A powerful reframe makes an ally of the therapeutic relationship

10 October 2022 Case Study

Claim coaching on long tail claims with entrenched mental health challenges brings up all sorts of quirks. But there are several common characteristics these cases share which could be holding up a return to employment:

  • a therapeutic relationship where a provider advocates for staying off work
  • ineffective treatment lacking an outcome focus
  • personal life challenges that complicate and confuse what is work/non-work related
  • a firmly entrenched shift in identity from ‘worker’ to ‘sick person’
  • a need for certainty and comfort which makes staying off work the safer option.


The case team’s client was less than 50 years old but had adjustment reaction that had already led to more than 10 years off work. Trapped by a lack of confidence and motivation, the individual relied heavily on others, particularly the power of their therapeutic relationship.

Running out of options, with no clear strategy or path forward, the team would normally have adopted a medically focused approach, recommending stopping ineffective treatment, independent medical examinations, claim cessation and even litigation. Talk about a bad outcome.

But there was a ‘win-win’ within our grasp.

Solution: Reposition the provider

The key was to stop viewing the therapeutic relationship and advocacy as a problem and reframe it as an opportunity to make the path back into work simpler, faster and safer. After all, providers who advocate are aiming to protect; they want what’s best.

Through conversation skills training, we were able to support the claim team to turn their client’s therapeutic provider into a return to work advocate.

The key was to acknowledge and praise their role to date and emphasise the importance of their input moving forward. So, we suggested the claim team change up their next conversation, using these phrases over the phone and in emails.

Thanks for providing your insightful report. I know how much X values your opinion and input. (praise, connection).

From your report, it seems identity and fear of both interviews and work are important. (I understand the problem)

Sometimes we use external providers to help a person look for work. (I have a solution that’s easy and person-centred)

I’d like to involve an external provider to complement the psychology treatment you provide. Given the value X places on your opinion, I’d appreciate your input into the characteristics of a provider so we can find someone that is right for her. (Your treating role is an important part of return to work).

The result: The provider began to advocate work to their patient.

While we offered volunteer work as a steppingstone, the client was keen to start looking for paid jobs. Knowing they were supported by their case manager and claims team, they had newfound confidence.

That’s what we call working for better.

Imagine what’s possible when you have the know-how to use these kinds of tactics, conversation techniques and interpersonal skills to consistently create positive change.

MOMENTA HQ is what happens when you combine expertise in medical research, positive psychology, behavioural science and change theory. And that’s the power we can bring to your team.

Curious and ready to talk to one of our experts?

Written by Momenta HQ on October 10, 2022