Helping Injured Workers Overcome the Fear of Returning to Work

It’s natural for people to feel some fear, anxiety or reluctance about returning to their jobs after being out of the workplace for a period of time due to an injury. Factors that contribute to the hesitancy to return to work are length of time off, the nature of the injury, the extent of the injury and attitudes about recovery from the injury. Some injured workers wonder whether they’ll be able to physically perform their job or if they are risking reinjury by returning to work. These concerns, both real and anticipated, can delay a return to work and increase recovery time.

Getting back to work aids recovery in the reestablishment of routine, access to social relationships, a sense of contribution and much more. In fact, the experience of productivity can be the turning point in long-term recovery. Physical and mental aspects work in tandem to restore function after an injury. In workers’ compensation cases, the focus is often to measure the physical recovery as an indication of return-to-work threshold, but recovery is quicker and more thorough when the psychological and attitudinal dimensions are included. 

Cognitive behavioral therapy (CBT) effectively treats injured workers, helps them regain their mental health and gets them back to work and the important job of enjoying life again. A differentiating component of cognitive behavioral therapy (compared with other psychological therapies) is its focus on strategically challenging and adjusting behaviors. Below are six universal and effective strategies for promoting coping behaviors for injured workers as they transition back to the workplace. 

Maintain a schedule

Without regular working hours, it’s easy to slip on a regimented routine, opting instead to sleep in, stay up late, push off meals and grooming and generally put off until tomorrow what is best done today. To maintain personal productivity toward physical recovery, it is important to help injured workers create a daily schedule for themselves with an emphasis on personal care activities, including eating healthy meals, exercise and grooming. 

Taking care of the activities of daily living is critical to maintaining good mental health because it promotes a routine, which encourages productivity and accountability. Sticking to a routine during recovery also keeps the individual poised for transitioning into a work schedule once it’s time to return to the job. Maintaining a schedule can decrease stress/anxiety and lessen the likelihood of inactivity developing into depression, which can delay recovery and lengthen the time spent on workers’ compensation.

Sleep regularly

Sleep is an integral human function; sleep affects mood, productivity, physical performance, healing and the immune system. After an injury, sleep can be harder to obtain. Pain from an injury, emotional trauma and pain medication can interfere with routine sleep. Behaviors surrounding sleep and the bedtime routine require special attention for those recovering from an injury. 

Make sure to engage in activities that promote nighttime relaxation to optimize sleep cycles. This includes avoiding caffeine, alcohol, brightly lit rooms and any type of screen time for several hours before bedtime, as these can disturb the circadian rhythm. When trying to get to sleep, keep the bedroom dark and cool to create a comfortable space more conducive to sleeping. It is also recommended that the bedroom not serve double duty as an office or a craft room, but be a dedicated restful area.

Learn self-advocacy

Workers who learn to advocate for themselves lessen their stress, anxiety and depression. Being an active contributor in the recovery plan helps individuals mentally rehearse recovery, an important step in physical recovery. 

Being clear about feelings and thoughts and asking for what they want empowers employees to take responsibility for themselves. Workers who learn self-advocacy demonstrate an internal locus of control and gain the confidence to express critical feedback (e.g. pain during repetitive motion or needing a break from a loud environment.) Assertive role-playing exercises can help teach self-advocacy.

Apply problem-solving skills

Another empowering strategy that helps to increase confidence is problem-solving. Learning proactive and alternative methods to resolve situations helps employees to reduce feelings of stress and anxiety brought on by not knowing what to do in a given situation. Understanding how to solve problems as they arise can help workers to feel more confident returning to work. Problem-solving involves a step-by-step process:

• Identify the problem
• Understand why it is a problem
• Develop a list of possible solutions to the problem
• List the pros and cons of each solution
• Choose the most effective solution
• Put the solution into action
• Evaluate the outcome
• Work on how to improve the solution

Engaging in the problem-solving process reduces emotional flooding and reactivity. Strengthening the cognitive problem-solving impulse yields more behavioral options and flexibility.

Practice self-monitoring

Self-monitoring, such as the practice of writing down thoughts, feelings and actions experienced in a specific situation, can reveal patterns and relationships in typical thoughts and behaviors. These components affect one another and the way in which the worker reacts to them. By recognizing patterns, workers, with the help of a licensed therapist, can identify and modify behaviors they find detrimental and gain perspective on how to deal with new situations as they occur.

Engage in mindfulness

Mindfulness is the practice of witnessing the current environment as it is with interest and open-mindedness. Importantly, mindfulness “in the moment” precludes thoughts of the future and the past (where worry, fear, and loss are examined), thus lessening stress, anxiety and judgment. Practicing mindfulness has many health benefits, including lowering blood pressure, reducing chronic pain and improving sleep. Engaging in the present moment without judgment interrupts the negative thoughts cycles, replacing them with a sense of appreciation. Mindfulness can be practiced in guided sessions, therapy sessions or on your own.

By replacing negative patterns of thinking with coping practices, injured workers can learn to better manage stress, anxiety and depression. Cognitive behavioral therapy is a brief intervention to help injured employees practice new thoughts and behaviors that interrupt destructive habits so they can initiate the confidence and recovery necessary to return to work.