Untangling trauma through conversation

10 October 2022 Case Study

Too often a person is out of work because of a complex web of medical and social factors. It’s the reason the bio-psycho-social approach is widely supported.

But what does that look like in practice?

Background and challenges:

Doug was 30 years old and employed in the prison system. After being exposed to several traumatic incidents, he’d lodged a mental health claim,  but over time his case had become a puzzle that seemed impossible to solve. The claims team were stumped.

Solution: This complex case was worked through in three phases

Phase 1: Uncover the real problems

It sounds so simple, but through conversation, the claims team discovered Doug had a lot going on, even beyond his work-related trauma:

  • his mum had recently passed away from a drug overdose
  • there was a long history of domestic violence and alcohol misuse by family members
  • despite his motivation to escape his demons, a lack of social and familiar support meant they haunted him at every turn
  • he’s a quiet, shy and gentle man with big dreams that quickly turn to overwhelm
  • several inpatient stays had left him feeling defeated

While the claims team were focused on solving the medical problem, these rich insights – the key to unlocking Doug’s future – remained untapped. But armed with understanding, the team could come at the puzzle from a new angle.

Phase 2: Broaden the ‘prescription’ for real person-centred planning

When you want change in mental health, it helps to broaden the ‘prescription’ as a catalyst for connection, confidence and motivation.

The team were able to support Dough through:

  • a gym program – with Doug’s interest sparked, we built a regular exercise routine. Strength and conditioning of the spinal and limb muscles is proven to have a positive effect on emotional well-being.
  • routine and structure – overwhelm is a symptom of too much uncertainty. A solid routine makes daily life more predictable, giving people ‘room’ to cope with bigger, more uncertain goals.
  • behavioural activation – to change how we feel, we must change what we do, so we shaped the future with steps that fulfilled Doug’s need for comfort and connection.
  • pro-active rehabilitation –  a walk is a good way to talk (side-by-side), get active, and build confidence in the everyday.
  • encouraging ownership – Doug was invited to collaborate and own new routines, ensuring he was invested in the outcomes. 

Phase 3: words matter

By making small, simple changes , conversation skills could be used to raise Doug’s confidence, increase his sense of connection and positively reinforce the actions he was taking:

It’s great you’re thinking about this. It shows you’re thinking about the next step.

You know, you’re the expert on what’s best for you.

What might be good about this for you?

It’s important to feel certain …

Let’s work on this together.

I know you might need some time to think this through. Let’s talk again on …

It’s a great goal. Now let’s break it down so we have some clear steps and know what’s next.

The result:

Doug was able to summon the courage to continue and achieved his goal of a return to study. As he collected small wins, his confidence grew. He knows it’s a journey, but with structure and a mounting sense of capability, Doug’s on his way. That’s what we call working for better.

Written by Momenta HQ on October 10, 2022