships and get out of the driver's seat so that their client can take back the wheel.

I think I’m OK with riding shotgun for now. Are you? 

 

Let's Celebrate the Beauty in Not Knowing It All:

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Further reading: Michelle Loch at Rewired Leadership has been instrumental in my learning around what it means to be a facilitator for my clients rather than expert. If you want to have more powerful conversations with your clients, please consider one of her programs.

Feature image by Melpomene/shutterstock.com

 

#SlowDownSunday: The Stress-Free Job

Welcome back to #SlowDownSunday! As we wrap up the weekend and move into a new week, I want to use this time to slow down and reflect on what made it onto our radars in the last 7 days.

This week? Lets talk about stress:

A post from the New York Times popped into my newsfeed this morning: In Desperate Pursuit of the Zero-Stress Job.

It got me thinking about how many of our clients (and their treating health professionals) believe that the only job they can succeed in is one without:

  • pressure
  • deadlines
  • anxiety-provoking situations
  • times of stress

I’m not sure that this job exists. 

And I’m not sure that a life without stress and anxiety exists either. 

I don’t say this to diminish the havoc that stress and anxiety can wreak on a person’s life. And I’m not suggesting that we encourage people to pursue unnecessary stress in their life or work.

But when we set a goal to completely avoid something that is a side effect of being, well, alive, I think we might be creating some problems. 

So why are we so afraid of stress?

It makes sense that stress is something we'd rather avoid. Stress sucks. And we've all read the articles and been told by our doctors about the health effects of prolonged stress. Our adrenal glands just weren't built to be on high-alert around the clock. 

But stress-free living has a dark-side.

The Yerkes-Dodson Law tells us that people need a baseline level of stress in order to perform effectively. Zero stress doesn't necessarily mean that we'll function better, or that we're able to navigate life more effectively. 

In the pursuit of the stress-free life, we also have to say no to the things in life that are innately difficult, yet rewarding and meaningful.

When we talk about a stress-free life, we are also talking about a life that is devoid of human connection.

We are talking about a life with no new experiences or environments, one without opportunities to learn and grow and develop ourselves, to pursue meaning and purpose and the things we really care about. 

The stress free life comes at a cost. 

This reminds me of something Russ Harris says often in his teachings: 

"Don't set goals that a dead person can do better than you."

I don't know about you, but a goal like "avoid being stressed or anxious" is something that a dead person would totally kick my butt at. 

So my question to people who feel that their lives, and their choices, are at the mercy of stress and anxiety is this: no one but you can decide your limit. But… 

Is there something valuable enough that you could make room for some anxiety and stress in order to have it? 

As Rehabilitation Counsellors we are in a unique position to ask this question of our clients. What if we could work with our clients to:

  • Minimise unnecessary stress through suitable job choices and accommodations;
  • Help people develop the resilience and strategies to effectively manage and respond to the stress that cannot be avoided;
  • Identify the things that are worth pursuing as part of a rich and multidimensional life, even if that means stress and anxiety come along for the ride;
  • Talk about whether working could help them achieve the things they value, and empower people to do more of what matters.

So what do you think: Is the stress-free life one worth living? 

Oh, and one last thing…. what was on your radar this week? 

Image credit: The images in this post by Bernard Goldbach and Franklin Ramos are licensed under CC by 2.0.

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You, Me & The RC: Meet Ross

Welcome the first instalment of You, Me & The RC, a series in which I convince a very patient Rehabilitation Counsellor to let me buy them coffee and probe them about what it means to be an RC. Would you or someone you know like to be featured? Reach out here

Meet Ross Miller

Ross has been working in the disability sector for over 30 years. As a guy with a hearing and visual impairment (Ross is legally blind and affectionately refers to himself as a "blindie"), he brings a unique level of insight and personal experience to his work. 

How did you discover Rehabilitation Counselling?

I knew that I wanted to work with people. I actually found social sciences and Rehabilitation Counselling as I was looking through a university course guide... The course at Lidcome [University of Sydney] just looked like a good bet to me. I didn't know where I wanted to end up but it was exactly what I was looking for. 

Did having a visual and hearing impairment influence your choice to become an RC?

Well, no, not at all! But it does impact the way I work with people. I've had my fair share of experiences where people have had opinions about what I can and can't do. One of the great lessons is that you must take personal responsibility, even if you have been treated badly by the system, because you cannot rely on others to do so. And so I try to impart that onto my clients, too.
When you see opportunities or barriers, don't put the responsibility on others to follow them up or chase them down. Making your own decisions is the only way forward and assigning blame and abdicating your responsibility to others will never give you control over your health and livelihood. 

How do you help your clients figure out what their personal role in their recovery should look like?

This is the sort of thing that can take a couple of sessions - to really understand someone's situation and their perspective on what's happening for them. You can't go preaching to people right away if you don't fully understand their sense of what their role should be. It really is a matter of serious listening and trying to get a grip on how they see their place and where eventually they would like to be. 

I've created a few posters that I keep in my office which talk about this idea of taking back control. From the moment you get injured, your employer wants part of you and your time, your doctor wants part of you and your time, and so does your insurer and your physio and all the rehab people... and suddenly, you have lost of all your independence and power.
Because everyone else wants something from you, no one is going to give you that power. You have to take it for yourself and take control. It's not about being defiant but rather taking in advice and information and asking yourself how you want to apply it all so you can get your life back. 

Is there often a "lightbulb" moment for your clients?

A lot of them, yes. But we will all work with people who just don't want to take ownership. There's not a lot we can do about that. I can't make the change happen for someone else, but I can give the resources and support they need in order to make it happen if they choose to take ownership over their lives again.  

Ross, you're pretty well known to us as the King of Transferable Skills. 

What's the key to an excellent Transferable Skills Analysis?

You really, really need to take the time to break down each skill. I see people coming up with a list of only 5 or 6 transferable skills for a client and I think that's hilarious. 

Take something like "computer skills". I've seen people write something like "good computer skills" in a report and leave it at that. No. You have to break it down. 

Even if you break it down into "basic Excel skills" and "intermediate Word skills", what do you really mean by that? Get specific. What can they do in Excel? Can they enter in formulas, manipulate data or do they just know how to type numbers into cells? In what context are they using it - for banking, accounts, for marketing data? These small things add up to a much larger skill-set that can be transferred into a new role.

It's the same thing for communication skills. We use communication for so many different reasons in many different ways. What are the specific tasks? In what environment? Who are they communicating with? What outcome do those skills help a person achieve in each context? You have to delve into that stuff.  

That's how you end up with 5 pages of transferable skills for a client! And it's all legitimate stuff that they can use in a new role. 

What's your most memorable client story?

I remember one client where we really got to help someone turn their life around.
We worked with a gentleman who had been a labourer his whole life, totally illiterate. He was roughing it out in a park when we started working with him. We got him involved in a Work Action Group that we used to run, it was a club that covered what it took to get back into employment. 

Beyond just helping him find work, we helped him work on his relationships and day to day functioning. It was amazing when an employer called saying that they wanted to hire him - they were so impressed that he was the first person they thought of!

We still talk about him now, especially with my clients today, as an example of how people can turn their lives around when they're supported in taking back personal responsibility for their future. You can move forward even with barriers, if you make that choice.

Any advice for working with people who have a visual impairment? 

It's not that different to any other condition you work with, in that you need to know the research and what's available for each person's injury or condition. How can you help them if you don't have an idea of what the symptoms are like, what the supports are like and what could help? So yes, research.
Especially for blindies, there is so much great technology that we can use. On my iPhone and iPad, this stuff is there out of the box, and it's same with Samsung too. I have a hard time believing that blindies can't use the internet when I do it everyday - I've learned it. 

But I'm still waiting for my hearing aids to come with bluetooth built in!

 

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Rethinking Mindfulness

Unless you've been hiding under a large rock (or perhaps meditating on one), you're probably a bit sick of hearing about mindfulness by now. From colouring books to apps to breathing exercises, we've reached mindfulness saturation.

Mindfulness has become the poster-child for our fight against the stresses of modern life. Hard day at work? You should try mindfulness. Kids testing your patience? Do some breathing exercises. Got anxiety or depression? Focus on the present and watch your worries melt away. 

Those are some mighty big promises. It's no wonder then that so many of us find mindfulness to be so underwhelming. 

"I just sat quietly for 10 minutes and I don't feel any better. What gives?!?" 
Rethinking Mindfulness: Control, Awareness and Choice.

Rethinking Mindfulness: Control, Awareness and Choice.

And how many of us have worked with clients, particularly people with a mental illness or longstanding pain, who have tried mindfulness or breathing exercises and think it's all a big crock? 

So... is mindfulness a sham? 

Do you see a trend in the way we've been using (and abusing) mindfulness? 

  • "I should try mindfulness to reduce my stress"
  • "Will these breathing exercises make me less anxious?"
  • "My [insert well-meaning person with an opinion here] said that meditation would help my pain"

We've been using mindfulness as a control strategy [1], which is not its intended purpose. 

Mindfulness is not about eliminating painful thoughts, feelings or sensations. It's not about "focusing on something else" (like your body parts, or your breathing) and it's not about positive thinking and willpower. 

It's actually the opposite. 

Mindfulness practice requires us to make room for the uncomfortable stuff instead of struggling against it.

In a nutshell, being mindful is about being present to all that's happening around (and within) ourselves. And the goal is to do this without judgement and without getting too attached to whatever thought, feeling or sensation we notice. 

This concept sounds simple enough but it's really, really hard

Our minds have evolved to tune into the thoughts and feelings that trouble us. The brain is like the ultimate threat detection device and it wants to hold tightly onto potential threats and do something about it because that's what used to keep us alive. 

By contrast, mindfulness asks us to hold stressful thoughts, feelings and sensations lightly.

Your brain does not want to let go of pain, or worry, or stress. So when we use mindfulness as a way to control, minimise or avoid those things, we're often left feeling disappointed because we're fighting against a biologically hard-wired response. Some people even feel more stressed after mindfulness meditation than before they started! [2]

So our approach to mindfulness might need to shift a little bit. Mindfulness, by definition, is not about dropping or letting go of the painful stuff. It's about holding it lightly and making room for it. 

So why bother making room?

Two reasons:

1. Control is kind of an illusion anyway:

Have you noticed how hard it is to not think about something? Seriously. Whatever you do, don't think about penguins right now. Don't think about their adorable little feet or their cute white bellies. 

How'd you do? 

Unless you have superhuman levels of control, you probably just thought about penguins. And even if you did manage to not think about them, imagine trying to keep up that level of control for the rest of the day without being totally consumed by not. thinking. about. penguins. which brings me to point #2...

2. Control comes at a cost. 

When we make "mindfulness" about gaining control or getting relief, whatever we're trying to avoid or minimise often gets louder. It consumes our field of vision and demands attention. In white-knuckling our way through painful experiences, we miss out on opportunities to engage in the stuff that matters to us. We become mindless. 

In being mindful, really mindful, we make room for the uncomfortable stuff so that we have the energy to notice and choose (if we wish) to do the things that we care about. 

Is there something you care about enough that you would choose it, even if the pain or discomfort came along for the ride as well?

Mindfulness does not promise control or relief. Mindfulness offers choice.

Could be a useful discussion to have with our clients who have said that breathing exercises don't work or that they just hate the idea of mindfulness. What are they hoping to get out of it in the first place?

Still not convinced that mindfulness can help us do more of what matters by creating room to move? Then give this resource a spin:

3 mindfulness exercises for people who hate mindfulness:

Struggle with Mindfulness?

No zen meditations here.

Try these 3 exercises to ease into mindfulness & being present.

I like spam less than I like meditating. None of that here. Powered by ConvertKit

References and further reading:

[1] Dr Russ Harris speaks extensively about the issue of acceptance vs control in mindfulness in his book, ACT Made Simple.

[2] Creswell, J. D., Pacilio, L. E., Lindsay, E. K., & Brown, K. W. (2014). Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology, 44, 1-12.

Dr Sarah McKay @ Your Brain Health: Does Meditation Stress You Out?

And one last thing... 

Are you a mindfulness convert or still doubtful? How do you find calm in your life?