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 the expert! If you want to have more powerful conversations with your clients, please consider one of her programs.

Feature image by Melpomene/shutterstock.com

 

What Does Trump's Victory Mean For The Labour Market... And For Us?

women-in-factory

It is a surreal day today. Despite 9000 miles of separation between our home in Australia and the action in the U.S., it’s hard to not feel the energy of what has been a shocking turn of events over the past 24 hours.

Political history has been made. All of the pollers and journalists and pundits got it wrong, and we are now faced with the reality that Donald Trump is America’s president-elect. 

It is hard to fathom that millions of people have openly stood behind a man who has mocked and denigrated women, racial minorities and people with disabilities. This is a man whose empire was built upon the labour of the very people he plans to marginalise and an economic system that guaranteed his success in life from the moment he was born. He is a man who was elected not due to his experience or understanding of complex political issues, nor his temperament, but rather because he spoke into the quiet xenophobia, bigotry and a disillusionment with modern politics and government that has been rising up within too many for too long. It is the same force that saw Brexit pass and Tony Abbott's election as prime minister in 2013.

That is not what I want to talk about today, and other people have expressed their thoughts far more eloquently than I have above. It is also not the purpose of this blog.

Still, I know that so many of my readers are ambitious and talented young women who likely feel shocked and saddened by today's news.  I want you to know that you are not alone. Able-Minded has and will always be a place for people just like you, a place where we will continue to talk about how we can do what is right and fair, in the service of helping our clients find meaning and purpose through gainful work - work that they may not have been able to participate in if it were not for our support. 

On days like today, where it is easy to feel powerless and diminished, never forget the capacity that you have, right now, to change another person’s life for the better. Helping a person return to work is like opening a door to their financial security, physical and mental wellbeing and a connection to community that all humans need and deserve. On a day like today where it feels difficult to go to work and return to your busy inbox, missed phone calls and reports that need writing, remember this. Remember that today you can use your skills and talents to counteract what feels like a century of social and cultural progress undone, all in a single election.

You can continue to be the voice for people who are told they are damaged goods, both in subtle and overt ways; to help them find their place in a constantly shifting, sometimes volatile labor market. It is an act that can change people’s lives, and the lives of their families, for the better. 

And so we turn our attention to one of the many sentiments that helped bring Trump to power: 

Trump’s unapologetic nationalism struck a chord with many working-class Americans affected by under- and unemployment. He spoke directly into their fears of their jobs being moved offshore or taken away by immigrants willing to do the work for less:

“They’re stealing our jobs; they’re beating us in everything; they’re winning, we’re losing.”

Trump's promises to improve infrastructure and create millions of onshore jobs in the process have resonated, despite evidence suggesting that manufacturing employment in the U.S. continues to grow and offshore jobs are in decline

But if Trump is wrong about the threat of overseas workers, why are so many people in blue-collar jobs struggling to find work, or find enough of it? Not just in the U.S., but here in Australia as well? 

It’s not because of offshoring or immigration. 

The real cause of the jobs crisis among blue-collar workers? It's Automation:

“The American manufacturing resurgence hasn’t helped many of the country’s blue-collar workers who were let go in the past two decades... in part because the modern factory environment is driven by high-tech equipment, robotics, flexible scheduling, and lean techniques. These factories depend on workers who are adept at programming and overseeing high-tech equipment; able to handle multiple jobs throughout the factory as product demand shifts, rather than a single station on an assembly line; and proficient enough with manufacturing concepts that they can recommend plant improvements, large and small, on their own.
— Jeffrey Rothfeder, The New Yorker

The simple truth is that technology and automation are not going away. 

The Foundation for Young Australians has revealed that as many as 70 percent of the courses people under 25 are enrolled in today are for jobs that will not exist in the future.

Unskilled and entry level roles are dying. This is a trend that will continue over the next 10-15 years. Income disparity is likely to remain an issue as demand increases for skilled workers. And with increased job flexibility, we will see less job security as more temporary, part-time or contract roles emerge.

And this is why we are so needed. 

As Rehabilitation Consultants we are going to be working with more and more clients who have been left behind by a labour market that requires more from them than ever before. We are the ones who will be tasked with helping them retrain and up-skill in order to remain competitive candidates for employment. Creating more jobs will not solve this issue because it is a problem that lies at the very heart of how modern work is evolving - rapidly so. 

The notion of a stable life-long career was left behind in the 20th century and it continues to disintegrate today. With technology advancements along with greater workplace freedom and flexibility comes a great deal of uncertainty, particularly for our manual labourers.

The notion of a stable life-long career was left behind in the 20th century and it continues to disintegrate today. With technology advancements along with greater workplace freedom and flexibility comes a great deal of uncertainty, particularly for our manual labourers.

Moving jobs back onshore is not going to solve the employment crisis that low-skilled workers are facing. In cases where automation and new technology has not replaced them, manual workers and labourers often find themselves in crisis after an injury or illness that prohibits them from performing their job. 

I have seen too many injured or unwell clients who were deemed totally and permanently disabled - and therefore unemployable - as a result of being offered simple retraining either too late or not at all. In occupational rehab, there is a strong push to prioritise a return to pre-injury role above all else, which means that we often miss out on a crucial window of opportunity to help people retrain and up-skill before their disability becomes entrenched. Alas, It is often the case that we find ourselves chasing a rapid outcome over a sustainable one. 

I don’t mean to demonise insurers and our compensation systems in saying this, because at the same time I have worked with many clients who did not believe they should have to up-skill or retrain to find a new role. The situation we find ourselves in is no-one’s fault, but it is everyone’s responsibility. 

Although he may have been wrong about the cause and the remedy, Trump was right about something: low-skilled jobs are at risk. 

As Rehabilitation Counsellors we have an important role to play in helping our clients and other stakeholders understand that the skills that kept people employed in the past are not good enough anymore, regardless of whether we can return someone to their pre-injury capacity.

Medical management is not enough, and Rehabilitation Counsellors, with our understanding of the labour market, vocational decision-making and retraining must form part of the solution to the blue-collar jobs crisis. It isn't going to get any better. 

We must become educators as much as we are advocates. The nature of work itself is changing. An artificial boost in job openings will not solve this issue. Do you feel ready to have this conversation with your clients? 

 

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Where Can a Rehab Counsellor Work? (and How to Actually Get a Job as One)

Without a doubt, the most frequently asked question from my readers is “Sooooo…. Natalie…. where can a Rehab Counsellor work and what will I being doing each day.... also, how do I actually get a job and not suck at my career?”

OK, that was actually four questions (you guys are cheeky like that), and each deserves their own special kind of attention. 

So today, let’s talk about question number one: what can I actually do with my fancy-pants degree and.... 

Where Do Rehabilitation Counsellors Work?

I’m glad you asked. Because you’ve been mislead - kind of.

where-can-rehab-counsellor-work

From ASORC

Rehabilitation Counsellors are Allied Health Professionals who work within a counselling and case management framework to assist people who are experiencing disability, a health condition or social disadvantage to participate in employment or education, or to live independently and access services in the community.
Rehabilitation Counsellors are specialist counsellors that understand the impact of disability, health conditions and disadvantage on people's lives, and especially the importance that work and education plays in achieving a sense of inclusion, independence, optimism and self esteem.

Wow. That's enough to make you feel pretty damn good about your career prospects.

Rehab Counsellors are so badass. (I can confirm, but then again I'm a little biased.)

And yet, a quick look at job sites like SEEK suggests that the only place a Rehab Counsellor is welcome is inside a type of setting called “Occupational Rehabilitation”. 

Occupational Rehabilitation providers are looking for Rehabilitation Counsellors all the time.

They also employ other allied health professionals like Psychologists, Occupational Therapists, Physiotherapists and Exercise Physiologists in similar roles.

They might specialise in areas like: 

  • Workers Compensation

  • Comprehensive Third Party Insurance (CTP)

  • Life Insurance and Income Protection

  • Or some combination of the above. 

(Do you feel like you're taking a mutliple choice exam yet?)

This means you’ll be working with clients who are currently not able to work due to an injury or illness.

As a rule of thumb (there are always exceptions), Workers Compensation clients have been injured at work, CTP clients were injured on the road, and Life Insurance Customers might have become unwell at work, at home or anywhere, really, because they’ve taken out a policy that covers a portion of their income incase they become sick.

You might also see some job ads by providers who specifically work with government portfolios, like people employed by the Department of Defence, as an example. 

At this stage, you might be wondering… is that it? 

"I thought rehabilitation counselling was diverse, and broad. I thought I’d be helping people do more than return to work, and I didn’t know I’d be working with people who didn’t choose to get help (sometimes, this happens)."

- you.

This is especially jarring when you consider that so much of our training as Rehabilitation Counsellors is about working with people who have a developmental or lifelong disability - which frankly you don’t see much of when you’re working with an occupational Rehab Provider. 

The result? a silent epidemic of cranky-pants rehab counsellors who hate their jobs.

So what’s a Rehab Counsellor to do? 

Well, the first thing is to remember that working inside a Rehabilitation Provider can be really great. That’s what I do right now, and I’m part of a team of the most inspiring and talented people I’ve ever known. I learn every day. I make a difference in people’s lives. We really care about our clients and we only partner with insurers who want the best for their clients too. 

The other thing I want to remind you is about why you chose this career in the first place: You believe that everyone can find meaningful, purposeful work, and that where there’s a will, there’s a way (I know you believe this because of all the emails I receive from people like you who say exactly that). 

So.. if you’re in a job you don’t like, and you’re not working with clients and customers you love - it’s up to you to do something about it. Nothing is going to change unless we’re brave enough to set boundaries around the kind of work we will and won’t do, and the type of difference we want to make in our clients’ lives. 

The Hidden Job Market for Rehab Counsellors

The thing that strikes me the most about Rehab Counsellors who throw their hands up in the air about their job prospects is that… we’re literally trained to do the opposite of that. 

Because any decent Rehab Counsellor knows advertised jobs are just a tiny portion of the opportunities that exist for us, right? 

I know Rehabilitation Counsellors who work for Lifetime Care and Support, a speciality portfolio that helps people live better lives after a spinal cord or traumatic brain injury. 

I know Rehabilitation Counsellors who work with refugees and people from different cultures who have experienced incredible trauma and are trying to build a new life.

I know Rehabilitation Counsellors who have gone on to work inside insurance companies and community organisations, helping them better serve their clients and manage their processes more effectively. 

I know Rehabilitation Counsellors who have trained hundreds of other Rehabilitation Counsellors through events and workshops that they’ve developed. 

I know Rehabilitation Counsellors who have gone on to work in research, lecture in universities (hey, that’s me!) and help the next generation of Rehab Counsellors think differently about the kind of work we do and why it matters. 

That’s a hell of a lot more than SEEK would lead you to believe is out there. 

But you won’t get there by passively applying for jobs (though you already knew that, didn’t you?)

You’ll get there by building connections and real relationships with people you excite and inspire you. 

It’s incredible what happens when you reach out to people who share the same passion you do. You’d be amazed by the kind of opportunities you can carve out for yourself if you’re brave enough to speak up. 

My challenge to you:

  • What kind of work excites you?
  • Who do you really want to work with? 

When you know the answers, you owe it to yourself do some research beyond the job ads on SEEK.

  • Which companies already do the work you want to do?
  • Who can you email and reach out to, to learn more? 
  • What opportunities can you create for yourself? 

When in doubt, do for yourself what you’d do for your clients. 

It’s a big world out there. 

Make it yours. 

 

Share with us in the comments below: where would you like to work as a Rehab Counsellor?

That Time a Client Made Me Cry.

I was somewhere between Marrickville and Petersham when I started crying in my car. 

I had just finished my second session with Kyle: a dad with a masters degree whose life had been completely derailed by a bipolar episode and several months of hospitalisation. 

On that day, Kyle and I met at a cafe to speak about what we could work on together. He hadn’t been out of hospital for long - less than three months - but he really wanted to be doing something because he knew that volunteering, even one day a week, was going to keep him healthy. 

On paper, Kyle sounds like a dream client. He was super motivated. Kind. Collaborative. Intelligent. 

He was like a unicorn, if unicorns could take out income protection policies. 

The kind of client who (1) I knew I could help and (2) actually wanted it.

And this is exactly the reason why I found myself crying inside my beat-up Mazda 3 after our session.

Because it wasn’t fair. 

It wasn’t fair that severe mental illness had robbed Kyle of 5 years of his life - his marriage, his kids, his job, his health.

It wasn’t right that someone who hadn’t done anything wrong spent the next 3 years trying to find a balance between medications and treatment that did the job without making him feel like a zombie with tremors.

It was wrong that Kyle went from having a successful career to being a patient in a psych ward. 

It wasn’t fair. 

Being a health professional requires you to face the harsh realities of life and cruel tricks that fate likes to play on us:

The injustices, the mistreatments, the follies of our healthcare and compensation systems.

Many of our clients are people who were in the wrong place at the wrong time, people who fell through the cracks, people who just got a raw deal and are suddenly facing a life they didn’t plan for. 

As a case manager, it’s all too easy to become the person who shoulders that burden for your clients. 

As a rehab counsellor in my twenties, who has lived a privileged and, let’s be honest, a very sheltered life, I have always been confronted by the hardships my clients face. Sometimes that burden and sadness can culminate in the driver's seat of your car as you drive back to work after a session. 

Sometimes that burden is more insidious.

It can be a feeling of heaviness in your chest and in your heart that becomes hard to shake. Maybe your feet start to move a little more slowly as you get ready for work in the morning and prepare for the day ahead. Maybe it feels like that fiery passion you had for helping people just doesn’t burn so bright any more. 

That’s how empathy burnout feels. 

There are so many things you can do to look after yourself when you start to feel this way. You’re already doing well if you can recognise empathy burnout for what it is and notice when you start to slip into this place. 

And yes, in the short term at least, taking breaks (even, dare I say it, a holiday or two) and making time for self-care will always give you a boost. 

But there is a fundamental shift in our thinking that we all need to make if we want to beat this thing - because shouldering the burden for our clients has never helped anyone, ever (source: science). 

I keep a little post-it note in my notebook to remind me of this every day: 

I didn’t get my client into this, and I definitely can’t get them out of it. But I can choose to walk beside them and help, and they can choose to say yes.

It seems almost too obvious to see it written there - but it’s true. How often do we expect ourselves to be The Fixer of All That is Broken and make all the bad stuff go away? To help, to make it better and BE REALLY MAD about how unfair everything is? (Uh - I hope it’s not just me here?)

Imagine if, before every session, you reminded yourself that while you don’t have the power to fix things, you have something even more incredible: the opportunity to offer your client support and guidance while they take back control of their life - if they choose to accept it? 

...(Big fat emphasis on the choice element here, guys.)

 

P.S. Kyle is a fake name. Client confidentiality is kind of a big deal. 

My Crisis of Meaning (And What to Do When You Hit Yours)

Most Rehab Counsellors choose this career because they want to help people, pure and simple. 

So it makes sense that most of us go into this role with some pretty lofty expectations about what it means to be a Rehab Counsellor.

  • We want to help people find meaning. 
  • We want to help people get their lives back. 
  • We want to help people overcome adversity and do the stuff that matters. 

I actually think that these high expectations are what set so many Rehab Counsellors up to crash and burn. 

Burnout and turnover rates are pretty high in this industry - but is it our own fault?

Do we have unrealistic expectations about what this job really entails, and the difference we can make? 

Well... Yes. But also no. 

Let me explain. 

I present to you: The Roller Coaster Curve 

The roller coaster curve maps out my first year of being a rehab counsellor almost to a tee. 

Early on, we’ve got Uninformed Optimism. You’ll be in this stage if you:

  • Are considering becoming a rehab counsellor
  • Are studying to become one
  • Have just started your first job

At this point, everything about Rehab Counselling is AWESOME. You’re being sold ideas of helping people, collaborative work, creative problem solving and helping people reconnect with meaning and purpose. 

Everything Is AWESOME!!! in the Uninformed Optimism Stage.

It’s sunshine, puppy dogs, and total ignorant bliss. Good times. 

Our rollercoaster then chugs along to Stage 2: Informed Pessimism. 

Informed pessimism happens when you’ve been around the block a couple of times. 

  • Maybe you’ve had a client who had no desire to get better or treated you with disrespect.
  • Maybe you’ve had an experience at uni that left you underwhelmed.
  • Maybe you’ve become bogged down by unnecessary paperwork and red-tape that leaves you feeling frustrated and completely restricted

At this point, you’re feeling a little (or very) jaded.

Disillusioned, maybe, but still hopeful and ready to press on. 

And then…. comes the tipping point. 

Stage 3: The crisis of meaning. 

My crisis of meaning happened after a few months into my first job as a Rehab Counsellor. I was working with clients with really serious health issues and what felt like a lack of support and skills to actually help them. 

I was doubting myself, doubting my choices, and I dreaded going to work every day. I was ready to throw in the towel. 

The thing about the crisis of meaning is that it happens to nearly every Rehab Counsellor who cares about their job and wants to help people.

Why?

  1. Your studies will not and cannot prepare you for what it’s like to have a real, live complex and confusing human being in front of you. 
  2. Add on those lofty expectations we spoke about earlier - like changing people’s lives and helping them find meaning and purpose - and it’s no wonder we find ourselves in a crisis. 

I’m not saying this to scare you or deter you - I’m saying this so that you know that you’re not crazy if you’ve ever felt this way too. 

And I’m saying it so that you can give yourself a break and put down your superhero cape for a minute. 

Not every client who comes to you will be a good fit. And not every client will be receptive to your desire to help. 

You can’t change everyone’s life - but the impact you can make in this job is still so, so real. 

For every client who has been a total nightmare to work with, there’s been another who has thanked me for how I helped them. 

For every time that I wanted to smack my head into a wall out of frustration, there have been times when I’ve been floored by the amazing, intelligent and hardworking people I’ve encountered in this job. 

Your crisis of meaning will still probably come - but whether you crash and burn or pull through is up to you. 

The people who crash and burn forget that every job has it’s sucky moments.

Even people like Mark Manson, who makes a living out of writing awesome things every day, feel this way:

“I am living my dream job…. and I still hate about 30% of it. Some days more.”

So… what are we to do? Do we give up on the idea of helping people?

Nooooooooooo. Please don’t do that. 

But what if we stopped expecting so much of ourselves? 

I think Paul Jarvis is on to something here: 

“I think what’s better is that we just find a place where we can make a difference. And, making a difference is fairly easy. First, you just have to leave things better than you found them. Second, you have to leave yourself better than when you started.”

I really want to emphasise the second part. Making a difference isn’t about running yourself into the ground - and you absolutely, completely, and totally have the power to decide whether you’re going to let this happen. 

Much of it is about the mind shift involved in seeing yourself as a facilitator rather than an expert.

It’s also about being able to clarify expectations and vouch for yourself, like we explore in the Survival Guide

And if you’re in a crisis of meaning right now (or maybe just feeling a little bit grumpy today), here are some questions to ask yourself: 

  • How can I look after myself today?
  • What can I do that excites me?
  • What small win can I tick off by the end of the day? (cleaning your desk TOTALLY counts, by the way.)

You might like to check out something I’ve written earlier about self-care, too. 

And remember that you’re not the only one who has felt this way. In fact, there’s a whole heap of us behind the scenes reading the Able-Minded newsletter, which you can sign up for at the end of this post.

OK, over to you:

How do you look after yourself when you’ve had a bad day (or week, or month)? 

 
 

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Feature image by J. Nathan Matias is licensed under CC by 2.0.