Mental illness can occur in response to traumatic events such as motor vehicle and workplace injuries, or can arise organically over time. Mental health impacts functioning at home, within the community and at the workplace. Our occupational therapists and counsellors are skilled in assisting clients who experience functional limitations arising from anxiety, post-traumatic stress disorder, depression, and other psychological conditions using cognitive-behavioural and trauma informed approaches. The latter focuses on building client trust, the reframing of perceived threats as opportunities for growth, and assisting clients with strategies to build and maintain support networks. Programs are provided in collaboration with the client’s physician, mental health professional, the funder and other stakeholders to ensure a coordinated and well supported rehabilitation plan.
Counselling services are provided to assist clients recovering from post concussion symptoms as well as anxiety, depression, PTSD and a host of other emotional stressors that impact recovery. Through 1:1 individual treatment, services target development of effective coping strategies and resilience as clients adapt to changes in functioning and transition back to a range of pre injury activity. Counselling may include cognitive behavioural therapy, talk therapy, dialectical behaviour therapy, mindfulness and acceptance-based therapy and other approaches depending on the client’s needs, preferences and assessment findings. As part of the clinical team, our counsellors work in collaboration with rehabilitation team members including OTs, PTs, kinesiologists and the client’s primary care physician. In order to provide convenient and timely access to counselling, especially during the return- to-work transition, services are provided virtually via our secure telehealth platform.
Some clients have difficulty participating in activities due to overwhelming mental health symptoms. Occupational therapists work with clients to identify situations and triggers that increase their levels of distress and lead to activity avoidance. Clients are provided with reassurance and education, in addition to strategies to manage symptoms which may include deep breathing, relaxation, visualization and mindfulness techniques. Occupational therapists work with clients and their mental health professionals to establish a graduated exposure program. This occurs concurrently with the building of self management strategies to help clients safely resume their pre-disability activities.
Clients who present with a stable profile of mental health symptoms but also experience challenges initiating and participating in daily activities may benefit from behavioural activation directed by an occupational therapist. The process is collaborative and places a strong emphasis on trust building and client choice whenever possible. Behavioral activation seeks to help clients resume structured and regular participation in self-care, home management, active exercise and community access. Basic and instrumental activities of daily living are increased in a systematic fashion along with the client’s participation in social and leisure activities and other meaningful roles. A consistent and structured activity schedule occurring in the client’s natural environment provides a solid foundation to return to work and pre-disability activities.
Work reintegration includes Functional Assessment to determine the client’s cognitive and psychosocial abilities (and physical abilities as relevant). These abilities are matched against critical job demands determined through a Job Site Visit and consultation with the client and employer. Job demands are cognitive, affective, interpersonal and physical in nature. By understanding the gap between abilities and critical job demands, an appropriate Graduated Return-to-Work (GRTW) program can be designed. Symptom triggers, including work environment and setting, are taken into consideration. Exposure to work tasks is carefully planned and increased. Apart from increasing work duration and task complexity, successful GRTWs address how coping and other strategies can be implemented in the workplace to support durable return to work. Pacing, activity modification, problem solving, assertive communication, mindfulness and relaxation techniques are some of the strategies utilized.