SNN_December 2022 Issue_web low res

NEW ZEALAND SPINAL TRUST 34
Thinking about work after an SCI: what helps?
We wanted to understand how to help people think positively about work after an SCI. We developed a ‘gardening
model’ to help explain the different types and degrees of growth and support an individual needs to action return-towork
(RTW) plans following SCI. We conceptualised the individual with a new SCI as a seed – with potential for growth
but requiring specific conditions to flourish.
HOPE IS KEY
The potential to work is within each
person, but energy is required to
start the process and sustain
change. We found that hope (like
energy from sunlight) is needed to
turn initial RTW ideas into goals
and plans following injury. Early
conversations about work allow
people to feel hopeful - but the
inclusion of clouds illustrates that,
at times, hopefulness about RTW
can fluctuate. Early conversations
and individualised support
improved people’s confidence and
self-belief in their ability to achieve
their RTW goals.
DIFFERENT SUPPORTS REQUIRED
Identifying supports or resources
that need to be in place for
individuals to develop their own
RTW-focused goals and actions.
Some people require a lot of
support (like climbers), and others
don’t need much at all.
What helps:
• Allow people time to explore
their thoughts about disability
and develop coping or
adjustment strategies.
• Clarity about the individual’s
function is typically required
before pathways towards RTW
can be developed or enacted.
STIMULATING GROWTH
Exploring options about work and
mapping out possible pathways to
get back to the type of work that
best meets their needs and
preferences. Early conversations
give people information and
support to maintain their selfconfidence
and self-belief.
What helps:
• Over time these conversations
can become increasingly
targeted towards specific
options that might work for the
individual and their particular
situation.
• Support the person to feel in
control of their RTW pathway.
PREPARING THE TEAM GROUND
The entire rehabilitation team (the
soil) needs to believe that work is
possible following SCI. Family and
employers may also need to be
included in the ‘team’ – ensuring
that people can hear consistent
hopeful messaging.
What helps:
• RTW goals should be included
in inpatient goals and
reinforced in day-by-day
rehabilitation practice.
• The whole team should
consistently reinforce positive
messages about future work
options and about what is
possible and/or expected in
terms of work after an SCI.
PREPARING THE SEED
People are ready to think about
and plan for work at different
times. It is helpful for early
conversations to focus on how
work fits into each person’s sense
of purpose and self. Getting to
know the whole person and their
unique situation is essential.
What helps:
• Hearing positive stories about
others’ work experiences after
an SCI.
• Focus on a person’s strengths,
skills and resources – not just
their new challenges as a result
of the SCI.
• Allow people to think and talk
about work in their own time.
LINKING WITH EMPLOYERS OR
FUTURE RTW SUPPORT TEAMS
Ongoing vocational support is
required to ensure that growth is
sustained. What conditions does
each person need to flourish?
What helps:
• People must remain hopeful
about work. Ongoing support
is required to help them
maintain hope and enact RTW
plans.
• Communication between
vocational rehabilitation
providers needs to occur - so
people can seamlessly
continue exploring work
options that will work for
them.